新冠肺炎疫情期间角膜塑形镜眼轴控制效果观察

目的 探讨新冠肺炎疫情期间OK镜对眼轴控制的效果是否会受影响。方法 2022年1月至2023年1月配戴OK镜56眼、多焦点近视离焦框架眼镜38眼、普通单焦点框架眼镜23眼及2021年1月至2022年1月配戴OK镜23眼学生被纳入研究。比较各组眼轴1年内的变化值,采用独立样本t检验及单因素方差分析统计方法。结果 疫情期间配戴OK镜组学生眼轴年增长值最低0.152±0.116mm,其次是多焦点近视离焦框架眼镜组0.189±0.124mm,但两组之间无明显统计学差异(P=0.967),配戴普通单焦点框架眼镜眼轴增长最多0.451±0.156mm,与前两组之间差异均有统计学意义(P<0.01)。配戴OK镜学生眼轴增长与非疫情期间0.171±0.115mm相比眼轴增长值略减少,但差异无统计学意义(P=0.828)。结论 疫情期间OK镜对眼轴增长的控制效果没有受到影响。     

多焦点近视离焦眼镜对近视儿童对比敏感度的影响

目的 观察多焦点近视离焦眼镜(DIMS)对低中度近视儿童对比敏感度(CS)的影响.方法 收集低中度近视儿童患者87例(165眼),随访6个月,观察暗室无炫光环境下,戴普通单焦点框架眼镜(SFFG)、戴DIMS眼镜后3天、3个月和6个月对CS的影响,并进行统计学分析.结果 暗室无眩光环境下,配戴DIMS眼镜3天,3c/d...     

改良式多焦软性角膜接触镜矫正老视的视觉效果

目的：探讨改良式多焦点软性角膜接触镜（多焦软镜）和单光软性角膜接触镜（单焦软镜）联合验配方式矫正老视的视觉效果。方法：前瞻性研究。于2018 年1—12 月在温州医科大学附属眼视光医院招募20例老视观察对象（老视度数+1.00～+2.00 D）,分别按多焦法（双眼配戴多焦软镜）、单眼视法（一眼配戴远用单焦软镜,一眼配戴近用单焦软镜）和改良法（主视眼配戴单焦软镜,非主视眼配戴多焦软镜）3种方法验配角膜接触镜。每种方法配戴1周,间隔1周作为洗脱期,分析选用单光框架眼镜和3种接触镜矫正方法矫正下的观察对象双眼远、中、近距离100%及10%的双眼对比度视力（后文中视力均为双眼视力）,同时采用VFQ-25汉化版视觉质量量表评估视觉效果。通过单因素方差分析不同方法下视力的差异。结果：在远距视力对比中,多焦法视力低于单光框架眼镜（t=3.91,P=0.001）和改良法（t=2.94,P=0.008）。在50 cm处100%和10%对比度时,多焦法（100%：t=-4.76,P<0.001;10%：t=-4.22,P<0.001）、单眼视法（100%：t =-3.50,P=0.002;10%：t=-4.76,P<0.001）和改良法视力（100%：t=-4.22,P<0.001;10%：t=-3.90,P=0.001）均高于单光框架眼镜;在30 cm处100%和10%对比度时,多焦法（100%：t=-4.36,P<0.001;10%：t=-5.48,P<0.001）、单眼视法（100%：t =-7.43,P<0.001;10%：t =-4.03,P=0.001）和改良法（100%：t =-5.67,P<0.001;10%：t=-3.93,P=0.001）视力均高于单光框架眼镜。所有观察对象中有1 例认为单光框架眼镜最佳,7 例认为多焦法最佳,2 例认为单眼视法最佳,10 例认为改良法最佳。结论：联合多焦法和单眼视法的改良验配方法能很好地矫正老视,提供不弱于单眼视法和多焦法的视觉效果,更容易被老视患者接受。     

