한국안광학회지 (Journal of Korean Ophthalmic Optics Society)

한국안광학회 (The Korean Ophthalmic Optics Society)
권호 표지

피팅 상태에 따른 RGP 렌즈와 각막과의 간극 비교

A Comparison of the Contact Areas between Cornea and RGP Lenses by Fitting Status

  • 박은혜 (서울과학기술대학교 안경광학과) ;
  • 김소라 (서울과학기술대학교 안경광학과) ;
  • 박미정 (서울과학기술대학교 안경광학과)
  • Park, Eun Hye (Dept. of Optometry, Seoul National University of Science and Technology) ;
  • Kim, So Ra (Dept. of Optometry, Seoul National University of Science and Technology) ;
  • Park, Mijung (Dept. of Optometry, Seoul National University of Science and Technology)
  • 투고 : 2012.07.31
  • 심사 : 2012.09.15
  • 발행 : 2012.09.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 본 연구에서는 형상 및 난시도가 상이한 각막에 구면 및 비구면 RGP 렌즈를 피팅 상태를 달리하여 착용시켰을 때 각막과 렌즈와의 간극에 미치는 영향을 알아보아 적절한 RGP 렌즈의 선택에 도움이 되고자 하였다. 방법: 직난시를 가진 $(25.12{\pm}3.52)$세의 90안에 구면과 비구면 RGP 렌즈를 각기 다른 피팅 상태로 착용시키고 플루레신 염색의 정량적인 분석을 위하여 중심부, 중간주변부 및 주변부로 나눠 면적을 계산하여 각막과 콘택트렌즈의 간극을 비교하였다. 결과: 양호한 피팅 시 중심부와 주변부 면적은 렌즈 디자인에 따른 유의한 차이가 있었으나 스팁 혹은 플랫하게 피팅되었을 때의 중심부 면적은 각막형상과 렌즈 디자인에 따른 차이는 없었다. 각막 형상에 따라 분석하였을 때 양호한 피팅과 플랫 피팅에서는 두 렌즈 디자인 모두에서 중심부와 주변부 면적이 각막 형상에 따라 통계 적으로 유의하게 달라졌으나, 스팁 피팅에서는 차이가 없었다. 각막 난시도에 따라 분석하였을 때 각막형상에 상관없이 각막난시가 증가함에 따라 일정하게 중심부 및 주변부의 면적이 변하는 양호한 피팅의 경우와는 달리 스팁 피팅과 플랫한 피팅의 경우는 원형 각막과 대칭나비형 각막에서의 면적 변화 양상이 상이하였다. 결론: 본 연구에서 는 RGP 렌즈를 스팁이나 플랫하게 피팅 되었을 경우 양호한 피팅시 보다 각막난시나 각막 형상에 따른 렌즈와 각막과의 간극 변화가 더 커지며 이러한 결과는 구면 RGP 렌즈와 비구면 RGP 렌즈 모두에서 공통적으로 나타나는 것임을 알 수 있었다.

Purpose: In this study, the effect of lens fitting status on the contact area between spherical/aspherical RGP lens and the cornea having different astigmatic degree and corneal type was investigated for guiding the proper selection of RGP lens. Methods: Spherical and aspherical RGP lenses were applied on ninety eyes $(25.12{\pm}3.52years)$ having with-the-rule astigmatism by different fitting status. Then, their central, mid-peripheral and peripheral areas of fluorescein pattern were calculated and compared for the quantitative evaluation of the contact area between spherical/aspherical RGP lens. Results: The central and peripheral areas with the alignment fitting was significant different based on lens design. However, the central area didn't show any significant difference by lens design and corneal type when fitted in steep or flat. When analyzed by the corneal shape, both lenses with alignment and flat fitting had significant difference in central and peripheral areas. However, the central, mid-peripheral and peripheral areas with steep fitting didn't show the difference by corneal types. When analyzed by the astigmatic degree, the central and peripheral areas with alignment fitting changed proportionally to the increase of corneal astigmatism regardless of corneal shape. With steep and flat fitting, however, the central, mid-peripheral and/or peripheral areas in round- and symmetric bowtie-typed corneas showed the conflicting result when compared to those of alignment fitting when analyzed by the astigmatic degree. Conclusions: In this study, it was confirmed that the contact areas of cornea and RGP lens fitted steep and flat status were largely affected by the corneal type and corneal astigmatism rather than RGP lens fitted in alignment status. Also, this result commonly occurred in both spherical and aspherical RGP lenses.

