目的：观察高透氧性硬性透气性角膜接触镜(RGPCL)矫正深板层角膜移植(DALK)术后角膜前表面规则性的临床疗效。

方法：前瞻性病例对照研究。选取2017-07/2019-01期间在北部战区总医院接受戴镜治疗的DALK术后的患者28例28眼，按照非随机自愿原则分为两组：术后配戴RGPCL镜治疗组18例18眼； 术后戴框架眼镜治疗组10例10眼。分别记录患者戴镜前、戴镜后3、6mo和1a的裸眼视力(UCVA)、矫正远视力(CDVA)和屈光度的变化，并应用Oculus Pentacam三维眼前节分析仪行角膜形态检查，记录患者各时间点的的角膜前表面平坦曲率(K1)、陡峭曲率(K2)、最大曲率(Kmax)、前表面散光、表面变异系数(ISV)、高度非对称指数(IHA)、垂直非对称指数(IVA)和高度轴偏心指数(IHD)的变化。

结果：两组患者UCVA、SE、K2、Kmax、前表面散光、IVA和IHD的差异无统计学意义(P>0.05)。CDVA、K1、ISV和IHA配戴RGPCL组患者戴镜后 3mo为0.38±0.16、45.40±3.19D、35.48±18.46、27.91±17.19， 6mo为0.37±0.16、43.73±3.39D、30.48±16.28、25.18±16.66，1a为0.34±0.21、43.64±3.30D、25.97±15.23、23.46±15.24，配戴框架眼镜组患者戴镜后 3mo为0.65±0.16、45.82±3.52D、49.39±15.73、28.45±16.96， 6mo为0.60±0.15、45.11±3.06D、48.18±15.13，25.95±15.93，1a为0.58±0.16、45.61±3.30D、46.67±15.45、25.48±15.51，有差异(P<0.05)。

结论：RGPCL在提高DALK术后患者的矫正视力，改善角膜不规则性方面安全有效，比框架眼镜有明显优势。

METHODS: A prospective case-control study. 28 patients accepted RGPCL or frame glassed after DALK surgery during 2017-07/2019-01 in the General Hospital of Northern Theater Command were selected. We divided them into 2 groups according to the principle of non-random voluntariness. 18 patients(18 eyes)accepted RGPCL while 10 patients(10 eyes)accepted frame glasses were selected. Data were collected preoperative, 3mo, 6mo and 1a later, including uncorrected distant visual acuity(UCVA), corrected distant visual acuity(CDVA)and refractive diopter. Furthermore, the Oculus Pentacam Three-dimensional Anterior eye Analyzer was used to examine the corneal morphology. We calculated corneal anterior surface smooth curvature(K1), steep curvature(K2), maximum curvature(Kmax), anterior corneal surface astigmatism, Index of Surface Variance(ISV), Index of Height Asymmetry(IHA), Index of Vertical Asymmetry(IVA)and Index of Height Decentration(IHD).

RESULTS: We found no statistically significant differences between the two groups in UCVA, SE, K2, Kmax, anterior corneal surface astigmatism, IVA and IHD(P>0.05), but we found significant differences in CDVA, K1, ISV and IHA(P<0.05). In terms of CDVA, the data at 3mo was(0.38±0.16, 45.40±3.19D, 35.48±18.46, 27.91±17.19), 6mo was(0.37±0.16, 43.73±3.39D, 30.48±16.28, 25.18±16.66)and 1a was(0.34±0.21, 43.64±3.30D, 25.97±15.23, 23.46±15.24)in the RGPCL group. The data at 3mo was(0.65±0.16, 45.82±3.52D, 49.39±15.73, 28.45±16.96), 6mo was(0.60±0.15, 45.11±3.06D, 48.18±15.13, 25.95±15.93)and 1a was(0.58±0.16, 45.61±3.30D, 46.67±15.45, 25.48±15.51)(P<0.05).

CONCLUSION: RGPCL is safe and effective to improve CDVA and correct the regularity of anterior corneal surface after DALK and has advantage over frame glasses.