Purpose

To report the use of corneoscleral lenses (CSL) in keratoconus patients who were unsatisfied with their visual outcomes after keratoplasty surgery.

Methods

Eleven consecutive cases with unsatisfactory vision with spectacles, due to irregular astigmatism, preferred to try CSL before SL due to handling or economic issues. An eye examination included refraction and visual acuity assessment, anterior eye biomicroscopy, ocular fundus examination, corneal topographic analysis, endothelial-cell count (ECC) and evaluation of corneal biomechanical parameters (corneal resistance factor, CRF; corneal hysteresis, CH; corneal-compensated intraocular pressure, IOPcc). The fitting process was performed using a diagnostic fitting set. Subjective visual quality and comfort, and CSL usage time were also recorded. Patients were monitored for 1 year.

Results

Two patients presented intolerance to CSL. Therefore, nine patients (6 males and 3 females; the mean±SD age, 44.56 ± 17.33 years, range 27–82) were fitted with CSL. The log MAR visual acuity of these eyes improved significantly with CSL in relation to the best spectacle-corrected vision (0.02 ± 0.06 vs 0.22 ± 0.15, respectively; p = 0.007). Patients reported prolonged usage times (an average of 9.78 ± 1.99 h; range, 8–14). No significant adverse ocular effects or clinically relevant changes in ocular parameters (ECC, CH, IOPcc, central corneal thickness and keratometry; all p > 0.05), visual quality, comfort rating or usage time were found during the 1-year follow-up.

Conclusion

Corneoscleral lenses could be fitted in non-severe cases after keratoplasty surgery with optimal visual results as they can be a safe and healthy alternative option.

中文翻译：

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用于角膜移植术后视力康复的角膜巩膜隐形眼镜。

目的

报告在角膜移植术后对视力结果不满意的圆锥角膜患者中使用角膜巩膜镜 (CSL)。

方法

连续11例配镜视力不满意，因不规则散光，由于操作或经济问题，首选在SL之前尝试CSL。眼科检查包括屈光度和视力评估、前眼生物显微镜检查、眼底检查、角膜地形分析、内皮细胞计数 (ECC) 和角膜生物力学参数评估（角膜阻力因子，CRF；角膜滞后，CH；角膜代偿眼压，IOPcc）。拟合过程是使用诊断拟合集进行的。主观视觉质量和舒适度以及 CSL 使用时间也被记录下来。对患者进行了为期 1 年的监测。

结果

两名患者对 CSL 不耐受。因此，9 名患者（6 名男性和 3 名女性；平均 ± SD 年龄，44.56 ± 17.33 岁，范围 27-82）符合 CSL。这些眼睛的 log MAR 视力与最佳眼镜矫正视力相比，CSL 显着提高（分别为 0.02 ± 0.06 和 0.22 ± 0.15；p = 0.007）。患者报告使用时间延长（平均 9.78 ± 1.99 小时；范围，8-14）。在 1 年的随访期间，没有发现显着的眼部不良反应或眼部参数（ECC、CH、IOPcc、中央角膜厚度和角膜曲率；所有p > 0.05）、视觉质量、舒适度等级或使用时间的临床相关变化。

结论

角膜巩膜镜片可以安装在角膜移植手术后的非严重病例中，并获得最佳视觉效果，因为它们是一种安全和健康的替代选择。