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: 7797396
• 负责人: RAYMOND A APPLEGATE
• 金额: $ 37.13万
• 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/7797396
• 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镜片车床方面的进步，已经证明可以为高像差眼睛设计和制造定制的波前引导软隐形眼镜。与通常为高像差眼睛规定的刚性镜片矫正相比，这些镜片提供了更高的舒适度、视网膜图像质量和视觉性能。不幸的是，目前向患者提供这种镜片所需的过程非常耗时且过于复杂，在临床上不可行或具有成本效益。为了以安全有效的方式将这项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晶状体运动； 2) 开发高效的设计流程，根据所需的镜头移动和所需的光学和视觉性能水平智能地实施单独的光学校正； 3) 研究检查这些定制镜片的纵向功效和安全性。下面列出了这项为期 5 年的资助的具体目标，并将直接解决高度畸变眼睛样本人群中的这些问题。将测试以下假设： 1. 由角膜曲线匹配和传统稳定方法组成的多组件稳定技术可用于可预测且有效地将定制波前引导软隐形眼镜的光学区域与高像差眼睛的光学系统对齐。 2.可以开发一种时间和成本高效的智能设计过程，将测量的镜片运动、所需的视网膜图像质量和所需的视觉性能定量地集成到定制镜片的设计中。 3. 当以日常佩戴方式佩戴时，波前引导软镜片矫正可持续改善光学质量、视觉性能、舒适度和佩戴时间，并可量化地提高生活质量。这里提出的工作是 NIH/NEI 使命的核心，因为一旦成功完成，它将把实验室研究转化为临床护理，减少视力障碍并提高高度畸变眼睛个体的生活质量。公共健康相关性：定制波前引导软隐形眼镜可补偿个体高像差眼睛的低阶像差（球面像差、柱面像差）和高阶像差（彗差、三叶形、球面像差等），已在多个独立研究实验室环境中小规模得到验证。这些早期工作表明，定制软性隐形眼镜的设计可以满足或超过当前硬性矫正金标准的性能。然而，软镜片技术的这些进步是以设计和制造过程的显着复杂性为代价的，使得目前形式的定制隐形眼镜不可能大规模临床部署。这就提出了一个问题：为了使定制波前导软隐形眼镜获得临床相关性，必须克服哪些障碍？这些障碍可以概括为三个词：稳定、优化、示范。这笔赠款的具体目标将是：1）开发方法，使定制的软性隐形眼镜在眼睛上实现可预测的稳定性； 2) 研究能够高效、智能地优化定制隐形眼镜治疗的方法，以减轻光学像差对视觉衰弱水平的影响；3) 演示定制软性隐形眼镜在日常佩戴方式中的功效。对这些问题的研究将产生在当前临床文化中利用这一有前景的新技术所需的知识和工具。据推测，成功完成这些目标将带来能够量化改善由于疾病、创伤或先前的手术干预而患有眼睛光学高度像差的个体的光学性能、视觉性能、舒适度和生活质量的方法。 1