AIM: To record aberrations with a corneal topographic device on the anterior surface of the cornea at different time-points prior to wearing and following discontinued use of rigid gas permeable (RGP) contact lenses. ...AIM: To record aberrations with a corneal topographic device on the anterior surface of the cornea at different time-points prior to wearing and following discontinued use of rigid gas permeable (RGP) contact lenses. The effect of wearing RGP on the anterior surface of the cornea was discussed to provide guidance for clinical refractive error correction.METHODS: The study objects were 24 eyes from 24 patients. All patients underwent identical examination procedures prior to lens use, as well as afterwards, including slit-lamp examination, non-contact tonometer measurement, computer optometry and corneal curvature measurement, subjective refraction test, and corneal topography analysis. The patients wore contact lenses everyday for 1 month and then discontinued. Corneal topographies were recorded at certain time points of 30 minutes, 1 day, 3, 7 and 14 days following use.RESULTS: Total corneal aberration at each time point following discontinued use of RGP contact lenses was less than the time point prior to use. Detailed results were as follows: root mean square (RMS) (pre)=(1.438± 0.328)μm, RMS (30 minutes) =(1.076 ±0.355)μm, RMS (1 day) =(1.362 ±0.402)μm, RMS (3 days) =(1.373 ±0.398)μm, RMS (7 days) =(1.387 ±0.415)μm, and RMS (14 days) = (1.430±0.423)μm. Results showed that at 30 minutes after discontinued use of RGP contact lenses, almost all 2 ndand 3 rd-order aberrations change. Quadrafoil Z10 and spherical Z12 of the 4 th-order were also changed. Alterations to Z5, Z6, and Z12 at 1 day after discontinued use were significant differences compared with the time period prior to RGP use: Z5 and Z6 decreased, and Z12 increased slightly. Z5 and Z6 remained decreased at 3 days after discontinued use, but Z9 and Z10 continued to increase and Z12 returned to levels prior to RGP use. At 14 days after discontinued use, all aberrations were notsignificantly different from the values prior to use.CONCLUSION: The use RGP contact lenses greatly reduced total aberration of the anterior surface of the cornea. Changes to 2 ndand 3 rd-order aberrations (including Z3, Z4, Z5, Z6, Z7, and Z8) were more significant. Following discontinued use of RGP contact lenses, the majority of lower order aberrations returned to original levels in a short period of time. During this process, a transient higher order aberration appeared, but all changes disappeared within 14 days after discontinued use of RGP contact lenses.展开更多
AIM: To evaluate the effect of rigid gas permeable contact lens(RGP-CL) on corneal morphological parameters and vision-related quality of life in keratoconus(KC) patients.METHODS: Totally 57 eyes of 30 KC patients who...AIM: To evaluate the effect of rigid gas permeable contact lens(RGP-CL) on corneal morphological parameters and vision-related quality of life in keratoconus(KC) patients.METHODS: Totally 57 eyes of 30 KC patients who were followed-up for more than two years, including 17 RGP wearers(32 eyes) and 13 non-wearers(25 eyes) were retrospectively analyzed. Initial medical history and corneal topography were collected at baseline. Corneal topography, corneal aberration, optical coherence tomography, and vision-related quality of life questionnaires were performed at the last follow-up.RESULTS: According to corneal topography, increase of the flattest keratometric values was higher in RGP wearers than in non-wearers(P=0.038). The morphological parameters, including symmetry index of front corneal curvature(P=0.004) and Baiocchi-Calossi-Versaci index front(P=0.047), were lower in RGP wearers than in nonwearers. Vertical coma was smaller in RGP wearers than non-wearers in 3.0, 5.0, 6.0, and 7.0 mm pupil diameters, respectively(P<0.05). The environmental triggering domain of ocular surface disease index was worse in RGP wearers as compared to non-wearers(P=0.003). At the last followup, there were no significant differences in constituent ratios of KC progression, corneal thickness topography, epithelial thickness topography, morphological parameters of corneal topography, and other questionnaire scores between the two groups(all P>0.05).CONCLUSION: Long-term use of RGP does not worsen KC but may cause corneal epithelial remodeling to increase symmetry of corneal anterior surface, reduce corneal vertical coma and improve visual quality. However, RGP wearing causes a slight decrease in vision-related quality of life. The occurrence of ocular surface symptoms is mainly associated with environmental triggering factors.展开更多
