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Title: [Therapeutic effect of rigid permeable contact lenses on irregular astigmatism after keratoplasty].
Author: Zhang J, Qi XL, Li J, Kong LY, Wang YN, Liu MN, Shi WY, Gao H.
Journal: Zhonghua Yan Ke Za Zhi; 2019 Jun 11; 55(6):413-418. PubMed ID: 31189270.
Abstract:
Objective: To evaluate the clinical effect of rigid permeable contact lenses (RGPCL) in the correction of irregular astigmatism after keratoplasty. Methods: Retrospective case study. From June 2012 to December 2016, 31 patients (37 eyes) who underwent corneal transplantation were tested and fitted with RGPCL. The patients' data of primary disease, interval from keratoplasty to contact lens fitting, uncorrected visual acuity, best spectacle-corrected visual acuity, best RGPCL-corrected visual acuity, contrast visual acuity before and after RGPCL wear, corneal topography and corneal endothelium parameters before and after RGPCL wear were collected, including ocular complications and comfort of contact lenses. Results: Among the 31 patients, 24 were male and 7 were female, with age of (31.3±5.8) years. The mean interval between grafting and initial contact lens fitting was (4.6±2.3) years. Uncorrected visual acuity, best spectacle-corrected visual acuity, and best RGPCL-corrected visual acuity were 0.81±0.21, 0.54±0.13, and 0.10±0.07, respectively (t=7.170, 16.617, 17.866; all P<0.05). The average astigmatism was -5.76±2.23 D and -0.83±0.47 D before and after wearing RGPCL (t=8.531, P<0.05). After wearing RGPCL, the contrast visual acuity of 100%, 25%, 10%, and 5% was increased from 0.95±0.33, 1.18±0.21, 1.40±0.00, and 1.40±0.00 to 0.12±0.15, 0.37±0.17, 0.65±0.25, and 0.96±0.29, respectively (t=5.972, 8.473, 9.243, 5.104; all P<0. 05). There were no obvious changes of corneal endothelium parameters during the observation period. No obvious corneal allograft rejection or other complications occurred, and 94.6% (35/37) of the patients felt comfortable with wearing RGPCL. Conclusions: RGPCL wear is safe and effective in correcting irregular astigmatism after corneal transplantation. We can obtain good corrected vision and improve contrast visual acuity, especially for patients who can not wear spectacles. (Chin J Ophthalmol, 2019, 55: 413-418). 目的： 评价硬性透气性角膜接触镜（RGPCL）矫正角膜移植术后不规则散光的临床疗效。 方法： 回顾性系列病例研究。收集2012年6月至2016年12月在山东省眼科医院试戴并成功验配了RGPCL的角膜移植术后患者31例（37只眼）。其中男性24例（30只眼），女性7例（7只眼），年龄（31.3±5.8）岁。收集患者原发病、首次配戴RGPCL距离角膜移植的时间，logMAR视力表检查患者的裸眼视力（UCVA）、最佳框架眼镜矫正视力（BCVA）及RGPCL的矫正视力，配戴RGPCL前后不同对比度视力，配戴RGPCL前后角膜地形图和角膜内皮各参数，配戴RGPCL的眼部并发症及舒适度评估。采用独立样本配对t检验对角膜形态学参数、角膜地形图检查结果及角膜内皮参数等数据进行比较。 结果： 31例患者首次配戴RGPCL的时间为术后（4.6±2.3）年。UCVA、BCVA、RGPCL矫正视力分别为0.81±0.21、0.54±0.13、0.10±0.07（t=7.170，16.617，17.866；P<0.05）。配戴RGPCL前后主观验光平均柱镜度数为（-5.76±2.23）和（-0.83±0.47）D（t=8.531，P<0.05）。配戴RGPCL后100%、25%、10%、5%的不同对比度视力分别由0.95±0.33、1.18±0.21、1.400±0.00、1.40±0.00提高至0.12±0.15、0.37±0.17、0.65±0.25、0.96±0.29（t=5.972，8.473，9.243，5.104；P<0.05）。观察期内角膜内皮各参数戴镜前后无明显改变，未发现角膜移植排斥反应及其他并发症，94.6%（35/37）的患者戴镜感觉舒适。 结论： RGPCL矫正角膜移植术后不规则散光安全有效，均可获得良好的矫正视力，提高不同对比度视力。（中华眼科杂志，2019，55：413-418）.

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