渐进多焦镜治疗高AC/A调节性内斜视的研究

目的探讨一种新的非手术光学疗法——用渐进多焦镜治疗高AC/A调节性内斜视的效果。方法16例高AC/A调节性内斜视患儿,配戴渐进多焦镜,视远为全矫镜片,下加屈光度为+2．50～+3．00D,观察戴镜前后的视远、视近斜视度、AC/A值的变化。结果16例患儿戴镜前均存在高AC/A值,其中13例患儿戴镜治疗后AC/A值显著降低,戴镜前为7．29±1．60,最后复诊时为4．19±1．63,戴镜治疗前后AC/A值差异有统计学意义(t=5．909,P=0．000)：另3例患儿戴镜后AC/A值不降低,随诊过程中出现内斜视度加大,AC/A值为8．12±2．21,手术治疗后继续佩戴渐进多焦镜治疗,最后复诊时AC/A值为5．43±0．15。戴镜前16例患儿视远正位,视近内斜视15°～20°,戴镜治疗或联合手术治疗后最终视远、视近均正位。结论配戴渐进多焦镜能有效降低非屈光性调节性内斜视异常高的AC/A值,消除视近和视远时的斜视度差,从而达到眼位矫正目的。     

单眼LASIK矫正近视性屈光参差疗效分析

目的探讨单眼准分子激光原位角膜磨镶术（LASIK）治疗单眼近视所致屈光参差的效果。方法采用对单跟等效球镜度-2．50D以上的近视性屈光参差42例，进行单眼LASIK手术前后平均屈光度、屈光参差度数、最佳矫正视力和裸眼视力进行评价，术后随访6～12月。结果术前平均等值球镜度数为-4．66D（-2．50D--9．25D），术后减少至-0．62D（0～-1．70D），LASIK对平均等值球镜改变为-4．38D（-2．00D～-8．00D）。术前两眼平均屈光参差为-5．23D（-2．5D～-9．25D），术后减少至-0．50D（0～-1．25D）。术前术后BCVA（最佳矫正视力）范围均为0．6～1．0，平均最佳矫正视力从术前1．0提高到1．04；术后裸眼视力≥1．0者39跟，平均裸跟视力从术前的0．13术后提高至1．0。结论单眼LASIK治疗近视性届光参差不仅能提高患眼的最佳矫正视力和裸眼视力，解除单眼近视、散光所致的屈光参差对眼镜或角膜接触镜不能耐受的痛苦，而且对恢复双眼单视功能具有积极意义。     

LASIK与PRK治疗中低度近视的疗效比较

目的比较LASIK及PRK治疗中低度近视的疗效。方法LASIK手术152眼，等值球镜－2．00D～－6．00D平均－4．97±0．90D；PRK手术230眼，等值球镜－1．00D～6．00D，平均－4．11±1．03D。术后随访12月以上，比较两种方法的可预测性、有效性、安全性及稳定性。结果LASIK及PRK术后12月裸眼视力≥1．0者分别达95．4％及96．5％；屈光度在±1．00D以内的分别达94．7％及94．8％；各有1眼矫正视力较术前下降超过2行以上；各有2眼及13眼眼压较术前升高超过1．07kPa。结论LASIK术和PRK治疗中、低度近视的疗效基本一致。     

薄角膜中低度近视患者LASIK术后4年疗效观察

目的观察准分子激光原位角膜磨镶术（LASIK）治疗中央角膜厚度小于500μm中低度近视的安全性和远期疗效。方法选取2003年1至12月于我院接受LASIK手术的薄角膜中低度近视患者72例（136只眼），术前中央角膜厚度463～498μm（484．95±6．65）μm，术前等效球镜度-6．00～-1．50D（-3．74±1．27）D。检查术后4年的视力、屈光状态、Irreg值、角膜后表面Diff值和中央角膜厚度，并与术前及术后早期数据进行统计学对比和分析。结果术后4年均未发生继发进行性角膜扩张或医源性圆锥角膜，最佳矫正视力均无下降，平均等效球镜度为（-0．15±0．53）D，其中122只眼（89．7％）在-0．50～＋0．50D之间，屈光回退≥1．00D者8只眼（5．9％）；术后各阶段视力、等效球镜度、3mIrreg、5mIrreg以及中央角膜厚度差异无显著性（P〉0．05）；术后早期Diff值较术前明显增长（P〈0．05），但3个月后出现递减趋势。结论LASIK手术治疗薄角膜中低度近视具有良好的预测性和稳定的远期疗效。     

