Lim, Shin Gyu;Lee, Min Ha;Choi, Sun Mi;Park, Sang Hee;Kim, So Ra;Park, Mijung
Journal of Korean Ophthalmic Optics Society
/
v.17
no.2
/
pp.143-151
/
2012
Purpose: The present study was conducted to investigate whether there is any difference in the centration of spherical RGP lens on cornea according to corneal types, corneal astigmatism and lens fitting states. Methods: Spherical RGP lens was fitted on 29 eyes of round-typed cornea and 45 eyes of symmetric bowtie-typed cornea with 0.00~2.75 D of corneal astigmatism in alignment, steep or flat. Their lens centrations on cornea were analyzed by taking photographs. Results: The centration of spherical RGP lens in the vertical direction was decentrated to downward direction in all cases, and the degree of decentration was not consistent. The lens centration in horizontal direction was significantly more-decentrated to the temporal meridian as base curve of lens was increased, and the degree of decentration was different according to the corneal type, corneal astigmatism and fitting states. With the same degree of astigmatism, the lens decentration to the temporal meridian was bigger in round-typed cornea than that in symmetirc bowtie-typed cornea. Conclusions: The centration of spherical RGP lens varies depending on lens fitting states, corneal astigmatism, and corneal types. Thus, the consideration of these factors may improve the success rate in RGP lens prescription.
To assess the preference and efficacy of empirical fitting methods with spheric and aspheric RGP lenses. Methods: Healthy 37 subjects were fitted with spheric design (diameter 9.3 mm) on right eye and aspheric design (dia 9.6 mm) on the left eye. Base curves which were fitted empirically (using on-K, Kavg-0.50D (or 1.00D) and manufacturer's recommended fitting guide) were compared with another base curve which obtained the best diagnostic fit with spheric and aspheric RGP lenses. The preference and fitting type (lid attachment or interpalpebral) for two design lenses were investigated 2 weeks after fitting RGP lenses. Results: Of 33 successful RGP lens-wearing subjects, 76% preferred spheric design compared with 24% of aspheric RGP lens wearers. Sixty seven percent were fitted with lid-attachment in spheric lenses, whereas 64% were fitted with lid-attachment in aspheric lenses. The acceptable fit success rates within ${\pm}$0.50D of base curves were 97% for the on-K fit, 100% for the Kavg-0.50D fit and 100% of the manufacturer's guide fit compared with the diagnostic fit in spheric design, whereas 91%, 79% and 94% reported on-K, Kavg-1.00D and manufacturer's guide, respectively, in aspheric design. Conclusions: Although aspheric RGP lenses are more popular in the Korean market, it is still preferable to fit subjects with spheric RGP lenses. Empirical fitting may be best accomplished with the spheric lenses using Kavg-0.50D fit and the manufacturer's fitting guide, whereas aspheric RGP lens designs are unacceptable lens fit based on empirical fitting.
Purpose: The present study was performed to investigate a relationship between the stable centrations of spherical RGP lens and aspherical RGP lens on cornea and corneal eccentricity. Methods: Two RGP lenses with different designs were fitted in alignment, steep or flat on total 84 eyes having corneal eccentricity of 0.28~0.78. The stable centration of lenses on cornea was analyzed by taking photographs with a high-speed digital camera. Results: The stable centrations of spherical and aspherical RGP lenses in horizontal direction were decentrated to temporal side. More centration to median side was shown when corneal eccentricity was larger. The difference between the stable centrations of spherical and aspheric RGP lenses according to corneal eccentricity was bigger when the fitting state was flatter. The difference in the stable centrations of aspherical RGP lens was smaller than that of spherical RGP lens regardless of fitting status. The stable centrations of spherical and aspherical RGP lenses in vertical direction were located below corneal apex regardless of fitting status however, there was no significant difference analyzed by the variation of corneal eccentricity. However, there were many cases that RGP lenses were in upper eyelid with increasing corneal eccentricity. Conclusions: The consideration of corneal eccentricity is required for RGP lens fitting and manufacturing aspherical RGP lens since the stable centration of spherical RGP lens as well as aspherical RPG lens' centration was changed depending on corneal eccentricity.
