摘要
目的 :探讨软硬组合式接触镜 (PiggybackLens)矫正治疗圆锥角膜的有效性和存在的问题。方法 :对 40眼中重度圆锥角膜由RGPCL变更使用PiggybackLens的原因 ,以及接触镜的选择、处方方法、PiggybackLens能否提高矫正视力、改善角膜不良形状 ,在急性水肿期的治疗效果 ,及其对角膜内皮的影响等问题进行统计分析。结果 :圆锥角膜变更使用PiggybackLens的主要原因是角膜混浊、瘢痕的加重 (40 % )和单独使用HCL稳定性差 ,易脱落 (35 % )。选用高含水 ,薄型弹性好的抛弃型SCL(DSCL)或频繁更换型SCL(FRSCL)及透气性硬性接触镜 (RGPCL)组合PiggybackLens可增强角膜表面精度 ,增大角膜曲率半径。PiggybackLens矫正视力均高于或等于RGPCL矫正视力。前者 5 7.5 % ,后者 45 .0 %可获 0 .8或更高的视力效果。PiggybackLens戴镜 3个月～ 1年后 ,角膜曲率半径平均增大 0 .9mm ,角膜散光度平均降低 4.5 3D。急性水肿期试用PiggybackLens,可于 2～ 3周内消除水肿、较好地恢复角膜形状。戴镜后角膜内皮细胞密度降低 ,平均细胞面积增大。结论 :单独使用RGPCL难度较大 ,配适状态不良 ,矫正视力差 ,无条件近期接受角膜移植的圆锥角膜病例变更使用PiggybackLens对改善自觉症状 ,提高矫正视力 ,改善角膜形状 。
Objective:To investigate the effects and problems of the piggyback lens in the correction and treatment of keratoconus.Methods:Piggyback lenses were successfully fitted in 40 eyes that suffered from moderate to advanced keratoconus. Results:The main reasons for a change to the piggyback lens were excessive scarring (40%) and the decentration of HCL (35%). Using high water content, good flexibility, thin disposable or frequent replacement SCL, combined piggyback lenses can improve the corneal surface on a consistent basis, thereby flattening the cornea. Prescribed RGPCL base curve ranged from 7.10mm to 8.40mm over the SCL. Visual acuity was corrected to better than 0.7 for 57.5% with the piggyback lens and 45% with RGPCL. After wearing piggyback lenses for 3 months to 1 year, the keratometric curvature increased 0.9mm on average and corneal astigmatism was reduced by 4.53D on average. The piggyback lens was tested on acute hydrops corneas. Edema was found to disappear within 2～3 weeks, and orthokeratology results were affected. The Dk/L value of the piggyback lens is lower than that for RGPCL and the cell size of the corneal endothelium was enlarged after wearing piggyback lenses.Conclusion:The piggyback lens is very useful for keratoconus. It can enhance the corrected vision in cases where HCL is hard to fit.
出处
《眼视光学杂志》
2000年第3期138-141,共4页
Chinese Journal of Optometry & Ophthalmology
关键词
圆锥角膜
治疗
软硬组合式接触镜
keratoconus/therapeutic use
piggyback lens/therapeutic use
FRSCL/therapeutic use
RGPCL/therapeutic use
corneal endothelium
