Pentacam眼前节分析系统在巩膜镜验配初始矢高选择中的应用.

doi:10.3760/cma.j.cn115909-20210913-00382

摘要
图/表
参考文献(28)
相关文章 (2)

全文: PDF 851KB HTML (1 KB)
输出: BibTeX | EndNote (RIS) 背景资料

文章导读

摘要

目的：评估Pentacam眼前节分析系统测量的眼前节生物学参数在巩膜镜（SL）验配初始镜片矢高（LSD）选择中的应用价值。方法：回顾性系列病例研究。选取2020 年10 月至2021 年6 月于南京医科大学附属眼科医院验配SL的角膜不规则散光或干眼患者32 例（53 眼）。所有患者均行SL验配前一般眼科检查，采用Pentacam采集角膜前表面平坦曲率（Kf）、陡峭曲率（Ks）、散光量、非球面参数Q值、中央角膜厚度（CCT）、角膜直径、前房深度（ACD）等数据。此外，采用Pentacam自带软件测量受检眼于13.50 mm弦长下的角膜矢高（CSH）。采用Pearson或Spearman相关以及线性回归分析各眼前节生物学参数与最终试戴评估修正后LSD的关系。结果：患者均完成初次SL试戴验配。Pentacam眼前节分析系统Scheimpflug images模式下所测量的13.50 mm弦长下CSH为（3 746±187）μm，试戴修正后LSD为（3 622±206）μm。相关分析结果显示：角膜前表面Kf、Ks、散光量、ACD及Pentacam测量的CSH与试戴修正后的LSD均呈正相关（r=0.36～0.84，均P<0.05）；CCT与试戴修正后LSD呈负相关（r=-0.35，P=0.011）；非球面参数Q值、角膜直径与试戴修正后LSD无相关性。将试戴修正后LSD作为因变量，校正相关因素后的线性回归方程显示Pentacam测量的CSH与试戴修正后LSD高度相关，即试戴修正后LSD=416.996+0.854×CSH（调整R2=0.63，F=89.17，P<0.001）。结论：Pentacam测量的部分眼前节生物学参数与SL试戴修正后的LSD相关，其中CSH可作为LSD选择的重要参考依据。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	徐珊珊
	胡艳
	齐艳
	等.

关键词 ：巩膜镜, Pentacam眼前节分析系统, 角膜矢高, 镜片矢高

Abstract：

Objective: To evaluate the value of using the Pentacam anterior segment analyzer to measure ocular

anterior segment parameters in the selection of initial lens sagittal depth (LSD) for scleral lenses (SL).

Methods: Retrospective serial case study. Thirty-two patients (53 eyes) with irregular corneal astigmatism

or dry eye disease were enrolled and fitted with SL in the Affiliated Eye Hospital of Nanjing Medical

University from October 2020 to June 2021. All patients underwent general ophthalmic examinations

before the initial SL fitting evaluation. Pentacam was used to obtain the ocular anterior segment parameters,

such as flat keratometry (Kf), steep keratometry (Ks), corneal astigmatism, aspheric factor (Q-value),

central corneal thickness (CCT), corneal diameter, and anterior chamber depth (ACD). In addition, the

built-in caliper of the Pentacam was used to measure corneal sagittal height (CSH) at a 13.50 mm chord

length. A Pearson or Spearman correlation analysis was used to evaluate the relationship between the

modified LSD and above-mentioned parameters measured by Pentacam, and a linear regression model

was created. Results: All patients completed the first SL fitting evaluation.The CSH measured in the

Scheimpflug images of the Pentacam were 3 746±187 μm under a 13.50 mm chord length, and the modified

LSD was 3 622±206 μm after fitting. The results of a correlation analysis showed that the modified LSD

was positively associated with Kf, Ks, corneal astigmatism, ACD and CSH (r ranged from 0.36 to 0.84, all

P<0.05). The modified LSD was negatively correlated with CCT (r=-0.35, P=0.011). However,there was

no correlation between the Q-value or corneal diameter and the modified LSD. Defining the modified LSD

as a dependent variable, the linear regression model showed that CSH measured by Pentacam was highly

correlated with the modified LSD after correcting for the other covariates. The linear regression equation

is LSD=416.996+0.854×CSH (adjusted R2=0.63, F=89.17, P<0.001). Conclusions: Some ocular anterior

segment parameters measured by Pentacamare correlated with the modified LSD, and CSH can be used as

an important reference for the selection of LSD inthe process of SL fitting.