准分子激光角膜屈光手术治疗近视及近视散光的疗效观察

目的评价准分子激光角膜屈光手术治疗近视的疗效。方法采用准分子激光角膜切削仪和自动报层角膜刀对332例628只眼近视及散光患者行PRK或Lasik手术，术前球镜屈光度-1．00～－23．00D（-6．12±4．05D），柱镜屈光度0～－5．00D，角膜屈光力43．35±1．31，术后随访一年。结果术后1年裸眼视力≥0．8占90．76％，实际矫正屈光度与预测矫正度绝对值差在±1．50D范围内达91％，术后半年角膜屈光力38．14±2．63。结论该手术具有安全、准确、可预测性强、矫正近视范围大等优点，低中度近视可选PRK手术，高度近视尤为-8．00D以上者，应选择Lasik手术，强调长期观察的重要性。     

准分子激光上皮下角膜磨镶术治疗近视散光的临床效果

目的探讨准分子激光上皮下角膜磨镶术（LASEK）治疗复性近视散光的疗效。方法200例（400眼）行LASEK术，术前裸眼视力0．01～0．3，最佳矫正视力0．8～1．5。术前球镜度数-2．00～-11．00D，柱镜度数-0.75～-4．00D。随访3～12月。结果术后裸眼视力为0．8～1．5，术后328眼（82．00％）有轻度不适。术后20眼（5．00％）出现haze：0．5级16眼，1．0级2眼，2．0级2眼。结论LASEK兼具了PRK和LASIK的优点，无严重并发症，手术预测性好。     

飞秒激光制瓣LASIK术前预防性视网膜光凝

目的观察低、中、高度近视飞秒激光制瓣准分子激光原位角膜磨镶术（LASIK）术前周边视网膜变性和裂孔进行预防性光凝的效果。方法近视1000例（2000眼）,年龄18—50岁,屈光度-1．00～-13．00D,散光-0．50～-4．00D。术前按屈光度分组：组I,-1．00～-3．00D,350例（700眼）;组Ⅱ,-3．25～-6．00D,360例（720眼）;组Ⅲ,-6．25～-13．00D,290例（580眼）。LASIK术前常规散瞳行90D前置镜眼底检查。结果发现严重周边视网膜变性和裂孔100眼,其中组I20眼,组Ⅱ44眼,组Ⅲ36眼,多发生于颞侧。组Ⅱ和组Ⅲ发生率高于组I。对此100眼进行532nm激光预防性光凝。光凝术后1个月复查,变性和裂孔区激光封闭良好,色素斑形成,遂行飞秒激光制瓣LASIK。术后6个月-1年随访,未发现孔源性视网膜脱离。结论LASIK术前眼底检查,对明确有严重视网膜变性或有裂孔者预防性激光光凝是安全有效的,能够减少或避免术后视网膜脱离的发生,保障术后效果。     

