圆锥角膜患者使用眼镜和硬性透气性接触镜矫正后的最小分辨角对数视力和立体视锐度
LogMAR and Stereoacuity in Keratoconus Corrected with Spectacles and Rigid Gas-permeable Contact Lenses.
作者信息
Nilagiri Vinay Kumar, Metlapally Sangeetha, Kalaiselvan Parthasarathi, Schor Clifton M, Bharadwaj Shrikant R
机构信息
Bausch and Lomb School of Optometry, Brien Holden Institute of Optometry and Vision Sciences, LV Prasad Eye Institute, Hyderabad, Telangana, India.
Prof. Brien Holden Eye Research Centre, Hyderabad Eye Research Foundation, LV Prasad Eye Institute, Hyderabad, Telangana, India.
出版信息
Optom Vis Sci. 2018 Apr;95(4):391-398. doi: 10.1097/OPX.0000000000001205.
SIGNIFICANCE
This study showed an improvement in three-dimensional depth perception of subjects with bilateral and unilateral keratoconus with rigid gas-permeable (RGP) contact lens wear, relative to spectacles. This novel information will aid clinicians to consider RGP contact lenses as a management modality in keratoconic patients complaining of depth-related difficulties with their spectacles.
PURPOSE
The aim of this study was to systematically compare changes in logMAR acuity and stereoacuity from best-corrected spherocylindrical spectacles to RGP contact lenses in bilateral and unilateral keratoconus vis-à-vis age-matched control subjects.
METHODS
Monocular and binocular logMAR acuity and random-dot stereoacuity were determined in subjects with bilateral (n = 30; 18 to 24 years) and unilateral (n = 10; 18 to 24 years) keratoconus and 20 control subjects using standard psychophysical protocols.
RESULTS
Median (25th to 75th interquartile range) monocular (right eye) and binocular logMAR acuity and stereoacuity improved significantly from spectacles to RGP contact lenses in the bilateral keratoconus cohort (P < .001). Only monocular logMAR acuity of affected eye and stereoacuity improved from spectacles to RGP contact lenses in the unilateral keratoconus cohort (P < .001). There was no significant change in the binocular logMAR acuity from spectacles to RGP contact lenses in the unilateral keratoconus cohort. The magnitude of improvement in binocular logMAR acuity and stereoacuity was also greater for the bilateral compared with the unilateral keratoconus cohort. All outcome measures of cases with RGP contact lenses remained poorer than control subjects (P < .001).
CONCLUSIONS
Binocular resolution and stereoacuity improve from spectacles to RGP contact lenses in bilateral keratoconus, whereas only stereoacuity improves from spectacles to RGP contact lenses in unilateral keratoconus. The magnitude of improvement in visual performance is greater for the binocular compared with the unilateral keratoconus cohort.
意义
本研究表明，与佩戴眼镜相比，双侧和单侧圆锥角膜患者佩戴硬性透气性（RGP）隐形眼镜后三维深度感知能力有所改善。这一新颖信息将有助于临床医生将RGP隐形眼镜视为圆锥角膜患者的一种治疗方式，这些患者抱怨佩戴眼镜时存在与深度相关的困难。
目的
本研究的目的是系统比较双侧和单侧圆锥角膜患者相对于年龄匹配的对照受试者，从最佳矫正球柱镜眼镜转换为RGP隐形眼镜时，logMAR视力和立体视锐度的变化。
方法
使用标准心理物理学方案，对双侧圆锥角膜患者（n = 30；18至24岁）、单侧圆锥角膜患者（n = 10；18至24岁）和20名对照受试者进行单眼和双眼logMAR视力以及随机点立体视锐度测定。
结果
在双侧圆锥角膜队列中，从眼镜转换为RGP隐形眼镜后，单眼（右眼）和双眼logMAR视力以及立体视锐度的中位数（第25至75四分位数间距）显著改善（P <.001）。在单侧圆锥角膜队列中，仅患眼的单眼logMAR视力和立体视锐度从眼镜转换为RGP隐形眼镜后有所改善（P <.001）。在单侧圆锥角膜队列中，从眼镜转换为RGP隐形眼镜后，双眼logMAR视力无显著变化。与单侧圆锥角膜队列相比，双侧圆锥角膜队列中双眼logMAR视力和立体视锐度的改善幅度也更大。佩戴RGP隐形眼镜的病例的所有结果指标仍比对照受试者差（P <.001）。
结论
在双侧圆锥角膜中，从眼镜转换为RGP隐形眼镜后，双眼分辨率和立体视锐度得到改善，而在单侧圆锥角膜中，仅从眼镜转换为RGP隐形眼镜后立体视锐度得到改善。与单侧圆锥角膜队列相比，双眼视觉性能的改善幅度更大。
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