한국안광학회지 (Journal of Korean Ophthalmic Optics Society)

한국안광학회 (The Korean Ophthalmic Optics Society)
권호 표지
DOI QR코드

DOI QR Code

모노비전, 변형된 모노비전, 멀티포컬 콘택트렌즈로 교정 시 20대 성인의 조절기능 비교

Comparison of Accommodative Function of Young Adults in their Twenties Wearing Monovision, Modified Monovision and Multifocal Soft Contact Lenses

  • 투고 : 2015.02.09
  • 심사 : 2015.04.14
  • 발행 : 2015.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

목적: 모노비전, 변형된 모노비전 및 비구면 멀티포컬 소프트콘택트렌즈로 교정 시 20대 성인에서 근거리 작업 후 조절기능의 변화를 비교하였다. 방법: 30명의 젊은 성인($23.53{\pm}2.37$세)을 대상으로 모노비전, 단초점 콘택트렌즈와 낮은 가입도의 중심부-근용 비구면 다초점 콘택트렌즈를 활용한 변형된 모노비전, 멀티포컬 콘택트렌즈의 교정방법을 사용하여 양안에 착용시키고, 일주일의 적응기간이 경과한 후 조절기능을 검사하였다. 조절기능 평가는 콘택트렌즈를 착용하고 1시간 동안 동영상을 시청하여 조절 부담을 유도한 후 원/근거리의 100%와 10% 대비시력, 조절반응, 근거리 조절용이성, 양성/음성상대조절력 등을 평가하였다. 모든 검사는 양안으로 실행하였다. 결과: 원거리 10% 대비시력은 모노비전에서 가장 낮았다(p<0.005). 조절반응량은 검사거리 1 m(1.00 D)에서 모노비전이 변형된 모노비전보다 작았고, 검사거리 40 cm(2.50 D)에서는 모노비전이 변형된 모노비전, 멀티포컬 콘택트렌즈보다 작았다(p<0.05). 근거리 조절용이성, 양성/음성상대조절력은 콘택트렌즈 교정법 사이에 차이가 없었다. 결론: 20대 성인에서 낮은 가입도의 모노비전 처방은 단초점렌즈보다 근거리 조절반응을 줄여주지만 중심부-근용 멀티포컬 콘택트렌즈를 이용한 '변형된 모노비전'과 멀티포컬 콘택트렌즈 처방은 조절이완에 영향을 주지 않는 것으로 생각된다.

Purpose: The purpose of this study was to compare the accommodative function of young adult in their 20s wearing monovision, modified monovision, and aspheric multifocal contact lenses at near task. Methods: Thirty young adults ($23.53{\pm}2.37years$) were fitted with monovision, modified monovision (the application of single vision contact lenses and center-near low addition aspheric multifocal contact lenses), and aspheric center-near multifocal contact lenses. After wearing these modalities during a week for adaption, and after watching visual display at computer for inducing accommodative pressure for 1 hour. The following assessments of accommodative function were made: contrast visual acuity (VA) at distance and near; accommodative response; near accommodative facility; and negative relative accommodation (NRA)/positive relative accommodation (PRA). All measurements were carried out binocularly. Results: In binocular distance VA with contrast of 10%, monovision was the worst among the four modalities (p=0.005). In accommodative response at 1 m (1.00 D), monovision was the lowest (p<0.05) and accommodative response at 40 cm (2.50 D) with monovision was lower than that of modified monovision and multifocal contact lens (p<0.05). We also found that there were no significant differences in accommodative facility and NRA/PRA among the four modalities. Conclusions: In young adult (20s), monovision with low add reduced the accommodative response at near task, however, modified monovision and multifocal lens with center-near type did not affect accommodative relaxation.