高度轴性近视白内障术后屈光状态与生存质量的关系

目的分析术前戴镜和不戴镜高度轴性近视白内障患者术后屈光状态与生存质量的关系，探讨该群体术后适宜的屈先状态。方法研究对象来自2004年5月至2005年1月间，因高度轴性近视白内障在温州医学院眼视先医院行白内障超声乳化摘除合并人工晶状体植入手术的住院患者73例（102眼），眼轴〉26．00mm、屈光力〉-6．00D。所有手术均由同一资深医师完成。术后1个月随访患者，手术前后行常规裂隙灯检查，眼底检查，裸眼远视力、最佳矫正视力、近视力、屈光力、角膜曲率及生存质量（quality of life，QOL）调查。研究中的QOL问卷包含4个方面的内容：①视远功能相关的问题。②视近功能相关的问题。③平素生活、娱乐及社交活动的能力。④白内障相关的症状。将患者分为术前戴镜和不戴镜两组，根据术后1个月屈先状态分亚组，Ⅰ组：0．75-1．50D，Ⅱ组：-1．625- -2．875D，Ⅲ组：-3．00- -7．50D。结果术后患眼远视力、最佳矫正视力、近视力比术前均有显著性提高，差异均有显著性：术前戴镜者和不戴镜者在术后视近QOL提高方面差异有显著性，其他各方面差异均无显著性。术前戴镜者在视近QOL提高方面，Ⅰ组QOL增加率低于Ⅲ组．差异有显著性；不戴镜者中Ⅰ组QOL增加率明显低于Ⅱ组，差异有显著性。结论高度轴性近视白内障患者术前戴镜者术后保留-3．00D以上的近视为宜，而术前不戴镜者术后保留-1．625- -2．875D的屈光状态为宜：预留术后屈先度数时，需要综合考虑患者的生活习惯、职业、文化程度等因素。     

硬性透气性角膜接触镜、渐进多焦镜和单光眼镜对青少年近视进展的延缓作用比较

目的比较硬性透气性角膜接触镜（RGPCL）、渐进多焦镜、单光眼镜对青少年近视发展的延缓作用。方法青少年近视患者85例（170眼）,年龄9～14岁,屈光度-1．00～4．OHDD。将这些患者分为3组给予不同矫正方式：RGPCL组30例,散光均低于1／2球镜;渐进镜组30例,均为近距内隐斜伴调节滞后≥＋0．25D;单光镜对照组25例。3组患者基本资料的差异均无统计学意义．均要求每日配戴6h以上。戴镜前和戴镜后1年,对各组眼生物参数进行测量和比较。对屈光度、角膜曲率、眼轴长度、前房深度、晶状体厚度等变化值进行单因素方差分析。结果随访1年后．3组近视患者的等效屈光度均有增长的趋势,RGPCL组增长（-0．48±0．42）D,渐进镜组增长（-0．54±0.36）D,单光镜组增长（-0．93±0．53）D,3组之间差异有统计学意义（F=29．36,,P=0．01）,其中单光镜组屈光度增加最多。3组患者的眼轴均有增长,角膜曲率均有变平的趋势,前房深度均有增加,品状体厚度也有变薄的趋势,但各组间变化差异均无统计学意义。结论与单光框架眼镜比较,RGPCL有延缓近视进展的作用,渐进多焦镜能延缓近距内隐斜患者的近视增长,但两者均不能阻止近视进展。     

渐变多焦点视力镜防治青少年近视的初步观察

目的：探讨多焦点视力镜防治青少年近视的疗效。方法：6～23岁青少年近视1597例,屈光度由-1．00～-6．00D。分为治疗组876例和对照组721例。前组应用渐变多焦点视力镜进行治疗,对照组配戴普通树脂镜片。治疗组根据其年龄与屈光度细分为4小组。所有病例每月复诊1次,并以8mo后复诊结果作为统计数据。结果：治疗组876例中多数近视程度得到有效控制,与对照组721例结果有显性差异。其中近视未得到控制共计18例,占治疗组病例的2．1％。该18例中有6例近视进展超过-1．00D。结论：渐变多焦点视力镜对控制青少年中低度近视的发展有较好的效果。     

渐变多焦镜治疗青少年近视的短期观察

目的统计渐变多焦镜对治疗青少年近视的治疗效果并对青少年近视的处理进行讨论。方法本文观察1746例,年龄6～23岁,屈光度-1.00D～-6.00D,分为治疗组和对照组。前组应用渐变多焦镜进行治疗,对照组配戴普通树脂镜片。治疗组根据其年龄与屈光度又分为四小组。所有病例每月复诊1次,取1年后复诊结果作为统计数据。结果治疗组中近视未得到控制者共39例,占治疗组的3.8%。该39例中有8例近视进展超过-1.00D。治疗组其余病例近视程度皆得到有效控制,与对照组结果差异有显著性。结论渐变多焦镜在对青少年近视的治疗,尤其是中低度的病例,显示出良好的临床治疗效果。本组的观察结果初步显示,对控制与延缓青少年近视进展,使用渐变多焦镜是一种可行的治疗方案。     

Reduction of myopia from corneal refractive therapy.

