Optical aberration and visual performance in highly aberrated eyes

高像差眼睛的光学像差和视觉性能

• 批准号: 7652856
• 负责人: RAYMOND A APPLEGATE
• 金额: $ 37.5万
• 依托单位: UNIVERSITY OF HOUSTON
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-04-01 至 2013-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7652856
• 关键词: Address; Clinic; Clinical; Coma; Complex; Contact Lenses; Cornea; Custom; Development; Disease; Eye; Generations; Goals; Gold; Grant; Hydrophilic Contact Lenses; Image; Individual; Keratoconus; Knowledge; Laboratories; Laboratory Research; Lead; Measures; Methods; Mission; Modality; Movement; Operative Surgical Procedures; Optics; Patients; Performance; Population; Price; Process; Quality of life; Research; Research Proposals; Retinal; Safety; Sampling; Techniques; Technology; Testing; Time; Translating; Trauma; Trefoil; Visual impairment; Work; base; clinical care; clinical practice; clinically relevant; cost effective; cost efficient; design; improved; lens; manufacturing process; meetings; method development; new technology; public health relevance; tool; visual performance

DESCRIPTION (provided by applicant): Recent laboratory-based research integrating advances in ocular wavefront sensing and ophthalmic lens lathing has demonstrated that custom wavefront-guided soft contact lenses can be designed and manufactured for the highly aberrated eye. These lenses provide improved comfort, retinal image quality and visual performance over rigid lens corrections routinely prescribed for the highly aberrated eye. Unfortunately the processes required to provide such a lens to the patient are currently time consuming and too complex to be clinically viable or cost effective. To translate this laboratory work into clinical practice in a safe and efficient manner requires: 1) development of efficient methods to predictably control lens movement; 2) development of an efficient design process to intelligently implement individual optical corrections based on required lens movement and desired optical and visual performance levels; and 3) studies examining longitudinal efficacy and safety of these custom lenses. The specific aims of this 5 year grant are listed below and will directly address these issues in a sample population of highly aberrated eyes. The following hypotheses will be tested: 1. A multi-component stabilization technique comprised of corneal curve matching and traditional stabilization methods can be used to predictably and efficiently align the optical zone of a custom wavefront-guided soft contact lens to the optics of the highly aberrated eye. 2. A time and cost efficient, intelligent design process can be developed that quantitatively integrates measured lens movement, desired retinal image quality and desired visual performance into the design of a custom lens. 3. When worn in a daily wear manner, wavefront guided soft lens corrections provide a sustained improvement in optical quality, visual performance, comfort and wear time with a quantifiable increase in quality of life. The work proposed here is central to the mission of the NIH/NEI in that when successfully completed, it will translate laboratory research into clinical care that reduces visual impairment and improves the quality of life of individuals with highly aberrated eyes. PUBLIC HEALTH RELEVANCE: Custom wavefront guided soft contact lenses that compensate for both low order aberrations (sphere, cylinder) and high order aberrations (coma, trefoil, spherical aberration, etc) of the individual highly aberrated eye have been demonstrated on a small scale within multiple independent research laboratory settings. These early works show that custom soft contact lenses can be designed to meet or exceed the performance of current gold standard rigid forms of correction. However, these advances in soft lens technology come at the price of significant complexity in the design and manufacture process, making large-scale clinical deployment of custom contact lenses in their current form impossible. This raises the question: what obstacles must be overcome in order for custom wavefront guided soft contact lenses to attain clinical relevance? These obstacles can be summarized in three words: stabilization, optimization and demonstration. The specific aims in this grant will: 1) develop methods to allow for predictable stabilization of a custom soft contact lens on the eye; 2) examine methods that allow for the efficient and intelligent optimization of customized contact lens treatments that mitigate the effects of visually debilitating levels of optical aberration and 3) demonstration of the efficacy of custom soft contact lenses in a daily wear modality. Examination of these issues will result in the knowledge and tools necessary to capitalize on this promising new technology in the current clinical culture. It is hypothesized that successful completion of these aims will lead to methods allowing quantifiable improvements in optical performance, visual performance, comfort and quality of life for the individual that, due to disease, trauma or prior surgical intervention, suffers from highly aberrated optics of the eye. 1

描述（由申请人提供）：最近基于实验室的研究整合了眼波前传感和眼科透镜车削方面的进展，证明可以为高度像差的眼睛设计和制造定制波前引导软性角膜接触镜。与常规为高度像差眼睛处方的刚性透镜矫正相比，这些透镜提供了改善的舒适度、视网膜图像质量和视觉性能。不幸的是，为患者提供这种透镜所需的过程目前是耗时的，并且太复杂而不具有临床可行性或成本效益。为了以安全和有效的方式将该实验室工作转化为临床实践，需要：1）开发有效的方法来可预测地控制透镜移动; 2）开发有效的设计过程，以基于所需的透镜移动和期望的光学和视觉性能水平智能地实施个体光学矫正;以及3）研究检查这些定制镜片的纵向功效和安全性。这5年补助金的具体目标如下所列，将直接解决高度像差眼睛样本人群中的这些问题。以下假设将被测试：1。由角膜曲线匹配和传统稳定方法组成的多部件稳定技术可用于可预测地和有效地将定制波前引导软接触透镜的光学区与高度像差眼睛的光学器件对准。2.可以开发一种时间和成本有效的智能设计过程，其将测量的透镜移动、期望的视网膜图像质量和期望的视觉性能定量地集成到定制透镜的设计中。3.当以日常佩戴方式佩戴时，波前引导的软性透镜矫正在光学质量、视觉性能、舒适度和佩戴时间方面提供了持续的改善，并且在生活质量方面具有可量化的提高。这里提出的工作是NIH/NEI的使命的核心，当成功完成时，它将把实验室研究转化为临床护理，减少视力障碍，提高高度像差眼睛的个人的生活质量。公共卫生相关性：已在多个独立研究实验室环境中以小规模证明了可补偿个体高度像差眼睛的低阶像差（球面、柱面）和高阶像差（彗差、三叶形、球面像差等）的定制波前引导软性角膜接触镜。这些早期的工作表明，定制的软性隐形眼镜可以被设计成达到或超过当前黄金标准硬性矫正形式的性能。然而，软透镜技术的这些进步是以设计和制造过程的显著复杂性为代价的，使得定制接触透镜以其当前形式的大规模临床部署是不可能的。这就提出了一个问题：为了使定制波前引导软性角膜接触镜达到临床相关性，必须克服哪些障碍？这些障碍可以用三个词来概括：稳定、优化和示范。该补助金的具体目标是：1）开发方法，以实现定制软性角膜接触镜透镜在眼睛上的可预测稳定性; 2）检查方法，以实现定制隐形透镜治疗的有效和智能优化，从而减轻视觉衰弱水平的光学像差的影响; 3）证明定制软性角膜接触镜在日常佩戴模式中的疗效。对这些问题的研究将产生必要的知识和工具，以在当前的临床文化中利用这一有前途的新技术。假设这些目标的成功完成将导致允许由于疾病、创伤或先前手术干预而遭受高度像差的眼睛光学的个体的光学性能、视觉性能、舒适度和生活质量的可量化改善的方法。1