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.
Purpose: The present study was aimed to compare the tear volume and distribution by corneal eccentricity when fitted with spherical and aspherical RGP lenses. Methods: Spherical and aspherical RGP lenses were fitted in best alignment on a total of 77 subjects (136 eyes) in their twenties and thirties without any ocular disease or ocular surgery experience. The tear volume was analyzed by estimating the concentration of tear stained with fluorescein in the center of RGP lens as well as at the mid-peripheral and peripheral areas, and the difference of tear distributions was analyzed according to corneal eccentricity. Results: Tear distribution from the center to the peripheral area was not significantly different when spherical RGP lenses were fitted on the corneal eccentricities of e < 0.38 and $0.68{\leq}e$, indicating the relatively even tear distribution compared with other corneal eccentricity. In the case of aspherical RGP lenses, the difference of tear distribution between the central and peripheral areas was smaller than spherical RGP lenses. The significant difference of tear distribution according to RGP lens design was observed in the corneal eccentricity of 0.48 < e < 0.68. In other words, more even tear distribution was shown when aspherical RGP lenses were fitted on the cornea with eccentricity of $0.48{\leq}e<0.68$ and spherical RGP lenses were fitted on the cornea with eccentricity $0.68{\leq}e$. Furthermore, tear volume in the mid-peripheral area increased with higher corneal eccentricity. Conclusions: The results suggest that the appropriate selection of RGP lens design according to corneal eccentricity is necessary since tear volume and distribution by the regions of spherical and aspherical lenses are affected by corneal eccentricity.
Purpose: The change of alignment between RGP lens and cornea according to the lens design was investigated by comparing the areas of fluorescein pattern in central and peripheral regions analyzed by astigmatic degree and corneal type when spherical and aspherical RGP lenses fitted in alignment. Methods: The fluorescein patterns of 90 eyes (19-30 years, $25.12{\pm}3.52$) having with-the-rule astigmatism were analyzed after spherical and aspherical RGP lenses fitted in alignment. Then, their fluorescent areas in central and peripheral regions were calculated and compared for the quantitative evaluation. Results: The case showing concordant base curve between spherical and aspherical RGP lenses in alignment fitting was 72% however, the possibility to have same base curves between spherical and aspherical RGP lenses in alignment fitting was to be less in the case of symmetric bowtietyped cornea and high astigmatism. The fluorescent area in peripheral region of aspherical RGP lens in alignment fitting was smaller than it of spherical RGP lens. Peripheral fluorescent areas in both RGP lenses decreased according to the increase of astigmatic degree and peripheral area in symmetric bowtie-typed corea was smaller than round-typed cornea's peripheral area. In the case of same astigmatic degree, peripheral fluorescent area of aspherical RGP lens was smaller in both corneal types. Conclusions: The results above suggest the changing degree in the alignment between RGP lens and cornea can be varied according to lens design, corneal astigmatism and corneal type. Thus, the results obtained from the quantitative analysis of the alignment between lens design and cornea may be used as the basic information about the establishment of guidelines for RGP lens fitting, the development of proper lens design, and different tear volume in partial regions.