PURPOSE.: The purpose of the study was to monitor the efficacy of corneal refractive therapy (CRT) lenses to reduce myopia over a 4-week period. Refractive error, keratometry, high and low contrast acuity, and subjective vision after 28 days of using CRT contact lenses were measured. METHODS.: Twenty-three myopes wore CRT HDS lenses, Dk = 100. The Nikon autokefractor/keratometer was used to measure the refractive error and keratometric changes. Visual acuity was measured using computerized high and low contrast charts and the subjects completed visual analog scales characterizing their vision on a daily basis. Measurements were performed at baseline (before lens insertion before sleep), immediately after lens removal the next morning and at 1, 3, 7, and 14 hours after eye opening. Measurements were made on the days following 1, 4, 10, and 28 nights of lens wear. After 72 hours of no lens wear, these parameters were again measured to assess corneal recovery. RESULTS.: The pretreatment manifest refraction (mean of OD and OS +/- standard deviation [SD]) was -2.72 DS +/- 1.06 and -0.55 DC +/- 0.40. Myopic spherical equivalent refractive error (+/- SD) decreased by 1.30 DS +/- 0.53 (range 0-3 D) immediately after lens removal on day 1 and by 2.59 DS +/- 0.77 by day 28 (range 1.25-3.88 D). The cylinder remained unchanged. Uncorrected visual acuity improved by 5 lines after one night and reached 0.00 LogMAR (6/6) by day 4. Visual acuity was maintained throughout the day by day 10. The day and time effect of the spherical equivalent change and the central corneal radius of curvature were statistically significant (p < 0.01) up to day 10 and remained the same until day 28. Central (autokeratometer) Ks flattened by 1.28 D +/- 1.35 after one night and 2.33 D +/- 1.30 by day 28. The subjective vision improved significantly from day 1 to day 28 (p < 0.01) and was maintained throughout the day from day 4 to day 28 (p < 0.01). All measures did not recover completely to baseline after 72 hours of no lens wear. CONCLUSIONS.: CRT lenses significantly reduced myopia, improved visual acuity and subjective vision, and flattened central corneal curvature. Maximal effect was achieved after 10 days and was maintained for the rest of the study period.     

Compensatory changes in eye growth and refraction induced by daily wear of soft contact lenses in young marmosets

Several studies have shown that growth of the primate eye responds in a compensatory direction to both positive and negative spectacle lenses--eyes grow more slowly and become hyperopic in response to positive lenses, and eyes grow more rapidly and become myopic in response to negative lenses. On the other hand, extended wear soft contact lenses, whether positively or negatively powered, induce hyperopia (Hung & Smith, 1996. Extended-wear, soft, contact lenses produce hyperopia in young monkeys. Optometry & Vision Science 73, 579-584.). We investigated whether responses in a compensatory direction occurred to soft contact lenses worn on a daily wear basis (8 h per day on an 8:16 h light:dark cycle). Ten infant marmosets (8-13 weeks of age) wore a soft contact lens, in one eye only, for 5-9 weeks. Lens powers used were zero (n = 2), +2 D (n = 1), +2 D followed after 5 weeks of lens wear by +4 D (n = 1) for 4 weeks, +4 D (n = 2), -2 D followed after 5 weeks of lens wear by -4 D (n = 2) for 4 weeks, -4 D (n = 2). At the end of the lens-wear period the positive lens-wearing eyes were more hyperopic relative to the fellow untreated eyes [mean +2.39 +/- 0.24 D (SE)] and the negative lens-wearing eyes were more myopic than the fellow untreated eyes [mean -2.48 +/- 0.91 D (SE)]. Fellow eyes were unaffected by lens wear [mean final refraction +0.45 +/- 0.09 D (SE)]. Plano lenses did not affect eye growth in either marmoset fitted with plano contact lenses.     