配戴球面与非球面设计硬性透气性角膜接触镜时全眼像差的比较

目的通过波前像差仪测量球面与非球面硬性透气性角膜接触镜（RGPCL）对全眼像差的影响。方法24例（48眼）近视患者,随机分成两组,每组12例,按照两阶段交叉设计：一组先配戴美康镜片（球面设计）,另一组先配戴美尼康镜片（非球面设计）,日戴1个月后测量戴镜时的全眼像差,之后停戴1个月,更换另一种镜片继续日戴1个月后再次测量戴镜时的像差。对配戴两种镜片时的像差值进行交叉设计的方差分析。结果配戴两种不同设计的镜片时,全眼总像差均方根（RMS）值分别为（0．439±0．183）μm和（0．42714）．190）μm,差异无统计学意义。配戴两种不同设计的镜片时,单项像差中离焦（F=56．175,P〈0．01）、垂直散光（F=4．263,P=0．029）和四叶草（F=3．410,P=0．037）的差异有统计学意义,其中配戴美尼康镜片的离焦数值高于美康,垂直散光、四叶草反之。其他各项像差值在两种镜片中差异无统计学意义。结论近视眼配戴球面及非球面设计的RGPCL时的像差值无显著差异,但非球面镜片形成的“偏负泪液镜”可造成更多的正性离焦,同时,非球面设计镜片相对球面镜片可更好地控制散光及某些高阶像差。     

角膜塑形镜和多区正向光学离焦眼镜及单焦框架眼镜的近视控制效果比较

目的：比较角膜塑形镜(OK镜)、多区正向光学离焦眼镜(DIMS)和单焦框架眼镜(SVS)对青少年近视的控制效果。方法：回顾性研究。选取2020-04/2021-03于宁波爱尔光明眼科医院就诊的近视患者111例221眼，根据近视矫正方式分为OK组(42例83眼)、DIMS组(30例60眼)和SVS组(39例78眼)。随访24mo，记录并分析所有患者戴镜前后眼轴和等效球镜度变化情况。结果：戴镜后6、12、18、24mo，三组患者眼轴均呈增长趋势，且SVS组患者眼轴增长量均高于OK组和DIMS组(P&#x0026;#x003C;0.01)。戴镜后24mo，角膜塑形镜的眼轴控制效果为59.7%，DIMS的眼轴控制效果为41.7%。戴镜后12、18、24mo，DIMS组和SVS组患者等效球镜度均呈增长趋势，且SVS组等效球镜度增长量均高于DIMS组(P&#x0026;#x003C;0.01)。戴镜后24mo，DIMS的近视度数控制效果为58.6%。结论：角膜塑形镜和DIMS对青少年近视的控制均有较好的临床效果，且角膜塑形镜的控制效果优于DIMS。     

三种光学矫正方式对少年儿童近视控制效果的临床观察

目的 比较少年儿童近视患者佩戴单焦点(SVL)镜片、多区正向光学离焦(DIMS)镜片及高度非球面微透(HAL)镜片12个月内等效球镜及眼轴长度变化，探讨三种光学矫正方式对少年儿童近视的控制效果。方法 回顾性病例对照研究。分析我院收集2019年8月至2021年12月儿童近视患者，分为三组，每组近视者40例(80只眼),分别为A组SVL镜片、B组DIMS镜片及C组HAL镜片，随访12个月分别记录三组患者戴镜3个月、6个月及12个月等效球镜及眼轴长度变化。结果 12个月内三组间等效球镜变化有显著性差异(F=64.475,P﹤0.01),A、B和C三组其等效球镜变化量分别为(-1.07±0.38)D、(-0.45±0.59)D和(-0.30±0.33)D;三组眼轴长度变化为(0.37±0.08)mm、(0.20±0.20)mm和(0.15±0.17)mm;三组间眼轴增长也有显著差异，(F=40.863,P﹤0.01),对于眼轴变化来说，B组及C组与A组相比，差异有显著性(P<0.01),C组与B组相比，差异也有统计学意义(P﹤0.05)。对于等效球镜变化量来说，B组及C组与A组相比，差异...     

