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。

Comparative study on visual quality of single vision and multifocal rigid gas permeable contact lenses

Objective　To investigate the effect of multifocal rigid gas permeable contact lens on visual quality of myopic patients. Methods　Fifteen myopic students (30 eyes) from North Sichuan Medical College were selected, and custom-made single vision rigid gas permeable contact lenses (SVRGPCL) and multifocal rigid gas permeable contact lenses (MFRGPCL) were used. The subjects were fitted with SVRGPCL firstly and then with MFRGPCL after one week of discontinuation. Two weeks after each lens was fitted, they received visual acuity, contrast sensitivity, wavefront aberration, optical function and scatter examinations, and completed subjective visual quality questionnaires. A paired t-test was used to compare the differences in visual quality after wearing the two lenses 2 weeks later. Results　There were no significant differences in best corrected visual acuity between patients wearing the two lenses (P=0.268). There were no significant differences in contrast sensitivity between patients wearing the two lenses at 3 cpd, 6 cpd, and 12 cpd spatial frequencies (all P＞0.05); at 18 cpd spatial frequency, contrast sensitivity of MFRGPCL wearers decreased compared to SVRGPCL wearers, and the difference was statistically significant (P=0.015). The total higher-order aberration, spherical aberration, coma aberration, and trilobite aberration of the corneas in patients wearing MFRGPCL increased compared with those in patienes wearing SVRGP, with statistically significant differences (all P<0.05). The objective scatter index increased with MFRGPCL compared with SVRGPCL, and the difference was statistically significant (P<0.001); there were no significant differences in modulation transfer function cutoff frequency, Strehl’s ratio, and three simulated contrast visions (OV100%, OV20% and OV9%) between the patients with two lenses at 4 mm and 6 mm pupil diameters (all P＞0.05). In the subjective visual quality questionnaires, there were no significant differences in the scores of visual clarity, daytime visual acuity fluctuation, near vision, distance vision, and satisfaction with corrected vision between patients with the two lenses (all P>0.05); the scores of glare and symptoms decreased in patients wearing MFRGPCL compared with those in patients wearing SVRGPCL, and the differences were statistically significant (both P<0.05). Conclusion　MFRGP provides good corrected visual acuity, contrast sensitivity, and optical function, with increased higher-order aberrations, scatter, and glare.