配戴硬性透气接触镜时角膜的生理变化

So Hyeon Bae, Youngsub Eom
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摘要

硬性透气(RGP)隐形眼镜由透氧性和润湿性极佳的材料制成,因此与现有镜片相比,不仅透氧性得到改善,而且还能矫正屈光不正,改善不规则角膜(如角膜炎)的视力。然而,镜片的硬质材料以及佩戴 RGP 隐形眼镜造成的角膜缺氧和高碳酸血症会引起角膜的各种生理变化。配戴 RGP 隐形眼镜时角膜可能发生的生理变化包括:粘蛋白球、角膜上皮厚度减少和增大、上皮屏障功能降低、角膜糜烂和染色、角膜细胞密度降低、角膜敏感性降低和基质不透明、隐形眼镜引起的周边溃疡、内皮出血、内皮多毛症增加和角膜形状改变。有必要了解所配戴的 RGP 隐形眼镜的性能,了解配戴 RGP 隐形眼镜对角膜造成的生理变化,并为患者提供正确的镜片处方和适当的教育。
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Physiological Changes in the Cornea When Wearing Rigid Gas Permeable Contact Lenses
Rigid gas permeable (RGP) contact lenses are made of materials with excellent oxygen permeability and wettability, so they not only improve oxygen permeability compared to existing lenses, but also provide correction of refractive errors and improved vision in irregular corneas such as keratoconus. However, the hard material of the lens along with hypoxia and hypercapnia of the cornea caused by wearing RGP contact lenses cause various physiological changes in the cornea. Physiological changes in the cornea that may occur when wearing RGP contact lenses include mucin balls, decreased corneal epithelial thickness and increased size, decreased epithelial barrier function, corneal erosion and staining, decreased keratocyte density, decreased corneal sensitivity, and stromal opacities, contact lens‐induced peripheral ulcers, endothelial blebs, increased endothelial polymegethism, and changes in corneal shape. It is necessary to know the performance of the RGP contact lenses being prescribed, be aware of the physiological changes in the cornea caused by wearing RGP contact lenses, and provide the correct lens prescription along with appropriate education to the patient.
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