配戴单焦点与多焦点硬性角膜接触镜近视患者视觉质量对比分析

目的　探讨多焦点设计的硬性角膜接触镜对近视患者视觉质量的影响。方法　选取川北医学院近视学生15例（30眼）,分别定制单焦点硬性角膜接触镜（SVRGP）与多焦点硬性角膜接触镜（MFRGP）。受试者先配戴SVRGP,停戴一周后配戴MFRGP,每种镜片配戴两周后分别进行视力、对比敏感度、波前像差、光学函数和散射检查,并完成主观视觉质量调查问卷。采用配对t检验比较受试者配戴两种镜片两周后视觉质量的差异。结果　配戴两种镜片后受试者最佳矫正视力差异无统计学意义（P=0.268)。在3 cpd、6 cpd、12 cpd空间频率下,配戴两种镜片后受试者对比敏感度差异均无统计学意义（均为P>0.05);在18 cpd空间频率下,配戴MFRGP后对比敏感度较配戴SVRGP后下降,差异有统计学意义（P=0.015）。配戴MFRGP后受试者角膜总高阶像差、球差、彗差、三叶草像差均较配戴SVRGP后增加,差异均有统计学意义（均为P<0.05）。配戴MFRGP后受试者客观散射指数较配戴SVRGP后增大,差异有统计学意义（P<0.001）;4 mm和6 mm瞳孔直径下,配戴两种镜片后受试者调制传递函数截止频率、斯特列尔比和3种模拟对比度视力（OV100%、OV20%、OV9%）差异均无统计学意义（均为P>0.05)。主观视觉质量问卷调查中,配戴两种镜片后受试者视觉清晰度、白天视力波动、近视力、远视力、对矫正视力的满意度5个项目评分差异均无统计学意义（均为P>0.05);配戴MFRGP后受试者眩光、症状2个项目评分较配戴SVRGP后下降,差异均有统计学意义（均为P<0.05）。结论　MFRGP可以为近视患者提供良好的矫正视力、对比敏感度和光学函数,但患者的高阶像差、散射和眩光有所增加。     

双眼植入Tecnis多焦点和单焦点球面人工晶状体的临床比较研究

目的 比较双眼植入Tecnis多焦点人工晶状体(IOL)与传统球面单焦点IOL对视觉功能的影响.方法 前瞻性临床研究.对100例(200只眼)患者实施超声乳化白内障吸除联合IOL植入术,采用随机数字表法随机植入前表面非球面和后表面衍射环的多焦点IOL(美国AMO公司Tecnis ZM900型;多焦点非球面组)与传统球面单焦点IOL(美国Bausch&Lomb公司Akreos Adapt型;单焦点球面组).随访3个月,检测两组IOL眼的5 m、1 m、63 cm、40 cm和30 cm各距离的裸眼视力和最佳远视力矫正下的近视力、调节幅度、全眼球差、对比敏感度、眩光敏感度以及近立体视锐度,并进行患者视功能和满意度问卷调查.对计量资料中两组数据进行正态性检验分析,满足正态分布的行t检验,不满足的行Mann-Whitney U检验,对计数资料行x2检验.结果 随访3个月后观察发现,30 cm和40cm距离多焦点非球面组的双眼远视力矫正下视力(logMAR视力)为0.24±0.12和0.22±0.11,明显优于单焦点球面组(Z=-8.261,P=0.000;Z=-5.508,P=0.000),其余各距离无明显差异;较之单焦点球面组,多焦点非球面组患者提高2.3～2.8 D的调节幅度(单眼Z=-10.655,P=0.000;双眼Z=-2.709,P=0.007);无论5 mm或3 mm瞳孔直径时多焦点非球面组的全眼球差[(0.027±0.160)μm,(0.006±0.083)μm]均小于单焦点球面组[(0.269±0.161)μm,(0.037±0.205)μm](Z=-8.815,P=0.000,Z=-2.791,P=0.005);两组的对比敏感度无明显差别,但单焦点球面组的眩光敏感度明显高于多焦点非球面组(P=0.0000);多焦点非球面组的裸眼近立体视锐度为(72.4±29.9)",优于单焦点球面组的(92.8±35.7)"(Z=-3.089,P=0.0002),近矫后近立体视锐度两组无统计学差异.结论 Tecnis多焦点非球面IOL较单焦点球面IOL可提供较好的近视力及调节幅度,提高近立体视锐度,非球面设计减少全眼球差,在一定程度上改善对比敏感度.     

