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Abstract：
OBJECTIVE: To evaluate the effect of rigid gas permeable contact lens (RGP-CL) on corneal morphological parameters and vision-related quality of life in keratoconus (KC) patients.
METHODS: Totally 57 eyes of 30 KC patients who were followed-up for more than two years, including 17 RGP wearers (32 eyes) and 13 non-wearers (25 eyes) were retrospectively analyzed. Initial medical history and corneal topography were collected at baseline. Corneal topography, corneal aberration, optical coherence tomography, and vision-related quality of life questionnaires were performed at the last follow-up.
RESULTS: According to corneal topography, increase of the flattest keratometric values was higher in RGP wearers than in non-wearers (P=0.038). The morphological parameters, including symmetry index of front corneal curvature (P=0.004) and Baiocchi-Calossi-Versaci index front (P=0.047), were lower in RGP wearers than in non-wearers. Vertical coma was smaller in RGP wearers than non-wearers in 3.0, 5.0, 6.0, and 7.0 mm pupil diameters, respectively (P<0.05). The environmental triggering domain of ocular surface disease index was worse in RGP wearers as compared to non-wearers (P=0.003). At the last follow-up, there were no significant differences in constituent ratios of KC progression, corneal thickness topography, epithelial thickness topography, morphological parameters of corneal topography, and other questionnaire scores between the two groups (all P>0.05).
CONCLUSIONS: Long-term use of RGP does not worsen KC but may cause corneal epithelial remodeling to increase symmetry of corneal anterior surface, reduce corneal vertical coma and improve visual quality. However, RGP wearing causes a slight decrease in vision-related quality of life. The occurrence of ocular surface symptoms is mainly associated with environmental triggering factors.
METHODS: Totally 57 eyes of 30 KC patients who were followed-up for more than two years, including 17 RGP wearers (32 eyes) and 13 non-wearers (25 eyes) were retrospectively analyzed. Initial medical history and corneal topography were collected at baseline. Corneal topography, corneal aberration, optical coherence tomography, and vision-related quality of life questionnaires were performed at the last follow-up.
RESULTS: According to corneal topography, increase of the flattest keratometric values was higher in RGP wearers than in non-wearers (P=0.038). The morphological parameters, including symmetry index of front corneal curvature (P=0.004) and Baiocchi-Calossi-Versaci index front (P=0.047), were lower in RGP wearers than in non-wearers. Vertical coma was smaller in RGP wearers than non-wearers in 3.0, 5.0, 6.0, and 7.0 mm pupil diameters, respectively (P<0.05). The environmental triggering domain of ocular surface disease index was worse in RGP wearers as compared to non-wearers (P=0.003). At the last follow-up, there were no significant differences in constituent ratios of KC progression, corneal thickness topography, epithelial thickness topography, morphological parameters of corneal topography, and other questionnaire scores between the two groups (all P>0.05).
CONCLUSIONS: Long-term use of RGP does not worsen KC but may cause corneal epithelial remodeling to increase symmetry of corneal anterior surface, reduce corneal vertical coma and improve visual quality. However, RGP wearing causes a slight decrease in vision-related quality of life. The occurrence of ocular surface symptoms is mainly associated with environmental triggering factors.
摘要：
目的：评估硬质透气性角膜接触镜（RGP-CL）对圆锥角膜（KC）患者角膜形态参数和视觉相关生活质量的影响。
方法：30例KC患者57只眼，随访2年以上，包括17名RGP佩戴者(32只眼)和13名非佩戴者(25只眼)进行回顾性分析。在基线时收集初始病史和角膜地形图。角膜地形图,角膜像差,光学相干层析成像，在最后一次随访时进行与视觉相关的生活质量问卷。
结果：根据角膜地形图，RGP佩戴者的最平坦角膜测量值的增加高于非佩戴者(P=0.038)。形态学参数，包括前角膜曲率的对称指数（P=0.004）和前Baiocchi-Calossi-Versaci指数（P=0.047），RGP佩戴者低于非佩戴者。在瞳孔直径为3.0、5.0、6.0和7.0mm时，RGP佩戴者的垂直慧差小于非佩戴者，分别为(P<0.05)。与未佩戴者相比，RGP佩戴者的眼表疾病指数的环境触发域较差（P=0.003）。在最后一次随访中，KC进展的构成比没有显着差异，角膜厚度地形图,上皮厚度形貌，角膜地形图的形态参数，其他问卷评分两组间比较(均P>0.05)。
结论：长期使用RGP不会使KC恶化，但可能会导致角膜上皮重塑，从而增加角膜前表面的对称性，减少角膜垂直昏迷，提高视觉质量。然而,RGP佩戴会导致视力相关生活质量略有下降。眼表症状的发生主要与环境触发因素有关。
方法：30例KC患者57只眼，随访2年以上，包括17名RGP佩戴者(32只眼)和13名非佩戴者(25只眼)进行回顾性分析。在基线时收集初始病史和角膜地形图。角膜地形图,角膜像差,光学相干层析成像，在最后一次随访时进行与视觉相关的生活质量问卷。
结果：根据角膜地形图，RGP佩戴者的最平坦角膜测量值的增加高于非佩戴者(P=0.038)。形态学参数，包括前角膜曲率的对称指数（P=0.004）和前Baiocchi-Calossi-Versaci指数（P=0.047），RGP佩戴者低于非佩戴者。在瞳孔直径为3.0、5.0、6.0和7.0mm时，RGP佩戴者的垂直慧差小于非佩戴者，分别为(P<0.05)。与未佩戴者相比，RGP佩戴者的眼表疾病指数的环境触发域较差（P=0.003）。在最后一次随访中，KC进展的构成比没有显着差异，角膜厚度地形图,上皮厚度形貌，角膜地形图的形态参数，其他问卷评分两组间比较(均P>0.05)。
结论：长期使用RGP不会使KC恶化，但可能会导致角膜上皮重塑，从而增加角膜前表面的对称性，减少角膜垂直昏迷，提高视觉质量。然而,RGP佩戴会导致视力相关生活质量略有下降。眼表症状的发生主要与环境触发因素有关。
