Yildiz Elvin, Toklu Meltem Tunca, Vural Ece Turan, Yenerel Nursal Melda, Bardak Handan, Kumral Esra Turkseven, Bardak Yavuz
Department of Ophthalmology (E.Y., M.T.T., E.T.V., N.M.Y., H.B., E.T.K., Y.B.), Ministry of Health, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.
Eye Contact Lens. 2018 Sep;44 Suppl 1:S50-S53. doi: 10.1097/ICL.0000000000000317.
To evaluate the accommodative response to different accommodative stimulus and to determine the changes in ocular higher-order aberrations with accommodation in keratoconus patients fitted with mini scleral lenses.
The study included 15 keratoconus patients wearing mini scleral lenses (Misa Scleral Lens-Microlens, Arnhem, the Netherlands) and 15 keratoconus patients wearing rigid gas permeable lenses. Hartmannn Shack aberrometer (IRX-3; Imagine Eyes, Orsay, France) was used for the evaluation of accommodation. Accommodative responses to the accommodative stimulus ranging from 0.5 to 5.0 diopters (D) with intervals of 0.5 D were recorded. Spherical, coma, trefoil aberration, and root mean square (RMS) of total higher-order aberrations (HOAs, third to sixth orders) at baseline, at 2.5 D stimulus, and at 5 D stimulus were also recorded.
Although accommodative response to accommodative stimulus of 0.5 to 2.5 D (with 0.5 D intervals) was similar in both groups, accommodative response to accommodative stimulus of 3.0 to 5.0 D was significantly lower in keratoconus group wearing mini scleral lenses. The coma, spherical, trefoil aberrations, and the RMS of total HOAs at baseline, at 2.5 D stimulus, and at 5 D stimulus were not significantly different between the groups. However, changes in the coma and trefoil aberrations and RMS of total HOA with 2.5 D and 5.0 D stimulus were significant only in the RGP group.
Accommodative response to increasing accommodative stimulus was found to be impaired in keratoconus patients wearing mini scleral lenses.
评估圆锥角膜患者佩戴迷你巩膜镜时对不同调节刺激的调节反应，并确定调节时眼高阶像差的变化。
本研究纳入15例佩戴迷你巩膜镜（荷兰阿纳姆的Misa巩膜镜 - 微透镜）的圆锥角膜患者和15例佩戴硬性透气性角膜接触镜的圆锥角膜患者。使用Hartmannn Shack像差仪（IRX - 3；法国奥赛的Imagine Eyes公司）评估调节功能。记录对0.5至5.0屈光度（D）、间隔为0.5 D的调节刺激的调节反应。还记录了基线、2.5 D刺激和5 D刺激时的球差、彗差、三叶草像差以及总高阶像差（HOAs，三阶至六阶）的均方根（RMS）。
尽管两组对0.5至2.5 D（间隔0.5 D）调节刺激的调节反应相似，但佩戴迷你巩膜镜的圆锥角膜组对3.0至5.0 D调节刺激的调节反应明显更低。两组在基线、2.5 D刺激和5 D刺激时的彗差、球差、三叶草像差以及总HOAs的RMS无显著差异。然而，仅在硬性透气性角膜接触镜组中，2.5 D和5.0 D刺激时彗差、三叶草像差以及总HOA的RMS变化显著。
发现佩戴迷你巩膜镜的圆锥角膜患者对增加的调节刺激的调节反应受损。
