Purpose: The purpose was to study the corneal refractive power changes associated with the wearing of everted silicone hydrogel soft lenses. Methods: The corneal refractive power and corneal astigmatism were measured using corneal topographer (CT-1000, Shin-nippon Co., Japan) for checking change of corneal refractive power and objective refractive error was measured by auto-refractometer (Natural vision-K 5001, Shin-nippon Co., Japan). We measured at baseline and 1 week after lens wearing. Results: The correcting of corneal refractive power could be effective in low myopia. It's more effective to the higher power of greatest meridian of cornea and the more corneal astigmatism. 73% of subjects' refractive error was decrease less than 1 D and 17% of the subjects had an reverse effect (increase) occurs. The reduction of objective refractive error was more effective when cornea refractive power was great or corneal astigmatism was much. Conclusions: Pressure which the everted silicone hydrogel lens to the cornea could be caused. It occurred as the degrees of corneal power, corneal astigmatism and objective refractive error differences. Selection of an appropriate subject is important considering difficulty of changing the parameters of the lens.
The purpose of this Study investigated corneal power, corneal astigmatism and corneal axis according to spherical equivalent of refractive error. We measured spherical equivalent, corneal power and corneal astigmatism in 100 subjects from January 2014 to July 2014. Measured spherical equivalent of refractive error were $-3.01{\pm}3.79D$, corneal power of $43.79{\pm}1.60D$ and corneal astigmatism of $-1.17{\pm}0.79D$ respectively. Prevalence of spherical equivalent of refractive error were as follows : myopes (61%), emmetropes (22%), hyperopes(17%). Corneal astigmatism of refractive error greater than +0.75D was 63% and prevalence of corneal astigmatism were as follows : with-the-rlue astigmatism (84.13%), against-the-rule astigmatism(9.52%) respectively. Corneal power by spherical equivalent increased from hyperopia to myopia. Between spherical equivalent of refractive error and the mean corneal power was significant correlation(r=-0.25, p=0.01). A correlation were found between corneal power and spherical equivalent of refractive error in adults. They have the highest distribution of prevalence myopia among the refractive error. When the refractive error was increased, we found that corneal power was steeper. It is recognized that this can be refractive error factor and correct visual function is considered.
Purpose: This study investigated the masking effect of the hydrogel lens and silicone hydrogel lens on the cornea with refractive surgery and without surgery. Methods: 24 university students (means age: $23.48{\pm}2.89years$) without refractive surgery (12, control group) and with refractive surgery (LASIK: 8, LASEK: 4, experimental group) participated in the study. Mean refractive errors of right eyes were -2.73 D for control group and -0.24 D for experimental group. The differences in the refractive power and corneal topography map between pre- and post-wearing the -3.00 D lenses were compared, and 2 kinds of hydrogel contact lenses (0.89 Mpa, 0.49 Mpa) and 2 kinds of silicone hydrogel lenses (1.5 Mpa, 0.8 Mpa) were used for -3.00 D lenses. NVision-K5001 (Shin nippon, Japan) was used to measure the refractive power and Keratograph 5M (Oculus, Germany) to measure the corneal topography map change. Results: Variations in the refractive power increased to the plus direction in the experimental group after wearing soft contact lenses. The corneal topography map showed significant changes on the both groups after wearing soft contact lenses (p<0.05). However there were no significant differences in the refractive power and corneal topography map variations by lens materials. Conclusions: Wearing soft contact lenses showed corneal topography map changes. Especially wearing soft contact lenses on the flat cornea after corneal refractive surgery showed greater corneal power changes. Therefore, it should pay attention to refractive change in case of prescribing soft contact lenses to patients with corneal refractive surgery.
Purpose: The purpose of this study is to investigate the effect of age in the response to long-term overnight orthokeratology (OK) lens wearing. Methods: Among volunteers, ninety-five healthy subjects who had no eye diseases and could wear OK contact lens at least for 8 hours every day were divided into three groups children, youngsters and young adults. Unaided logMAR visual acuity, refractive error, apical corneal radius, corneal asphericity and central corneal thickness were measured with different period; before and after one day, one week, two weeks, one month, three months and six months of OK lens wear. Paired student t-test, ANOVA analysis and Pearson correlation were used with a critical p value of 0.05 for statistical analysis. Results: All groups showed statistically significant (p<0.001) improvement in unaided visual acuity, a trend for flattening in the apical corneal radius, decrease in central corneal thickness and less prolate after OK lens wear. The child group showed significantly rapid change (p<0.001) in visual acuity, and apical corneal radius showed that they reached the targeted refractive change earlier compared with youngster and adult groups. The visual effect of OK lens was significantly related with the change in central corneal thickness after long-term OK lens wear, especially in child and youngster group, and central corneal thickness were highly correlated with the targeted refractive change. Conclusions: Visual acuity change is statistically correlated with the central corneal thickness change, which is highly correlated with targeted refractive change in the long-term orthokeratology and younger lens wearers showed a rapid response to OK lens wear, suggesting a reduced epithelial response with increasing age. The results found this study extends our understanding and development in the long-term orthokeratology.