学龄前儿童Titmus立体视检查图和颜氏第三代立体视检查图的适用性研究

目的 探讨Titmus立体视检查图和颜氏第三代立体视检查图对学龄前儿童的适用性。设计 横断面调查。研究对象 分层整群抽取北京市海淀区5所幼儿园3~6岁1021名儿童。方法 所有受试儿童进行视力、眼位、Titmus立体视和颜氏第三代立体视检查，能辨认立体盲图形或能明确说出立体盲图内无隐藏图形者认为检查成功。观察不同年龄儿童检查的成功率，比较不同年龄组儿童立体视锐度分布差异及两种立体视检查结果的差异。主要指标 立体视锐度。结果 3岁儿童Titmus检查成功率为91.2%，高于颜氏第三代检查的86.0%，随年龄增长两种检查方法的成功率逐步增高。在可以完成检查的正常儿童中，90%以上儿童能够达到的立体视锐度：Titmus检查3岁为100″，4岁为80″，5岁和6岁为60″；颜氏第三代立体视检查各年龄组均为60″。立体视锐度达到60″的百分比：Titmus检查随年龄逐步增加，4岁组高于3岁组（χ2=55.578，P=0.000）、5岁组高于4岁组（χ2=7.989，P=0.005）；颜氏第三代立体视检查各年龄组均在90%以上，在相邻两年龄组间均无统计学差异。两种立体视检查中心凹立体视比例的差异：3~6岁总体上有统计学差异（χ2=68.284，P=0.000），随着年龄增加两种方法的差异减小，5岁组（P=0.070）和6岁组（P=0.146）两种方法无统计学差异。结论 Titmus立体视检查图更适合于低龄儿童。学龄前儿童Titmus立体视检查图和颜氏第三代立体视检查图检查的正常参考值不同，5岁以上儿童两种检查方法正常参考值趋于一致。（眼科， 2020， 29： 339-343）     

OK镜治疗近视的并发症临床分析

目的：分析OK镜治疗近视的并发症,探讨其并发症产生的原因及处理措施,方法：对252例（483眼）近视进行过夜配戴OK镜治疗,回顾分析其并发症产生的原因,结果：OK镜治疗近视的并发症包括：角膜上皮损伤371眼（76．81％）,角膜溃疡7眼（1．45％）,角膜变性10眼（2．07％）,角膜知觉减退18眼（3．73％）,散光增加323眼（66．81％）,眩光122眼（25．26％）,结论：在OK镜治疗近视中,角膜上皮损伤,角膜缺氧,角膜温度升高,OK镜片的污染,镜片移位等可导致上述并发症的发生在OK镜治疗近视中,角膜上皮损伤,角膜缺氧,角膜温度升高,OK镜片的污染,镜片移位等可导致上述并发症的发生。     

角膜塑形镜、周边离焦眼镜、单光眼镜对儿童近视控制的一年效果

目的 评价角膜塑形镜、周边离焦眼镜、单光眼镜控制儿童近视进展的一年效果。设计 前瞻性非随机临床对照研究。研究对象 北京市眼科研究所、北京同仁验光配镜中心、北医眼视光远程视觉服务中心的近视儿童321例,其中141例（43.9%,141/321）完成一年随访。平均年龄（11.41±2.29）岁。方法 所有儿童配镜前进行视力、睫状肌麻痹后验光、裂隙灯、Lenstar眼生物参数测量及彩色眼底照相视盘旁萎缩弧分析。根据患者及监护人要求分别选择单光眼镜（single vision spectacle lenses, SV）、角膜塑形镜（orthokeratology, OK）、周边离焦眼镜（peripheral defocus spectacel lenses, PD）三种不同的矫正方式。观察三组间屈光度进展、眼轴增长及视盘旁萎缩弧扩大率的差异。主要指标 配镜前后屈光度、眼轴长度和视盘旁萎缩弧的改变。结果 完成一年随访者SV组47例、 OK镜组70例、PD组24例。平均等效球镜度（-2.89±1.34）D,平均眼轴长度（24.92±0.34）mm。最后随访时,3组儿童眼轴长度均增长,其中OK镜组增长（0.13±0.16）mm,明显低于其他两组（F=48.820,P<0.001）。SV组屈光度增长（-0.77±0.79）D,PD组屈光度增长（-0.94±0.47）D（t=1.080,P=0.283）。SV组、PD组、OK镜组视盘旁萎缩弧扩大率分别为66.7%、38.6%和15.0%（?字2=28.341,P<0.001）。结论 随访一年的结果表明,与单光眼镜、周边离焦眼镜相比,角膜塑形镜控制屈光度进展、眼轴增长、视盘旁萎缩弧扩大的效果最佳。（眼科,2016,25： 302-306）     

