Shen Jie, Spors Frank, Tsang Dorcas, McNaughton Lance E, Egan Donald J
Western University of Health Sciences, College of Optometry, Pomona, CA, USA.
University of Pikeville, Kentucky College of Optometry, Pikeville, KY, USA.
Med Hypothesis Discov Innov Ophthalmol. 2018 Fall;7(3):112-118.
This study investigated in-vivo changes of peripheral refraction with commercially available single vision and multifocal soft contact lenses, utilizing different designs and various corrective power values. Starting at the fovea, wave-front aberrations were measured up to 30 nasal retinal eccentricity, in 10 increments, using a commercially available Shack-Hartmann aberrometer. Three different types of contact lenses were fitted in an adult subject's right eye: Acuvue Oasys Single Vision (ASV), Proclear Multifocal D with 2.50 diopters (D) add power (PMD), and ArtMost SoftOK (SOK). Each lens type was fitted in corrective power values of -2.00 D, -4.00 D, and -6.00 D. Refractive errors were computed in power vector notation: The spherical equivalent (M), the Cartesian Jackson-Cross-Cylinder (J), and the oblique Jackson Cross Cylinder (J) from measured second order Zernike terms. Acuvue Oasys Single Vision lenses produced a slight myopic shift at 30 retinal periphery (-0.32 D ± 0.05) without significant differences between the various lens power values. Proclear Multifocal D lenses did not create clinically significant myopic shifts of at least -0.25 D. All SOK lenses produced clinically significant relative myopic shifts at both 20 (-0.61 D ± 0.08) and 30 (-1.42 D ± 0.15) without significant differences between the various lens power values. For all lens types and power values, off-axis astigmatism J was increased peripherally and reached clinical significance beyond 20 retinal eccentricity. The increased amount of off-axis astigmatism J did not show a significant difference for the same type of lenses with different dioptric power. However, at 30 retinal eccentricity, SOK lenses produced significantly higher amounts of off-axis astigmatism J, compared with ASV and PMD lenses (SOK versus ASV versus PMD: -1.67 D ± 0.09, -0.81 D ± 0.07, and -0.72 D ± 0.15). Both ASV and SOK lenses showed no clinically significant differences in the amount of introduced astigmatic retinal image blur, with various lens power values. Proclear Multifocal D lenses showed a systematic increase of astigmatic retinal image blur with an increase of add power. At 30 retinal eccentricity, -6.00 D SOK lenses introduced 0.73 D astigmatic retinal image blur, while PMD and ASV lenses introduced 0.54 D and 0.37 D, respectively. In conclusion, relative peripheral refractions, measured in-vivo, were independent of the contact lenses central corrective power. The SOK contact lenses demonstrated a stronger capability in rendering relative peripheral myopic defocus into far periphery, compared to the other lens designs used in this study. This was accompanied by higher amounts of introduced astigmatic retinal image blur.
本研究利用不同设计和各种矫正屈光度值的市售单焦点和多焦点软性隐形眼镜，调查周边屈光的体内变化。从中央凹开始，使用市售的夏克-哈特曼像差仪，以10°增量测量直至鼻侧视网膜偏心度30°处的波前像差。在一名成年受试者的右眼佩戴三种不同类型的隐形眼镜：酷视氧盈单焦点（ASV）、具有2.50屈光度（D）附加屈光度的百视明多焦点D（PMD）和爱尔康舒视氧（SOK）。每种镜片类型均以-2.00 D、-4.00 D和-6.00 D的矫正屈光度值进行佩戴。屈光不正采用屈光力矢量表示法计算：根据测量的二阶泽尼克项得出球镜等效度（M）、笛卡尔杰克逊交叉柱镜（J）和斜向杰克逊交叉柱镜（J）。酷视氧盈单焦点镜片在视网膜周边30°处产生了轻微的近视偏移（-0.32 D±0.05），不同镜片屈光度值之间无显著差异。百视明多焦点D镜片未产生至少-0.25 D的具有临床意义的近视偏移。所有SOK镜片在20°（-0.61 D±0.08）和30°（-1.42 D±0.15）处均产生了具有临床意义的相对近视偏移，不同镜片屈光度值之间无显著差异。对于所有镜片类型和屈光度值，离轴散光J在周边增加，在视网膜偏心度超过20°时达到临床意义。相同类型不同屈光度的镜片，离轴散光J增加量无显著差异。然而，在视网膜偏心度30°处，与ASV和PMD镜片相比，SOK镜片产生的离轴散光J量显著更高（SOK与ASV与PMD：-1.67 D±0.09，-0.81 D±0.07，和-0.72 D±0.15）。ASV和SOK镜片在引入的散光视网膜图像模糊量方面，不同镜片屈光度值之间均无临床显著差异。百视明多焦点D镜片随着附加屈光度增加，散光视网膜图像模糊呈系统性增加。在视网膜偏心度30°处，-6.00 D的SOK镜片引入0.73 D的散光视网膜图像模糊，而PMD和ASV镜片分别引入0.54 D和0.37 D。总之，体内测量的相对周边屈光与隐形眼镜的中央矫正屈光度无关。与本研究中使用的其他镜片设计相比，SOK隐形眼镜在将相对周边近视性离焦转化为远周边方面表现出更强的能力。这伴随着更高的散光视网膜图像模糊引入量。
