METHODS: This was a prospective observational case series of patients of healed hydrops in keratoconus fitted with an MSL (Keracare, Acculens, Lakewood, CO) who were managed for acute hydrops medically or surgically at least 3 months prior. Uncorrected visual acuity, best spectacles-corrected visual acuity, best lens-corrected visual acuity, topographic indices, keratometric indices, contact lens parameters, and ocular aberrometric changes were evaluated. All patients were followed up for at least 3 months.
RESULTS: Eighteen eyes of 17 patients were included in the analysis. The mean post-hydrops topographic values of the eyes included flat keratometric value (K1) 64.93±10.88 (range 44.30-93.40) diopters (D), steep keratometric value (K2) 70.41±10.92 D (range 45.8-98.6 D), and Kmax of 79.53±17.73 D (range 50-130.2). The final mini-scleral lens\'s mean dioptric power was -8.56±3.96 D (range -18 to -4). Visual acuity significantly improved from post-hydrops resolution uncorrected visual acuity of 1.5±0.71 logMAR to 0.79±0.18 logMAR best spectacles-corrected visual acuity to 0.27±0.01 logMAR best lens-corrected visual acuity ( P -value <0.0001). Similarly, there was considerable improvement in corneal aberrometric values after wearing an MSL. At the 3-month follow-up, 15 patients (16 eyes) were compliant to contact lens use with a minimum of 6 to 8 hr daily while two patients (2 eyes) were poorly compliant.
CONCLUSIONS: A MSL is a valuable option for visual rehabilitation in keratoconus following the resolution of acute hydrops.
方法:这是一个前瞻性观察性病例系列,其患者患有患有MSL(Keracare,Acculens,莱克伍德,CO)至少在3个月前接受过医学或手术治疗的急性积液。未矫正视力,最佳眼镜矫正视力,最佳镜片矫正视力,地形指数,角化指数,隐形眼镜参数,并评估了眼像差的变化。所有患者均随访至少3个月。
结果:17例患者的18只眼纳入分析。眼睛的平均积水后形貌值包括平坦的角膜曲率值(K1)64.93±10.88(范围44.30-93.40)屈光度(D),陡峭的角膜曲率值(K2)70.41±10.92D(范围45.8-98.6D),Kmax为79.53±17.73D(范围50-130.2)。最终微型巩膜晶状体的平均屈光度为-8.56±3.96D(范围-18至-4)。视力从积液后分辨率未矫正视力1.5±0.71logMAR到0.79±0.18logMAR最佳眼镜矫正视力到0.27±0.01logMAR最佳镜片矫正视力显着提高(P值<0.0001)。同样,佩戴MSL后,角膜像差测量值有相当大的改善。在3个月的随访中,15名患者(16只眼)遵从接触镜使用,每天最少6至8小时,而两名患者(2只眼)依从性差。
结论:在急性水肿消退后,MSL是圆锥角膜视觉康复的一个有价值的选择。