Efficacy and Safety of Aspherical Orthokeratology Lens for the Correction of Myopia

Objective: To evaluate the clinical efficacy and safety of the NOR aspherical orthokeratology lens for the correction of myopia. Methods: This was a prospective randomized controlled study. Subjects over 8 years of age with binocular myopia were randomly assigned to a study group or a control group. The study group wore a NOR aspherical orthokeratology lens, and the control group wore a Euclid orthokeratology lens (model: Night-wear). Follow-up was performed at 1 day, 1 week, 2 weeks, 1 month, 3 months, 6 months, 9 months, and 1 year after wearing the lenses. Uncorrected distance visual acuity, refractive error, keratometry value (K value), slit lamp examination results, lens condition, endothelial cell count, corneal thickness and intraocular pressure were recorded. Data analysis was performed using statistical methods such as an independent samples t test, Wilcoxon rank sum test, and Chi-square test. Results: A total of 291 subjects (143 subjects in the study group and 148 subjects in the control group) completed the initial wear. At each follow-up time after wearing the lenses, there were no statistically significant differences in the left and right eyes between the two groups (P>0.05) for visual acuity, refractive error or changes from baseline. There were no statistically significant differences in changes in the flat K value of both eyes or the steep K value of the right eyes (P>0.05). The differences in the changes in the steep K value of the left eye were not statistically significant except for 1 day and 9 months after wearing the lenses. There were no statistically significant differences in corneal thickness, endothelial cell count, intraocular pressure or their changes from baseline in the two groups (P>0.05) at 6-month and 1-year visits. At each follow-up time point, there were no serious complications in the two groups and there was no statistically significant difference in the incidence of complications between the two groups (P>0.05). At 1 year after wearing the lenses, the two groups of OK lenses were in good condition and were well fitted, and the comparison between the two groups showed no statistically significant difference (P>0.05). Conclusions: The NOR aspheric orthokeratology lens and the night-wearing orthokeratology lens are effective and safe for correcting myopia. The two orthokeratology lenses have the same efficacy and both have high security.     

非球面角膜塑形镜矫正近视的有效性和安全性

目的：评价非球面角膜塑形镜矫正近视的临床有效性和安全性。方法：前瞻性随机对照研究。选取年龄≥8岁的双眼近视患者,通过中央随机系统随机分配至试验组和对照组,试验组配戴NOR型非球面角膜塑形镜,对照组配戴欧几里德夜戴型角膜塑形镜。配戴后1 d、1周、2周、1个月、3个月、 6个月、9个月、1年进行随访,评估裸眼远视力、屈光度、角膜K值、裂隙灯显微镜检查结果、镜片情况、角膜内皮细胞计数、角膜厚度、眼压。采用独立样本t检验、Wilcoxon秩和检验、卡方检验等方法进行数据分析。结果：共291例受试者完成初次配戴,试验组143例,对照组148例。配戴后各随访时间点,2组左、右眼LogMAR裸眼远视力、屈光度及其相对于基线期变化值的差异均无统计学 意义（P>0.05）;2组左、右眼角膜平坦K值及右眼角膜陡峭K值相对于基线变化值差异均无统计学意 义（P>0.05）。除配戴后1 d、9个月以外,其余随访时间点,2组左眼角膜陡峭K值相对于基线变化值 差异均无统计学意义（P>0.05）。配戴后6个月、1年时,2组左、右眼角膜厚度、角膜内皮细胞计数、 眼压及其相对于基线期变化值的差异均无统计学意义（P>0.05）。各随访时间点,2组受试者均未出现严重并发症,并发症发生率的组间差异均无统计学意义（P>0.05）。配戴后1年时,2组角膜塑形镜 配适状态和镜片状态均良好且组间比较差异无统计学意义（P>0.05）。结论：NOR型非球面角膜塑形镜与夜戴型角膜塑形镜矫正近视的有效性和安全性良好,2种角膜塑形镜疗效一致且均具有较高的安全性。     

