配戴增加景深的角膜接触镜对老视眼调节功能的影响

The effect of extended depth of focus contact lenses on the accommodation of presbyopic eyes

目的评价配戴增加景深的接触镜对老视眼近视力和调节功能的影响。方法双盲自身对照试验。于2018年6至8月从海南省眼科医院职工或就诊患者家属中招募45~55岁的正视眼志愿者30名(男性15名,女性15名),年龄(49.6±4.5)岁,非主视眼配戴增加景深的软性角膜接触镜。检查戴镜及裸眼时的5 m远视力、40 cm近视力和60 cm近视力,并在40 cm距离检查单眼调节幅度,±1.00 D时的调节灵敏度,调节滞后或调节超前量,双眼正、负相对调节及调节性集合与调节比值(AC/A)。采用配对t检验和配对资料的Wilcoxon符号秩和检验对戴镜及裸眼时的视力和调节数据进行统计学分析。结果裸眼及配戴角膜接触镜时,受试眼40 cm近视力分别为4.59±0.14和4.69±0.10,差异有统计学意义(t=4.16,P<0.01);60 cm近视力分别为4.74±0.10和4.74±0.12,差异无统计学意义(t=0.626,P>0.05);5 m远视力分别为5.00±0.06和4.96±0.06,差异有统计学意义(t=3.89,P<0.01)。裸眼及戴镜时受试眼的调节幅度分别为(3.26±0.26)和(4.00±0.51)D,戴镜时有明显提高(t=7.59,P<0.01);裸眼及戴镜时单眼调节灵敏度分别为(2.67±1.60)和(3.53±1.87)周/min,差异有统计学意义(t=2.17,P<0.05)。戴镜时的正、负相对调节与裸眼时相比,差异无统计学意义(t=1.90,0.66;P>0.05);戴镜时的AC/A和调节滞后量与裸眼时相比,差异亦无统计学意义(Z=0.83,0.11;P>0.05)。结论配戴增加景深的接触镜可以提高老视眼的近视力和调节幅度、调节灵敏度等调节功能。

Objective To evaluate the effect of extended depth of focus contact lenses on the accommodation of presbyopic eyes.Methods It was a double-blind randomized controlled trial.Thirty eyes of 30 emmetropic volunteers(15 males,15 females)who were staff or family members of Hainan Eye Hospital,aged(49.6±4.5)years,were selected.Non-dominant eyes were fitted with soft contact lenses with an extended depth of field.The subjects and examiners were double-blind.Visual acuities of the subjects were examined at 5 m,40 cm and 60 cm distance before and after the contact lens wear.Meanwhile,the monocular accommodative amplitude,monocular accommodative facility(±1.00 D),accommodative response,binocular positive/negative relative accommodation and accommodation convergence/accommodation at 40 cm distance were measured.The data were analyzed by paired t test and Wilcoxon signed rank test before and after the contact lens wear,and a P value less than 0.05 was considered statistically significant.Results Before and after the contact lens wear,the visual acuity at 40 cm was 4.59±0.14 and 4.69±0.10,and the difference was statistically significant(t=4.16,P<0.01).The visual acuity at 60 cm was 4.74±0.10 and 4.74±0.12,and the difference had no statistical significance(t=0.626,P>0.05).The distance visual acuity was 5.00±0.06 and 4.96±0.06,and the difference was statistically significant(t=3.89,P<0.01).The monocular accommodative amplitude was significantly improved from(3.26±0.26)D to(4.00±0.51)D(t=7.59,P<0.01).The monocular accommodative facility was also significantly improved from(2.67±1.60)cyc/min to(3.53±1.87)cyc/min(t=2.17,P<0.05).There was no statistically significant difference in the positive and negative relative accommodation(t=1.90,0.66;P>0.05).The accommodation convergence/accommodation and adjustment lag had no statistical significance(Z=0.83,0.11;P>0.05).Conclusion Wearing contact lenses with an extended depth of field can improve the near vision and accommodation of presbyopes.