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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 ,具有很高的使用价值
Objective: To investigate the effectiveness and existing problems of correction of corneal keratoconus with hard and soft contact lens (PiggybackLens). Methods: The reason why PiggybackLens was changed by RGPCL in 40 patients with moderate to severe keratoconus and whether the contact lenses were chosen or prescribed by the method of prescription were examined. PiggybackLens can improve the corrected visual acuity, improve the cornea’s poor shape, its therapeutic effect in acute edema and its effect on corneal endothelium The impact of such issues as statistical analysis. RESULTS: Keratoconus was the main cause of changes in PiggybackLens due to corneal opacity, scarring (40%) and poor stability with HCL alone (35%). The combination of PiggybackLens with high water content, thin and flexible disposable SCL (DSCL) or frequent replacement SCL (FRSCL) and rigid rigid RGG (RGPCL) can enhance corneal surface accuracy and increase corneal radius of curvature. PiggybackLens corrected visual acuity were higher than or equal to RGPCL corrected visual acuity. The former 5 7.5%, the latter 45.0% can be 0.8 or higher visual acuity. PiggybackLens wearing glasses 3 months to 1 year after the corneal radius of curvature increased by an average of 0. 9mm, corneal astigmatism average reduction of 4.5 3D. PiggybackLens, a trial of acute edema, can eliminate edema within 2 to 3 weeks and restore corneal shape better. After wearing the corneal endothelial cell density decreased, the average cell area increased. Conclusion: RGPCL alone is more difficult to use, with poor fitness, poor vision correction, unconditional keratoplasty recently accepted keratoplasty changes in the use of PiggybackLens to improve the symptoms, improve visual acuity, improve corneal shape, with high value