关键词: 硬性透气性角膜接触镜, 角膜瘢痕, 视力, 角膜

Abstract: Objective To evaluate the clinical effect of rigid gas permeable (RGP) contact lens in correcting irregular astigmatism caused by different position and severity of traumatic corneal scar formation. Design Prospective case series. Participants 44 cases (44 eyes) of patients with traumatic corneal scar in Beijing Tongren Hospital with poor visual acuity corrected with framed glasses and without important fundus damage. Methods Patients wore RGP for at least 8 hours a day. All patients were examined including visual acuity, slit-lamp biomicroscopy, fundus photography, keratometry, and corneal topography. According to the position of corneal scar, the patients were divided into central cornea scar (26 eyes), peripheral cornea scar (16 eyes) and limbal corneal scar (2 eyes) three groups. According to the severity, the patients were divided into corneal nebula (11 eyes), corneal macula (24 eyes) and corneal leucoma (9 eyes) three groups. According to the status of lens, the patients were divided into phakic eyes (17 eyes), intraocular lens eyes (8 eyes) and aphakic eyes (19 eyes) three groups. There was no statistical difference in the astigmatism value of corneal topography among each group. Paired t-test was used for comparing the best corrected vision acuity (BCVA) before and after 6-month RGP therapy. Main Outcome Measures LogMAR BCVA. Results After wearing RGP for 6 months, the BCVA in the central, peripheral and limbal groups was (0.40±0.34), (0.21±0.28) and (0.18±0.04), respectively. The BCVA wearing RGP was compared with that of frame glasses, and the difference in central and peripheral groups was statistically significant (t=2.907, P=0.003; t=2.213, P=0.011; t=0.772, P=0.052). After wearing RGP for 6 months, the BCVA in the corneal nebula, pannus and leucoma groups was (0.18±0.22), (0.36±0.33) and (0.37±0.36), respectively. The BCVA wearing RGP was compared with that of frame glasses, and the difference in corneal pannus group was statistically significant（t=1.232, P=0.261; t=2.251, P=0.025; t=0.663, P=0.507). After wearing RGP for 6 months, the BCVA in phakic, intraocular lens and aphakic group was (0.28±0.36), (0.39±0.31) and (0.23±0.25), respectively. The BCVA wearing RGP was compared with that of frame glasses, and the difference in all three groups was statistically significant（t=2.021, P=0.022; t=2.718, P=0.009; t=2.059. P=0.017). Conclusion Compared with frame glasses correction, patients with central and peripheral traumatic corneal scar are more suitable to be corrected by RGP for good vision. Corneal pannus compared corneal nebula and leucoma is more suitable to be corrected by RGP for good vision. （Ophthalmol CHN, 2020, 29: 350-354）

Key words: rigid gas-permeable contact lenses, corneal scar, vision, cornea