不同镜片材料的角膜屈光治疗，第2部分：透氧性对角膜形状和光学特性的影响。

Lu Fenghe, Simpson Trefford, Sorbara Luigina, Fonn Desmond

Centre for Contact Lens Research, School of Optometry, University of Waterloo, Canada [corrected]

Optom Vis Sci. 2007 Apr;84(4):349-56. doi: 10.1097/OPX.0b013e3180437e6e.

PURPOSE

To compare the effects of two different oxygen transmissible (Dk/t) lenses on corneal shape and optical performance after one night of corneal refractive therapy (CRT(R)) for myopia.

METHODS

Twenty myopic subjects were fit with Menicon Z (MZ) (Dk/t = 90.6, Paragon CRT(R) lenses) on one eye and an Equalens II (EII) CRT lens (Dk/t = 47.2) on the contralateral eye (eye randomized). Corneal topography, refractive error and aberrations were measured before lens insertion (baseline), and the following day after overnight lens wear, on lens removal and 1, 3, 6, 12 h later. Root mean square wavefront errors were measured using 4.5 mm pupils.

RESULTS

Averaged over position and time, the horizontal corneal curvature was statistically different between the MZ and EII lens-wearing eyes (p = 0.011). The central cornea flattened similarly (p = 0.886) and the mid-periphery steepened in both eyes (p = 0.061) from baseline. The EII lens-wearing eyes were steeper in the mid-periphery than the MZ eyes immediately after lens removal and at the 1-h visit (p < or = 0.032). Central corneal flattening and mid-peripheral corneal steepening regressed over time (all p < 0.001) but did not recover to baseline by 12 h (all p < 0.004). Myopia was reduced equally by 0.84 +/- 0.83 D for the MZ-lens wearing eyes and 0.84 +/- 0.87 D for the EII eyes (p = 0.969). Coma increased from baseline 1.85X (0.056 +/- 0.081 microm) for the MZ-lens wearing eyes and 1.72X (0.048 +/- 0.084 microm) for the EII eyes (both p < 0.001). Spherical aberration increased from baseline 4.55X (0.101 +/- 0.077 microm) for the MZ-lens wearing eyes and 4.31X (0.085 +/- 0.076 microm) for the EII eyes (both p < 0.001), but there were no differences between the MZ and EII eyes (all p > or = 0.308). Coma and spherical aberration did not return to baseline by 12 h (both p < or = 0.007).

CONCLUSIONS

After one night of CRT lens wear, changes in corneal shape were slightly different, with more mid-peripheral steepening in the EII eyes compared to the MZ eyes. Change in central corneal curvature and optical performance were similar in both eyes.

目的

比较两种不同透氧性（Dk/t）的镜片在进行一晚角膜屈光治疗（CRT®）后对近视患者角膜形态和光学性能的影响。

方法

20名近视受试者一只眼佩戴目立康Z（MZ）（Dk/t = 90.6，帕拉贡CRT®镜片），对侧眼佩戴Equalens II（EII）CRT镜片（Dk/t = 47.2）（眼睛随机分配）。在插入镜片前（基线）、佩戴镜片过夜后的次日、取出镜片时以及之后1、3、6、12小时测量角膜地形图、屈光不正和像差。使用4.5毫米瞳孔测量均方根波前误差。

结果

综合位置和时间来看，佩戴MZ和EII镜片的眼睛水平角膜曲率在统计学上存在差异（p = 0.011）。与基线相比，双眼中央角膜均同样变平（p = 0.886），中周边角膜均变陡（p = 0.061）。在取出镜片后即刻以及1小时检查时，佩戴EII镜片的眼睛中周边比佩戴MZ镜片的眼睛更陡（p≤0.032）。中央角膜变平和中周边角膜变陡随时间推移而消退（所有p < 0.001），但到12小时时未恢复到基线水平（所有p < 0.004）。佩戴MZ镜片的眼睛近视平均降低0.84±0.83 D，佩戴EII镜片的眼睛近视平均降低0.84±0.87 D（p = 0.969）。佩戴MZ镜片的眼睛彗差较基线增加1.85倍（0.056±0.081微米），佩戴EII镜片的眼睛彗差增加1.72倍（0.048±0.084微米）（两者p < 0.001）。佩戴MZ镜片的眼睛球差较基线增加4.55倍（0.101±0.077微米），佩戴EII镜片的眼睛球差增加4.31倍（0.085±0.076微米）（两者p < 0.001），但MZ和EII眼睛之间无差异（所有p≥0.308）。彗差和球差到12小时时未恢复到基线水平（两者p≤0.007）。