키워드

참고문헌

  1. Digieco Report. Tap On The Door of Mobile First World: Nielsen Koreanclick Mobile Behavioral Data, 2015. https://www.kdi.re.kr/infor/kresearch_view.jsp?ac=127673 (14 January 2015).
  2. The Wall Street Journal. Korea's smartphone population tops milestone, 2014. http://blogs.wsj.com/korearealtime/2014/07/28/koreas-smartphone-population-tops-milestone (28, July. 2014).
  3. Conlon EG, Lovegrove WJ, Chekaluk E, Pattison PE. Measuring visual discomfort. Vis Cogn. 1999;6(6):637-663. https://doi.org/10.1080/135062899394885
  4. Tyrrell RA, Leibowitz HW. The relationship of vergence effort to reports of visual fatigue following prolonged near work. Hum Factors. 1990;32(3):341-357.
  5. Sheedy JE, Hayes JN, Engle J. Is all asthenopia the same? Optom Vis Sci. 2003;80(11):732-739. https://doi.org/10.1097/00006324-200311000-00008
  6. Park KY, Bak KJ, Lee JG, Lee YS, Roh JH. Factors affecting the complaints of subjective symptoms in VDT operators. J Korea Occup Med. 1997;9(1):156-169.
  7. Koh KH. Clinical performance analysis of lenses for accommodative function improvement. MA Thesis. Eulji University, Daejeon. 2008.
  8. Gwiazda JE, Hyman L, Norton TT, Hussein M, Marsh-Tootle W, Marny R et al. Accommodation and related risk factors associated with myopia progression and their interaction with treatment in COMET children. Invest Ophthalmol Vis Sci. 2004;45(7):2143-2151. https://doi.org/10.1167/iovs.03-1306
  9. Aller TA, Wildsoet CF. Bifocal soft contact lenses as a possible myopia control treatment: a case report involving identical twins. Clin Exp Optom. 2008;91(4):394-349. https://doi.org/10.1111/j.1444-0938.2007.00230.x
  10. Rosen R, Jaeken B, Lindskoog PA, Artal P, Unsbo P, Lundstrm L. Evaluating the peripheral optical effect of multifocal contact lenses. Ophthalmic Physiol Opt. 2012;32(6):527-534. https://doi.org/10.1111/j.1475-1313.2012.00937.x
  11. Hasebe S, Nakatsuka C, Hamasaki I, Ohtsuki H. Downward deviation of progressive addition lenses in a myopia control trial. Ophthalmic Physiol Opt. 2005;25(4):310-314. https://doi.org/10.1111/j.1475-1313.2005.00301.x
  12. Westin E, Wick B, Harrist RB. Factors influencing success of monovision contact lens fitting: survey of contact lens diplomates. Optometry. 2000;71(12):757-763.
  13. Loewenfeld IE. The Pupil: Anatomy, Physiology, and Clinical Applications, Vol 1. Woburn: Butterworth-Heinemann, 1993:295-317.
  14. Bennett ES, Weissman BA. Clinical contact lens practice, 1st Ed. Philadelphia: Lipppincott Williams & wilkins, 2004;544-547.
  15. Anderson H, Hentz G, Glasser A, Stuebing K, Manny R. Minus-lens-stimulated accommodative amplitude decreases sigmoidally with age: A study of objectively measured accommodative amplitudes from age 3. Invest Ophthalmol Vis Sci. 2008;49(7)2919-2926. https://doi.org/10.1167/iovs.07-1492
  16. Rosenfield M, Carrel MF. Effect of near-vision addition lenses on the accuracy of the accommodative response. Optometry. 2001;72(1):19-24.
  17. Tarrant J, Severson H, Wildsoet CF. Accommodation in emmetropic and myopic young adults wearing bifocal soft contact lenses. Ophthalmic Physiol Opt. 2008;28(1):62-72. https://doi.org/10.1111/j.1475-1313.2007.00529.x
