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[角膜塑形术隐形眼镜矫正近视的光学特性(病例报告)]

[OPTIC PROPERTIES OF MYOPIC CORRECTION BY ORTHOKERATOLOGY CONTACT LENSES (A CASE REPORT)].

作者信息

Mýlková M, Pluháček F

出版信息

Cesk Slov Oftalmol. 2017 Spring;73(1):17-23.

Abstract

INTRODUCTION

Orthokeratology lenses present a special type of hard contact lenses, which is used especially for myopic correction. The lenses are applied during the night, when thanks to their special shape cause temporally (reversible) change of the cornea shape. During the day, there is not necessary to wear any other refractive correction. Due to the wearing regimen, there is, comparing to the classical contact lenses, higher risk of health complications. For their safe use, it is necessary to pay attention to the application of lenses of adequate parameters, follow up the care and hygiene precautions, regular controls and early treatment of possible problems. The application of contact lenses should be done by experienced and well-educated expert in contact lens fitting. In the Czech Republic, this method is practically not used.

AIM

The aim of the case report was to follow up the course of concrete application of orthokeratology lenses for myopic correction from the optic (refractive) point of view, and to evaluate the optic changes in the system of the eye. In the followed up subject, there were measured subjective changes in refraction, visual acuity, corneal curvature, corneal and whole eye aberrations, and corneal thickness during the period of one month after the beginning of lens application (initial phase). The same parameters were followed-up during one-month period since the termination of lens wearing for three months (second phase). The subject was a woman, 24 years old, myopic, with the refractive error in the right eye -3.0 spherical diopters and astigmatism of -0.25 cylinder in the axis 90°, and in the left eye -2.75 spherical diopters without astigmatism; without ophthalmologic or systemic diseases. The full correction of the refractive error after the orthokeratology lenses application occurred approximately after four nights (wearing the lenses overnight). Concurrently, during the day, slight recurrence to original values was evident. With the decreased refractive error, the uncorrected visual acuity improved accordingly. Further, the flattening of the central cornea was observed, e.g. increasing of the central cornea curvature diameter (maximum change was 0.22 mm in the right and 0.28 mm in the left eye) and slight thinning. The adverse accompanying optic phenomenon was increasing of the aberrations of higher orders, which presented subjectively by decreased visual acuity under mesopic conditions. One month after the termination of contact lenses wearing, all the followed-up parameters returned to original values.Key words: orthokeratology, orthokeratology contact lenses, myopic correction, hard contact lenses, rigid gas-permeable (RGP) lenses.

摘要

引言

角膜塑形镜是一种特殊类型的硬性隐形眼镜,特别用于近视矫正。这些镜片在夜间佩戴,由于其特殊形状会导致角膜形状发生暂时(可逆)变化。白天则无需佩戴任何其他屈光矫正器具。由于佩戴方式,与传统隐形眼镜相比,其出现健康并发症的风险更高。为安全使用,必须注意选择参数合适的镜片,遵循护理和卫生预防措施,定期检查并对可能出现的问题进行早期治疗。隐形眼镜的佩戴应由经验丰富且受过良好教育的隐形眼镜验配专家进行。在捷克共和国,这种方法实际上并未得到应用。

目的

本病例报告的目的是从光学(屈光)角度跟踪角膜塑形镜用于近视矫正的具体应用过程,并评估眼部系统的光学变化。在随访对象中,测量了镜片佩戴开始后一个月(初始阶段)内的主观屈光变化、视力、角膜曲率、角膜和全眼像差以及角膜厚度。在停止佩戴镜片三个月后的一个月内(第二阶段)对相同参数进行了随访。该对象为一名24岁女性,近视,右眼屈光不正为-3.00球镜度且在90°轴向上有-0.25柱镜度散光,左眼为-2.75球镜度无散光;无眼科或全身性疾病。角膜塑形镜佩戴后约四个晚上(夜间佩戴镜片)屈光不正得到完全矫正。同时,白天会明显出现轻微恢复到原始值的情况。随着屈光不正的降低,未矫正视力相应提高。此外,观察到中央角膜变平,例如中央角膜曲率直径增加(右眼最大变化为0.22mm,左眼为0.28mm)以及轻微变薄。伴随的不良光学现象是高阶像差增加,在中暗视觉条件下主观表现为视力下降。停止佩戴隐形眼镜一个月后,所有随访参数均恢复到原始值。

关键词

角膜塑形术;角膜塑形镜;近视矫正;硬性隐形眼镜;硬性透气性(RGP)镜片

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