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。

Analyzed the Visual Effect of an Improved Multifocal Contact Lens to Correct Presbyopia

Objective: To analyze the visual effect of an improved multifocal contact lens fitting method to correctpresbyopia. Methods: A prospective analysis was performed on 20 presbyopia participants (Add: +1.00 D-+2.00 D) who met the criteria from January to December 2018 in Eye Hospital, Wenzhou MedicalUniversity. Three methods for them to correct presbyopia, included multifocal method (both eyes wearingmultifocal soft lens), single visual method (one eye wearing single visual soft lens for distance, one eyewearing single visual soft lens for near) and improved multifocal method (single visual soft lens for thedominant eye, multifocal soft lens for the non-dominant eye). Each correction method would be used for1 week and there would be 1 week between each method to stop wearing the lens as the washout period.Analyzed the binocular correct vision of these 20 participants among these 3 correct methods, and useVFQ-25 Chinese version of the visual quality table to evaluate the visual effect for these 3 correct methods.ANOVA was used to analysis the difference of binocular correct vision among these correct methods.Results: The binocular correct vision of multifocal method was statistical lower than the single visualspectacle (t=3.91, P=0.001) and improved multifocal method (t=2.94, P=0.008) of distance correct vision.Different contrast of binocular correct vision at 50 cm of these three 3 correct methods were all higherthan single visual spectacle, included the same binocular correct of multifocal method (100%: t=-4.76,P<0.001; 10%: t=-4.22, P<0.001), improved multifocal method (100%: t=-4.22, P<0.001; 10%:t=-3.90, P=0.001) and single visual method (100%: t=-3.50, P=0.002; 10%: t=-4.76, P<0.001). Anddifferent contrast of binocular correct vision at 30 cm of these three 3 correct methods were also higher thansingle visual spectacle, included the same binocular correct of multifocal method (100%: t=-4.36, P<0.001;10%: t=-5.48, P<0.001), improved multifocal method (100%: t=-5.67, P<0.001; 10%: t=-3.93, P=0.001)and single visual method (100%: t=-7.43, P<0.001; 10%; t=-4.03, P=0.001). In all subjects there were 1subject considered the single visual spectacle was the best, 7 participants felt the multifocal method wasthe best, 2 subjects chose single visual method and 10 participants liked the improved multifocal method.Conclusion: The improved multifocal method which combined multifocal method and single visual methodcould achieve a good presbyopia correction effect, the binocular vision and visual quality of multifocalmethod was not weak of other two methods, and this method was easier to be accepted by participants.