CAJ | 학술논문

目的比较特殊设计和常规球面设计硬性透气性角膜接触镜(rigid gas-permeable,RGP)应用于LASIK术后出现视觉症状患者的临床疗效.方法将近视行LASIK手术矫正后出现视觉症状患者18例(18只眼)随机等分成两组:A组(常规球面设计RGP配戴组),B组(特殊设计RGP配戴组),观察两组患者RGP的配适状态、配戴前后波前像差变化情况及主观视觉症状变化.结果特殊设计RGP组的动态与静态配适评估结果均明显优于常规球面设计RGP组.与配戴前相比,两组患者配戴RGP后高阶像差的均方根值均显著降低(P＜0.001),其中球差,彗差以及第3、4阶像差较戴镜前下降明显(P＜0.05). A组患者戴镜前后第5阶像差差异无统计学意义(P＞0.05);B组患者戴镜后第5阶像差显著下降(P＜0.001).两种RGP在降低高阶像差不同成分的作用上存在差异,常规球面设计RGP对于降低第4阶像差及总高阶像筹作用较大,均方根值分别下降(0.434±0.155)μm及(0.615±0.268)μm,而特殊设计RGP第5阶像差及球差下降作用明显,均方根值分别下降(0.185±0.028)μm及(0.753±0.313)μm,两种RGP降低第3阶像差和彗差的作用差异无显著性(P=0.083和P=0.269).两组患者配戴RGP后原有主观视觉症状均明显改善(P＜0.05),相对于A组患者而言,B组患者的眩光及单跟复视症状减轻程度更为显著(P=0.011和P=0.023).结论 RGP配戴可显著减小LASIK术后患眼高阶像差,进而达到改善成像质量,减轻视觉症状的日的.特殊设计RGP应用于LASIK术后患者更易达到理想配适状态,可以作为治疗LASIK术后患者视觉质量低下的一种有效手段.
목적 비교특수설계화상규구면설계경성투기성각막접촉경(rigid gas-permeable,RGP)응용우LASIK술후출현시각증상환자적림상료효.방법 장근시행LASIK수술교정후출현시각증상환자18례(18지안)수궤등분성량조:A조(상규구면설계RGP배대조),B조(특수설계RGP배대조),관찰량조환자RGP적배괄상태、배대전후파전상차변화정황급주관시각증상변화.결과 특수설계RGP조적동태여정태배괄평고결과균명현우우상규구면설계RGP조.여배대전상비,량조환자배대RGP후고계상차적균방근치균현저강저(P＜0.001),기중구차,혜차이급제3、4계상차교대경전하강명현(P＜0.05). A조환자대경전후제5계상차차이무통계학의의(P＞0.05);B조환자대경후제5계상차현저하강(P＜0.001).량충RGP재강저고계상차불동성분적작용상존재차이,상규구면설계RGP대우강저제4계상차급총고계상주작용교대,균방근치분별하강(0.434±0.155)μm급(0.615±0.268)μm,이특수설계RGP제5계상차급구차하강작용명현,균방근치분별하강(0.185±0.028)μm급(0.753±0.313)μm,량충RGP강저제3계상차화혜차적작용차이무현저성(P=0.083화P=0.269).량조환자배대RGP후원유주관시각증상균명현개선(P＜0.05),상대우A조환자이언,B조환자적현광급단근복시증상감경정도경위현저(P=0.011화P=0.023).결론 RGP배대가현저감소LASIK술후환안고계상차,진이체도개선성상질량,감경시각증상적일적.특수설계RGP응용우LASIK술후환자경역체도이상배괄상태,가이작위치료LASIK술후환자시각질량저하적일충유효수단.
Objective To compare the clinical efficacy of specially designed and conventional rigid gas-permeable (RGP) contact lens on myopic post-LASIK patients with vision symptoms.Methods Eighteen patients (18 eyes) with visual complaints after conventional LASIK surgery for correcting myopia were randomly divided into two groups,group A (conventional RGP were fitted into) and group B (specially designed RGP were fitted into),to evaluate the fit relationship with RGP.The variety of subjective vision symptoms and wavefront aberrations between with and without RGP were identified by using questionnaire and Zywave aberrometer.Results Specially designed RGP was significantly superior to conventional RGP whatever in dynamic and static RGP fitting and assessment.The root mean square (RMS) value of the total higher-order aberrations in patients with RGP was significantly decreased than that without RGP (P＜0.001),no matter it was group A and group B.Among them,the RMS values of spherical aberration,coma,the third and fourth order aberrations in patients with RGP were significantly smaller than that without RGP (P＜0.05).The RMS value oftbe fifth order aberrations was significantly decreased in patients of group B after RGP wear (P＜0.001),compared with the results that there was a slightly increase in patients of group A,even though it showed no statistical difference (P＝0.803).Conventional RGP was the better to decrease the fourth order aberrations and the total higher-order aberrations (RMS values decreased 0.434 ±0.155μ m and 0.615±0.268μ m,respectively),while specially designed RGP was superior in the field of reduction the RMS values of coma and the third order aberrations (RMS values decreased 0.185±0.028μm and 0.753±0.313μm,respectively).There was no difference between two types of RGP in decreasing RMS values of coma and the third order aberrations (P=0.083 and P=0.269).The vision symptoms that troubled the patients of both two groups obviously improved afcer RGP wear (P＜0.05).Compared with the conventional RGP,glare and monodiplopia were dramatically relief in the patients with specially designed RGP (P=0.011 and P=0.023).Conclusions Post-LASIK patients with RGP could significantly reduce higher-order aberrations,which lead to improvements in image quality and alleviation of vision symptoms.Specially designed RGP applied to post-LASIK patients could be more easily to get an ideal fit relationship than conventional RGP,and can be used as the effective treatment to those patients suffered from low vision quality after LASLK procedure.