We researched the change of astigmatism power when the fixation point moved from far distance to near distance. Astigmatism power was measured by using both eyes open-view auto-refractometer. We divided the ages between 5 and 67 years old into 12 groups with 1,598 healthy eyes(male-698 eyes and female-900 eyes) without eyes problems and experiences of eyes operations. The mean power in far astigmatism showed that with-the-rule of the total astigmatism: -0.79D, with-the-rule of the corneal astigmatism: -1.07D and against-the-rule of the residual astigmatism : -0.79D were found most respectively. The correlation between cornea astigmatism and total astigmatism was y=0.7493 x + 0.5661 r=0.6510, residual astigmatism and total astigmatism was y=0.248 x - 0.5926 r=0.2598 and corneal astigmatism and residual astigmatism was y=-0.4439 x - 0.1813 r=-0.5551 in the far distance. The mean power in near astigmatism showed that with-the-rule of total astigmatism : -0.92D, with-the-rule of corneal astigmatism : -1.12D, against-the-rule of residual astigmatism : -0.87D were found most respectively. In the near distance, The correlation between corneal astigmatism and total astigmatism was y=0.6872 x + 0.5934 r=0.6204, residual astigmatism and total astigmatism was y=0.303 x - 0.6066 r=0.3165, corneal astigmatism and residual astigmatism was y=-0.46 x - 0.0626 r=-0.5322. When the fixation point moved far distance to near distance, the differences of power according to the type of astigmatism were total astigmatism: $-0.07D{\pm}0.44D$, corneal astigmatism: $-0.04D{\pm}0.54D$ residual astigmatism:$0.01D{\pm}0.53D$. Most of astigmatism refractive power was increased except for oblique-the -astigmatism. When the fixation point moved far distance to near distance, the change of astigmatism refractive power showed total astigmatism: 540 eyes(33.7%), corneal astigmatism: 638 eyes(39.9%), residual: 841 eyes(52.6%).
Purpose: To investigate the effect of corneal unique shape to changes of refractive full corrections when pupil size changes. Methods: Subjective refraction for monocular full correction was performed to 30 subjects ($23.33{\pm}1.78$ of age, 60 eyes) in two room conditions, 760 lx and 2 lx, respectively. Pupillary diameter was measured in two conditions and the change pattern was analyzed using a peak data of corneal topography. Results: Pupillary diameter was 3.74~4.00 mm in 760 lx and 5.52~5.90 mm in 2 lx. By comparison with refractive data in 760 lx, those data in 2 lx was changed as follows: more (-) spherical power of 17 eyes (28.3%), more (+) spherical power of 10 eyes (17.7%), more (-) cylinderical power of 17 eyes (28.8%), less (-) cylinderical power of 9 eyes (15.3%), and astigmatic axis rotation of 36 eyes (62.1%). From peak data of corneal topography, the changing pattern of two principal meridians was classified into 4 types. Conclusions: Expansion of the corneal refractive surface accompanied with pupillary dilation may be a main factor that effects the changing a values of subjective refraction because of unique corneal shape. Therefore, subjective refraction should be performed under the nearest lighting condition to a main living environment.
Purpose: To investigate the corneal recovery after discontinuing orthokeratology (OK) lenses wear in children for long-term period. Methods: Among the OK lens wearers who wear over 8 months and showed successful refractive correction, 25 subjects were selected who want to discontinue the OK lenses. Uncorrected visual acuity, refractive correction, corneal curvature (Sim K), central corneal thickness and corneal eccentricity were measured during the OK lens wearing period and after discontinuation for 1 month. Results: Uncorrected visual acuity and corneal shape had remodeled significantly during the OK lens wear and recovered significantly during the first week of discontinuation. Uncorrected visual acuity and refractive correction had achieved full recovery 2 weeks after discontinuation of lens wear and were highly correlated with the changes in corneal thickness. But corneal shape recovered slowly, eccentricity had recovered fully after 1 month and corneal curvature and central thickness had not been achieved full recovery until 1 month after discontinuation. Conclusions: Recovery of after longterm use of OK lens is rapid for refractive change, but slow for corneal curvature and central thickness that to refit the contact lenses, practitioners need patience.