Introduction: Keratoconus is a complex corneal disease that reduces visual acuity by progressively modifying the corneal shape and thickness, usually producing myopia and irregular astigmatism. Corneal collagen crossl...Introduction: Keratoconus is a complex corneal disease that reduces visual acuity by progressively modifying the corneal shape and thickness, usually producing myopia and irregular astigmatism. Corneal collagen crosslinking with riboflavin + ultraviolet-A radiation (CXL) has become a widely accepted treatment for progressive keratoconus. During CXL, riboflavin administration is performed by repeated manual instillation of solution drops on the cornea for 30 minutes, a procedure that is often uncomfortable for many patients and that consumes surgical facilities and staff resources. In this study, especially modified scleral contact lenses (MSCL) were employed for delivering riboflavin to the cornea during CXL. Objective: The study aimed at evaluating the safety and efficacy of MSCL as a drug delivery system, verifying if anterior chamber flare confirms riboflavin penetration and describes the impact on patient comfort and optimization of surgical staff and facility resources. Material and Method: This study included 8 eyes of 6 patients aged 16 - 25 years old with history of progressive keratoconus. After mechanical removal of corneal epithelium, the concave surface of the modified scleral contact lens was filled with riboflavin solution and the lens was placed on the patient’s eye during 30 minutes. The lens design allows the formation of a riboflavin layer between the lens and the exposed corneal stroma to facilitate riboflavin penetration. Patients with lens were allowed to stand up and wait for the second UVA phase outside the surgical room. Riboflavin diffusion was confirmed by biomicroscopic examination of the corneal stroma and anterior chamber with the lens in place. Patients returned and the lens was removed before UV-A irradiation at 3 mW/cm2 for 30 minutes. Statistical analysis was performed by comparing the following parameters of each patient pre- and post-CXL: Spherical equivalent (Sph.Eq.), Mean simulated keratometry (SimK-m) and corrected distance visual acuity (CDVA) using the Wilcoxon method for non-parametric data (p Results: The MSCL allowed patients to be transferred from the surgical room to wait for corneal impregnation with riboflavin. The MSCL was effective in delivering riboflavin to the cornea as confirmed by biomicroscopic examination of the cornea and anterior chamber. No intraoperative or postoperative complications were observed. MSCL use improved the patient comfort and reduced the burden on surgical staff and facilities. All analyzed parameters showed statistically significant differences pre- and post-CXL: Sph.Eq. p = 0. 018 (Median: -2.50;Average: -2.52);SimK-m p = 0. 006 (Median: 47.92;Average: 45.56). CDVA p = 0. 012 (Median: -0.45;Average: 0.42). Conclusion: The MSCL is a safe and efficacious device for riboflavin delivery during CXL. The present study permits slit lamp observation of anterior chamber flare to confirm riboflavin penetration, and provides added safety and comfort for the patient and convenience to healthcare providers by optimizing the use surgical facilities and staff. Keratometric, visual and refractive results were similar to those reported in the literature for CXL with manual riboflavin instillation. Additional studies with larger numbers of patients are needed to confirm the study findings.展开更多
