中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2013年
2期
79-83
,共5页
近视%散光%视觉质量%角膜塑形镜%Toric设计
近視%散光%視覺質量%角膜塑形鏡%Toric設計
근시%산광%시각질량%각막소형경%Toric설계
Myopia%Corneal astigmatism%Visual quality%Orthokeratology%Toric design
目的 观察不同设计角膜塑形镜配戴后角膜散光的变化,以及对视觉质量的影响.方法 病例对照研究.分3组观察戴镜前后的角膜散光、角膜地形图、角膜波前像差(Pentacam)、视力以及视觉干扰症状.A组30眼,低度角膜散光戴常规设计角膜塑形镜,获良好配适状态；B组30眼,低度角膜散光戴常规设计角膜塑形镜,配适状态不良,有明显偏位；C组31眼,中高度角膜散光戴toric设计角膜塑形镜,配适状态尚好.采用SPSS 16.0进行统计学分析.结果 戴镜后角膜散光B组增加,A组及C组有降低.角膜地形图傅立叶转换,3组非对称性散光增加3 mm区分别为(-0.393±0.329)D,(-4.050±2.084)D和(-0.494±0.522)D,P均＜0.01;3组高阶性散光增加3 mm区分别为(-0.011±0.055)D(P＞0.05),(-0.635±0.441)D(P＜0.01)和(-0.055±0.082)D(P＜0.01).3组3 mm区规则性散光、非对称性及高阶散光的差值比较有统计学意义(F=79.862、83.882、54.265,P均＜0.01).3组总体像差和总高阶像差,戴镜后均有不同程度增高,以B组最明显.各像差的差值比较中,仅前球差有统计学意义(F=18.048,P＜0.01).患者摘镜后裸眼视力,A组中36.7％为1.2,50.0％为1.0,13.3％为0.8,均无明显视觉症状；B组中36.7％为1.0,46.7％为0.9～0.8,13.3％为0.6～0.5,3.3％为0.4,47％有虚影、重影、眩光等视觉干扰症状；C组中9.7％为1.2,51.6％为1.0,16.1％为0.9～0.8,22.6％为0.6,16％有视觉干扰症状.3组视力比较差异有统计学意义(x2=20.252,P＜O.01).结论 角膜塑形镜的设计和配适状态明显影响角膜散光与视觉质量,适宜的Toric设计镜片可有效改善中高度角膜散光眼的配适,提高降低近视与散光度的角膜塑形效果.
目的 觀察不同設計角膜塑形鏡配戴後角膜散光的變化,以及對視覺質量的影響.方法 病例對照研究.分3組觀察戴鏡前後的角膜散光、角膜地形圖、角膜波前像差(Pentacam)、視力以及視覺榦擾癥狀.A組30眼,低度角膜散光戴常規設計角膜塑形鏡,穫良好配適狀態；B組30眼,低度角膜散光戴常規設計角膜塑形鏡,配適狀態不良,有明顯偏位；C組31眼,中高度角膜散光戴toric設計角膜塑形鏡,配適狀態尚好.採用SPSS 16.0進行統計學分析.結果 戴鏡後角膜散光B組增加,A組及C組有降低.角膜地形圖傅立葉轉換,3組非對稱性散光增加3 mm區分彆為(-0.393±0.329)D,(-4.050±2.084)D和(-0.494±0.522)D,P均＜0.01;3組高階性散光增加3 mm區分彆為(-0.011±0.055)D(P＞0.05),(-0.635±0.441)D(P＜0.01)和(-0.055±0.082)D(P＜0.01).3組3 mm區規則性散光、非對稱性及高階散光的差值比較有統計學意義(F=79.862、83.882、54.265,P均＜0.01).3組總體像差和總高階像差,戴鏡後均有不同程度增高,以B組最明顯.各像差的差值比較中,僅前毬差有統計學意義(F=18.048,P＜0.01).患者摘鏡後裸眼視力,A組中36.7％為1.2,50.0％為1.0,13.3％為0.8,均無明顯視覺癥狀；B組中36.7％為1.0,46.7％為0.9～0.8,13.3％為0.6～0.5,3.3％為0.4,47％有虛影、重影、眩光等視覺榦擾癥狀；C組中9.7％為1.2,51.6％為1.0,16.1％為0.9～0.8,22.6％為0.6,16％有視覺榦擾癥狀.3組視力比較差異有統計學意義(x2=20.252,P＜O.01).結論 角膜塑形鏡的設計和配適狀態明顯影響角膜散光與視覺質量,適宜的Toric設計鏡片可有效改善中高度角膜散光眼的配適,提高降低近視與散光度的角膜塑形效果.
