Usefulness of Rotation for Toric Soft Lenses Using Objective Refraction

타각적 굴절검사를 이용한 토릭 소프트 렌즈 회전 평가의 유용성

  • Yu, Dong-Sik (Department of Optometry and Vision Science, Kyungwoon University) ;
  • Moon, Byeong-Yeon (Department of Optometry, Kangwon National University) ;
  • Son, Jeong-Sik (Department of Optometry and Vision Science, Kyungwoon University)
  • Received : 2011.07.29
  • Accepted : 2011.09.17
  • Published : 2011.09.30

Abstract

Purpose: The clinical usefulness of rotation evaluation using objective refraction in toric soft lenses fitting was investigated. Methods: Toric soft lenses were fitted for 32 subjects (64 eyes; mean age of 24.69 ${\pm}$ 1.65 years) with astigmatism and both eyes of each subject were fitted with toric soft lenses. Objective refraction-based lenses rotation was evaluated from refraction and over-refraction data by indirect calculating technique. These calculated data were compared with the measured data from slit lamp with direct measuring technique. Results: Orientation of toric soft lenses around zero position (within ${\pm}$ 5$^{\circ}$ vertical line) was investigated. The orientations to the direction of nose of measured and calculated values were 69.78% and 63.64%, respectively, which showed similar values between two techniques. Agreement frequency between measured and calculated values in the magnitude of lenses rotation 54.69% and 82.82% for 10$^{\circ}$ and 20$^{\circ}$ of vertical line, respectively. The 95% limits of agreement between calculation and measurement were from -10.08$^{\circ}$ to 12.65$^{\circ}$, and mean difference was 1.29$^{\circ}$ within ${\pm}$ 10$^{\circ}$. The result showed there was no significant difference (p = 0.1984) and high correlation (r = 0.56, p = 0.0004) between two techniques. But the 95% limits of agreement was widen in ${\pm}$ 20$^{\circ}$ of vertical line. The magnitude of lens rotation between two methods was 9.66 ${\pm}$ 6.16$^{\circ}$, 16.17 ${\pm}$ 12.38$^{\circ}$ and 10.58 ${\pm}$ 12.02$^{\circ}$ for normal, loose and tight fitted conditions. Conclusions: From the results with smaller difference between two techniques, it was found that higher availability of subjective over-refraction data can be used as a supplementary tool for subjective refraction. An application using objective refraction with direct measuring could be provide high success in prescription on toric soft lenses.

목적: 토릭 소프트 렌즈 피팅에서 타각적 굴절검사를 이용하여 회전 평가의 임상적 유용성을 알아보고자 하였다. 방법: 난시가 있는 32명(64안, 평균 24.69${\pm}$1.65세)을 대상으로 토릭 소프트렌즈를 피팅하였다. 타각적 굴절검사와 덧댐굴절검사로부터 계산에 의해 렌즈 회전을 평가하여 세극등현미경으로 직접 측정한 값과 비교하였다. 결과: 토릭 소프트 렌즈 회전의 방향은 0점(수직선 ${\pm}$5$^{\circ}$이내) 기준으로 계산과 측정에서 각각 코 방향으로 69.78%와 63.64%로 서로 유사하였다. 계산과 측정에 따른 렌즈 회전 크기에 대한 일치 빈도는 두 방법 간의 차이 기준이 10$^{\circ}$이하에서 54.69%, 20$^{\circ}$이하에서 82.82%를 보였다. 두 방법의 95% 일치도 범위는 ${\pm}$10$^{\circ}$이하에서 -10.08$^{\circ}$~12.65$^{\circ}$(p = 0.1984)이며, 평균차이가 1.29$^{\circ}$로 두 값 사이의 일치성이 있는 것으로 평가되었고, 상관성(r = 0.56, p=0.0004)이 있는 것으로 나타났다. 하지만 ${\pm}$20$^{\circ}$이하에서 두 방법 간의 일치성의 범위가 더 넓게 나타났으며 상관관계가 없는 것으로 나타났다. 피팅 상태에서 두 방법 간의 렌즈 회전 크기 차이는 정상(normal) 피팅에서 9.66${\pm}$6.16$^{\circ}$, 느슨한(loose) 피팅에서 16.17${\pm}$12.38$^{\circ}$ 그리고 타이트(tight) 피팅에서 10.58${\pm}$12.02$^{\circ}$로 나타났다. 결론: 타각적 굴절검사를 기준으로 한 회전 평가와 직접 측정에 의한 회전 평가의 차이가 작을수록 타각적 덧댐굴절검사 값을 자각적 굴절검사를 위한 보조수단으로서 이용 가능성이 더 크며, 또한 정상적 피팅의 가능성이 더 높은 것으로 평가된다. 따라서 직접 측정하는 방법과 이 방법을 병행 적용함으로써 토릭 소프트렌즈의 처방 성공률을 더 높일 수 있을 것으로 본다.

Keywords

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