Evaluation of “high-cylinder” toric soft contact lenses

The purpose of this study was to evaluate lens performance, vision, and initial clinical success achievable with custom toric soft contact lenses fitted to patients with high amounts of astigmatism. Eleven subjects were fitted with high-water-content custom toric soft lenses for daily wear. Assessment/measurements of the lens-mark position on the eye, lens movement, visual acuity, wearing time, eye response to lens wear, and subjective evaluation of visual quality and stability were performed during the initial wearing/adaptation period. Nine subjects having an average of 3.16 D of astigmatism successfully wore the lenses on a full-time basis for 2 weeks of daily wear. The data indicated good visual acuity, but with great variability in subjective ratings of stability and quality of vision. Alignment of lenses on the eye was very good, ocular response was unremarkable, and seven of nine (78%) of the subjects elected to continue with lens wear after the initial 2 weeks of wear. The results suggest that high-cylinder toric hydrogels can provide reasonable vision and patient acceptance even while stability and overall quality of vision may be a challenge. Toric soft lenses in higher cylinder amounts, such as those utilized in this study, may be considered a reasonable vision correction option and one that can be provided in a straightforward and predictably successful manner in most cases.     

Myopia and contrast sensitivity function

PURPOSE: to measure the contrast sensitivity function of varying degrees of myopia with two types of optical correction (spectacle lens and contact lens). METHODS: One hundred and five myopic eyes and twenty-eight emmetropic eyes were collected. The myopic group included 105 eyes corrected with spectacle lenses and 71 eyes of them corrected with contact lenses, too; all had corrected vision acuity of 20/20 or better. The myopic eyes were divided into four groups: group 1 (-1D to -3D), low myopia; group 2 (-3.25D to -6D), medium myopia; group 3 (-6.25D to -12D), high myopia; and group 4 (> -12D), severe myopia. Spatial contrast sensitivity was measured using the OPTEC 2000 Contrast Sensitivity System. RESULTS: In groups 1 and 2, no statistically significant difference was found between myopes and emmetropes. In group 3, statistically significant loss of contrast sensitivity at higher spatial frequencies was found for myopic subjects corrected with spectacle lens, but not for myopes corrected with contact lens. In group 4, myopic subjects corrected with spectacle lenses showed significantly reduced contrast sensitivity function at all spatial frequencies; subjects corrected with contact lenses showed statistical sensitivity losses at 6, 12, 18 cycle/degree spatial frequencies. CONCLUSIONS: 1. We may suppose that low and medium myopes (groups 1 and 2), who showed normal contrast sensitivity functions, had no retinal dysfunction. 2. For high myopes, contact lens correction could reduce optical defocus and improve contrast sensitivity function in high spatial frequencies. 3. As retinal function disturbances occurred in severe myopes, the diminished contrast sensitivity was not fully compensated by contact lens correction. 4. Loss of contrast sensitivity might be interpreted as evidence for early retinal function disruption before retinal pathological events occur in severe myopes.     

An assessment of consecutively presenting orthokeratology patients in a Hong Kong based private practice

Purpose: The aim of this study was to collect objective, subjective and demographic data on consecutively presenting orthokeratology (ortho‐k) patients who attended for routine followup examination in a Hong Kong based private practice in May 2001. Method: Sixty‐nine patients who returned to the surveyed practice for follow‐up visits during the study period (May 2001) were interviewed and relevant data extracted from their files. Data collected included identification and estimation of the extent of complications encountered by ortho‐k patients and their satisfaction with the treatment. Results: Among the 61 patients who had been wearing ortho‐k lenses for at least one month, 50 patients were younger than 16 years old. Twelve children (24 per cent) had been reluctant to wear ortho‐k lenses before undergoing the treatment but, after commencement of lens wear, only one child was not very willing to wear the ortho‐k lenses. The mean pre‐ortho‐k spherical refractive error of these patients was ‐3.93 ± 2.30 D (OS only). Of the 59 patients who wore ortho‐k lenses for at least one month and who were on night therapy, 10 patients had to wear spectacles or contact lenses in the daytime due to significant residual myopia. There was no statistically significant correlation between post‐ortho‐k unaided visual acuity and pre‐ortho‐k refractive error (spherical, cylindrical or the equivalent sphere) in the 49 patients who did not need to wear any vision correction in the daytime. Of the 61 patients, four reported eye inflammation/infection during the treatment. All recovered their ocular health without any effect on their vision or corneal health. The incidence of corneal staining that required lens wear to be stopped appeared to increase with the duration of ortho‐k lens treatment. The incidence of staining was not related to refractive error, unaided visual acuity or the age of the subjects. The most common problem reported by the patients was lens binding and there were also reports of increased redness, itching, light sensitivity and secretion of mucus in the morning after opening their eyes. More than 50 per cent of the patients experienced some distance vision blur, which was worse towards the end of the day. For most patients, these problems occurred only occasionally. Higher pre‐ortho‐k spherical refractive error was related to poor near and distance vision and worse distance vision towards the end of the day. Conclusion: The majority of the patients interviewed were children who reported being ‘happy with the results of the treatment’. Night wear is the main wearing modality and in view of the increased risk of complications in overnight wear and the fact that a large number of the patients are children, the need for strict compliance with the practitioner's instructions for lens use and care cannot be overemphasised. With careful monitoring and good compliance, complications with overnight ortho‐k wear can be minimised. In view of the high incidence of lens binding, it is essential that patients and parents of young patients know the correct method to free a bound lens.     

