Hiline硬性透气性接触镜矫治圆锥角膜的临床观察

Clinical observation on Hiline rigid gas permeable contact lens for keratoconus

目的:观察Hiline硬性透气性接触镜(Hiline RGPCL)矫治圆锥角膜的临床应用效果,并对RGPCL基弧的预测指标进行分析。方法:在角膜地形图指导下,选取圆锥角膜患者36例57眼验配Hiline RGPCL,并按相关标准分为轻度组10眼,中度组24眼,重度组23眼。评估镜片配适状态,比较框架眼镜和Hiline RGPCL最佳矫正视力,并根据角膜曲率指标分析RGPCL基弧的预测性指标。结果:所有患者均能通过Hiline RGPCL获得满意的矫正视力,各组Hiline RGPCL与框架眼镜矫正视力比较差异有统计学意义(轻度组为t=-2.968,P=0.016,中度组为t=-6.293,P<0.01,重度组为t=-12.792,P<0.01)。平均RGPCL基弧为6.8±0.75,RGPCL基弧与角膜曲率具有相关性,其中轻度组RGPCL基弧与陡K值(Sim K steep)具有相关性(r=0.715,P=0.02),中度组RGPCL基弧与平均K值(Average K)及较平均K值陡0.2mm K值均具有相关性(r=0.495,P=0.014),重度组RGPCL基弧与角膜曲率各项指标均有相关性,其中角膜中央曲率相关性最强(r=0.802,P<0.01)。结论:在角膜地形图指导下,圆锥角膜患者验配Hiline RGPCL可以获得满意的矫正视力,并且通过不同预测性指标的选择有助于提高验配效率,值得在临床上推广应用。

AIM：To investigate the effect of the Hiline rigid gas permeable contact lens（Hiline RGPCL） for keratoconus in clinical practice and the predictors for RGPCL fitting.·METHODS：Fifty- seven eyes in 36 patients with keratoconus fitted with Hiline RGPCL were divided into three groups,mild（n = 10）,moderate（n = 24） and advanced（n = 23） group.After fitting evaluation,visual acuity measurements were taken to compare the best corrected visual acuity wearing spectacle lenses and Hiline RGPCL.The predictors for RGPCL fitting by the corneal curvature were analyzed.·RESULTS：In all groups,the application of Hiline RGPCL obtained acceptable vision.There was statistically significant improvement in vision with the Hiline RGPCL than that of with spectacle lenses in mild group（t=-2.968,P=0.016）,moderate group（t=-6.293,P0.01） and advanced group（t=-12.792,P0.01）.The mean base curve of the lens was 6.8 ± 0.75 mm.The base curve of RGPCL correlated with corneal curvature.In mild group,the base curve of RGPCL correlated with Sim K steep（r=0.715,P=0.02）.In moderate group,the base curve of RGPCL correlated with average K as well as 0.2mm steeper average K（r = 0.495,P=0.014）.In advanced group,the base curve of RGPCL correlated with every indicator,especially the corneal curvature in central area（r=0.802,P0.01）.·CONCLUSION：Guiding by corneal topography,improvement of visual acuity is successfully achieved by fitting with Hiline RGPCL.Selecting different predictors in different grades can reduce the complexity and improve the usefulness of the Hiline RGPCL in clinical practice.