The Comparison of Lens Movement by the Fitting States of Soft Contact Lenses in Normal and Dry Eyes

정상안과 건성안에서 피팅상태에 따른 각막에서의 소프트렌즈 움직임 비교

  • Jung, Da I (Department of Visual Optics, Seoul National University of Science and Technology) ;
  • Lim, Shin Kyu (Department of Visual Optics, Seoul National University of Science and Technology) ;
  • Kim, So Ra (Department of Visual Optics, Seoul National University of Science and Technology) ;
  • Park, Mijung (Department of Visual Optics, Seoul National University of Science and Technology)
  • 정다이 (서울과학기술대학교 안경광학과) ;
  • 임신규 (서울과학기술대학교 안경광학과) ;
  • 김소라 (서울과학기술대학교 안경광학과) ;
  • 박미정 (서울과학기술대학교 안경광학과)
  • Received : 2010.11.01
  • Accepted : 2011.03.19
  • Published : 2011.03.31

Abstract

Purpose: The study was performed to compare the differences in lens rotation, lens movement by blinking and lens centration with alignment or steep fitting of soft contact lens in normal and dry eyes. Methods: Total 40 eyes (aged 20~30 years) were classified into the normal (n=20) or dry eye group (n=20) by the diagnosis methods for dry eyes and worn soft contact lens (polymacon material) with alignment fitting or steep fitting. Lens rotation, lens movement by blinking and lens centration were separately measured immediately after lens wearing and after stabilization of tear film and compared by fitting states of soft contact lenses. Results: With steep fitting of soft contact lens in dry eyes, averaged lens rotation immediately after lens wearing was not significantly different from that of the normal eye group with alignment fitting however, lens rotation after stabilization in dry eyes was significantly larger than that in normal eyes. Any significant difference in lens movement by blinking was not shown in normal eyes. However, lens movement by blinking in dry eyes was increased with steep fitting. The range of lens centration on cornea in normal eyes with alignment fitting was more vertically distributed. On the other hand, the range of lens centration on cornea in dry eyes with alignment fitting was more horizontally distributed. Lens centration was shown to be changed by stabilization of tear film. That is, lens centrations were somewhat vertically widespread immediately after lens wearing and restrictively distributed in horizontal direction, respectively, with steep fitting in dry eyes. Conclusions: These results suggested that lens movements and centration in dry eyes were different from those of normal eyes. Especially, those differences between normal and dry eyes were much bigger with steep fitting of soft contact lenses. Thus, those differences should be considered for the comfortable and safe fitting of soft contact lens in dry eyes.

목적: 소프트렌즈를 얼라인먼트(alignment) 피팅 또는 스팁(steep) 피팅하였을 때 각막에서의 렌즈의 회전 움직임, 순목에 의한 이동거리 및 중심위치가 정상안과 건성안에서 어떠한 차이를 보이는지 알아보고자 하였다. 방법: 20~30대 남녀 40안을 정상안군과 건성안군으로 분류한 후 polymacon 재질의 소프트렌즈를 얼라인먼트 피팅 혹은 스팁피팅상태로 착용시키고 렌즈 착용 직후 및 눈물층이 안정화 되었을 때의 회전 움직임, 순목에 의한 이동거리, 중심위치를 비교하였다. 결과: 렌즈의 회전 움직임은 스팁하게 피팅하였을 경우 정상안 군은 얼라인먼트 피팅시와 큰 차이를 보이지 않았으나, 건성안 군에서는 눈물층이 안정화되는 시점에서의 평균 회전 움직임이 정상안 군보다 통계적으로 유의하게 컸다. 정상안 군에서는 피팅에 따른 렌즈 이동거리의 차이가 없었으나 건성안 군에서는 스팁하게 피팅된 경우 렌즈의 이동 거리가 증가하였다. 각막에서의 렌즈 중심 위치는 얼라인먼트 피팅된 렌즈를 착용한 정상안 군의 경우 수직 방향으로의 분포가 더 컸으나 건성안의 경우는 수평 방향으로의 분포가 더 컸다. 또한 건성안에 렌즈를 스팁하게 피팅하였을 때에는 렌즈를 착용한 직후 렌즈의 중심 위치가 수직방향으로도 다소 넓게 분포하였으며 눈물층이 안정화된 후에는 오히려 수평 방향의 분포가 좁아져 눈물층의 안정화에 따라 렌즈의 중심 위치가 변함을 알 수 있었다. 결론: 본 연구를 통하여 건성안에서의 소프트렌즈의 움직임과 중심 위치가 정상안의 경우와 상이하며 특히 스팁 피팅시에는 그 차이가 더 두드러짐을 알 수 있었다. 따라서 건성안에 소프트렌즈를 피팅할 시에는 본 연구를 통하여 확인할 수 있었던 정상안과의 차이를 고려해야 할 것으로 생각된다.

