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Kim, Lee, and Kim: The Influence of Factors Before Wearing Reverse-Geometry Lens on Visual Acuity After Wearing Reverse-Geometry Lens
Original Article

J Korean Ophthalmol Soc 2010;51(10):1305-1311.

Published online: 7 September 2010

DOI: https://doi.org/10.3341/jkos.2010.51.10.1305

The Influence of Factors Before Wearing Reverse-Geometry Lens on Visual Acuity After Wearing Reverse-Geometry Lens

Sung Hoon Kim, MD1, Jung Hoon Lee, MD, PhD1, Chun Sik Kim, MD, PhD2

1Department of Ophthalmology, Catholic Eye Clinic (Siji), Daegu, Korea

2Department of Ophthalmology, Catholic Eye Clinic (Seongseo), Daegu, Korea

Address reprint requests to Sung Hoon Kim, MD Department of Ophthalmology, Catholic Eye Clinic (Siji)#567-17, Sinmae-dong, Suseong-gu, Daegu 706-170, Korea Tel: 82-53-792-1200, Fax: 82-53-793-1200, E-mail: sh-kim15@hanmail.net

Received 26 October 2009       Accepted 23 July 2010

Copyright © 2010 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To determine whether patient factors (pre-fitting patient's data) before reverse-geometry lens (RGL) use could be predicting factors for the increase in visual acuity after RGL use.

Methods

The authors reviewed out patient records of 805 eyes of 423 patients wearing RGLs from March 2003 to May 2009. The relationship between patient factors on UVA before wearing a RGL examined at follow-ups and the IVA after wearing a RGL were analyzed.

Results

The spherical refractive errors and the cylindrical refractive errors showed statistically significant results (p <0.05). The lower was the refractive error, the greater were the UVA and IVA results. Correlations existed between the corneal astigmatism and UVA or IVA at three months (p < 0.05). The lower was the corneal astigmatism, the greater were the UVA and IVA results. Correlations were observed between the initial visual acuity and IVA, although the initial visual acuity cannot be a predictor. The other factors evaluated did not show statistically significant results (p > 0.05).

Conclusions

The refractive error and the corneal astigmatism may be strong predictors of UVA and IVA after RGL use. J Korean Ophthalmol Soc 2010;51(10):1305–1311

Keywords: Corneal astigmatism, Patients' data, Refractive error, Reverse-geometry lens

References

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Figure 1.
The ideal fluorescein pattern during follow-up period: 3- to 5-mm central bearing, narrow but brilliant secondary pooling ring, wide heavy mid-peripheral bearing ring, and well centered lens, and 1- to 2-mm movement after the blink.
jkos-51-1305f1.tif
Figure 2.
The ideal topographic pattern during follow-up period: well centered Bull's eye pattern.
jkos-51-1305f2.tif
Figure 3.
The mean uncorrected visual acuity (logMAR) at initial day and 1 day; 1, 2 weeks; 1, 3 months after wearing reverse-geometry lens (p<0.05†). *logMAR VA = uncorrected visual acuity (logMAR); †: paired t-sample test.
jkos-51-1305f3.tif
Figure 4.
The mean increase of uncorrected visual acuity (logMAR) during follow-up period from initial day to 1 day; 1, 2 weeks; 1, 3 months after wearing reverse-geometry lens (p<0.05†).* logMAR IVA=the mean increase of uncorrected visual acuity (logMAR); †: paired t-sample test.
jkos-51-1305f4.tif
Table 1.
Dermographics of patients
Variable Patients
N (Eyes) 423 (805)
Male/Female 164 (305)/259 (500)
OD/OS 408/397
Age (range) 10 ± 3.6 (6∼42)
Table 2.
Patients' data at the first examination before wearing RGL (pre-fitting patients' data)
Mean ± SD Median (range)
Age 10.3 ± 3.64 9 (6∼42)
Flat Keratometry (D) 42.65 ± 1.43 42.5 (38.5∼46.5)
Steep Keratometry (D) 43.90 ± 1.43 43.75 (40∼48.25)
Corneal Astigmatism (D) 1.75 ± 0.65 1.25 (0∼5)
Average Keratometry (D) 43.28 ± 1.32 43.25 (39.25∼47.325)
Spherical Refraction (D) −2.93 ± 1.65 −2.5 (+0.5∼-8.5)
Cylindrical Refraction (D) −0.49 ± 0.66 −0.25 (0∼-4.75)
Spherical Equivalent refraction (D) −3.18 ± 1.77 −3.18 (−0.5∼-9.125)
Eccentricity 0.53 ± 0.09 0.53 (0.24∼0.79)
Asphericity Initial VA* −0.28 ± 0.090.23 ± 0.15 −0.28 (−0.06∼-0.62) 0.2 (0.02∼0.9)
Initial LVA† 0.73 ± 0.31 0.7 (0.05∼1.7)

* Initial VA = uncorrected visual acuity (Han's vision test) at the first examination for RGL-fitting

† Initial LVA = uncorrected visual acuity (logMAR) at the first examination for RGL-fitting.

Table 3.
Comparison of uncorrected visual acuity during fol-low-up period
Mean SD p-value‡
logMAR VA (initial)* 0.76 0.32
logMAR VA (1 day)* 0.39 0.31 0.000
logMAR VA (1 week)* 0.18 0.21 0.000
logMAR VA (2 weeks)* 0.11 0.17 0.000
logMAR VA (1 month)* 0.10 0.16 0.029
logMAR VA (3 months)* 0.08 0.12 0.045
logMAR IVA (1 day)† 0.37 0.29
logMAR IVA (1 week)† 0.59 0.29 0.000
logMAR IVA (2 weeks)† 0.65 0.31 0.000
logMAR IVA (1 month)† 0.67 0.31 0.029
logMAR IVA (3 months)† 0.68 0.31 0.045

* logMAR VA () = uncorrected visual acuity (logMAR) examined at (follow-up time)

† logMAR IVA () = increase of visual acuity (logMAR) during (follow-up period-from the first examination)

‡ p-value = paired t sample test.

Table 4.
Analysis results between pre-fitting patient's data and visual acuity (logMar) through 3 months after wearing RGL
Factors‡ p-value§ Β (Beta)#
logMAR VA (1 month)* Spherical Refraction (D) 0.000 −0.426
Cylindrical Refraction (D) 0.008 −0.118
logMAR VA (3 months)* Spherical Refraction (D) 0.000 −0.319
Cylindrical Refraction (D) 0.006 −0.130
Corneal Astigmatism (D) 0.028 −0.101
logMAR IVA (1 month)† Spherical Refraction (D) 0.000 0.202
Cylindrical Refraction (D) 0.008 0.056
Initial LVA† 0.000 1.023
logMAR IVA (3 months)† Spherical Refraction (D) 0.000 0.119
Cylindrical Refraction (D) 0.006 0.049
Corneal Astigmatism (D) 0.028 0.037
Initial LVA∏ 0.000 1.003

* logMAR VA () = uncorrected visual acuity (logMAR) examined at (follow-up time)

† logMAR IVA () = increase of visual acuity (logMA during (follow-up period-from the first examination)

‡ Factor = statistically significant factors by patial correlation & multiple regressi analysis

§ p-value = multiple regression analysis

∏ Initial LVA = uncorrected visual acuity (logMAR) at the first examination for RGL-fittin

# Β (Beta) = standardized coefficients of multiple regression analysis. Y = (constant)+β1 X1+β2 X2+β3 X3+•••+β n X n Y = logMar VA or logMar IVA βn = standardized coefficients of each pre-fitting patient factors Xn = each pre-fitting patient factors.

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