目的:评价非球面高透氧性硬性透气性角膜接触镜(rig idgas-permeable contactlens,RGPCL)矫正特殊类型屈光不正的临床疗效及安全性。方法:收集2009-03/2009-12验配非球面高透氧性RGPCL的特殊屈光不正的患者53例99眼,分为:(1)高度近视组6眼;(2)高度散光8眼;(3)屈光参差组15眼;(4)高度近视+高度散光组(近视≥-6.00D或散光≥-2.00D)10眼;(5)高度近视+高度散光+屈光参差组8眼;(6)圆锥角膜组(确诊为圆锥角膜的患者)48眼;(7)混合散光2眼;(8)特殊类型屈光不正组(角膜屈光手术后)2眼。观察验配RGPCL后的矫正视力,并与框架镜的矫正视力比较。定期复诊,记录矫正视力、镜片配适及配戴情况。结果:本组病例戴框架镜(试镜架)的等效球镜度数为(-8.10±5.38)D,而RGP度数为(-6.50±4.13)D,两者差异有显著性(t=-7.499,P<0.01)。戴RGPCL后的视力矫正视力(LOGMAR)为(0.02±0.09),低于戴框架镜的最佳矫正视力(0.14±0.20)。两者具有统计学差异(t=7.03,P<0.01);戴镜3~6mo后,出现10眼角膜上皮擦伤,3眼镜片丢失。结论:应用非球面RGP可矫正高度近视散光、圆锥角膜及各种原因引起的高度屈光不正,其矫正视力明显优于框架眼镜,并有较高的舒适度和安全性,无明显的并发症发生。

·AIM:To investigate the clinical effect and safety of the non-spherical rigid gas-permeable contact lens(RGPCL)for special ametropia.·METHODS:Totally 53 patients 99 eyes with special ametropia from March to December,2009 were divided into six groups:(1)high myopia group 6 eyes;(2)high astigmatism 8 eyes;(3)anisometropia group 15 eyes;(4)high astigmatism+high myopia group(myopia:≥6.00D or astigmatism:≥2.00D,10 eyes);(5)high astigmatism+high myopia+anisometropia group 8 eyes;(6)keratoconus group 48 eyes;(7)mixed astigmatism 2 eyes;(8)special refractive error group(after corneal refractive surgery,2 eyes).The corrected visual acuity between the fitting RGPCL and the frame glass were compared.The corrected visual acuity,fitting lens and wearing situation were recorded.·RESULTS:In patients of wearing mirror frame,the degree of equivalent sphere was(-8.10±5.38)D whereas the degree of RGP was(-6.50±4.13)D.There were statistically significant difference(t=-7.499,P<0.01).Correctted visual acuity of non-spherical RGP lenses(LOGMAR)was(0.02±0.09),lower than that of spectacle lenses(0.14±0.20),and there was statistically significant improvement(t=7.03,P<0.01).After wearing glasses 3 to 6 months,corneal epithelial abrasion occurred in 10 eyes and glasses lost in 3 eyes.·CONCLUSION:The application of non-spherical RGP can correct high myopia astigmatism,keratoconus andthe various high refractive,and has a higher comfort and safety.Patients can adapt to lenses and they are superior to spectacles.No severe complications are observed.·

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