Synergeyes versus soft toric lenses: vision-related quality of life.

PURPOSE: The purpose of this study is to contrast the clinical and vision-related quality of life outcomes between Synergeyes, a hybrid contact lens, and Bausch & Lomb Soflens 66 Toric contact lenses in a cross-over design. Also, to determine subject preference of one mode of lens wear over the other. METHODS: The Synergeyes lens has a central rigid gas permeable portion made of Paragon HDS100 material (paflufocon D) bonded to the nonionic hydrophilic skirt material of 27% water (PolyHEMA hem-iberfilcon A). The Soflens 66 Toric lens is made of a nonionic hydrophilic 66% water (alphafilcon A) material. Subjects age 18 years and older with spherical refractive error between -0.50 and -8.00 D and astigmatism correction of -0.75 to -3.50 D were randomly assigned to wear one mode of contact lens for 1 month then wear the alternate mode for 1 month. Follow-up visits were done at 1 and 4 weeks. Data gathered at these visits included high-contrast log MAR distance visual acuity, average wearing time, comfortable wearing time, over-refraction, and slit lamp observations for corneal edema, conjunctival hyperemia, and corneal staining. At each visit, subjects were asked to rate overall comfort, dryness, and comfortable wearing time. Subjects were asked to complete the NEI-RQL-42 questionnaire at the end of each lens wearing period. Upon completion of both lens wearing modes, subjects were asked to choose their preferred mode. RESULTS: Fifty subjects completed the study; 22 (44%) preferred the Synergeyes lenses, and 28 (56%) preferred the Soflens 66 Toric soft lenses. Measured visual acuity was significantly better with the Synergeyes lenses. Of the 13 attributes analyzed in the RQL-42, a statistically significant difference between the two modes was found in only one category, "symptoms." In that category, subjects indicated fewer symptoms when wearing soft lenses. The subjects' ratings also showed significantly more comfort while wearing the soft toric lenses. CONCLUSIONS: Bausch & Lomb Soflens 66 Toric lenses were more comfortable and were perceived to produce less symptoms of dryness, itchiness, and lens awareness than Synergeyes lenses. Synergeyes lenses gave better visual acuity than the soft toric lenses.     