目的:评价硬性透氧性角膜接触镜(rigid gas permeable contact lens,RGPCL)对儿童高度近视的矫治作用。方法:对20例40眼14岁以下高度近视的儿童验配RG-PCL,同时将20例40眼戴框架眼镜高度近视的儿童作为对照组,1a内定期复查其眼的屈光度...目的:评价硬性透氧性角膜接触镜(rigid gas permeable contact lens,RGPCL)对儿童高度近视的矫治作用。方法:对20例40眼14岁以下高度近视的儿童验配RG-PCL,同时将20例40眼戴框架眼镜高度近视的儿童作为对照组,1a内定期复查其眼的屈光度、角膜屈折力及眼轴长度。结果:RGPCL组矫正视力明显优于框架眼镜组,两组差异有显著性意义;1a后的近视屈光度平均增加,RGPCL组为0.59±0.42D,框架眼镜组1.07±0.53D,两者差异有显著性意义(P<0.05);角膜屈折力平均减少,RGPCL组为0.22±0.19D,框架镜组为0.02±0.10D,两组间差异有显著性意义(P<0.05);眼轴平均增长,RGPCL组为0.29±0.20mm,框架眼镜组为0.49±0.25mm,两者差异有显著性意义(P<0.05)。结论:RGPCL可能由于提供了更好的视觉质量及更好地矫正了散光,在一程度上使角膜变平且减缓眼轴增长,从而起到阻止高度近视快速发展的作用。展开更多
目的:探讨采用硬性透氧性角膜接触镜(rigid gas permeable,RGP)治疗成人高度与特殊类型屈光不正的临床效果及安全性。方法:回顾性分析2010-01/2012-12在本院眼科中心验配RGP的110例185眼患者的临床资料,根据患者的屈光不正类型分为高度...目的:探讨采用硬性透氧性角膜接触镜(rigid gas permeable,RGP)治疗成人高度与特殊类型屈光不正的临床效果及安全性。方法:回顾性分析2010-01/2012-12在本院眼科中心验配RGP的110例185眼患者的临床资料,根据患者的屈光不正类型分为高度近视散光组49例92眼、圆锥角膜组36例64眼、特殊屈光不正组25例29眼,观察三组患者行RGP配戴后不同时间的视力、常规框架镜的矫正视力差异及不良反应情况。结果:配戴RGP后即刻,高度近视散光组的矫正视力为4.94±0.16,圆锥角膜组4.98±0.15,特殊屈光不正组4.87±0.19,均显著优于配戴框架镜时的矫正视力(4.86±0.23,4.79±0.22,4.61±0.27),且差异均具有统计学意义(P<0.05)。配戴RGP后第3,6mo三组患者的视力复查结果显示优于配戴框架镜时(P<0.05)。视散光组、圆锥角膜组、特殊屈光不正组配戴RGP后的视力分布明显优于配戴框架镜时(P<0.05)。结论:RGP配戴矫正成人高度与特殊类型屈光不正较普通框架镜均具有显著的效果,不会增加干燥、异物感、易疲劳等不良反应的发生率,值得临床应用推广。展开更多
目的:探讨配戴硬性透气性角膜接触镜(rigid gas permeable contact lens,RGPCL)、框架眼镜对青少年近视眼调节滞后(lag of accommodation)的差异。方法:对57例114眼10～15岁初诊的中、低度近视眼,行医学验光、角膜曲率和角膜地形图检查...目的:探讨配戴硬性透气性角膜接触镜(rigid gas permeable contact lens,RGPCL)、框架眼镜对青少年近视眼调节滞后(lag of accommodation)的差异。方法:对57例114眼10～15岁初诊的中、低度近视眼,行医学验光、角膜曲率和角膜地形图检查,根据家长意愿其中27例患者选择配戴RGPCL,30例患者配戴框架眼镜。两组在最佳矫正视力的基础上,采用低度中和动态检影法测定调节滞后量。配戴期间每3mo复查1次,1a后用同样方法再次测定调节滞后量进行对比分析。结果:眼调节滞后量,两组对比差异无统计学意义(F=1.961,P=0.121)。1a后,RGPCL组坚持配戴者25例50眼,调节滞后量对比差异无统计学意义(P>0.05);框架眼镜组27例54眼调节滞后量对比差异有统计学意义(F=4.658,P<0.05);两组对比差异有显著统计学意义(F=6.134,P<0.01)。结论:配戴RGPCL眼调节滞后量明显小于框架眼镜,对减缓青少年近视进展可有一定作用,应大力推广。展开更多
文摘AIM: To record aberrations with a corneal topographic device on the anterior surface of the cornea at different time-points prior to wearing and following discontinued use of rigid gas permeable (RGP) contact lenses. The effect of wearing RGP on the anterior surface of the cornea was discussed to provide guidance for clinical refractive error correction.METHODS: The study objects were 24 eyes from 24 patients. All patients underwent identical examination procedures prior to lens use, as well as afterwards, including slit-lamp examination, non-contact tonometer measurement, computer optometry and corneal curvature measurement, subjective refraction test, and corneal topography analysis. The patients wore contact lenses everyday for 1 month and then discontinued. Corneal topographies were recorded at certain time points of 30 minutes, 1 day, 3, 7 and 14 days following use.RESULTS: Total corneal aberration at each time point following discontinued use of RGP contact lenses was less than the time point prior to use. Detailed results were as follows: root mean square (RMS) (pre)=(1.438± 0.328)μm, RMS (30 minutes) =(1.076 ±0.355)μm, RMS (1 day) =(1.362 ±0.402)μm, RMS (3 days) =(1.373 ±0.398)μm, RMS (7 days) =(1.387 ±0.415)μm, and RMS (14 days) = (1.430±0.423)μm. Results showed that at 30 minutes after discontinued use of RGP contact lenses, almost all 2 ndand 3 rd-order aberrations change. Quadrafoil Z10 and spherical Z12 of the 4 th-order were also changed. Alterations to Z5, Z6, and Z12 at 1 day after discontinued use were significant differences compared with the time period prior to RGP use: Z5 and Z6 decreased, and Z12 increased slightly. Z5 and Z6 remained decreased at 3 days after discontinued use, but Z9 and Z10 continued to increase and Z12 returned to levels prior to RGP use. At 14 days after discontinued use, all aberrations were notsignificantly different from the values prior to use.CONCLUSION: The use RGP contact lenses greatly reduced total aberration of the anterior surface of the cornea. Changes to 2 ndand 3 rd-order aberrations (including Z3, Z4, Z5, Z6, Z7, and Z8) were more significant. Following discontinued use of RGP contact lenses, the majority of lower order aberrations returned to original levels in a short period of time. During this process, a transient higher order aberration appeared, but all changes disappeared within 14 days after discontinued use of RGP contact lenses.
