CAJ | 학술논문

目的观察RGPCL对圆锥角膜患者的视力及角膜前表面形态的影响.方法回顾性病例对照研究.Pentacam眼前节分析系统分期为KK2期的圆锥角膜眼,有效配戴RGPCL者22例(28眼)作为实验组,无效配戴RGPCL者8例(9眼)作为对照组,均为理想或可接受的三点接触的配适状态.观察配戴RGPCL 1年后的矫正视力及配戴前后角膜前表面形态学参数的变化.采用配对t检验进行数据分析.结果配戴RGPCL 1年后患者矫正视力提高,明显优于框架眼镜.与对照组相比,角膜前表面曲率平坦K值变化不大(P＞0.05),而陡峭K值明显变小(t=4.420,P＜0.01),角膜散光变小(t=4.271,P＜0.01),形态学参数中表面变异指数(ISV)、高度不对称性指数(IHA)变小(t=2.939,P＜0.01;t=1.690,P＜0.05),最小曲率半径(Rmin)变大(t=2.315,P＜0.05),圆锥角膜指数(KI)、中央圆锥角膜指数(CKI)、IVA、高度离心指数(IHD)差异无统计学意义(P＞0.05).所有患眼随诊期都无严重并发症出现.结论配戴RGPCL对KK2期圆锥角膜眼不但可提高视力而且能改善病变区角膜形态,是目前非手术方法矫治圆锥角膜的安全有效方法.
목적 관찰RGPCL대원추각막환자적시력급각막전표면형태적영향.방법 회고성병례대조연구.Pentacam안전절분석계통분기위KK2기적원추각막안,유효배대RGPCL자22례(28안)작위실험조,무효배대RGPCL자8례(9안)작위대조조,균위이상혹가접수적삼점접촉적배괄상태.관찰배대RGPCL 1년후적교정시력급배대전후각막전표면형태학삼수적변화.채용배대t검험진행수거분석.결과 배대RGPCL 1년후환자교정시력제고,명현우우광가안경.여대조조상비,각막전표면곡솔평탄K치변화불대(P＞0.05),이두초K치명현변소(t=4.420,P＜0.01),각막산광변소(t=4.271,P＜0.01),형태학삼수중표면변이지수(ISV)、고도불대칭성지수(IHA)변소(t=2.939,P＜0.01;t=1.690,P＜0.05),최소곡솔반경(Rmin)변대(t=2.315,P＜0.05),원추각막지수(KI)、중앙원추각막지수(CKI)、IVA、고도리심지수(IHD)차이무통계학의의(P＞0.05).소유환안수진기도무엄중병발증출현.결론 배대RGPCL대KK2기원추각막안불단가제고시력이차능개선병변구각막형태,시목전비수술방법교치원추각막적안전유효방법.
Objective To investigate the effects of wearing RGPCL on visual acuity and anterior surface morphology in keratoconus.Methods Patients diagnosed with keratoconus in the KK2 stage using Pentacam software were recruited for a retrospective,comparative case series study.Twenty-two patients (28 eyes) who were prescribed RGPCL were included in the lens-wearing group.Eight patients (9 eyes) who wore glasses and seldom wore RGPCL were included in the control group.Subjects were fitted using the three-point-touch fitting method.The mean follow-up period was 12 months.Visual acuity was evaluated for both groups.The changes in the morphologic parameters on the anterior corneal surface were measured with Pentacam for comparisons between the lens-wearing and control groups.Data were analyzed with a paired t test.Results Corrected visual acuity improved after wearing RGPCLs,and the improvement was significantly better than for those who wore glasses.The Pentacam study showed there was a statistically significant flattening of the steep simulated keratometry (t=4.420,P＜0.01) compared to the control group.Although there was no significant difference in the flattest simulated keratometry after RGPCL wear (P＞0.05),corneal astigmatism decreased (t=4.271,P＜0.01).A significant reduction was found in the morphological parameters of ISV and IHA (t=2.939,P＜0.01; t=1.690,P＜0.05),while Rmin increased (t=2.315,P＜0.05).KI,CKI,IVA,IHD were not significantly different after RGPCL wear (P＞0.05).No serious eye complications were observed during the follow-up period.Conclusion Proper RGPCL fitting improves visual acuity and reshapes the ocular surface.These lenses are an effective and safe non-surgical treatment for keratoconus patients.