Keywords

References

  1. Pearson R. M., "A review of the limitations of the first hydrogel contact lenses", Clin. Exp. Optom., 93(1):15-25(2010). https://doi.org/10.1111/j.1444-0938.2009.00444.x
  2. Jalbert I., Sweeney D. F., and Stapleton F., "The effect of long-term wear of soft lenses of low and high oxygen transmissibility on the corneal epithelium", Eye, 23(6):1282-1287(2009). https://doi.org/10.1038/eye.2008.307
  3. Dumbleton K. A., Woods C. A., Jones L. W., and Fonn D., "Comfort and adaptation to silicone hydrogel lenses for daily wear", Eye Contact Lens, 34(4):215-223(2008). https://doi.org/10.1097/ICL.0b013e31816499dc
  4. Brennan N. A., Coles M. L., and Ang J. H., "An evaluation of silicone-hydrogel lenses worn on a daily wear basis", Clin. Exp. Optom., 89(1):18-25(2006). https://doi.org/10.1111/j.1444-0938.2006.00003.x
  5. Schafer J., Mitchell G. L., Chalmers R. L., Long B., Dillehay S., Barr J., et al., "The stability of dryness symptoms after refitting with silicone hydrogel contact lenses over 3 years", Eye Contact Lens, 33(5):247-252(2007). https://doi.org/10.1097/ICL.0b013e3180587e21
  6. Long B. and McNally J., "The clinical performance of a silicone hydrogel lens for daily wear in an Asian population", Eye Contact Lens, 32(2):65-71(2006). https://doi.org/10.1097/01.icl.0000175915.01688.ba
  7. Donshik P., Long B., Dillehay S. M., Bergenske P., Barr J. T., Secor G., et al., "Inflammatory and mechanical complications associated with 3 years of up to 30 nights of continuous wear of lotrafilcon A silicone hydrogel lenses", Eye Contact Lens, 33(4):191-195(2007). https://doi.org/10.1097/ICL.0b013e31802cc275
  8. Chapman G. J., Vale A., Buckley J., Scally A. J., and Elliott D. B., "Adaptive gait changes in long-term wearers of contact lens monovision correction", Ophthalmic Physiol. Opt., 30(3):281-288(2010). https://doi.org/10.1111/j.1475-1313.2010.00725.x
  9. Papas E. B., Decenzo-Verbeten T., Fonn D., Holden B. A., Kollbaum P. S., Situ P., et al., "Utility of short-term evaluation of presbyopic contact lens performance", Eye Contact Lens, 35(3):144-148(2009). https://doi.org/10.1097/ICL.0b013e3181a20361
  10. Bennett E. S., "Contact lens correction of presbyopia", Clinical and Experimental Optometry, 91(3):265-278(2008). https://doi.org/10.1111/j.1444-0938.2007.00242.x
  11. 김태훈, 민경록, 성아영, "대학생들의 콘택트렌즈 착용 실태에 관한 연구", 한국안광학회지, 10(2):151-157(2005).
  12. Begley C. G., Caffery B., Nichols K. K., and Chalmers R., "Responses of contact lens wearers to a dry eye survey", Optom. Vis. Sci., 77(1):40-46(2000). https://doi.org/10.1097/00006324-200001000-00012
  13. Jansen M. E., Begley C. G., Himebaugh N. H., and Port N. L., "Effect of contact lens wear and a near task on tear film break-up", Optom. Vis. Sci., 87(5):350-357(2010).
  14. Lemp M. A., "Report of the national eye institute/industry workshop on clinical trials in dry eyes", CLAO J., 21(4):221-232(1995).