키워드

참고문헌

  1. Koo KL, Choi SK, Lee HY. Classification of corneal topography and analysis of astigmatism based on computer- assisted videokeratography. J Korean Oph Opt Soc. 1993;34(11):1101-1108.
  2. Lowther GE, Synder C. Contact lenses; procedure and techniques, 2nd Ed. Boston: Butterworth-Heinemann, 1992;66.
  3. Choe OM, Gang MJ. Effects of base curve on fitting with the current soft contact lenses. J Korean Oph Opt Soc. 2000;5(2):65-72.
  4. Sweeney DF, Jalbert I, Covey M, Sankaridurg PR, Vajdic C, Holden BA, et al. Clinical characterization of corneal infiltrative events observed with soft contact lens wear. Cornea. 2003;22(5):435-442. https://doi.org/10.1097/00003226-200307000-00009
  5. Zadnik K, Barr JT, Steger-May K, Edrington TB, McMahon TT, Gordon MO. Comparison of flat and steep rigid contact lens fitting methods in keratoconus. Optom Vis Sci. 2005;82(12):1014-1021. https://doi.org/10.1097/01.opx.0000192349.11525.de
  6. Kim DH, Bae HY, Han MG. The clinical study on the visual acuity and cornea of ez-NANOsense 2 RGP contact lens. J Korean Oph Opt Soc. 2007;12(4):55-69.
  7. Orsborn GN, Zantos SG, Godio LB, Jones WF, Barr JT. Aspheric rigid gas permeable contact lenses: practitioner discrimination of base curve increments using fluorescein pattern evaluation. Optom Vis Sci. 1989;66(4):209-213.
  8. Fink BA, Hill RM, Carney LG. Effects of rigid lens edge lift changes on tear pump efficiency. Optom Vis Sci. 1991;68(6):409-413. https://doi.org/10.1097/00006324-199106000-00001
  9. Young G. The effect of rigid lens design on fluorescein fit. Contact Lens Anterior Eye. 1998;21(2):41-46. https://doi.org/10.1016/S1367-0484(98)80039-8
  10. Kim SR, Park SI, Lee SE, Park MJ. A comparison of lens centrations on cornea with RGP lens fitting by the measured values using keratometer and corneal topography. J Korean Oph Opt Soc. 2011;16(1):41-50.
  11. Park EH, Kim SR, Park MJ. The comparison of fluorescein patterns between spherical RGP lens and aspherical RGP lens by corneal type and astigmatic degree. J Korean Oph Opt Soc. 2012;17(1):37-45.
  12. Bogan SJ, Waring GO 3rd, Ibrahim O, Drews C, Curtis L. Classification of normal corneal topography based on computer-assisted videokeratography. Arch Ophthal. 1990;108(7):945-949. https://doi.org/10.1001/archopht.1990.01070090047037
  13. Hogben CA. A practical and simple equivalent for student's T test of statistical significance. J Lab Clin Med. 1964;64:815-819.
  14. Huck SW, MeLean RA. Using a repeated measures ANOVA to analyze the data from a pretest-posttest design: a potentially confusing task. Psychological Bulletin. 1975;82(4): 511-518. https://doi.org/10.1037/h0076767
  15. Driscoll WC. Robustness of the ANOVA and Tukey- Kramer statistical tests. Computers & Industrial Engineering. 1996;31(1-2):265-268. https://doi.org/10.1016/0360-8352(96)00127-1
  16. Kim DS. Analysis on the depressing force to the cornea by fitted spherical lens. J Korean Oph Opt Soc. 2011; 16(1):1-10.
  17. Davis R, Keech P, Dubow B, Ames K. Making RGP fitting efficient and successful. Contact Lens Spectrum. 2000;15(10):40-47.
  18. Fink BA, Mitchell GL, Raasch TW, Hill RM. Enhancing RGP contact lens performance: comparing back surface options. Optometry. 2002;73(10):605-613.
  19. Cho HK, Choi JH, Yang JW, Lee YC, Kim SY. Visioncorrection effect of RGP contact lens in patients with corneal opacity following repaired corneal perforations. J Korean Oph Opt Soc. 2010;51(10):1312-1318. https://doi.org/10.3341/jkos.2010.51.10.1312
  20. Ames KS, Erickson P. Optimizing aspheric and spheric rigid lens performance. CLAO J. 1987;13(3):165-170.
  21. Schwallie JD, Barr JT, Carney LG. The effects of spherical and aspheric rigid gas permeable contact lens: Corneal curvature and topography changes. ICLC. 1995;22(3- 4):67-79.
  22. Kok JH, Boets EP, van Best JA, Kijlstra A. Fluorophotometric assessment of tear turnover under rigid contact lenses. Cornea. 1992;11(6):515-517. https://doi.org/10.1097/00003226-199211000-00005