硬性透气性角膜接触镜治疗轻中度圆锥角膜的疗效分析

Analysis of Effect of RGPCL(Rigid Gas-Permeable Contact Lens) for Mild-To-Moderate Keratoconus

目的:通过分析比较轻、中度圆锥角膜患者佩戴硬性透气性角膜接触镜(RGPCL)后视力及治疗前后圆锥角膜的Orbscan-Ⅱ角膜地形图相关参数的变化,观察记录RGPCL对轻、中度圆锥角膜的治疗效果。方法:随机选取2005年5月至2010年4月在北京大学深圳医院收治的轻、中度圆锥角膜病例共18例,35只眼。观察记录佩戴RGPCL前裸眼视力,戴框架眼镜矫正视力及佩戴RGPCL后矫正视力。应用Orbscan-Ⅱ分析评价RGPCL治疗轻中度圆锥角膜前后相关参数变化,观察佩戴RGPCL后1年、2年Orbscan-Ⅱ指标,包括最大模拟曲率(SimKmax)、模拟散光度数(SimK’S Astry)、角膜中央3.0 mm不规则性(3.0 mm zone irreg)、角膜中央5.0 mm不规则性(5.0 mm zone irreg)、后表面高度(后表面Differ值)、角膜最薄厚度。结果:视力正常(≥1.0)与视力异常(<1.0)三组间比较,差异具有统计学意义(P<0.05),其中,RGPCL治疗前裸眼视力与RGPCL治疗前佩戴框架矫正视力组比较,差异具有统计学意义(P<0.05)。佩戴RGPCL治疗前,治疗后1年,治疗后2年,Orbscan–Ⅱ角膜地形图相关参数(SimKmax、SimK’S Astry、3.0 mm zone irreg、5.0 mm zone irreg、后表面Differ值、角膜最薄厚度)比较,差异均无统计学意义(P>0.05)。结论:RGPCL治疗轻中度圆锥角膜安全有效,矫正视力效果明显优于传统框架眼镜,有控制轻中度圆锥角膜发展的作用。

Objective Through analysis and comparison to vision of mild-to-moderate keratoconus patients after wearing RGPCL and the change of the parameters related to Orbscan Corneal topographic map after the treatment for keratoconus, to observe and record the curative effect of rigid gas-permeable contact lens（RGPcl） for mild and moderate keratoconus. Methods A total of 18 patients with moderate and moderate keratoconus were enrolled from May 2005 to April 2010 in Shenzhen Hospital of Peking University, 35 eyes. Observe the record wearing RGPCL before the uncorrected vision, wearing glasses glasses to correct vision and wear RGPCL corrected visual acuity. The Orbscan-Ⅱ analysis was used to evaluate the changes of RGPCL in the treatment of mild to moderate keratoconus. The 1-year and 2-year Orbscan-Ⅱ indexes were observed, including the maximum simulated curvature（SimKmax）, simulated radiance（Sim K＇s Astry）, corneal central 3.0 mm zone irreg, 5.0 mm zone irreg, 5.0 μm zone irreg, rear surface height（Differ value on the posterior surface）, and thinner cornea. Results Normal vision（ ≥ 1.0） and vision disorders（ 1.0） among the three groups, the difference was statistically significant（P〈0.05）, among them, RGPCL before treatment of uncorrected visual acuity and RGPCL treatment before wearing the frame correction visual acuity group, the difference was statistically significant（P〈0.05）. Before RGPCL treatment, 1 year after treatment, 2 years after treatment, Orbscan-Ⅱ corneal topographic parameters（SimKmax, Sim K＇s Astry, 3.0 mm region irreg, 5.0 mm region irreg, posterior surface Differ value, the thinnest thickness of the cornea）, The difference was not statistically significant（P〈0.05）. Conclusion The curative effect of RGPcl for mild-to-moderate keratoconus is safe and effective, vision correction effect of RGPcl is superior to traditional frame glasses. There was good curative effect of controlling the development of mild-to-moderate keratoconus by RGPcl.