OK療法治療近视180例分析

目的 探讨过夜配戴角膜矫形镜(OK镜)对近视的治疗效果。方法 使用OK镜治疗近视患者180例358只眼,按近视程度分为低度、中度、高度近视,观察其治疗前及治疗後1天、1周、1个月、3个月及1年的视力、屈光度、角膜曲率及并发症情况。结果 100％病例治疗後视力迅速提高,但停止治疗後短时间内视力、近视度就回退到治疗前水平。治疗过程中可出现复视、角膜上皮损伤、视力波动等并发症。结论 OK镜治疗近视效果快、简便安全,但作用不持久,仅能暂时改变角膜曲率而降低近视程度。     

Glare and halo with refractive correction

Background: The aim of this investigation was to compare glare and halo with various methods of refractive correction. Methods: Ninety‐eight eyes of healthy pre‐presbyopes were analysed for the presence of glare and halo using computer‐generated stimuli. Subjects were divided into three groups: emmetropes without correction, single vision plastic lens spectacle wearers (with clean and dirty lenses) or single‐vision soft contact lens wearers. Results: No significant difference in glare was found among groups. Significant differences were noted in halos between emmetropes and both contact lens (p < 0.001) and uncleaned spectacle groups (p < 0.05) but not with cleaned spectacles. The reduction in halo size after cleaning the lenses was significant (p < 0.0187). Conclusions: Contact lens and unclean spectacle wearers both have significantly larger halos than emmetropes and those wearing cleaned spectacle lenses. Unclean spectacles may affect the accuracy of results in psychophysical and clinical testing.     

Benefit of coloured lenses for age-related macular degeneration

PURPOSE: To evaluate and compare the functional and perceived benefits of wearing coloured lenses by patients with age-related macular degeneration (ARMD). METHOD: Ten subjects with early ARMD and five elderly controls wore a selection of NoIR wrap-around coloured lenses (yellow 29.7% light transmission, orange 22.9%, red 16.8% and grey 10.3%), each for a duration of 7 days. Contrast sensitivity, colour vision, visual acuity, the effect of glare and peripheral sensitivity were measured for each lens and compared with a control (no lens) condition. Subjective ratings of visual performance were also scored. RESULTS: Compared with the no filter condition, red and grey lenses reduced contrast sensitivity whereas yellow and orange lenses increased contrast sensitivity. These objective changes were supported by subjective ratings in subjects with ARMD. Grey lenses reduced the loss of contrast sensitivity usually suffered in the presence of glare, whereas visual acuity and peripheral sensitivity decreased with red lenses. Colour vision became distorted with red lenses in control subjects, but was relatively unaffected by the use of coloured lenses in subjects with ARMD. CONCLUSIONS: The subjective benefit of coloured lenses appears to be due to a minor enhancement of contrast sensitivity.     

Visual performance of subjects wearing presbyopic contact lenses.

