Topographical thickness of the epithelium and total cornea after overnight wear of reverse-geometry rigid contact lenses for myopia reduction.

摘要

PURPOSE. To investigate topographical thickness changes of the epithelium and total cornea measured with optical coherence tomography (OCT) after overnight wear of rigid gas-permeable lenses. METHODS. Reverse geometry design CRT (Dk = 100) rigid (test) lenses (Paragon Vision Sciences, Mesa, AZ) were randomly fitted on one eye of each of 20 neophyte subjects (mean age, 24.6 +/- 2.7 years) and the other eye was fitted with an alignment tricurve rigid lens of the same material (control). Epithelial and total corneal thickness was measured at intervals of 10 degrees across a 10-mm zone of the horizontal meridian of the cornea, before and after overnight wear. Refractive error was measured with an autorefractor. These measurements were repeated 20 and 60 minutes and 3, 6, and 12 hours after lens removal. RESULTS. After one night of lens wear, myopia decreased in the test eye by 1.18 +/- 0.81 D, which was significantly different from baseline (P < 0.001). No significant change was found in the control eye. Twelve hours after removal, two thirds of the myopic reduction was still present. Different topographical swelling patterns were induced by the two lens designs, with greatest swelling occurring in the center with the control lens and in the midperiphery with the test lenses (polynomial regression: P < 0.005). Significantly greater central corneal swelling was found with the control lens than the test lens (6.9% +/- 3.1% vs. 4.9% +/- 2.0%, respectively, P = 0.006). The effect on epithelial thickness differed between lenses and depended on both position and time (F((48,912)) = 2.3; P = 0.000). Immediately after removal of the test lens, the central epithelium was 5.1% +/- 4.5% thinner than baseline, and all other locations (P < 0.005 post hoc tests) and the epithelium in the midperiphery showed significant thickening (1.9% on the temporal side and 2.4% on the nasal side, both P < 0.006 compared with the baseline). There were no significant changes in epithelial thickness with the control lens during the study period (post hoc tests: P > 0.05). CONCLUSIONS. The optical coherence tomograph is a sensitive instrument that can detect small changes in epithelial and corneal thickness across the entire cornea. Topographical thickness changes of the epithelium and total cornea induced by one night of reverse-geometry lens wear appear to be associated with the decrease of myopia.