青少年近视眼配戴RGPCL、Ortho—K及框架眼镜一年后调节滞后的差异

目的探讨青少年近视眼配戴硬性透气性角膜接触镜（rigid gas permeable contact lens,RGPCL）、角膜塑型镜（orthokeratology,Ortho—K,OK镜）及框架眼镜后调节滞后的差异。方法70名（70眼）9～14岁中低度青少年近视眼患儿,行医学验光、角膜曲率、角膜地形图检查后,根据检查结果、患儿及家长依从性等综合评估,对其中25名患儿选择配戴RGPCL,25名患儿配戴Ortho—K,其余20名患儿配戴框架眼镜。配戴期间每3个月复查1次,1年以后测定RGPCL组戴镜屈光度、Ortho—K组脱镜后的残余屈光度及框架眼镜组的屈光度．并使用开放视野型红外验光仪测量其在2～5D调节刺激下的调节反应．计算相对应的调节滞后和调节反应／刺激（AR／AS）斜率。对相关数据采用单因素方差分析的LSD检验。结果总共有57人完成测量。在2D调节刺激水平下,RGPCL、Ortho—K和框架眼镜组的调节滞后值间差异无统计学意义（P〉0．05）;在3D、4D、5D调节刺激水平下,3组问的调节滞后值差异均具有统计学意义（F=4．373,P〈0．05;F=5．833,P〈0．01;F=6．157,P〈0．01）,Ortho—K组的调节滞后值最小,RGPCL组次之,而框架眼镜组的调节滞后值最大。调节反应／刺激（AR／AS）斜率也呈现同样趋势,但3组间差异无统计学意义（P〉0．05）。结论配戴RGPCL和Ortho—K1年后,患儿在高调节需求时的调节滞后值明显低于框架眼镜组,其在延缓青少年近视进展中可以起到积极的作用。     

The Children's Overnight Orthokeratology Investigation (COOKI) pilot study.

PURPOSE: Innovations in contact lens materials and designs allow patients to wear contact lenses during sleep to flatten the cornea and temporarily to reduce myopic refractive error and improve unaided visual acuity. We conducted the Children's Overnight Orthokeratology Investigation (COOKI) pilot study, a case series, to describe the refractive error and visual changes, as well as the slitlamp observations associated with overnight orthokeratology in children, over a period of 6 months. METHODS: Twenty-nine 8- to 11-year-old children with myopia between -0.75 and -5.00 D and <-1.50 D corneal toricity were fitted with corneal refractive therapy contact lenses (Paragon Vision Sciences, Mesa, AZ). They were examined within 1 hour of awakening and about 6 hours later at 1 day, 1 week, 2 weeks, 1 month, 3 months, and 6 months after the first night of contact lens wear. At each visit, the logarithm of the minimum angle of resolution (logMAR) visual acuity, manifest refraction, slitlamp examination, and corneal topography were performed. RESULTS: Twenty-three subjects completed the 6-month study. Three subjects decided not to wear contact lenses, two did not achieve acceptable fits, and one moved from the area. At the 6-month afternoon visit, the mean +/- SD uncorrected high-contrast visual acuity was +0.08 +/- 0.15 logMAR (Snellen equivalent, 20/24), and the mean +/- SD spherical equivalent refraction was -0.16 +/- 0.66 D. The corneas of three-fifths of the subjects showed mild staining at the morning visit, and one-third of the patients showed mild corneal staining at the afternoon visit. The most common type of stain was central punctate staining. No subjects experienced lasting adverse visual effects from cornea-reshaping contact lens wear during the study period. CONCLUSIONS: Overnight cornea-reshaping contact lenses are efficacious for young myopic patients, and no children experienced a serious adverse event during the study.     

Protein accumulation on disposable extended wear lenses

We investigated protein accumulation on disposable extended wear contact lenses. Fifteen volunteers were fit with one low water content, non-ionic lens (Bausch & Lomb's SeeQuence) randomly assigned to one eye and a high water content ionic lens (Vistakon's Acuvue) assigned to the fellow eye. During the first 7 weeks of extended wear the lenses were removed weekly for sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) analysis of protein deposition, and replacement lenses were inserted. Four subjects completed additional test sessions of 1 minute, 15 minutes, 24 hours, and 1 week extended wear. Lysozyme accumulation, as measured by SDS-PAGE, increased with wearing times up to one week on all Acuvue lenses, but after 24 hours wear lysozyme accumulation did not increase on the SeeQuence lens. Proteins falling into the reported molecular weight ranges of albumin, PMFA, IgG, IgA (sec), lactoferrin and subunits of protein G were evident on all gels at 1 minute of wear, but these protein groups did not have a detectable increase in deposition after 24 hours wear for either the SeeQuence or the Acuvue lenses. In most cases, the protein accumulation evident from SDS-PAGE analysis was not observable by biomicroscopy using standard clinical methods. A few patients reported preference for the initial comfort and vision achieved by the Acuvue lens, but no preference was found after adaptation.