Key words： scleral lenses Pentacam anterior segment analyzer corneal sagittal height lens sagittal depth

收稿日期: 2021-09-13

PACS:

基金资助:

通讯作者: 薛劲松（ORCID：0000-0001-5197-7784），Email：25068411@qq.com

引用本文:

徐珊珊, 胡艳, 齐艳, 等.. Pentacam眼前节分析系统在巩膜镜验配初始矢高选择中的应用.[J]. 中华眼视光学与视觉科学杂志, 2022, 24(2): 131-136. Shanshan Xu, Yan Hu, Yan Qi,et al. The Application of Pentacam Anterior Segment Analyzer in the Selection of Initial Sagittal Height in Scleral Lens Fitting. Chinese Journal of Optometry Ophthalmology and Visual science, 2022, 24(2): 131-136. DOI: 10.3760/cma.j.cn115909-20210913-00382

链接本文:

https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20210913-00382 或 https://www.cjoovs.com/CN/Y2022/V24/I2/131

[1]	Michaud L, Lipson M, Kramer E, et al. The official guide to scleral lens terminology. Cont Lens Anterior Eye, 2020, 43(6):
52	9-534. DOI: 10.1016/j.clae.2019.09.006.
[2]	Fadel D, Ezekiel DF. Fenestrated scleral lenses: back to the origins? review of their benefits and fitting techniques.Optom Vis Sci, 2020, 97(9): 807-820. DOI: 10.1097/OPX.0000000000001562.
[3]	La Porta WS, Becco D SR, Gomes J, et al. The use of the esclera scleral contact lens in the treatment of moderate to severe dry
	eye disease. Am J Ophthalmol, 2016, 163: 167-173. e1. DOI:10.1016/j.ajo.2015.11.034.
[4]	Scanzera AC, Ahmad A, Shorter E. Adjunct use of therapeutic scleral lens for exposure keratopathy after severe chemical burn. Case Rep Ophthalmol, 2021, 12(1): 243-247. DOI: 10.1159/000511223.
[5]	Kumar M, Shetty R, Lalgudi VG, et al. The effect of scleral lenses on vision, refraction and aberrations in post-LASIK ectasia, keratoconus and pellucid marginal degeneration.Ophthalmic Physiol Opt, 2021, 41(4): 664-672. DOI: 10.1111/opo.12802.
[6]	Sorbara L, Maram J, Fonn D, et al. Metrics of the normal cornea: anterior segment imaging with the Visante OCT. Clin Exp Optom, 2010, 93(3): 150-156. DOI: 10.1111/j.1444-0938.2010.00472.x.
[7]	Vincent SJ, Alonso-Caneiro D, Collins MJ. Optical coherence tomography and scleral contact lenses: clinical and research applications. Clin Exp Optom, 2019, 102(3): 224-241. DOI: 10.1111/cxo.12814.
[8]	Tom LM, Jacobs DS. Advances in anterior segment OCT for the design and fit of scleral lenses. Int Ophthalmol Clin, 2019,59(4): 31-40. DOI: 10.1097/IIO.0000000000000284.
[9]	Doctor K, Vunnava KP, Shroff R, et al. Simplifying and understanding various topographic indices for keratoconus using Scheimpflug based topographers. Indian J Ophthalmol, 2020,68(12): 2732-2743. DOI: 10.4103/ijo.IJO_2111_20.
[10]	Phu J, Tong J, Kalloniatis M. Intra-session repeatability of anterior chamber depth across the chamber width using Pentacam Scheimpflug imaging in healthy subjects. Ophthalmic Physiol Opt, 2021, 41(6): 1273-1284. DOI: 10.1111/opo.12880.
[11]	Ye Y, Zhao J, Niu L, et al. Long-term evaluation of anterior lens density after implantable collamer lens V4c implantation in
	patients with myopia over 40 years old. Br J Ophthalmol, 2021:1-6. DOI: 10.1136/bjophthalmol-2021-319205.
[12]	Rathi VM, Mandathara PS, Dumpati S, et al. Change in vault during scleral lens trials assessed with anterior segment optical