We investigated refractive errors and corneal power with 3 factors such as M, $J_0$, and $J_{45}$ as power vector to find out the changes of refractive errors of the before and after cataract surgery in 119 adults aged 45~85 years with cataract. After the surgery, the 3 factors were changed as $-0.29{\pm}2.38D$ to $-0.18{\pm}0.69D$ in spherical equivalent power which is the M factor, $-0.34{\pm}0.68D$ to $-0.05{\pm}0.42D$ in the $J_0$ factor, and $0.11{\pm}0.45$ to $0.02{\pm}0.17$ in the $J_{45}$ factor. Before and after the surgery, corneal mean refractive power, $J_0$, and $J_{45}$ were changed from $44.11{\pm}1.61D$ to $44.20{\pm}1.58D$, $0.01{\pm}0.50D$ to $0.08{\pm}0.49D$, and $0.02{\pm}0.29$ to $0.08{\pm}0.49$, respectively. The results showed that $J_0$ was the highest relativeness in correlation of the pre- and post-surgery for refractive errors, mean corneal power was the highest correlation for corneal power factor, and corneal power factor was the higher correlation much more than refractive error factor.
Purpose: To evaluate the changes of refractive power when worn soft contact lenses were temporarily removed. Methods: 91 soft contact lens wearers (15 males and 76 females; total 182 eyes) from 17 to 39 years of age (average: $24{\pm}4.8$ years) were participated. Objective and subjective refraction, and corneal radius were measured at 0, 30, 60 and 90 min after lens removal. The changes in refractive power were evaluated between measurements over time. The other parameters such as types of lenses, fitting and wearing conditions were also assessed. Results: Objective refraction, subjective refraction and corneal radius were significantly changed according to measured time (p<0.0001). A moderate myopic shifts was observed at the beginning (30 min after lens removal) and a slight myopic shift at the late of measurement (60 min to 90 min after lens removal). There are no significant differences between lens types, fitting states, wearing time, wearing days and sleeping time in the previous day. However, there was significant interaction in changes for corneal radius between measuring time and lens type (p=0.017), fitting state (p=0.019), and sleeping time prior to the test (p=0.010). Conclusions: Time to reach refractive and corneal radius stability after contact lens removal revealed at least more than 60 min, regardless of types of lenses, fitting and wearing conditions. Therefore, refraction for correction should be performed after waiting for more than that time as possible.
Purpose: This study is for compared the change of corneal refractive power before and after wearing of rigid gas permeable contact lense with diagnostic method which is 1 D flatter than alignment fitting on right eye and alignment fitting on left eye for 2 months and investigate the preference. Methods: Twenty middle school and high school students (40 eyes) who had never worn a contact lense before for no corneal topographical change, no ocular disease, no experience of ophthalmic surgery and have normal tear amount were selected for this study and corneal refractive power were examined before wearing rigid gas permeable contact lense and adaptation status and corneal examination were performed after 10 days of wearing and after cheking up the continuation of wearing, all candidate wear contact lens 8 hours per day for 2 month and corneal refractive power were compared. Results: After 2 months of wearing with 1 D flatter than the alignment fitting on right eyes, there was significant difference in the central corneal refractive power was $43.84{\pm}1.33D$, flat K power was $43.05{\pm}1.29D$, and steep K power was $44.61{\pm}1.42D$ decreased than before wearing (p<0.001, 0.001, 0.047). The e-value of the principal meridians also shows statistically significant difference (p=0.037, 0.015). After 2 months of wearing with alignment fitting on left eyes, the central corneal refractive power was $44.40{\pm}1.26D$, flat K power was $43.57{\pm}1.23D$. and flat K e-value was $0.58{\pm}0.05$ which showed no statistically significant difference (p = 0.769, 0.614, 0.181). But steep K power was $45.25{\pm}1.36$, and steep K e-value was $0.45{\pm}0.18$ which shows statistically significant difference (p=0.018, 0.027). Conclusions: Consider the comfort, clear vision, dryness for preference fitting investment, 6 students (30%) prefer right eye which is 1 D flatter fitting, 14 students (70%) prefer left eye which is alignment fitting. For rigid gas permeable fitting needed for accurate examination and should prescribe the alignment fitting which is suitable for each cornea.
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