Fitting effect of scleral lens for moderate and severe keratoconus
10.3760/cma.j.cn115989-20230911-00094
- VernacularTitle:中重度圆锥角膜患者巩膜镜试戴效果评估
- Author:
Qi FAN
1
;
Kaili YANG
;
Shengwei REN
Author Information
1. 河南省人民医院眼科 河南省立眼科医院 郑州大学人民医院 河南大学人民医院，郑州 450003
- Keywords:
Keratoconus;
Therapy;
Visual acuity;
Scleral lens;
Rig gas-permeable contact lens;
Clarity
- From:
Chinese Journal of Experimental Ophthalmology
2023;41(12):1179-1186
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the fitting effect between rig gas-permeable contact lens (RGPCL) and scleral lenses (SLs) in moderate and severe keratoconus eyes.Methods:A cross-sectional study was performed.Fifty-two eyes of 42 keratoconus patients were recruited in Henan Eye Hospital from September 2022 to September 2023.Based on steep keratometry (Ks) value, patients were divided into moderate stage (48 D≤Ks<55 D, 28 eyes) and severe stage (Ks≥55 D, 24 eyes). RGPCL and SLs were fitted normatively in all eyes.Fluorescein staining and anterior segment optical coherence tomography were performed under a slit lamp.The distance between the central and lateral centers of the lenses and the cornea, the centering of the lenses, the mobility of the lenses and the peripheral fit of the lenses were observed.Best corrected visual acuity (BCVA) converted to logarithmic minimum angle of resolution, comfort score, wetness score and clarity score were recorded.Differences in the above parameters of each patient between RGPCL and SLs wear were compared.The improvement of the above parameters after RGPCL and SLs wear was compared in moderate and severe patients.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Henan Eye Hospital (No.HNEECKY-2019[5]-04). Written informed consent was obtained from each patient before any medical examination.Results:After RGPCL wear, the mean BCVA, comfort, wetness, and clarity score were 0.19(0.10, 0.30), 5.5(3.0, 7.0) points, 7.0(5.0, 8.0) points and 7.0(4.0, 8.0) points, respectively.After SLs wear, the mean BCVA, comfort score, wetness score and clarity score were 0.10(0.00, 0.10), 8.0(8.0, 9.0) points, 8.0(8.0, 9.0) points and 8.0(6.0, 9.0) points, respectively.Compared with RGPCL wear, the BCVA, comfort score, wetness score and clarity score of SLs were significantly improved ( Z=-5.887, -6.064, -5.705, -5.516; all at P<0.001). There was a moderate positive correlation between BCVA and Kmax after SLs wearing ( rs=0.519, P<0.001), and had a moderate negative correlation with TCT ( rs=-0.535, P<0.001). There was a moderate positive correlation between the clarity score of the SLs and TCT ( rs=0.303, P=0.029). In the moderate and severe subgroup analysis, BCVA, comfort score, wetness score and clarity score were significantly improved after SLs wear compared to RGPCL (all at P<0.05). In addition, the clarity score was significantly improved in severe keratoconus compared to moderate keratoconus ( Z=-3.100, P=0.002). Conclusions:In patients with moderate to severe keratoconus, RGPCL can improve BCVA to a limited extent.SLs can significantly improve patients' comfort, wetness and visual clarity while improving their BCVA.
