圆锥角膜患者配戴硬性透氧性角膜接触镜后波前像差的改变

摘要

Objective To investigate the changes of wavefront aberrations in keratoconus corrected with rigid gas permeable contact lens (RGPCL).Methods It was a prospective case-control study.Twenty-five patients (43 eyes) confirmed by corneal topography as keratoconus were corrected with RGPCL.Their corrected visual acuity (VA) and wavefront aberrations were detected by iTrace dynamic laserefraction before and after wearing RGPCL for 2 weeks.Lower-order abberations LOAs,higher-order abberation HOAs,coma,spherical and trefoil were measured.The results measured were compared using paired samples t test.Results There were statistic differences in total ocular wavefront aberrations,LOAs,HOAs,coma and trefoil.Total ocular wavefront aberrations were reduced from 9.12±4.20 μm to 1.67±0.92 μm after wearing RGPCL (t=9.062,P＜0.01); LOAs were reduced from 8.88-±3.90 μm to 1.37±0.75 μm after wearing RGPCL (t=9.507,P＜0.01); HOAs were reduced from 1.90±0.14 μm to 0.79±0.21 μm after wearing RGPCL (t=2.473,P＜0.05); coma were reduced from 0.99±0.15 μm to 0.30±0.18 μm after wearing RGPCL (t=2.364,P＜0.05); trefoil were reduced from 0.92±0.19 μm to 0.22±0.14 μm after wearing RGPCL (t=2.757,P＜0.05).There were no statistics differences in spherical abberation.Spherical abberation were reduced from 0.54±0.25 μm to 0.32±0.27 μm after wearing RGPCL (t=1.239,P＞0.05).Conclusion Keratoconus patients with RGPCL can reach satisfying corrected visual acuity and visual quantity.Total ocular wavefront aberrations were significant reduced after wearing RGPCL.%目的 研究圆锥角膜患者配戴硬性透氧性角膜接触镜(RGPCL)后波前像差及视觉质量的改变.方法 前瞻性病例对照研究.收集在山西省眼科医院就诊的圆锥角膜患者25例(43眼),选配合适的RGPCL配戴2周后,分别于配戴前及配戴后测定其矫正视力,采用iTrace波前像差仪进行戴镜前后的全眼波前像差测量,并测量戴镜前后高阶、低阶像差及高阶像差中的球差、彗差及三叶草样散光.采用配对样本t检验对数据进行统计学分析.结果 配戴RGPCL前后,配戴前眼球总像差为(9.12±4.20)μm,配戴后为(1.67±0.92)μm,差异有统计学意义(t=9.062,P＜0.01).低阶像差在配戴前为(8.88±3.90)μm,配戴后为(1.37±0.75)μm,差异有统计学意义(t=9.507,P＜0.01);高阶像差在配戴前为(1.90±0.14)μm,配戴后为(0.79±0.21)μm,差异有统计学意义(t=2.473,P＜0.05);彗差在配戴前为(0.99±0.15)μm,配戴后为(0.30±0.18)μm,差异有统计学意义(t=2.364,P＜0.05);三叶草样散光在配戴RGPCL前为(0.92±0.19)μm,配戴后为(0.22±0.14)μm,差异有统计学意义(t=2.757,P＜0.05);球差在配戴RGPCL前为(0.54±0.25)μm,配戴后为(0.32±0.27)μm,差异无统计学意义(t=1.239,P＞0.05).结论 RGPCL为圆锥角膜患者提供了良好的矫正视力,配戴RGPCL后波前像差明显降低,视觉质量明显改善.