Purpose: In the present study, a difference in tear volume between the cornea and the rigid gas permeable (RGP) lens relative to corneal shape and corneal astigmatism was investigated by the alignment fitting status of spherical and aspherical RGP lenses. Methods: Spherical and aspherical RGP lenses were fitted with alignment in 77 subjects (135 eyes) who were in their 20~30s. Tear volume stained with fluorescein was qualitatively analyzed by dividing cornea into center, mid-peripheral and peripheral parts. Results: For the spherical RGP lens fitting, tear volume differences were found in each part in all corneal types. For the aspherical RGP lens fitting, tear volume differences were in each corneal part in symmetric bow tie- and asymmetric bow tie-type corneas. However, the tear was equally distributed from the center to the peripheral part in round- and oval-type corneas. In the group with corneal astigmatism lower than 1.25 D, tear volume between center and peripheral parts, and mid-peripheral and peripheral parts, was different when a spherical RGP lens was fitted. However, tear volume in each part was not different in the group with corneal astigmatism over 1.50 D. Moreover, the tear volumes of the central and mid-peripheral parts were proportionally increased with increasing corneal astigmatism in both spherical and aspherical RGP lenses. Furthermore, aspherical RGP lenses showed greater increments than spherical RGP lenses. Conclusions: The results revealed that the difference in tear volume between aspherical RGP lens and cornea was less than spherical RGP lens, and the difference in tear volume varied according to corneal shape and astigmatism. In addition, the method of measuring relative tear volume between RGP lens and cornea that was established in the present study can be used to evaluate tear volume between contact lens and cornea.
Purpose: The present study was conducted to analyze any difference in the movement of aspheric RGP lens by the amounts of keratometiric astigmatisms using keratometer and corneal topography. Methods: Corneal curvatures in thirty six eyes of males and females of with-the-rule keratometric astigmatisms in their twenties were measured by a keratometer and worn aspheric RGP lenses. Then, lens rotations, vertical and horizontal movements of lens by blinking were measured to compare with lens movements when aspheric RGP lenses were fitted by total keratometric astigmatisms using corneal topography. Results: The case having higher amount of central keratometric astigmatism was 61.1% of subjects, however, 36.1% of subjects showed higher total keratometric astigmatism indicating that central keratometric astigmatism was not always bigger than total keratometric astigmatism. Since over 0.25 diopter difference between total and central keratometric astigmatisms was shown in 19 eyes (52.8% of subjects), the prescription for lens fitting could be changed. Significant difference in horizontal movement was detected with increase of astigmatism when it compared based on the amount of keratometric astigmatism measured by a keratometer. However, there was no significant difference in lens rotation, horizontal and vertical movements by comparison with the amount of total keratometric astigmatism using a corneal topography. When central keratometric astigmatism measured by keratometer was bigger than total keratometric astigmatism estimated by corneal topography, bigger lens rotation was shown compared with opposite case. Also, the tendency of bigger lens rotation was measured with the increase of keratomatric astigmatism in the case of same prescription having same base curves with same amount of keratometric astigmatism but different curvatures. Conclusions: From the present study, we concluded that lens movements on cornea were not totally different when aspheric RGP lens fitted on with-the-rule astigmatism by keratometer and corneal topography. However, there was some difference in certain lens movements. Therefore, we concluded that further study on the relationship between the prescriptions for lens fitting should be conducted for improving the rate of successful lens fitting by keratometer or for the proper application of corneal topography for lens fitting.
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.
Purpose: This study was to evaluate corneal topography, contrast sensitivity and ocular response of a RGP, back surface aspherical contact lens compared with a spherical contact lens. Methods: A total 37 subjects were fitted with a spherical lens in right eye and an aspherical in the left eye and were evaluated for changes in corneal topography and contrast sensitivity over a 2-month period. Results: Thirty-four of 37 subjects completed the 2-month study. The corneal topography did not show differences between spherical and aspherical RGP lenses. The eyes fitted with the aspherical lenses demonstrated a greater reduction in contrast sensitivity compared with their spherical counterparts under photopic condition. Subjects preferred comfort and ocular responses provided by the spherical lens. Conclusions: Corneal topography when comparing spherical and back surface aspherical RGP lenses did not show any significant difference in the subjects. Spherical RGP lens yields better contrast sensitivity and preference than aspherical RGP lens at photopic condition. Further investigation of aberrations induced by contact lens design is warranted to explain the observed differences in visual performance.
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