文摘AIM: To evaluate the effect of rigid gas permeable contact lens(RGP-CL) on corneal morphological parameters and vision-related quality of life in keratoconus(KC) patients.METHODS: Totally 57 eyes of 30 KC patients who were followed-up for more than two years, including 17 RGP wearers(32 eyes) and 13 non-wearers(25 eyes) were retrospectively analyzed. Initial medical history and corneal topography were collected at baseline. Corneal topography, corneal aberration, optical coherence tomography, and vision-related quality of life questionnaires were performed at the last follow-up.RESULTS: According to corneal topography, increase of the flattest keratometric values was higher in RGP wearers than in non-wearers(P=0.038). The morphological parameters, including symmetry index of front corneal curvature(P=0.004) and Baiocchi-Calossi-Versaci index front(P=0.047), were lower in RGP wearers than in nonwearers. Vertical coma was smaller in RGP wearers than non-wearers in 3.0, 5.0, 6.0, and 7.0 mm pupil diameters, respectively(P<0.05). The environmental triggering domain of ocular surface disease index was worse in RGP wearers as compared to non-wearers(P=0.003). At the last followup, there were no significant differences in constituent ratios of KC progression, corneal thickness topography, epithelial thickness topography, morphological parameters of corneal topography, and other questionnaire scores between the two groups(all P>0.05).CONCLUSION: Long-term use of RGP does not worsen KC but may cause corneal epithelial remodeling to increase symmetry of corneal anterior surface, reduce corneal vertical coma and improve visual quality. However, RGP wearing causes a slight decrease in vision-related quality of life. The occurrence of ocular surface symptoms is mainly associated with environmental triggering factors.
文摘Introduction: Keratoconus is a complex corneal disease that reduces visual acuity by progressively modifying the corneal shape and thickness, usually producing myopia and irregular astigmatism. Corneal collagen crosslinking with riboflavin + ultraviolet-A radiation (CXL) has become a widely accepted treatment for progressive keratoconus. During CXL, riboflavin administration is performed by repeated manual instillation of solution drops on the cornea for 30 minutes, a procedure that is often uncomfortable for many patients and that consumes surgical facilities and staff resources. In this study, especially modified scleral contact lenses (MSCL) were employed for delivering riboflavin to the cornea during CXL. Objective: The study aimed at evaluating the safety and efficacy of MSCL as a drug delivery system, verifying if anterior chamber flare confirms riboflavin penetration and describes the impact on patient comfort and optimization of surgical staff and facility resources. Material and Method: This study included 8 eyes of 6 patients aged 16 - 25 years old with history of progressive keratoconus. After mechanical removal of corneal epithelium, the concave surface of the modified scleral contact lens was filled with riboflavin solution and the lens was placed on the patient’s eye during 30 minutes. The lens design allows the formation of a riboflavin layer between the lens and the exposed corneal stroma to facilitate riboflavin penetration. Patients with lens were allowed to stand up and wait for the second UVA phase outside the surgical room. Riboflavin diffusion was confirmed by biomicroscopic examination of the corneal stroma and anterior chamber with the lens in place. Patients returned and the lens was removed before UV-A irradiation at 3 mW/cm2 for 30 minutes. Statistical analysis was performed by comparing the following parameters of each patient pre- and post-CXL: Spherical equivalent (Sph.Eq.), Mean simulated keratometry (SimK-m) and corrected distance visual acuity (CDVA) using the Wilcoxon method for non-parametric data (p Results: The MSCL allowed patients to be transferred from the surgical room to wait for corneal impregnation with riboflavin. The MSCL was effective in delivering riboflavin to the cornea as confirmed by biomicroscopic examination of the cornea and anterior chamber. No intraoperative or postoperative complications were observed. MSCL use improved the patient comfort and reduced the burden on surgical staff and facilities. All analyzed parameters showed statistically significant differences pre- and post-CXL: Sph.Eq. p = 0. 018 (Median: -2.50;Average: -2.52);SimK-m p = 0. 006 (Median: 47.92;Average: 45.56). CDVA p = 0. 012 (Median: -0.45;Average: 0.42). Conclusion: The MSCL is a safe and efficacious device for riboflavin delivery during CXL. The present study permits slit lamp observation of anterior chamber flare to confirm riboflavin penetration, and provides added safety and comfort for the patient and convenience to healthcare providers by optimizing the use surgical facilities and staff. Keratometric, visual and refractive results were similar to those reported in the literature for CXL with manual riboflavin instillation. Additional studies with larger numbers of patients are needed to confirm the study findings.