목적 관찰불동설계각막소형경배대후각막산광적변화,이급대시각질량적영향.방법 병례대조연구.분3조관찰대경전후적각막산광、각막지형도、각막파전상차(Pentacam)、시력이급시각간우증상.A조30안,저도각막산광대상규설계각막소형경,획량호배괄상태；B조30안,저도각막산광대상규설계각막소형경,배괄상태불량,유명현편위；C조31안,중고도각막산광대toric설계각막소형경,배괄상태상호.채용SPSS 16.0진행통계학분석.결과 대경후각막산광B조증가,A조급C조유강저.각막지형도부립협전환,3조비대칭성산광증가3 mm구분별위(-0.393±0.329)D,(-4.050±2.084)D화(-0.494±0.522)D,P균＜0.01;3조고계성산광증가3 mm구분별위(-0.011±0.055)D(P＞0.05),(-0.635±0.441)D(P＜0.01)화(-0.055±0.082)D(P＜0.01).3조3 mm구규칙성산광、비대칭성급고계산광적차치비교유통계학의의(F=79.862、83.882、54.265,P균＜0.01).3조총체상차화총고계상차,대경후균유불동정도증고,이B조최명현.각상차적차치비교중,부전구차유통계학의의(F=18.048,P＜0.01).환자적경후라안시력,A조중36.7％위1.2,50.0％위1.0,13.3％위0.8,균무명현시각증상；B조중36.7％위1.0,46.7％위0.9～0.8,13.3％위0.6～0.5,3.3％위0.4,47％유허영、중영、현광등시각간우증상；C조중9.7％위1.2,51.6％위1.0,16.1％위0.9～0.8,22.6％위0.6,16％유시각간우증상.3조시력비교차이유통계학의의(x2=20.252,P＜O.01).결론 각막소형경적설계화배괄상태명현영향각막산광여시각질량,괄의적Toric설계경편가유효개선중고도각막산광안적배괄,제고강저근시여산광도적각막소형효과.
Objective To observe the changes in corneal astigmatism after patients are fitted with different ortho-k contact lens (CL) designs and the influence of these lenses on visual quality.Methods In a case-control study,corneal astigmatism,corneal topography,wavefront aberrations (Pentacam),visual acuity and visual disturbance symptoms were observed in three groups (groups A,B,C) before and after CL wear.Group A (30 eyes) had lower corneal astigmatism and wore a general ortho-k contact lens design that fit quite well; group B (30 eyes) had lower corneal astigmatism and wore a general ortho-k contact lens design that did not fit well and was obviously decentered; group C (31 eyes) had higher corneal astigmatism and wore toric ortho-k contact lenses with an acceptable fit.SPSS 16.0 statistical software was used to analyze the data.Results Changes in corneal astigmatism after fitting with the ortho-k CL:astigmatism increased in group B but was lower in groups A and C.Fourier analysis from corneal topography:increases in asymmetry for all three groups at 3 mm were (-0.393±0.329)D,(-4.050±2.084)D,and (-0.494±0.522)D,respectively,all at P＜0.001.Higher order aberrations in the three groups increased at 3 mm and were (-0.011±0.055)D (P＞0.05),(-0.635±0.441)D (P＜0.001) and (-0.055±0.082)D (P＜0.01).The three groups at 3 mm regular:differences in the comparison of astigmatism,asymmetry and higher order aberrations were statistically significant,F=79.862,F=83.882,F=54.265,respectively,all at P＜0.01.After fitting with ortho-k CLs,the total aberrations and total higher order aberrations for the three groups increased in varying degrees,with group B as the most significant.A comparison of the difference in aberrations:only the anterior surface of the spherical aberration had a statistically significant difference (F=18.048,P＜0.01).After the CLs were removed:in group A 36.7 ％ achieved a UVA of 1.2,50.0％ achieved 1.0 and 13.3％ achieved 0.8; in group B 36.7％ achieved 1.0,46.7％achieved 0.9-0.8,13.3％ achieved 0.6-0.5,and 3.3％ achieved 0.4; in group C 9.7％ achieved 1.2,51.6％ achieved 1.0,16.1％ achieved 0.9～0.8 and 22.6％ achieved 0.6.There were statistically significant differences in UVA between the three groups (x2=20.252,P＜0.01).Patients reported a variety of visual disturbance symptoms such as ghost,fringe,glare,etc.In group A,0％ reported visual disturbance symptoms,with 16％ in group C and 47％ in group B.Conclusion Ortho-k contact lens design and fitting significantly impact corneal astigmatism and visual quality.Appropriate ortho-k CL toric designs can be highly effective for improving the CL fitting and enhancing the corneal reshaping effect for some higher order corneal astigmatisms.
