隐形眼镜配戴对近视眼视网膜成像质量的影响

Effect of Contact Lenses on Retinal Image Quality in Myopic Eyes

【目的】了解软性和硬性透气性隐形眼镜配戴对近视眼视网膜成像质量的影响,探讨硬性透气性隐形眼镜减缓近视发展的可能机制。【方法】矫正视力正常的近视眼志愿者20人40眼,用像差仪检查同一志愿者配戴前、配软性和硬性透气性隐形眼镜后的波前像差。【结果】同一受试者配戴硬性透气性隐形眼镜后与配戴前的波前像差比较,第2、4阶像差明显减小(P<0.05),而配戴软性隐形眼镜后与配戴前的波前像差比较,第2、3、6阶像差明显增加(P<0.05)。合并有散光的同一受试者配戴硬性透气性隐形眼镜后与配戴前比较,第2、4阶像差明显减小(P<0.05),配戴软性隐形眼镜后与配戴前比较,第4、6、7阶像差明显增加(P<0.05)。【结论】硬性透气性隐形眼镜配戴可明显减小近视眼的波前像差,从而改善其视网膜成像质量;配戴软性隐形眼镜则可增加近视眼的波前像差。硬性透气性隐形眼镜配戴可能通过改善视网膜物像质量而减缓青少年近视的进一步发展。

[Objective] To investigate the effect of soft and rigid gas permeable （RGP） contact lenses on image quality in myopic eyes and to determine the mechanism of the progression of myopia controled by RGP. [Methods] Wave-front aberrations were tested on 40 myopic eyes of 20 subjects who had good corrected visual acuities using a subjective aberrometer. Every subject was measured without contact lenses, with soft contact lenses, and with RGP. [Results] The root of mean square （RMS） of the second and fourth order Zernike aberrations in patients with RGP was significantly smaller than that without contact lenses （P〈 0.05）. The RMS of the second, third, and sixth order Zernike aberrations in patients with soft contact lenses was significantly greater than that without contact lenses （P〈 0.05）. In myopia with astigmatism, the RMS of the second and fourth order Zernike aberrations in patients with RGP is significantly smaller than that without contact lenses （P〈 0.05）. The RMS of fourth, sixth, and seventh order Zernike aberrations in the patients with soft contact lenses was significantly greater than that without contact lenses in myopia with astigmatism （P〈 0.05）. [Conclusion] The subjects with RGP yielded significantly better optical quality than the soft contact lens. The mechanism that RGP of controhng or reducing the progression of myopia in adolescent maybe via improving retinal image quality.