亲水性角膜接触镜对眼高阶像差的影响

Changes of ocular higher order aberration in eyes wearing spherical and aspherical soft contact lens

目的探讨球面和非球面亲水性角膜接触镜对人眼高阶像差的影响，以指导亲水性角膜接触镜的验配。方法前瞻性系列病例研究。收集验配亲水性角膜接触镜的屈光不正患者52例，按照随机的原则分为两组，每组26例52只眼，一组配戴球面亲水性角膜接触镜；另一组配戴非球面亲水性角膜接触镜。戴镜前后检测角膜地形图和波振面像差。采用SPSS13．0统计学软件对各高阶波像差RMS值进行数据处理。对球面组和非球面组裸眼和戴镜后各项像差的比较采用配对设计资料的t检验，对于两组戴镜后各项像差变化的比较采用成组设计资料两样本均数比较的t检验。检验显著性标准α=0．05。结果球面镜片组戴镜后总高阶像差（High）、慧差（T．Coma）、三叶草（T．Trefoil）、四叶草（T．4Foil）、球差（T．Sph）、散光像差（HiAstig）RMS值均增加，各项高阶像差的差异均有统计学意义（P〈0．05）。非球面镜片组戴镜后仅慧差和三叶草RMS值增加，差异有统计学意义（P〈0．05）。球面镜片组总高阶像差、四叶草、球差、散光像差RMS值的增量较非球面组增量大，差异有统计学意义（P〈0．05）。结论球面亲水性角膜接触镜较非球面镜片引入更多高阶像差，非球面亲水性角膜接触镜的成像质量优于传统球面亲水性角膜接触镜。

Objective To evaluate and compare the wavefront characteristics of normal eyes with and without hydrogen spherical and aspherical soft contact lenses for correction of myopia. Methods Higher order aberrations （HOA） of 52 eyes of 26 spherical soft contact lens users and 52 eyes of 26 aspherical soft contact lens users who had no ocular diseases other than myopia were quantified with a Nidek Marco three dimensional Wave wavefront analyzer. Zemike＇ s polynomial was used to describe the wavefront measurements. Root mean square （RMS） values of the total HOAs, total coma, total trefoil and total spherical aberrations were obtained in the same eyes with and without soft contact lenses. Paired sample t-test was used to analyze the data. Results RMS values of the High, T.Coma, T.Trefoil, T.4Foil, T.Sph, HiAstig increased significantly after fitting with spherical soft contact lenses （P 〈0.05）. RMS values of High, T.Coma, T.Trefoil increased significantly after fitting with aspherical soft contact lenses （P 〈0.05）. There was significant difference among High, T.4Foil, T.Sph, HiAstig in the aberrations changes of spherical and aspherical Soft Contact Lens （P 〈0.05）. Conclusions Wavefront analysis show that spherical soft contact lenses for myopia induce more significant increase in total HOA than aspherical soft contact lenses.