软性角膜接触镜与透气性硬性角膜接触镜对像差的影响

目的 分析配戴软性角膜接触镜、透气性硬性角膜接触镜（rigid gas-permeable contact lens,RGP）患者波前像差及角膜地形图在配戴前后的变化,探讨角膜接触镜对人眼屈光系统成像质量的影响.设计前瞻性随机对照临床研究.研究对象近视眼患者41例（80眼）.方法 软镜组20例（40眼）配戴软性角膜接触镜,RGP组21例（40眼）配戴RGP镜片,患者治疗前后作角膜地形图及波前像差检查,随访观察12个月.主要指标观察配戴接触镜治疗前后角膜地形图及波前像差的变化.结果 软镜组患者治疗后角膜表面规则指数（surface regularityindex,SRI）及角膜表面非对称指数（surface asymne-tryindex,SAI）有所增加,而RGP组SRI及SAI轻度下降;戴镜条件下,两组的整体波前像差（软镜组：0.58;RGP组：0.91）均低于治疗前裸眼的整体波前像差（软镜组：0.71;RGP组：1.21）;配戴后裸眼条件下,RGP组整体像差低于治疗前,且以低阶像差下降为主,而软镜组整体像差高于治疗前,各阶像差呈均匀上升趋势.结论 良好配适状态下的角膜接触镜均可使像差减小,使患者获得优质的光学矫正.

Changes of wave-front aberration wearing soft contact lenses and rigid gas-permeable contact lenses

Objective To evaluate the changes of aberration and corneal topography induced by different contact lenses.Design Prospective,randomized,comparative clinical trial.Participants 41 patients(80 eyes) with myopia.Methods 41 new contact lenses wearers were followed up for 12 months,20 of them with soft contact lenses,the other 21 with rigid gas-permeable(RGP) contact lenses.Refraction,corneal topography and wave-front aberration were measured both before and 12 months after the treatment.Main Outcome Measures The root-meansquare(RMS) value of total and each orders wave-front aberrations was calculated.Results Surface asymmetry index(SAI) and surface regularity index(SRI) tended to increase in soft contact lenses group,but decreased in RGP lenses group.The mean RMS value of the aberrations of both groups decreased while wearing lenses,from 0.71 to 0.58 in soft contact lenses group,and from 1.21 to 0.91 in RGP group,respectively.Twelve months after the wearing lenses treatment,aberration under the condition of naked eye increased in soft contact lens group,whereas tended to decrease in RGP group.Further more,each orders of aberration equally increased in soft contact lens group;meanwhile only low orders reduced in RGP group.Conclusion The optic quality of eye can be improved either by wearing soft contact lens or RGP lens.