Kurna Sevda Aydin, Sengör Tomris, Un Murat, Aki Suat
Fatih Sultan Mehmet Education and Research Hospital, Ophthalmology Clinics, Istanbul, Turkey.
Clin Ophthalmol. 2010 Sep 7;4:959-66. doi: 10.2147/opth.s9464.
To evaluate success rates in the correction of astigmatism with toric and spherical soft contact lens fitting.
30 patients with soft toric lenses having more than 1.25 D of corneal astigmatism (25 eyes; Group A) or having 0.75-1.25 D of corneal astigmatism (22 eyes; Group B) and 30 patients with soft spheric lenses having 0.75-1.25 D of corneal astigmatism (28 eyes; Group C) or less than 0.75 D of corneal astigmatism (23 eyes; Group D) were included in the study. Corrected and uncorrected monocular visual acuity measurement with logMAR, biomicroscopic properties, autorefractometry and corneal topography were performed for all patients immediately before and at least 20 minutes after the application of contact lenses. Success of contact lens fitting was evaluated by three parameters: astigmatic neutralization, visual success, and retinal deviation.
After soft toric lens application, spheric dioptres, cylindric and keratometric astigmatism, and retinal deviation decreased significantly in Groups A and B (P < 0.05). In Group C, spheric dioptres and retinal deviation decreased (P < 0.05), while cylindric and keratometric astigmatism did not change significantly (P > 0.05). In Group D, spheric dioptres, retinal deviation, and cylindric astigmatism decreased (P < 0.05). Keratometric astigmatism did not change significantly (P > 0.05) and astigmatic neutralization even increased.
Visual acuity and residual spherical equivalent refraction remained between tolerable limits with the use of toric and spheric contact lenses. Spherical lenses failed to mask corneal toricity during topography, while toric lenses caused central neutralization and decrease in corneal cylinder in low and moderate astigmatic eyes.
评估使用复曲面和球面软性接触镜矫正散光的成功率。
纳入30例软性复曲面接触镜患者，其中角膜散光超过1.25 D的患者25眼（A组）或角膜散光为0.75 - 1.25 D的患者22眼（B组），以及30例软性球面接触镜患者，其中角膜散光为0.75 - 1.25 D的患者28眼（C组）或角膜散光小于0.75 D的患者23眼（D组）。在佩戴接触镜前及佩戴后至少20分钟，对所有患者进行logMAR矫正和未矫正单眼视力测量、生物显微镜检查、自动验光和角膜地形图检查。通过散光中和、视觉成功和视网膜偏差三个参数评估接触镜验配的成功率。
应用软性复曲面接触镜后，A组和B组的球镜度数、柱镜和角膜曲率计散光以及视网膜偏差均显著降低（P < 0.05）。C组球镜度数和视网膜偏差降低（P < 0.05），而柱镜和角膜曲率计散光无显著变化（P > 0.05）。D组球镜度数、视网膜偏差和柱镜散光降低（P < 0.05）。角膜曲率计散光无显著变化（P > 0.05），散光中和甚至增加。
使用复曲面和球面接触镜时，视力和残余球镜等效屈光度保持在可耐受范围内。在地形图检查中，球面镜未能掩盖角膜散光，而复曲面镜在低中度散光眼中导致中央中和和角膜柱镜度数降低。