	coherence tomography. Cont Lens Anterior Eye, 2017, 40(3):157-161. DOI: 10.1016/j.clae.2017.03.008.
[13]	Pullum KW. Contact lenses. Oxford: Butterworth Heinemann,1997: 566-608.
[14]	van der Worp E, Bornman D, Ferreira DL, et al. Modern scleral contact lenses: a review. Cont Lens Anterior Eye, 2014, 37(4):
24	0-250. DOI: 10.1016/j.clae.2014.02.002.
[15]	Witsberger E, Schornack M. Scleral Lens Use in Neurotrophic Keratopathy: a review of current concepts and practice. Eye
	Contact Lens, 2021, 47(3): 144-148. DOI: 10.1097/ICL.0000000000000748.
[16]	Otchere H, Jones L, Sorbara L.The impact of scleral contact lens vault on visual acuity and comfort. eye contact lens, 2018,
44	(Suppl 2): S54-S59. DOI: 10.1097/ICL.0000000000000427.
[17]	Ritzmann M, Caroline PJ, Borret R, et al. An analysis of anterior scleral shape and its role in the design and fitting of scleral
	contact lenses. Cont Lens Anterior Eye, 2018, 41(2): 205-213.DOI: 10.1016/j.clae.2017.10.010.
[18]	曹建雄, 常平骏, 李瑾, 等. 基于Pentacam对角膜屈光指数的评价. 中华眼视光学与视觉科学杂志, 2020, 22(8): 596-601.DOI: 10.3760/cma.j.cn115909-20191205- 00326.
[19]	李鸿钰, 李军, 宋慧. 基于Pentacam的角膜后前表面曲率半径比值分布及其对角膜屈光力的影响. 眼科新进展, 2020,40(11): 1065-1069. DOI: 10.13389 /j.cnki.rao.2020.0238.
[20]	Weber SL, Ambrosio RJ, Lipener C, et al. The use of ocular anatomical measurements using a rotating Scheimpflug camera
	to assist in the Esclera (R) scleral contact lens fitting process.Cont Lens Anterior Eye, 2016, 39(2): 148-153. DOI: 10.1016/j.
	clae.2015.09.007.
[21]	Piñero DP, Martinez-Abad A, Soto-Negro R, et al. Differences in corneo-scleral topographic profile between healthy and keratoconus corneas. Cont Lens Anterior Eye, 2019, 42(1): 75-84. DOI: 10.1016/j.clae.2018.05.005.
[22]	Van Nuffel S, Consejo A, Koppen C, et al. The corneoscleral shape in keratoconus patients with and without specialty lens
	wear. Cont Lens Anterior Eye, 2021, 44(3): 101343. DOI: 10.1016/j.clae.2020.06.001.
[23]	Mas-Aixala E, Gispets J, Lupon N, et al. The variability of corneal and anterior segment parameters in keratoconus. Cont
	Lens Anterior Eye, 2016, 39(6): 466-470. DOI: 10.1016/j.clae.2016.05.003.
[24]	DeNaeyer G, Sanders DR, Michaud L, et al. Correlation of corneal and scleral topography in cases with ectasias and normal
	corneas: the SSG study. J Cont Lens Res Sci, 2019, 3(1): 10-20.DOI: 10.22374/jclrs.v3i1.33.
[25]	Kim S, Lee JS, Park YK, et al. Fitting miniscleral contact lenses in Korean patients with keratoconus. Clin Exp Optom, 2017,100(4): 375-379. DOI: 10.1111/cxo.12424.
[26]	Macedo-De-Araujo RJ, Amorim-De-Sousa A, Queiros A, et al. Relationship of placido corneal topography data with scleral lens fitting parameters. Cont Lens Anterior Eye, 2019, 42(1):20-27. DOI: 10.1016/j.clae.2018.07.005.
[27]	Compan V, Oliveira C, Aguilella-Arzo M, et al. Oxygen diffusion and edema with modern scleral rigid gas permeable contact lenses. Invest Ophthalmol Vis Sci, 2014, 55(10): 6421-6429. DOI: 10.1167/iovs.14-14038.
[28]	Barr JT, Wilson BS, Gordon MO, et al. Estimation of the incidence and factors predictive of corneal scarring in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK)Study. Cornea, 2006, 25(1): 16-25. DOI: 10.1097/01.ico.0000164831.87593.08.