각공막 측면부가 소프트 콘택트렌즈 피팅에 미치는 영향에 관한 연구 = A study of the Influence of Corneoscleral Profile on Soft Contact Lens Fitting

국문 초록 (Abstract)

목적: 본 연구의 목적은 세극등 현미경으로 확인된 각공막 측면부의 형태에 따라 소프트 콘택트렌즈 피팅 차이를 비교 분석하여 콘택트렌즈 피팅 시 각공막 측면부의 중요성과 연관성에 대해 알아보고자 하였다. 방법: 각막굴절 교 정수술을 받지 않고 눈에 안질환이 없는 33명(65안)을 대상으로 상, 하측 각공막 측면부 형태를 확인한 후 다중커 브 구면 소프트 콘택트렌즈로 피팅하였다. 각공막 측면부 형태에 따라 그룹을 분류하고 편심, 순목 후 움직임, 래그, 푸 쉬업 검사를 진행하였다. 분류된 그룹들은 검사 항목에 따라 비교하였고, 피팅 상태를 확인하였다. 결과: 각공막 측 면부 상측 이행부위가 부드러운 볼록 혹은 접선 그룹이 상측 이행부위가 뚜렷한 볼록 혹은 접선 그룹보다 순목 후 움직임(p = 0.000), 이측 래그(p = 0.003), 비측 래그(p = 0.001), 하측 래그(p = 0.021)에서 유의하게 더 컸고, 상대적으로 느슨한 피팅 상태를 보여주었다(p = 0.041). 각공막 측면부 하측 이행부위가 부드러운 볼록 혹은 접선 그룹이 하 측 이행부위가 뚜렷한 볼록 혹은 접선 그룹보다 순목 후 움직임(p = 0.000), 비측 래그(p = 0.001), 하측 래그(p = 0.049)에서 유의하게 더 컸고, 상대적으로 느슨한 피팅 상태를 보여주었다(p=0.021). 결론: 각공막 측면부 형태를 고려하여 소프트 콘택트렌즈 후면 디자인을 결정하면 보다 적절한 피팅 상태를 제공할 수 있을 것으로 사료된다.

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this study was to investigate the importance and correlation of the corneoscleral profile (CSP) with contact lens fitting by comparing and analyzing the differences in soft contact lens fitting based on the corneoscleral shape profile identified on slit-lamp images. Methods: Thirty-three subjects (65 eyes) with no history of refractive keratoplasty or eye diseases were fit with multi-curve spherical soft contact lenses after identifying the corneoscleral shape profiles on the superior and inferior ocular surfaces. The subjects were categorized under groups based on the corneoscleral shape profile, and decentration, post-blink movement, lag, and push-up test were examined. The groups were compared based on the test items, and the fitting statuses were checked. Results: On the superior ocular surface, the group with a fluid convex or tangential corneoscleral transition showed significantly larger post-blink movement (p = 0.000) and temporal (p = 0.003), nasal (p = 0.001), and inferior (p = 0.021) lags, and relatively loose fitting (p = 0.041) compared to the group with a marked convex or tangential corneoscleral transition. On the inferior ocular surface, the group with a fluid convex or tangential corneoscleral transition showed significantly larger post-blink movement (p = 0.000) and nasal (p = 0.001) and inferior (p = 0.049) lags, and relatively loose fitting (p = 0.021) compared to the group with a marked convex or tangential corneoscleral transition. Conclusions: Designing the back surface of a soft contact lens based on the corneoscleral shape profile provides a more appropriate fitting condition.

참고문헌 (Reference)

1 Hall L, "What You Need to Know about Sagittal Height and Scleral Lenses"

2 Lee A. Hall, "The Influence of Corneoscleral Topography on Soft Contact Lens Fit" Association for Research in Vision and Ophthalmology (ARVO) 52 (52): 6801-, 2011

3 Alex Muntz, "Tear exchange and contact lenses: A review" Elsevier BV 8 (8): 2-11, 2015

4 Eef van der Worp, "Sagittal height differences of frequent replacement silicone hydrogel contact lenses" Elsevier BV 38 (38): 157-162, 2015

5 LEON F. GARNER, "Sagittal Height of the Anterior Eye and Contact Lens Fitting" Ovid Technologies (Wolters Kluwer Health) 59 (59): 301-305, 1982

6 Graeme Young, "Ocular sagittal height and soft contact lens fit" Elsevier BV 15 (15): 45-49, 1992

7 Lin MC, "Measurement of post-lens tear thickness" 40 (40): 2833-2839, 1999

8 Hom MM, "Manual contact lens prescribing and fitting" Butterworth-Heinemann 275-323, 2006

9 Müller Treiber A, "Kontaktlinsen Know-how" DOZ Verlag 27-282, 2010

10 Douthwaite WA, "Initial selection of soft contact lenses based on corneal characteristics" 28 (28): 202-205, 2002

11 Seong JS, "Influence of base curve on the fit of soft contact lenses" 3 (3): 33-37, 1998

12 Lee EH, "Fitting of soft contact lenses" 5 (5): 173-180, 2000

13 Lee A. Hall, "Factors Affecting Corneoscleral Topography" Association for Research in Vision and Ophthalmology (ARVO) 54 (54): 3691-, 2013

14 van der Worp E, "Exploring Beyond the Corneal Borders"

15 GRAEME YOUNG, "Evaluation of Soft Contact Lens Fitting Characteristics" Ovid Technologies (Wolters Kluwer Health) 73 (73): 247-254, 1996

16 Mark J. Roseman, "Effects of base curve on the fit of thin, mid-water contact lenses" Elsevier BV 20 (20): 95-101, 1993

17 Billert R, "Die praxisnahe Kontaktlinsenanpassung" Optonia 92-, 2014

18 Bretschneider N, "Die Messungen im Vorfeld einer Contactlinsen-Anpassung"

19 Meier D, "Das corneo-skleral-profil-ein kriterium individueller kontaktlinsenanpassung" 26 (26): 4-11, 1992

20 Allmoslechner A, "Das OCT im praktischen Einsatz" 5 : 74-77, 2013

21 Gaggioni M, "Das Corneo-Skleral-Profil" 29 (29): 66-71, 1987

22 Lowther GE, "Contact lenses: procedures and techniques" Butterworth-Heinemann 24-28, 1992

23 Caroline PJ, "Contact Lens Case Reports:Three Rules of Scleral Fitting"

24 Caroline PJ, "Contact Lens Case Reports: The Effect of Corneal Diameter on Soft Lens Fitting"

25 Caroline PJ, "Contact Lens Case Reports: Elevating Our Knowledge of the Corneal Surface"

26 Javier González-Cavada, "Base Curve Influence on the Fitting and Comfort of the Senofilcon A Contact Lens" Elsevier BV 2 (2): 90-93, 2009

27 Kempgens C, "Anpassung individueller weicher Kontaktlinsen" 51 (51): 6-11, 2017

28 van der Worp E, "A Guide to Scleral Lens Fitting"