多功能保養液與隱形眼鏡間的生物相容性之客觀及主觀性測量分析

Analysis of Objective and Subjective Measures Associated with Multipurpose Solution and Contact Lens Biocompatibility

羅時宜(SHIH-YI LO)

指導教授 ： 吳宛儒

中臺科技大學/健康科學院/生物科技暨醫學工程研究所/碩士(2018年)

摘要

在現今社會中，配戴軟式隱形眼鏡已經成為矯正屈光不正的常用且便利的方法，其中彩色拋棄式隱形眼鏡已不僅是生活所需，更是美妝的一大重點，且軟式隱形眼鏡在國內更是能輕易購得。先前許多文獻指出多功能保養液可能導致角膜上皮細胞有些特徵性的反應，造成角膜染色及舒適度下降等症狀。因此透過前瞻性、隨機、雙盲、交叉性、相互比對的方式進行臨床實驗，分析兩款彩色月拋隱形眼鏡與三款多功能保養液的六種搭配組合對於成年人眼睛的主觀症狀及客觀徵兆的影響。
本研究進行六種組合之評估，分別在角膜染色、結膜染色、瞼結膜刺激反應、眼部舒適度及疼痛敏感度上，做分析比對，並且使用SPSS 20做為統計工具，運用分析方法包括成對樣本 t 檢定(paired sample t-test)、變異數分析(ANOVA)、事後比較檢定Least Significant Difference (LSD)試驗、斯皮爾曼等級相關(Spearman rank correlation)、皮爾森積差相關(Pearson product-moment correlation)分析，以了解兩款鏡片與三款多功能保養液之組合對眼睛的影響。
結果顯示純雙胍類(biguanide-base)防腐劑的保養液對於鏡片A之保養液組合在下方區域的角膜染色及角膜染色總面積都有較嚴重及顯著的染色等級。在下方區域的角膜染色與同一種鏡片的其他藥水組合相比是有顯著差異(p =0.03)，而在角膜染色總面積與鏡片B和同款藥水組合相比有較嚴重及顯著的染色等級(p =0.03)。鏡片B之保養液組合的角膜染色狀況，無論在角膜下方或總面積上都比鏡片A輕微也無顯著(p> 0.05)。使用藥水1及藥水3中，鏡片A顯著比鏡片B之組合能獲得更好的舒適度(p=0.04; p=0.03)。而舒適度與客觀徵兆之間無統計上的相關性(p> 0.05)。根據本研究初步的分析，舒適度與疼痛敏感度間也似乎並無顯著相關。

關鍵字

隱形眼鏡 ； 多功能保養液 ； 角膜染色

並列摘要

Soft contact lens wear has become a popular and convenient way to correct for refractive error; this is especially true of disposable cosmetic soft lens which has become a way of fashion and can be easily obtained in today’s market. Previous studies have suggested that preservatives in multipurpose solutions (MPS) can affect the health of the eye and cause signs and symptoms that include corneal staining and possibly discomfort. This study is a prospective, double-masked, randomized, crossover clinical study aimed to explore the subjective symptoms and objective signs associated with the biocompatibility of six multipurpose solution and contact lens combinations on the adult eye.
Factors such as corneal and conjunctival staining, palpebral conjunctival hyperemia, ocular discomfort and pain sensitivity between the six solution and lens combinations were examined and analyzed using the SPSS software (version 20). In order to understand the meaning and relevance of the parameters examined, analytical methods such as the paired sample t-test, analysis of variance (ANOVA) for statistical analysis of variables, the post hoc Least Significant Difference (LSD) correction for multiple comparisons, the Spearman rank correlation, and the Pearson product-moment correlation were performed to examined the effects that various solution and lens combinations have on the eyes.
Results from our study indicated that Lens A and Solution 1 combination has more severe and significant corneal staining (p=0.03) in both the inferior corneal region and total corneal area in comparison to other Lens A and solution combinations tested. The total area of staining is also significantly greater (p=0.03) than Lens B and Solution 1 combination. In comparison to Lens A and solution combinations, Lens B and solution combinations produces less and insignificant (p> 0.05)corneal staining in all regions of the cornea. Lens A achieves better comfort than Lens B and solution combinations more significantly with MPS 1 and MPS 3 (p=0.04; p=0.03). There was no statistically significant correlation between ocular discomfort and objective signs (p> 0.05). Based on the preliminary results from this study, there seems to be no significant correlation between ocular discomfort and pain sensitivity as well.

並列關鍵字

Contact Lens ； Multipurpose Solutions ； Corneal Staining

參考文獻

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