CAJ | 학술논문

目的通过对角膜前表面波阵面的测量,研究配戴RGPCL及停戴之后角膜前表面的形态变化.方法临床观察.使用客观波阵面仪测量30人(60只眼)在配戴RGPCL之前及停戴之后的30 min及1、3、7、14 d后的角膜前表面像差,并进行各时间点的对照分析.对停戴后各时间点、各像差项及各组间进行方差分析、配对t检验.结果配戴RGPCL前、停戴后30 min及1、3、7、14 d时配戴者双眼角膜前表面7阶32项Zernike像差均方根值分别为1.438±0.328,1.076±0.355、1.362±0.402、1.373±0.398、1.387±0.415及1.448±0.423.其中停戴30 min时,2阶、3阶像差几乎全部改变(Z3、Z4、Z5、Z6、Z7、Z8),4阶中的四叶草(quadrafoil Z10)和球差(spherical Z12)2项改变,这些改变中除Z8、Z9、Z10增大外,其余均为减少.停戴后1 d相比配戴前,Z5、Z6减少,Z12比戴前有所增加(F=2.869～5.549,P=0.001～0.042).停戴后3 d,Z5、Z6依然比配戴前减少,而Z9和Z10又再次出现增加,Z12恢复到配戴前水平.停戴7 d后,只有Z6和Z9略有改变,其余均恢复至配戴前.停戴14 d时各阶像差与配戴前已无变化(F=0.018～1.876,P=0.154～0.650).结论配戴RGPCL能显著减少角膜前表面总像差,这种改变在停戴后30 min最为明显,随着停戴时间延长慢慢减少,低阶像差基本都在较短时间内恢复戴前水平,在恢复过程中可能会产生一过性的高阶像差,但所有改变均在停戴2周内停止.
목적 통과대각막전표면파진면적측량,연구배대RGPCL급정대지후각막전표면적형태변화.방법 림상관찰.사용객관파진면의측량30인(60지안)재배대RGPCL지전급정대지후적30 min급1、3、7、14 d후적각막전표면상차,병진행각시간점적대조분석.대정대후각시간점、각상차항급각조간진행방차분석、배대t검험.결과 배대RGPCL전、정대후30 min급1、3、7、14 d시배대자쌍안각막전표면7계32항Zernike상차균방근치분별위1.438±0.328,1.076±0.355、1.362±0.402、1.373±0.398、1.387±0.415급1.448±0.423.기중정대30 min시,2계、3계상차궤호전부개변(Z3、Z4、Z5、Z6、Z7、Z8),4계중적사협초(quadrafoil Z10)화구차(spherical Z12)2항개변,저사개변중제Z8、Z9、Z10증대외,기여균위감소.정대후1 d상비배대전,Z5、Z6감소,Z12비대전유소증가(F=2.869～5.549,P=0.001～0.042).정대후3 d,Z5、Z6의연비배대전감소,이Z9화Z10우재차출현증가,Z12회복도배대전수평.정대7 d후,지유Z6화Z9략유개변,기여균회복지배대전.정대14 d시각계상차여배대전이무변화(F=0.018～1.876,P=0.154～0.650).결론 배대RGPCL능현저감소각막전표면총상차,저충개변재정대후30 min최위명현,수착정대시간연장만만감소,저계상차기본도재교단시간내회복대전수평,재회복과정중가능회산생일과성적고계상차,단소유개변균재정대2주내정지.
Objective The present study used a corneal topographic device to record aberrations on the anterior surface of the cornea at different time-points prior to wearing and following discontinued use of rigid gas permeable (RGP) contact lenses. The effect of wearing RGPCL on the anterior surface of the cornea was discussed to provide guidance for clinical refractive error correction. Methods The study objects were 60 eyes from 30 patients. All patients underwent identical examination procedures prior to lens use, as well as afterwards, including slit-lamp examination, non-contact tonometer measurement, computer optometry & corneal curvature measurement, subjective refraction test, and corneal topography analysis. The patients wore contact lenses every day for 1 month and then discontinued. Corneal topographies were recorded at certain time points of 30 min, 1 day, 3 days, 1 week, and 2 weeks following use. Results Total corneal aberration at each time point following discontinued use of RGP contact lenses was less than the time point prior to use. Detailed results are as follows; root mean square (RMS) (pre) = (1.438 ±0.328), RMS (30 min) = (1.076 ± 0.355), RMS (1 day) = (1.362 ± 0.402) , RMS (3 day) =(1.373 ± 0.398), RMS (7 day) = (1.387 ± 0.415), and RMS (14 day) = (1.448 ± 0.423) .Results showed that at 30 minutes after discontinued use of RGP contact lenses, almost all 2nd-and 3rd-order aberrations were altered. Quadrafoil Z10 and spherical Z12 of the 4th-order were also changed. Alterations to Z5, Z6, and Z12 at 1 day after discontinued use were significant compared with the time period prior to RGP use: Z5 and Z6 decreased, and Z12 increased slightly( F =2. 869 ～5. 549 ,P =0. 001 ～0. 042). Z5 and Z6remained decreased at 3 days after discontinued use, but Z9 and Z10 continued to increase and Z12 returned to levels prior to RGP use ( P ＞ 0. 05 ). At 2 weeks after discontinued use, all aberrations were not significantly different from the values prior to use ( P ＞ 0. 05). Conclusions The use RGP contact lenses greatly reduced total aberration of the anterior surface of the cornea. Changes to 2nd- and 3rd-order aberrations ( including Z3, Z4, Z5, Z6, Z7, and Z8 ) were more significant. Following discontinued use of RGP contact lenses, the majority of lower order aberrations returned to original levels in a short period of time. During this process, a transient higher order aberration appeared, but all changes disappeared within 2 weeks after discontinued use of RGP contact lenses.