初次配镜应如何指导软性隐形眼镜的处方开具？

How should initial fit inform soft contact lens prescribing.

作者信息

Boychev Nikolay, Laughton Deborah S, Bharwani Gulshan, Ghuman Hafsa, Wolffsohn James S

机构信息

Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, United Kingdom.

出版信息

Cont Lens Anterior Eye. 2016 Jun;39(3):227-33. doi: 10.1016/j.clae.2015.11.001. Epub 2015 Nov 19.

DOI:10.1016/j.clae.2015.11.001

PMID:26778151

Abstract

PURPOSE

To investigate how initial HEMA and silicone-hydrogel (SiHy) contact lens fit on insertion, which informs prescribing decisions, reflect end of day fit.

METHODS

Thirty participants (aged 22.9±4.9 years) were fitted contralaterally with HEMA and SiHy contact lenses. Corneal topography and tear break-up time were assessed pre-lens wear. Centration, lag, post-blink movement during up-gaze and push-up recovery speed were recorded after 5,10,20min and 8h of contact lens wear by a digital slit-lamp biomicroscope camera, along with reported comfort. Lens fit metrics were analysed using bespoke software.

RESULTS

Comfort and centration were similar with the HEMA and SiHy lenses (p>0.05), but comfort decreased with time (p<0.01) whereas centration remained stable (F=0.036, p=0.991). Movement-on-blink and lag were greater with the HEMA than the SiHy lens (p<0.01), but movement-on-blink decreased with time after insertion (F=22.423, p<0.001) whereas lag remained stable (F=1.967, p=0.129). Push-up recovery speed was similar with the HEMA and the SiHy lens 5-20min after insertion (p>0.05), but was slower with SiHy after 8h wear (p=0.016). Lens movement on blink and push-up recovery speed was predictive of the movement after 8h of wear after 10-20min SiHy wear, but after 5 to 20min of HEMA lens wear.

CONCLUSIONS

A HEMA or SiHy contact lens with poor movement on blink/push-up after at least 10min after insertion should be rejected.

摘要

目的

研究初次佩戴时水合甲基丙烯酸羟乙酯（HEMA）和硅水凝胶（SiHy）隐形眼镜的适配情况，这有助于配镜决策，并反映一天结束时的适配情况。

方法

30名参与者（年龄22.9±4.9岁）双侧分别佩戴HEMA和SiHy隐形眼镜。在佩戴镜片前评估角膜地形图和泪膜破裂时间。在佩戴隐形眼镜5、10、20分钟和8小时后，通过数字裂隙灯生物显微镜相机记录注视向上时的中心定位、滞后、眨眼后运动以及上推恢复速度，并记录舒适度。使用定制软件分析镜片适配指标。

结果

HEMA和SiHy镜片的舒适度和中心定位相似（p>0.05），但舒适度随时间下降（p<0.01），而中心定位保持稳定（F=0.036，p=0.991）。HEMA镜片眨眼时的运动和滞后比SiHy镜片更大（p<0.01），但插入后眨眼时的运动随时间减少（F=22.423，p<0.001），而滞后保持稳定（F=1.967，p=0.129）。插入后5-20分钟，HEMA和SiHy镜片的上推恢复速度相似（p>0.05），但佩戴8小时后SiHy镜片的上推恢复速度较慢（p=0.016）。在佩戴SiHy镜片10-20分钟后以及佩戴HEMA镜片5至20分钟后，眨眼时的镜片运动和上推恢复速度可预测佩戴8小时后的运动情况。