巩膜镜治疗严重眼表疾病的有效性和安全性

The efficacy and safety of scleral lenses in treating severe ocular surface disease

摘要

巩膜接触镜通常称为巩膜镜，是一种新型的大直径高透氧性硬性眼表接触镜，能够覆盖角膜、角膜缘及部分巩膜。与传统的角膜接触镜 (rigid gas permeable，RGP) 相比，巩膜镜具有广泛的适应症，能有效减轻疼痛和刺激、维持眼表湿润、促进角膜上皮修复、并延长药物作用时间。这些特性使其在治疗圆锥角膜、干眼症、角膜移植后散光、屈光不正、角膜退化或营养不良以及角膜外伤等眼表疾病方面展示出显著的临床疗效，解决了传统 RGP 难以克服的问题。本文主要对巩膜镜在眼表疾病治疗中的治疗原理、有效性、安全性以及临床治疗中的优势与局限进行了详细总结，旨在更全面地发挥其在临床上的治疗价值。

Abstract

Scleral contact lens, commonly called scleral lens, is a new type of large-diameter, highly oxygen-permeable, rigid ocular surface contact lens that can cover the cornea, limbus and part of the sclera. Compared to the traditional rigid gas permeable (RGP) corneal contact lens, the scleral lens has a wider range of indications and can effectively reduce pain and irritation. It also has advantages in maintaining ocular surface hydration, promoting corneal epithelial repair and prolonging drug action. These properties enable it to demonstrate significant clinical efficacy in the treatment of ocular surface diseases such as keratoconus, dry eye, post-keratoplasty astigmatism, refractive errors, corneal degeneration or dystrophy and corneal trauma. What's more, scleral lenses can solve problems that are difficult to overcome with traditional RGPs. This article mainly provides a detailed summary of the treatment principles, efficacy and safety of scleral lenses in the treatment of ocular surface diseases, as well as the advantages and limitations of clinical treatment, with the aim of giving full play to their clinical therapeutic value.

关键词

巩膜镜 / 眼表疾病 / 圆锥角膜 / 干眼症 / 角膜移植术后

Key words

Scleral lens / Eye surface diseases / Conus cornea / Dry eye disease / After corneal transplantation

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