Berntsen David A, Mitchell G Lynn, Barr Joseph T
The Ohio State University College of Optometry, Columbus, Ohio 43210, USA.
Optom Vis Sci. 2006 Jun;83(6):354-9. doi: 10.1097/01.opx.0000221401.33776.54.
The purpose of this study is to determine the effect of corneal refractive therapy (CRT) on refractive error-specific quality of life.
The National Eye Institute Refractive Error Quality of Life Instrument (NEI RQL-42) was administered to 20 myopic patients (mean spherical equivalent -3.11 D +/- 0.96 D) between the ages of 21 and 37 years both before and 1 month after being successfully fit with Paragon CRT lenses. High- and low-contrast best-corrected visual acuity (BCVA) and higher-order aberrations were also measured. Scores for the 13 NEI RQL-42 subscales were calculated and a Wilcoxon sign rank test was used to determine whether there was a significant change in each of the subscale scores. Post hoc power analyses were also performed.
Statistically significant changes were found in three of the 13 NEI RQL-42 subscales. Significant improvements in subscale score were found for the symptoms (mean +/- standard deviation, 10.18 +/- 10.57, p = 0.0007) and dependence on correction (43.13 +/- 27.42, p < 0.0001) subscales. A significant reduction was found in the glare subscale (-32.50 +/- 35.22, p = 0.001). No significant changes were found in the clarity of vision, expectations, near vision, far vision, diurnal fluctuations, activity limitations, worry, suboptimal correction, appearance, or satisfaction with correction subscales.
CRT may improve a patient's perception of their visual independence, decrease the amount of ocular symptoms they report, and increase symptoms of glare. A larger, well-controlled clinical trial is necessary to verify these results. An increase in patient-reported glare is likely the result of measured increases in higher-order aberrations after CRT, especially spherical aberration under mesopic and scotopic conditions.
本研究旨在确定角膜塑形术(CRT)对特定屈光不正生活质量的影响。
对20名年龄在21至37岁之间的近视患者(平均等效球镜度数为-3.11 D±0.96 D)在成功佩戴Paragon CRT镜片之前和之后1个月进行了美国国立眼科研究所屈光不正生活质量量表(NEI RQL-42)评估。还测量了高对比度和低对比度最佳矫正视力(BCVA)以及高阶像差。计算了NEI RQL-42的13个分量表的得分,并使用Wilcoxon符号秩检验来确定每个分量表得分是否有显著变化。还进行了事后功效分析。
在NEI RQL-42的13个分量表中,有3个发现了统计学上的显著变化。症状分量表(平均±标准差,10.18±10.57,p = 0.0007)和对矫正的依赖分量表(43.13±27.42,p < 0.0001)的得分有显著改善。眩光分量表有显著降低(-32.50±35.22,p = 0.001)。在视力清晰度、期望、近视力、远视力、昼夜波动、活动限制、担忧、矫正不足、外观或对矫正的满意度分量表中未发现显著变化。
CRT可能会改善患者对视觉独立性的感知,减少他们报告的眼部症状数量,并增加眩光症状。需要进行更大规模、严格控制的临床试验来验证这些结果。患者报告的眩光增加可能是CRT后测量到的高阶像差增加的结果,尤其是在中间视觉和暗视觉条件下的球差。