[1]杨丽媛,杨君.硬性高透气性角膜接触镜对圆锥角膜患者角膜光密度的影响[J].眼科新进展,2023,43(10):786-789.[doi:10.13389/j.cnki.rao.2023.0158]
　YANG Liyuan,YANG Jun.Effects of rigid gas permeable contact lenses on corneal densitometry in patients with keratoconus[J].Recent Advances in Ophthalmology,2023,43(10):786-789.[doi:10.13389/j.cnki.rao.2023.0158]
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硬性高透气性角膜接触镜对圆锥角膜患者角膜光密度的影响/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
43卷
期数:
2023年10期
页码:
786-789
栏目:
应用研究
出版日期:
2023-10-05

文章信息/Info

Title:
Effects of rigid gas permeable contact lenses on corneal densitometry in patients with keratoconus
作者:
杨丽媛; 杨君
300070　甘肃省兰州市，甘肃省人民医院眼视光学中心
Author(s):
YANG Liyuan; YANG Jun
Department of Optometry,Gansu Provincial Hospital,Lanzhou 300070,Gansu Province,China
关键词:
圆锥角膜; 硬性高透气性角膜接触镜; 角膜光密度; 透明性
Keywords:
keratoconus;  rigid gas permeable contact lens;  corneal densitometry;  transparency
分类号:
R774
DOI:
10.13389/j.cnki.rao.2023.0158
文献标志码:
A
摘要:
目的　探讨硬性高透气性角膜接触镜（RGP）对圆锥角膜患者角膜光密度的影响。
方法　选取2020年1月至6月于甘肃省人民医院眼视光学中心就诊的圆锥角膜患者45例（45眼）作为研究对象。根据Amsler-Krumeich圆锥角膜分级方法对患者进行分级和分组。45例圆锥角膜患者中轻度(Ⅰ级)组15例（15眼）、中度(Ⅱ级) 组15例（15眼）、重度(Ⅲ/Ⅳ级) 组 15例（15眼）。三组患者戴镜前及戴镜后3个月、6个月和12个月行常规视力、裂隙灯检查。采用Pentacam三维眼前节分析系统检测患者角膜最大曲率(Km）、最薄点角膜厚度(TCT)、角膜后表面高度(PCE) 以及角膜光密度。角膜光密度主要分析角膜12 mm直径范围内的数值，以角膜顶点为中心，分别测量0～2 mm、>2～6 mm、>6～12 mm和整体0～12 mm范围内的角膜光密度。并根据角膜厚度将角膜分为3层，记录角膜前层(120 μm)、后层(60 μm)、中层(前后层之间厚度) 和全层的角膜光密度。对比三组患者戴镜前后角膜光密度的差异，分析其变化与Km、TCT、PCE的相关性。
结果　戴镜前三组患者之间Km、TCT和PCE差异均有统计学意义（均为P<0.05），中度组和重度组患者Km和PCE大于轻度组，TCT小于轻度组（均为P<0.05）。轻度组和中度组圆锥角膜患者不同直径范围内前层、中层、后层和全层的角膜光密度在戴镜后与戴镜前相比差异均无统计学意义（均为P>0.05）。重度组圆锥角膜患者在戴镜后6个月0～2 mm、>2～6 mm直径范围内前层、中层和全层角膜光密度较戴镜前有升高的趋势，但差异均无统计学意义（均为P>0.05）。圆锥角膜患者0～2 mm前层角膜光密度变化（戴镜后12个月与戴镜前的差值）与戴镜前Km呈正相关（r=0.405,P=0.03）。0～2 mm、>2～6 mm 前层角膜光密度变化与戴镜前PCE呈正相关（r=0.323,P=0.02；r=0.203,P=0.01）。0～2 mm、>2～6 mm前层角膜光密度变化与戴镜前TCT呈负相关（r=-0.168,P=0.03；r=-0.207,P=0.04）。其余不同深度直径范围内角膜光密度的变化与Km、PCE和TCT之间无显著相关性（均为P>0.05）。
结论　圆锥角膜患者长期配戴RGP后角膜光密度相对稳定，角膜透明度未有明显下降，RGP是矫治圆锥角膜患者安全且有效的手段。
Abstract:
Objective　To investigate the effects of rigid gas permeable (RGP) contact lenses on corneal densitometry (CD) in patients with keratoconus.
Methods　Forty-five patients (45 eyes) with keratoconus who received treatment in the Optometry Center of Gansu Provincial People’s Hospital from January to June 2020 were selected. According to the Amsler-Krumeich classification of keratoconus, the patients were divided into the mild (grade I) group (15 patients with 15 eyes), moderate (grade Ⅱ) group (15 patients with 15 eyes) and severe (grade Ⅲ/Ⅳ) group (15 patients with 15 eyes). All patients underwent visual acuity and slit lamp examinations before and 3, 6, and 12 months after wearing RGP lenses. The maximum corneal curvature (Km), the thinnest corneal thickness (TCT), the posterior corneal elevation (PCE), and the CD were obtained by Pentacam. CD was measured in the 0-2 mm, >2-6 mm, >6-12 mm and 0-12 mm diameter ranges, respectively, with the corneal apex at the center. The cornea was divided into 3 layers according to the thickness. CD values were recorded in the anterior (120 μm), central (between the anterior and posterior layers), posterior (60 μm) and whole layers. The difference in CD before and after wearing the RGP lenses was compared among the three groups, and the correlations between CD and Km, TCT, PCE were analyzed.
Results　Before wearing the RGP lenses, there were statistically significant differences in Km, TCT and PCE among the three groups (all P<0.05). Km and PCE in the moderate and severe groups were greater than those in the mild group, while TCT was smaller than that in the mild group (all P<0.05). No statistical differences were found in the mild and moderate groups in CD in the anterior, central, posterior and whole layers in different diameter ranges after wearing the RGP lenses compared with those before wearing the RGP lenses (all P>0.05). The severe group showed a mild CD increase in the anterior, central and whole layers in the 0-2 mm and >2-6 mm diameter ranges 6 months after wearing the RGP lenses, but the differences were not statistically significant (all P>0.05). The changes in CD (the difference between 12 months after and before wearing RGP lenses) in the anterior layer in the 0-2 mm range were positively correlated with Km before wearing RGP lenses (r=0.405, P=0.03). The changes in CD in the anterior layer in the 0-2 mm and >2-6 mm ranges were positively correlated with PCE (r=0.323, P=0.02; r=0.203, P=0.01) and negatively correlated with TCT (r=-0.168, P=0.03; r=-0.207, P=0.04) before wearing RGP lenses. There was no significant correlation between the changes of CD and Km, PCE, TCT in other layers and diameter ranges (all P>0.05).
Conclusion　CD is relatively stable in patients with keratoconus after wearing RGP lenses, and corneal transparency does not decrease significantly. Wearing RGP lenses is a safe and effective method for patients with keratoconus.

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备注/Memo

备注/Memo:
甘肃省自然科学基金项目（编号：17JR5RA039）；兰州市科技计划项目（编号：2022-5-58）
更新日期/Last Update: 2023-10-05