以光學同調斷層掃描觀察並分析軟式隱形眼鏡配戴與角膜間空隙之形成因子

Optical Coherence Tomography for the Evaluation of Contact Lens Fitting: a Pilot Analysis of Gap Formation Factors

張育碩(Yu-Shuo Chang)

指導教授 ： 鄭宏銘 ； 林培正

中山醫學大學/醫學科技學院/生物醫學科學學系碩士班/碩士(2012年)

https://doi.org/10.6834/CSMU.2012.00182

摘要

本研究以眼部斷層掃描儀器觀察軟式隱形眼鏡配戴時，角膜與鏡片間的空隙形成情形並且分析空隙形成的相關因子。實驗方法為挑選角膜平均弧度在7.85以上的受試者，給他們配戴同一廠牌同一款式不同基弧的兩種拋棄式隱形眼鏡八小時，並以光學相干斷層掃瞄觀察隱形眼鏡與角膜間的空隙、配戴前後的結膜充血程度、配戴後舒適度問卷調查、配戴後生理性淚液分泌量。結果顯示：（1）配戴隱形眼鏡後，空隙形成的位置與角膜散光軸度有關，數量與角膜散光度數有關；（2）配戴基弧8.8鏡片其鏡片後空隙較基弧8.4鏡片為集中；（3）配戴基弧8.4鏡片的受試者結膜充血程度較嚴重，且可能與鏡片後空隙有關；（4）結膜充血程度與舒適度呈反相關。根據以上結果顯示，軟式隱形眼鏡配戴與角膜間的空隙與選擇的鏡片基弧以及角膜散光有關係，我們並依此提出角膜間隙指數，做為未來預測角膜間隙出現與否之參考；本文亦為第一篇以光學相干斷層掃描儀器檢測軟式隱形眼鏡配戴在角膜上的貼合程度與舒適度之文章。

關鍵字

隱形眼鏡 ； 光學相干斷層掃瞄 ； 基弧 ； 角膜散光 ； 角膜間隙

並列摘要

This study represents the first investigation on the gap formation factors with contact lens fitting by using OCT (Optic Coherence Tomography) in Taiwan. Volunteers with corneal curvature over 7.85 mm were recruited, with their clinical refraction errors measured and recorded. They were then asked to wear contact lenses with base curves at 8.8 and 8.4 mm for 8 hours on two separate days. After each 8-hour wear, bulbar redness and gap formation as detected by OCT were assessed. Then, Schirmer’s test was performed with a questionnaire for discomforts associated with fitting. The results showed: (1) Gap formation areas and numbers were associated with corneal astigmatism, but not total astigmatism. More gaps were detected in eyes of higher corneal astigmatism, (2) More gaps were found in the central cornea wearing contact lens with the base curve at 8.8 mm, while this concentration to the central cornea was not seen with the base curve at 8.4 mm, (3) Those with base curve at 8.4 mm appeared to show more severe bulbar redness than with base curve at 8.8 mm, and less gap formation appeared to link with less bulbar redness, (4) Discomforts associated with contact lens fitting as indicated by visual analogue scale analysis was inversely correlated with the extent of bulbar redness before and after contact lens wear, (5) We suggest the gap index demonstrate the peripheral corneal curvature objectively and related with gap formation and different contact lens curvature as data we show upper. OCT is a novel evaluation tool for contact lens fitting. This study showed that gap numbers and gap formation areas are mainly affected by base curves of contact lens and corneal astigmatism.

並列關鍵字

Contact lens ； Optical Coherence Tomography（OCT） ； Base Curve（BC） ； Corneal Astigmatism ； Corneal Gap

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