Objective To study the therapeutic effects of rigid gas permeable contact lenses ( RGPCL ) on the treatment of refractory errors in keratoconus .Methods This was a retrospective study .Thirty-two patients (62 eyes) with keratoconus were included .There were 24 males and 8 females, aged from 15 to 38 years old and averaged at 23.3 years. Subjects were divided into 4 groups according to the severity of keratoconus: phase I group ( n =22), corneal refraction was ≤48.00 D;phase II group ( n =15), corneal refraction ≤53.00 D, no corneal scar, and corneal thickness ≥400μm;phase III group ( n =13), cornealrefraction>53.00 D, the refractive error of myopia or astigmatism was up to -8. 00~-10.00 D, and the corneal thickness was thinned to 200~400μm, but no corneal scar;phase IV group ( n =12), corneal refraction was not measureable and there were corneal scars .Except 3 eyes in phase IV groupthat were waiting for-elective keratoplasty, other 59 eyes were prescribed with RGPCL, and best corrected visual acuity(BCVA) were compared for spectacles and RGPCL wearing using a paired t-test.The follow-up periods were between 3 and 24 months afterwards . Results (1) BCVA achieved with spectacles in phase I , II, III, and IV groups were 0.823 ±0.182, 0.468 ±0.248, 0.289 ±0.178, and 0.151 ±0.147, respectively.Accordingly, BCVA achieved with RGPCL were 0.955 ±0.106, 0.933 ±0.123, 0.831 ±0.197, and 0.678 ±0.277.Both spectacles and RGPCL BCVA generally deteriorated with the severity of keratoconus .BCVA achieved with RGPCL was significantly better than with spectacles at every disease phase .Paired t-test results in phase I, II, III, and IV were t =-3.321, P =0.003;t =-8.882, P =0.000;t =-7.408, P =0.000;and t =-8.262, P =0.000.2) BCVA achieved with RGPCL was significantly better than with spectacles in all 59 eyes as a whole group ( t =-10.218, P =0.000).3) There were 29 eyes (49.2%) prescribed with specially designed RG-PCL and 30 eyes (50.8%) prescribed with regular spherical or non-spherical RGPCL.4) No severe complicationssuch as corneal neovascularization or corneal ulcers were reported .There were 23% mild to moderate corneal staining , which oc-curred mainly in phase III and IV patients .Conclusion We demonstrated that RGPCL was effective in refractive correc-tion for keratoconus .Early treatment with RGPCL will result in better visual acuity outcomes .%目的：观察硬性透氧性隐形眼镜（ RGPCL ）矫治圆锥角膜的临床疗效。方法回顾性研究。32例（62只眼）圆锥角膜患者，男24例，女8例，年龄15～38岁，平均年龄23．25岁。 I期，角膜屈光度数≤48．00 D，共22只眼；Ⅱ期，角膜屈光度数≤53．00 D，未见角膜瘢痕，角膜厚度≥400μm，共15只眼；Ⅲ期，近视和/或散光度数-8．00～-10．00 D，角膜屈光度数＞53．00 D，未见中央部瘢痕，角膜厚度200～400μm，共13只眼；Ⅳ期，屈光度无法测量，角膜瘢痕，共12只眼。除Ⅳ期中有3只眼等待角膜移植外，余59只眼行框架眼镜、RGPCL验配，比较框架眼镜与RGPCL矫正视力的情况。复诊观察角膜情况，随访时间3～24个月。结果（1） I、Ⅱ、Ⅲ、Ⅳ期框架眼镜平均视力分别为0．823±0．182、0．468±0．248、0．289±0．178、0．151±0．147；I、Ⅱ、Ⅲ、Ⅳ期佩戴RGPCL后平均视力分别为0．955±0．106、0．933±0．123、0．831±0．197、0．678±0．277。 I、Ⅱ、Ⅲ、Ⅳ期随病变严重程度，框架眼镜矫正视力和佩戴RGPCL的矫正视力均下降。各期比较均为RGPCL矫正视力优于框架眼镜视力（ I、Ⅱ、Ⅲ、Ⅳ期分别比较框架眼镜和RGPCL的矫正视力行配对t检验：t ＝-3．321， P ＝0．003；t ＝-8．882， P ＝0．000；t ＝-7．408， P ＝0．000；t ＝-8．262， P ＝0．000）。（2）59只眼平均框架眼镜矫正视力为0．513±0．324，佩戴RGPCL的平均矫正视力为0．880±0．190，两者比较差别有统计学意义（ t ＝-10．218， P ＝0．000），佩戴RGPCL后视力明显优于框架眼镜视力。（3）佩戴特殊设计圆锥片有29只眼（占49．2％），其余30只眼佩戴球面或非球面RGPCL（占50．8％）。（4）随访时间内均未发现角膜缘新生血管、角膜溃疡严重并发症，角膜点状染色发生率为23％，Ⅲ、Ⅳ期患者多见。结论 RGPCL矫治圆锥角膜的临床疗效显著，早期治疗视力效果更佳。
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