日戴和夜戴角膜塑形镜对波前像差的影响

目的观察采取日戴和夜戴两种方式配戴角膜塑形镜(Ortho-K CL)后人眼波前像差的变化。设计回顾性病例系列。研究对象配戴Ortho-K CL的近视患者92例(180眼)。方法92例(180眼)近视患者分别采用日戴(35例,70眼)和夜戴(57例,110眼)两种方式配戴Ortho-K CL。用WFA1000B主观波前像差仪分别测量患者戴镜前、戴镜1个月后戴镜中、摘镜后的波前像差。检查结果通过Matlab数学软件直接获取35项Zemike系数及每阶Zemike系数的均方根(RMS)值。主要指标每阶Zemike系数的RMS值。结果日戴组戴镜中的像差均高于戴镜前,除2阶像差之外,其余各阶像差比较差异均有统计学意义(P均<0.01);摘镜后的像差均高于戴镜前,总高阶、3、4阶的差异有统计学意义(P均<0.05);戴镜中与摘镜后像差的差异无统计学意义(P均>0.05)。夜戴组戴镜中的像差高于戴镜前,除2、3、6阶之外,其余各阶像差的差异均有统计学意义(P均<0.05);摘镜后的像差高于戴镜前,总体RMS、总高阶、3、4阶的差异有统计学意义(P均<0.05);戴镜中与摘镜后像差的差异无统计学意义(P均>0.05)。结论日戴和夜戴Ortho-K CL戴镜中和摘镜后均增加了眼部高阶像差。戴镜时日戴组增加的高阶像差比夜戴组更为明显,而摘镜后夜戴组增加的高阶像差比日戴组更为明显。(眼科,2007,16:351-354)

The effects of Ortho-K contact lens by day and overnight wear on wave-front aberrations

Objective To investigate the change of wave-front aberrations after Ortho-K contact lens(CL)by day and overnight wear.Design Retrospective case series.Participant 180 eyes of 92 myopic patients wearing Ortho-K CL.Method Wave-front aberra- tions of 180 eyes of 92 myopic patients wearing Ortho-K CL were analyzed.Patients were divided into by day wear and overnight wear groups.Wave-front aberrations were measured with WFA 1000B subjective aberrometer before and 1 month after Ortho-K CL wear. Wave-front aberrations at initial,after one month of CL fitting and without CL were measured in same condition,and RMS values for overall wave-front aberrations and each order of the Zernike aberrations were analyzed with Matlab software.Main Outcome Measures RMS value of Zernike coefficient of each order.Result Compared with initial aberration in wear by day group,total RMS and each or- der aberrations(except 2nd order)with lens fitting significantly increased(P<0.01);total higher order RMS,3rd and 4th order aberra- tions without lens fitting significant increased(P<0.05);there was no significantly difference between with lens fitting and without lens fitting(P>0.05).Compared with initial aberration in overnight wear group,overall wavefront aberrations and the RMS(except 2nd,3rd and 6th order Zernike aberrations)with lens fitting significantly increased(P<0.05);overall wave-front aberrations,total higher order RMS(RMS-2),3rd and 4th order aberrations without lens fitting significantly increased(P<0.05);there was no significant difference between with lens fitting and without lens fitting(P>0.05).Conclusion The high order aberrations with lens fitting and without lens fit- ting increased in each group.The aberration with lens fitting in wear by day group was higher than that in overnight wear group,while the aberration without lens fitting in overnight wear group was higher than that in wear by day group.(Ophthalmol CHN,2007,16: 351-354)