PURPOSE: The purpose of this study is to assess the visual performance of subjects wearing gas-permeable (GP) multifocal contact lenses, soft bifocal contact lenses, GP monovision lenses and spectacles. METHODS: The study included 32 subjects between the ages of 42 and 65 years wearing GP monovision, the Acuvue Bifocal (Vistakon), the Essentials GP Multifocal (Blanchard), and progressive addition lenses (PAL; spectacles group). There were eight subjects in each of these groups who were already wearing these modalities. Binocular low (18%) and high (95%) contrast acuities were recorded using the Bailey-Lovie chart; binocular contrast sensitivity from 1.5 to 18 cycles per degree (cpd) measured with the Vistech VCTS 6500 system, and monocular glare sensitivity at three luminance settings (400, 100, and 12 foot lamberts) was measured using the brightness acuity tester (BAT). Binocular near visual task performance (a modified version of letter counting method used in previous presbyopic studies) was also assessed. RESULTS: For the contact lens-wearing groups, subjects wearing GP multifocals provided the best binocular high and low contrast acuity followed by soft bifocal wearers. There was relative parity between the binocular high and low contrast acuity with PAL and GP multifocal wearers. Monovision acuity, measured binocularly, was determined to be lower than the other three groups with this difference being most significant with high contrast acuity. Among contact lens-wearing groups, it was observed that GP multifocal lens wearers experienced the lowest amount of monocular disability glare followed by soft bifocal wearers and monovision wearers. Subjects wearing soft bifocal lenses and monovision demonstrated slightly reduced binocular contrast sensitivity at all spatial frequencies. In the contact lens groups, GP multifocal lens wearers had the highest binocular contrast sensitivity at all spatial frequencies, on parity with PAL wearers, except at the highest spatial frequency (18 cpd) at which PAL wearers had better vision. Error scores for the binocular near visual task performance between the four groups revealed subjects with GP multifocal lenses and PAL wearers to have the least errors, followed by monovision users and then soft bifocal wearers with the most errors. CONCLUSION: Subjects wearing GP multifocals, soft bifocals, monovision, and PAL spectacles have good binocular contrast sensitivity, satisfactory binocular low and high contrast acuity, and increased sensitivity to glare. Presbyopic subjects requiring the use of contact lenses under dim light levels could benefit from GP multifocal lenses. Contrast and glare sensitivity evaluations provide significant information regarding the visual performance of the presbyopic contact lenses and should be included in regular presbyopic contact lens fitting.     

Visual performance of rigid gas permeable contact lenses in patients with corneal opacity.

PURPOSE: To evaluate the visual performance of rigid gas permeable (RGP) contact lenses in patients with nebular and nebulo-macular corneal opacity and correlate the improvement in visual acuity with other visual parameters. METHODS: In a prospective study, visual performance of RGP contact lenses was evaluated in eyes with corneal opacity involving the pupillary area. The baseline visual acuity and other visual parameters with glasses were compared with those recorded with RGP contact lenses. The visual functions evaluated were visual acuity, contrast sensitivity, glare acuity, and mesopic vision. Binocular status with RGP contact lenses was assessed. All patients were followed up for 3 months. RESULTS: Twenty-eight eyes (26 patients) with nebular or nebulo-macular corneal opacity were included in this study. All eyes (100%) achieved significantly better visual performance with RGP contact lenses than with glasses (P< 0.0020). Visual acuity of 6/9 or better was achieved in 50% of patients with RGP contact lenses compared to none with glasses. RGP contact lenses improved the visual acuity by 0.27 decimals over the baseline value with glasses, butthe improvement for mesopic vision and glare acuity was significantly lower at 0.15 and 0.06 decimals respectively. Similarly, contrast sensitivity did not improve to the same extent as visual acuity. Stereopsis was present only in patients with best corrected visual acuity of 6/9 or better with RGP lenses. CONCLUSION: RGP contact lenses improved the visual acuity and other visual performance in patients with reduced vision due to nebular or nebulo-macular corneal opacity. However, contrast sensitivity, glare acuity, and mesopic vision did not improve to the same extent as visual acuity.     

Role of short-wavelength filtering lenses in delaying myopia progression and amelioration of asthenopia in juveniles

