LASIK术后特殊设计硬性透气性角膜接触镜再矫正前后的视觉质量探讨

doi:10.3760/cma.j.issn.1674-845X.2012.02.002

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Abstract Objective To investigate the clinical effect of reverse geometry design rigid gas permeable contact lenses (RGDRGPCLs) for improving postoperative visual quality in the patients who had undergone laser in situ keratomileusis (LASIK) and discuss reasons for the decline in visual quality. Methods In this prospective study， 20 patients (28 eyes) who wore RGDRGPCLs after LASIK surgery to improve defective visual quality were chosen during the period of 2010.01-2010.10. A Pentacam three-dimensional anterior segment analyzer and CGT-1000 contrast sensitivity measuring instrument were used to obtain corneal wavefront aberrations， contrast sensitivity and subjective symptoms in patients. Meanwhile， the corneal wavefront aberrations of 15 myopic patients (30 eyes) who were wearing spectacles were compared to those of the postoperative patients with and without RGDRGPCLs. SPSS 13.0 statistical software was used for an independent samples t test， paired samples t test and linear correlation analysis of the related data. Results Comparative root mean square （RMS） values of total aberration， total higher-order aberrration， spherical aberration and posterior corneal spherical aberrations for post-LASIK patients were significantly different when spectacle （t=-7.684， -5.658， -5.342， 4.039， P<0.05） and RGDRGPCL wearers were compared (t=4.510， 4.520， 3.826， -4.672， all P<0.05). No significant difference was found for coma (horizontal， vertical). Corneal anterior aberrations of postoperative patients were different from RGDRGPCL wearers （t=4.361， P<0.01）， but there was no significant change found when patients who wore RGDRGPCLs were compared to myopic patients. The total trefoil aberration between myopic and postoperative patients with （t=-7.464， P<0.01） or without RGDRGPCLs wear was statistically significant (t=-7.027， P<0.01)； however， no difference was found within the postoperative patient group. No difference between contrast sensitivity or glare contrast sensitivity was found among postoperative patients who wore either glasses or RGDRGPCLs. The best corrected visual acuity of postoperative patients wearing RGDRGPCLs negatively correlated to RMS value of corneal total aberration (r=-0.469， P=0.037). RGDRGPCL wear improved the patient satisfaction rate for visual quality as much as 95%. Conclusion Severe corneal higher-order aberrations caused by LASIK surgery is a major reason for the decline in visual quality. The values of total aberration， spherical aberration and others were reduced by wearing RGDRGPCLs， which can help to improve postoperative visual quality.

Key words： Keratomileusis laser in situ Contact lenses rigid gas permeable Reverse geometry design Refractive correction

Received: 03 June 2011

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	ZHOU Jian-lan
	CHI Hui
	CHANG Yong
	XIE Pei-ying

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ZHOU Jian-lan,CHI Hui,CHANG Yong等. Visual quality analysis of post-LASIK patients wearing reverse geometry design rigid gas permeable contact lenses[J]. Chinese Journal of Optometry Ophthalmology and Visual Science, 2012, 14(2): 68-73.

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https://www.cjoovs.com/EN/10.3760/cma.j.issn.1674-845X.2012.02.002 OR https://www.cjoovs.com/EN/Y2012/V14/I2/68

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