The Clinical Effects Of Rigid Gas Permeable Contact Lens For Myopia Combined With High Astigmatism In Adolescents

ObjectiveIn order to investigate the clinical effects of RGPCL for myopia combined with high astigmatism in adolescents,a retrospective study was conducted.51 patients(96eyes)with myopia and high astigmatism(≥-2.50DC),who were first fitted with RGPCL at the Optometry Center of the First Affiliated Hospital of Chengdu Medical College and were able to regularly review for more than one year,aged 8-18 year,average age of 13.5 ± 3.2 year.40 patients(80 eyes)with myopia and high astigmatism(≥-2.50DC),who were first fitted with spectacles at the Optometry Center of the First Affiliated Hospital of Chengdu Medical College and were able to regularly review for more than one year,aged 8-18 year,average age 13.2 ± 3.5 year.Observed for 1 year,compared the two groups with the best corrected visual acuity,sphere diopter,axial length,cylinder diopter,the average radius of corneal curvature.And observed the corneal endothelial cell density,intraocular pressure,and corneal complications before and after wearing RGPCL.MethodsRGPCL group: From January 2014 to December 2016,51 patients(96 eyes)with myopia and high astigmatism(≥-2.50DC),who were first fitted with RGPCL at the Optometry Center of the First Affiliated Hospital of Chengdu Medical College and were able to regularly review for more than one year,aged 8-18 year,average age of 13.5 ±3.2 year.When entering the group,the sphere diopter was between-1.25 D ~-8.50 D,the average sphere diopter(-5.35 ± 2.58D),the cylinder diopter was between-2.50 DC ~-5.00 DC,and the average cylinder diopter(-3.22 ± 0.86 DC).Spectacles group: From January 2014 to December 2016,40 patients(80 eyes)with myopia and high astigmatism(≥-2.50DC),who were first fitted with spectacles at the Optometry Center of the First Affiliated Hospital of Chengdu Medical College and were able to regularly review for more than one year,aged 8-18 year,average age 13.2± 3.5 year.When entering the group,the sphere diopter was between-2.00 D ~-8.00 D,the average sphere diopter(-5.01 ± 2.21D),the cylinder diopter(-2.50 DC ~-4.75DC),and the average cylinder diopter(-3.26 ± 0.71DC).The RGPCL group was corrected with the same brand of rigid gas permeable contact lens,and the spectacles group was corrected with the same brand of single-focus resin spectacles.Observed for 1 year,compared the two groups with the best corrected visual acuity,sphere diopter,axial length,cylinder diopter,the average radius of corneal curvature.And observed the corneal endothelial cell density,intraocular pressure,and corneal complications before and after wearing RGPCL.All data were conducted by SPSS21.0 statistical software.The measurement data were expressed as x ± s.Using paired t test and independent sample t test for data analysis.Result1.In the RGPCL group,the average best corrected visual acuity was 0.86 ± 0.15,when first wearing.In the spectacles group,the average best corrected visual acuity was0.68 ± 0.17 when first wearing.One year later,the average best corrected visual acuity of the RGPCL group was 0.92 ± 0.14.The best corrected visual acuity of the spectacles group after wearing glasses for 1 year was 0.73 ± 0.15.Corrected visual acuity with RGPCL was better than spectacles.The BCVA improved most rapidly after wearing RGPCL for 1 week,and the corrected visual acuity remained stable after 1 week.2.In the RGPCL group,the average sphere diopter increased by 0.32 ± 0.24 D after one year.In the spectacles group,the average sphere diopter increased by 0.77±0.38 D after one year.The independent sample t test used for the average change of the sphere diopter in the two groups,t = 9.544,P = 0.000,less than 0.05,and the difference was statistically significant.3.In the RGPCL group,the axial length increased by 0.07 ± 0.02 mm after one year.In the spectacles group,the axial length increased by 0.16 ± 0.07 mm after one year.The independent sample t test was used for the average change of the axial length in the two groups,t = 12.028,P <0.05,the difference was statistically significant.4.In the RGPCL group,the average cylinder diopter was-3.22 ± 0.86 DC,one year later,the average cylinder diopter was-2.83 ± 0.89 DC.After paired t test,t = 3.008,P =0.002,the difference was statistical significance.There was no significant change in cylinder diopter before and after wearing in the spectacles group.5.In the RGPCL group,the average radius of corneal curvature was 7.72 ± 0.23 mm,one year later,the average radius of corneal curvature was 7.85 ± 0.24 mm.After paired t test,t = 3.646,P = 0.000,the difference was statistically significant.There was no significant change in the average radius of corneal curvature before and after wearing in the spectacles group.6.There was no significant changes in the corneal endothelial cell density and intraocular pressure in the RGPCL group before and after wearing,and the differences were not statistically significant(P> 0.05).7.There were 4 eyes of Grade I,2 eyes of Grade II and 1 eye of Grade III with the corneal epithelium injury in the RGPCL group,but all cured.Conclusion:The RGPCL has a definite curative effect on myopia combined with high astigmatism,can significantly and safely improve the corrected visual acuity,delay the increase of diopter and axial length.