Hiraoka Takahiro, Okamoto Chikako, Ishii Yuko, Kakita Tetsuhiko, Okamoto Fumiki, Oshika Tetsuro
Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Invest Ophthalmol Vis Sci. 2008 Oct;49(10):4314-20. doi: 10.1167/iovs.07-1586. Epub 2008 May 23.
To investigate prospectively the time course of changes in ocular higher-order aberration and contrast sensitivity after overnight orthokeratology.
Data from 34 eyes of 17 patients who completed 1-year follow-up examinations were analyzed. The manifest refraction was -2.17 +/- 0.86 D at baseline. Ocular higher-order aberrations for a 4-mm pupil were measured, and the root-mean-square (RMS) of the third-, fourth-, and total higher-order aberrations were determined. Contrast sensitivity was assessed at four spatial frequencies, and the area under the log contrast sensitivity function (AULCSF) was calculated. These examinations were performed before and 1, 2, 3, 6, and 12 months after commencement of the procedure.
The treatment significantly increased third-, fourth-, and total higher-order RMS (all P < 0.0001, paired t-test). Log contrast sensitivity significantly decreased at all four spatial frequencies, and AULCSF was also significantly reduced after the treatment (P < 0.0001). To assess the time course of changes in these parameters, posttreatment data were analyzed by using repeated-measures analysis of variance. There were no significant fluctuations in manifest refraction; uncorrected visual acuity; third-, fourth-, and total higher-order RMS; and AULCSF (all P > 0.05). In addition, there was no significant variance in log contrast sensitivity at each spatial frequency during the 1-year follow-up period (all P > 0.05).
The initial reduction in optical quality of the eye and quality of vision after the procedure is stable during the treatment period of at least 1 year, and the reduction does not worsen further after 1 month. Orthokeratology candidates should be fully informed of these changes.
前瞻性研究夜间角膜塑形术后眼高阶像差和对比敏感度的变化时间进程。
分析了17例完成1年随访检查患者的34只眼的数据。基线时的明显屈光不正为-2.17±0.86D。测量4mm瞳孔的眼高阶像差，并确定三阶、四阶和总高阶像差的均方根（RMS）。在四个空间频率下评估对比敏感度，并计算对数对比敏感度函数下的面积（AULCSF）。这些检查在手术开始前以及术后1、2、3、6和12个月进行。
治疗显著增加了三阶、四阶和总高阶RMS（所有P<0.0001，配对t检验）。在所有四个空间频率下，对数对比敏感度均显著降低，治疗后AULCSF也显著降低（P<0.0001）。为了评估这些参数的变化时间进程，使用重复测量方差分析对治疗后的数据进行分析。明显屈光不正、未矫正视力、三阶、四阶和总高阶RMS以及AULCSF均无显著波动（所有P>0.05）。此外，在1年随访期间，每个空间频率下的对数对比敏感度均无显著差异（所有P>0.05）。
术后眼睛光学质量和视觉质量的初始下降在至少1年的治疗期内是稳定的，且1个月后下降不会进一步恶化。角膜塑形术的候选者应充分了解这些变化。