文摘目的:评价硬性透氧性角膜接触镜(rigid gas permeable contact lens,RGPCL)对儿童高度近视的矫治作用。方法:对20例40眼14岁以下高度近视的儿童验配RG-PCL,同时将20例40眼戴框架眼镜高度近视的儿童作为对照组,1a内定期复查其眼的屈光度、角膜屈折力及眼轴长度。结果:RGPCL组矫正视力明显优于框架眼镜组,两组差异有显著性意义;1a后的近视屈光度平均增加,RGPCL组为0.59±0.42D,框架眼镜组1.07±0.53D,两者差异有显著性意义(P<0.05);角膜屈折力平均减少,RGPCL组为0.22±0.19D,框架镜组为0.02±0.10D,两组间差异有显著性意义(P<0.05);眼轴平均增长,RGPCL组为0.29±0.20mm,框架眼镜组为0.49±0.25mm,两者差异有显著性意义(P<0.05)。结论:RGPCL可能由于提供了更好的视觉质量及更好地矫正了散光,在一程度上使角膜变平且减缓眼轴增长,从而起到阻止高度近视快速发展的作用。
文摘目的:探讨采用硬性透氧性角膜接触镜(rigid gas permeable,RGP)治疗成人高度与特殊类型屈光不正的临床效果及安全性。方法:回顾性分析2010-01/2012-12在本院眼科中心验配RGP的110例185眼患者的临床资料,根据患者的屈光不正类型分为高度近视散光组49例92眼、圆锥角膜组36例64眼、特殊屈光不正组25例29眼,观察三组患者行RGP配戴后不同时间的视力、常规框架镜的矫正视力差异及不良反应情况。结果:配戴RGP后即刻,高度近视散光组的矫正视力为4.94±0.16,圆锥角膜组4.98±0.15,特殊屈光不正组4.87±0.19,均显著优于配戴框架镜时的矫正视力(4.86±0.23,4.79±0.22,4.61±0.27),且差异均具有统计学意义(P<0.05)。配戴RGP后第3,6mo三组患者的视力复查结果显示优于配戴框架镜时(P<0.05)。视散光组、圆锥角膜组、特殊屈光不正组配戴RGP后的视力分布明显优于配戴框架镜时(P<0.05)。结论:RGP配戴矫正成人高度与特殊类型屈光不正较普通框架镜均具有显著的效果,不会增加干燥、异物感、易疲劳等不良反应的发生率,值得临床应用推广。
文摘目的:探讨配戴硬性透气性角膜接触镜(rigid gas permeable contact lens,RGPCL)、框架眼镜对青少年近视眼调节滞后(lag of accommodation)的差异。方法:对57例114眼10～15岁初诊的中、低度近视眼,行医学验光、角膜曲率和角膜地形图检查,根据家长意愿其中27例患者选择配戴RGPCL,30例患者配戴框架眼镜。两组在最佳矫正视力的基础上,采用低度中和动态检影法测定调节滞后量。配戴期间每3mo复查1次,1a后用同样方法再次测定调节滞后量进行对比分析。结果:眼调节滞后量,两组对比差异无统计学意义(F=1.961,P=0.121)。1a后,RGPCL组坚持配戴者25例50眼,调节滞后量对比差异无统计学意义(P>0.05);框架眼镜组27例54眼调节滞后量对比差异有统计学意义(F=4.658,P<0.05);两组对比差异有显著统计学意义(F=6.134,P<0.01)。结论:配戴RGPCL眼调节滞后量明显小于框架眼镜,对减缓青少年近视进展可有一定作用,应大力推广。