  15. Ramamoorthy P., Sinnott L. T., and Nichols J. J., "Contact lens material characteristics associated with hydrogel lens dehydration", Ophthalmic Physiol. Opt., 30(2):160-166(2010). https://doi.org/10.1111/j.1475-1313.2009.00705.x
  16. Yeniad B., Beginoglu M., and Bilgin L. K., "Lid-wiper epitheliopathy in contact lens users and patients with dry eye", Eye Contact Lens, 36(3):140-143(2010). https://doi.org/10.1097/ICL.0b013e3181d94e82
  17. Fonn D., "Dryness with contact lenses and dry eye: are they the same or different?", Eye Contact Lens, 35(5):219(2009). https://doi.org/10.1097/ICL.0b013e3181bb390f
  18. 이병준, 홍재현, 정다이, 박미정, "건성안 검사 방법의 신뢰도에 대한 연구", 한국안광학회지, 13(1):15-20(2008).
  19. Horwath-Winter J., Berghold A., Schmut O., Floegel I., Solhdju V., Bodner E., et al., "Evaluation of the clinical course of dry eye syndrome", Arch. Ophthalmol., 121(10):1364-1368(2003). https://doi.org/10.1001/archopht.121.10.1364
  20. Mengher L. S., Bron A. J., Tonge S. R., and Gilbert D. J., "A non-invasive instrument for clinical assessment of the pre-corneal tear film stability", Curr. Eye Res., 4(1):1-7(1985). https://doi.org/10.3109/02713688508999960
  21. Madden R. K., Paugh J. R., and Wang C., "Comparative study of two non-invasive tear film stability techniques", Curr. Eye Res., 13(4):263-269(1994). https://doi.org/10.3109/02713689408995787
  22. 임경직, 이진학, "건성안에서의 Tear Meniscus Height", 대한안과학회지, 33(1): 29-31(1992).
  23. Narayanan S., Miller W. L., Prager T. C., Jackson J. A., Leach N. E., McDermott A. M., Christensen M. T., and Bergmanson J. P. G., "The diagnosis and characteristics of moderate dry eye in non-contact lens wearers", Eye Contact Lens, 31(3):96-104(2005). https://doi.org/10.1097/01.ICL.0000140907.45705.E2
  24. 박미정, 양재헌, 김선미, 박상일, 박상희, 김소라, "일일 착용 렌즈의 착용기간 초과시 유발되는 렌즈의 중심 안정위치 및 순목횟수 변화", 한국안광학회지, 13(4):51-58(2008).
  25. 최병철, 박성현, "SPSS와 SAS분석을 통한 실험계획법의 이해", 초판, 민영사, 서울, pp.26-30(2005).
  26. 박미라, 이재원, "EXCEL을 이용한 의학데이터의 통계분석", 초판, 자유아카데미, 서울, pp.159-165(2007).
  27. Cheung S. W., Cho P., Chan B., Choy C., and Ng V., "A comparative study of biweekly disposable contact lenses: silicone hydrogel versus hydrogel", Clin. Exp. Optom., 90(2):124-131(2007). https://doi.org/10.1111/j.1444-0938.2006.00107.x
  28. Monticelli M. V., Chauhan A., and Radke C. J., "The effect of water hydraulic permeability on the settling of a soft contact lens on the eye", Curr. Eye Res., 30(5):329-336(2005). https://doi.org/10.1080/02713680590934085
  29. Wolffsohn J. S., Hunt O. A., and Chowdhury A., "Objective clinical performance of comfort-enhanced daily disposable soft contact lenses", Cont. Lens Anterior Eye, 33(2):88-92(2010). https://doi.org/10.1016/j.clae.2010.01.004
  30. Guillon M., Maissa C., and Ho S., "Evaluation of the effects on conjunctival tissues of Optive eyedrops over one month usage", Cont. Lens Anterior Eye, 33(2):93-99(2010). https://doi.org/10.1016/j.clae.2010.01.007