  18. Montes Mico R, Madrid Costa D, Radhakrishnan H, Charman WN, Ferrer BT. Accommodative functions with multifocal contact lenses: A pilot study. Optom Vis Sci. 2011;88(8):998-1004. https://doi.org/10.1097/OPX.0b013e31821c0ed8
  19. Alpern M, Larson BF. Vergence and accommodation, IV. Effect of luminance quantity on the AC/A. Am J Opthalmol. 1960;49(5):1140-1149.
  20. Mah KC. Binocular test, 2nd Ed. Daihaksurim. 2007;77-79.
  21. Ko BU, Ryu WY, Park WC. Pupil size in the normal Korean population according to age and illuminance. J Korean Ophthalmol Soc. 2011;52(4):401-406. https://doi.org/10.3341/jkos.2011.52.4.401
  22. Schor C, Landsman L, Erickson P. Ocular dominance and the interocular suppression of blur in monovision. Am J Optom Physiol Opt. 1987;64(10):723-730. https://doi.org/10.1097/00006324-198710000-00002
  23. Gupta N, Naroo SA, Wolffsohn JS. Visual comparison of multifocal contact lens to monovision. Optom Vis Sci. 2009;86(2):98-105. https://doi.org/10.1097/OPX.0b013e318194eb18
  24. Rajagopalan AS, Bennett ES, Lakshminarayanan V. Visual performance of subjects wearing presbyopic contact lenses. Optom Vis Sci. 2006;83(8):611-615. https://doi.org/10.1097/01.opx.0000232185.00091.45
  25. Han GA, Hwang JH, Mah KC. Objective measurement of accommodative responses with open-field autorefractor. Korean J Vis Sci. 2009;11(1):35-44.
  26. Pettersson AL, Ramsay MW, Lundstrom L, Rosen R, Nilsson M, Unsbo P et al. Accommodation in young adults wearing aspherical multifocal soft contact lens. J Modern Optics. 2011;58(19-20):1804-1808. https://doi.org/10.1080/09500340.2011.618890
  27. Madrid-Costa D, Ruiz-Alcocer J, Radhakrishnan H, Ferrer-Blasco T, Montes-Mico R. Changes in accommodative response with multifocal contact lenses: a pilot study. Optom Vis Sci. 2011;88(11):1309-1316. https://doi.org/10.1097/OPX.0b013e31822be35a
  28. Zellers J, Alpert T, Rouse M. A review of the literature and a normative study of accommodative facility. J Am Optom Assoc. 1984;55(1):31-37.
  29. Gracia A, Cacho P, Lara F. Evaluating relative accommodations in general binocular dysfunctions. Optom Vis Sci. 2002;79(12):779-787. https://doi.org/10.1097/00006324-200212000-00010
  30. Plainis S, Atchison DA, Charman WN. Power profiles of multifocal contact lenes and their interpretation. Optom Vis Sci. 2013;90(10):1066-1077. https://doi.org/10.1097/OPX.0000000000000030
  31. Montes-Mic R, Ali, JL. Distance and near contrast sensitivity function after multifocal intraocular lens implantation. J Cataract Refract Surg. 2003;29(4):703-711. https://doi.org/10.1016/S0886-3350(02)01648-6

피인용 문헌

  1. Objective Evaluation of Asthenopia Using Accommodative Microfluctuation in the High-Frequency Region vol.23, pp.4, 2018, https://doi.org/10.14479/jkoos.2018.23.4.477
  2. Changes in Visual Function According to the Addition of Center-near Designed Multifocals and Utilization as Contact Lenses for Fatigue vol.20, pp.1, 2015, https://doi.org/10.17337/jmbi.2018.20.1.69
  3. Accommodative Changes with Center-Near Multifocal Contact Lenses in Young Adults with Accommodative Infacility vol.21, pp.4, 2015, https://doi.org/10.17337/jmbi.2019.21.4.587
  4. Direction Changes in the Dominant Eye and Comparison of Single-Eye Inset Amounts Depending on the View Distance vol.25, pp.1, 2015, https://doi.org/10.14479/jkoos.2020.25.1.19