AIM: To evaluate the positive effects of blue-violet light filtering lenses in delaying myopia and relieving asthenopia in juveniles. METHODS: Sixty ametropia juveniles (aged range, 11-15y) were randomized into two groups: the test group (30 children, 60 eyes), wearing blue-violet light filtering lenses; and the control group (30 children, 60 eyes), wearing ordinary aspherical lenses. Baseline refractive power of the affected eyes and axial length of the two groups was recorded. After 1-year, the patients underwent contrast sensitivity (glare and non-glare under bright and dark conditions), accommodation-related testing, asthenopia questionnaire assessment, and adverse reaction questionnaire assessment. RESULTS: After 1y of wearing the filtering lenses, changes in refractive power and axial length were not significantly different between the two groups (P>0.05). Under bright conditions, the contrast sensitivities at low and medium-frequency grating (vision angles of 6.3°, 4.0°, and 2.5°) with glare in the test group were significantly higher than in the control group (P<0.05), while the contrast sensitivity at low-frequency grating (vision angles of 6.3° and 4.0°) in the absence of glare in the test group was higher than in the control group (P<0.05). Under glare and non-glare dark conditions, the contrast sensitivities of various frequencies in the test group did not show significant differences compared with those in the control group (P>0.05). In the test group, the amplitude of accommodation, accommodative lag, and accommodative sensitivity of patients wearing glasses for 6 and 12mo were significantly elevated (P<0.05), while the asthenopia gratings were significantly decreased (P<0.05). Nevertheless, in the control group, the amplitude of accommodation, accommodative lag, and accommodative sensitivity after 12mo were not significantly altered compared with baseline (P>0.05), and the asthenopia grating was not significantly decreased (P>0.05). In addition, after wearing glasses for 6 to 12mo, the asthenopia grating of patients in the test group decreased significantly compared with the control group (P<0.05). At 12mo, the constituent ratio of adverse reactions did not show significant difference between the two groups (P>0.05). CONCLUSION: A 1-year follow-up reveal that compare with ordinary glasses, short-wavelength filtering lenses (blue/violet-light filters) increase the low- and medium-frequency contrast sensitivity under bright conditions and improved accommodation. They effectively relieved asthenopia without severe adverse reactions, suggesting potential for clinical application. However, no significant advantages in terms of refractive power or axial length progression were found compared with ordinary aspheric lenses.     

多焦点与单焦点非球面人工晶状体植入后视觉质量的临床观察

目的 评价多焦点非球面阶梯渐进衍射型人工晶状体(IOL)植入术后患者的视觉质量.方法 前瞻性非随机对照研究.2008年1月到2009年1月于首都医科大学附属北京同仁眼科中心诊断为双眼白内障的患者50例(100只眼)分别植入单焦点非球面AcrySof IQ(SN60WF)或多焦点非球面AcrySof IQ ReSTOR(SN6AD3)IOL.记录两组患者手术前后裸眼远、近及中间距离视力,矫正远、近距离视力.术后6个月,检测患者明视和暗视、有或无眩光状态的对比敏感度并在正常瞳孔下检测波阵面相差.视功能和生存质量调查问卷评价患者主观的视觉功能.术前、术后及组间计量资料采用配对样本t检验.计数资料采用x2检验.结果 术后两组裸眼远视力(t=1.018,P=0.265),最佳矫正近视力(t=0.679,P=0.501),等效球镜度数(t=0.233,P=0.876)差异无统计学意义,最佳矫正远视力单焦点组较好(t=2.388,P=0.021).裸眼近视力多焦点组明显优于单焦点组(t=11.311,P=0.000),未矫正中间距离视力多焦点组则低于单焦点组(t=2.414,P=0.020).术后,多焦点组较单焦点组的总像差(F=5.169,P=0.041),总低阶像差(F=4.973,P=0.036),总高阶像差高(F=4.640,P=0.048),两组间离焦(F=0.862,P=0.358)散光(F=3.893,P=0.052),彗差(F=2.724,P=0.105),球差(F=1.743,P=0.055),三叶草差(F=3.014,P=0.109)差异无统计学意义.两组术后最佳镜片矫正的远距离对比敏感度在暗视无眩光6 c/d频段差异有统计学意义(t=2.16,P=0.041).在暗视有眩光3 c/d(t=2.329,P=0.029)和6 c/d(t=2.087,P=0.048)频段差异有统计学意义.两组术后视远时脱镜率均大于96%.看近时多焦点组16%(4/25),单焦点组60%(15/25)戴镜.日常总戴镜频率单焦与多焦点组分别为64%(16/25)和24%(6/25).主要视觉干扰中复视、夜间视物困难和眩光多焦点组比例较高,近距视物模糊单焦点组较多.结论 与单焦点IOL比较,多焦点IOL可提供更宽的焦距范围,因此患者裸眼近视力较好,阅读脱镜率较高,具有较好的视觉功能,但对比敏感度有所下降.