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以高透氧硬式隱形眼鏡矯正圓錐角膜
Correction of Keratoconus with Rigid Gas Permeable (RGP) Contact Lens
摘要
目的：分析以一般高透氧硬式隱形眼鏡來矯正圓錐角膜病患的結果，並嘗試找出簡單的裝配原則。 方法：此為一回溯性的研究，我們收集了過去十年中在長庚醫院被診斷為圓錐角膜、並且由同一位醫師以一般高透氧硬式隱形眼鏡矯正成功者，統計其結果。我們也分析角膜曲度及各種角膜地圖指數與所裝配隱形眼鏡的基弧間的相關係數，嘗試找出一簡單的裝配原則。此外並探討隱形眼鏡廠牌（基弧設計）、圓錐在角膜地圖上的位置、及圓錐角膜的嚴重程度對裝配原則的影響。 結果：我們一共收集了25位（48隻病眼）以一般高透氧硬式隱形眼鏡矯正成功的圓錐角膜病例，其中包括輕度至嚴重的圓錐角膜。裝配隱形眼鏡後平均追蹤的時間為37.7個月，病眼可獲得平均三行視力的改善。而隱形眼鏡的基弧半徑則與角膜曲度儀所測量到的”最平曲度半徑值”相關度最高。隱形眼鏡廠牌（基弧設計）、圓錐在角膜地圖上位置、及圓錐角膜的嚴重程度均是影響基弧選擇的因素。 結論：以一般高透氧硬式隱形眼鏡來矯正圓錐角膜為一簡單可行的方法。以角膜曲度儀所測量到的”最平曲度半徑值”為隱形眼鏡試片基弧半徑去裝配，並根據隱形眼鏡基弧設計、圓錐的位置、及圓錐角膜的嚴重程度等因素去調整基弧大小，可節省裝配的時間。
關鍵字
無資料並列摘要
Purpose: To analyze the feasibility of fitting keratoconus with non-keratoconic rigid gas permeable (RGP) contact lens, and also to find a simple rule for the base curve of the contact lens. Method: We retrospectively collected the keratoconus cases who were diagnosed in the past ten years the Chang-Gung Memorial Hospital and were fitted successfully with non-keratoconic RGP by the same doctor. The status of their refraction and contact lens fitting were recorded. The correlations between their keratometric readings or topographic indices and the base curves of the contact lenses were also analyzed. The influences of the design of the lenses, the position of the cone, and the severity of the disease on the base Curve were surveyed as well. Result: Forty-eight eyes in 25 keratoconus patients, including all disease seventies, could be successfully fitted with non-keratoconic RGP. The mean follow up time is 37.7 months, with an average improvement of three lines of Snellen acuity. The base curve of the lens was most correlated with the flat keratometric reading. The design of the lenses, the position of the cone, and the severity of the disease are all factors in determining the base curves. Conclusion: Fitting of keratoconus with non-keratoconic RGP is feasible. As for the base curve of the lens, start with the flat keratometric reading and adjust according to the design of the lenses, the position of the cone, and the severity of the disease would be most time-saving for initial fitting.