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目的探讨角膜散光的大小、轴向与球性、散光软性角膜接触镜的配适状态、舒适度之间的关系。设计前瞻性随机区组对照临床研究。研究对象284例自愿受试者,现在或曾经配戴软性角膜接触镜。方法受试者的平均近视屈光度为(-5.18±2.53)D,平均散光度为(0.81±0.50)D。每位受试者在接受眼部检查、验光、角膜地形图检查后,于其左眼间隔一定的时间先后配戴球性和散光软性接触镜。根据受试者左眼角膜散光的轴向将人群分为三组:第一组,顺规散光组(132眼);第二组,逆规散光组(76眼);第三组,斜轴散光组(76眼)。同时,根据受试者角膜散光度数的不同分为以下三组:第四组,<0.75D共153眼;第五组,≥0.75D、<1.50D,共106眼;第六组,≥1.50D共25眼。主要指标镜片中央定位、覆盖度、活动度、散光镜片的旋转性和稳定性以及舒适度。结果在前三组和后三组对比中,镜片覆盖度、活动度、旋转性及稳定性指标组间均无显著性差异。散光镜片的稳定性在3分钟、15分钟明显优于第1分钟。散光镜片的中央定位优于球性软镜(P=0.00),最佳中央定位的比例分别为54%与48%;散光镜片活动度大于球镜(P=0.02),两者活动度不良所占的比例分别为18%与19%;散光镜片舒适度差于球镜(P=0.00),不可接受的比例散光片为14%,球镜片为5%。结论软性角膜接触镜的配适与舒适度较少地受到角膜散光的影响。球性软镜可在一定程度上作为首选配戴。
Objective To investigate the relationship between the corneal astigmatism size, axial and spherical, astigmatism soft lens contact lens fit state and comfort. Design prospective randomized block controlled clinical study. Subjects: 284 volunteers, now or who have worn soft contact lenses. Methods The average myopic refraction of subjects was (-5.18 ± 2.53) D, and the average astigmatism was (0.81 ± 0.50) D. Each subject underwent ophthalmic examination, optometry, corneal topography examination, in the left eye at intervals after a period of time to wear a spherical and astigmatism soft contact lenses. The subjects were divided into three groups based on the axial corneal astigmatism of the left cornea: the first group, the astigmatism group (132 eyes); the second group, the astigmatism group (76 eyes); the third group, the oblique axis Astigmatism group (76 eyes). At the same time, according to the different degree of corneal astigmatism subjects were divided into the following three groups: the fourth group, <0.75D total of 153 eyes; the fifth group, ≥ 0.75D, <1.50D, a total of 106 eyes; D total of 25 eyes. The main indicators of the central positioning of the lens, coverage, activity, astigmatism lens rotation and stability and comfort. Results In the first three groups and the latter three groups, there was no significant difference between the lens coverage, activity, rotation and stability indexes. The stability of the astigmatism lens in 3 minutes, 15 minutes was significantly better than the first minute. The center of astigmatism lens was better than that of spherical soft mirror (P = 0.00), the best central positioning was 54% and 48% respectively. The astigmatism lens activity was greater than spherical lens (P = 0.02) Accounting for 18% and 19%, respectively; astigmatism lens comfort was worse than spherical mirror (P = 0.00), unacceptable proportion of astigmatism was 14%, spherical lens was 5%. Conclusions Soft corneal contact lenses are less affected by the corneal astigmatism due to their lower fitness and comfort. Ball soft mirror to a certain extent as the preferred wear.