Customized Contact Lenses

描述(由申请者提供)：这个翻译工程研究项目的长期目标是改善患有圆锥角膜等异常角膜疾病的人的视力。在之前的资助期间，我们开发了测量这些眼睛的波前误差的能力，我们还开发了定制的软性角膜接触镜，可以补偿他们的极高阶眼像差。虽然这些定制的镜片可以在视觉性能上产生实质性的改善，但需要做更多的工作才能将视力恢复到正常值。特别是，晶状体在角膜上不可预测的平移和旋转影响了这种益处，可能是因为神经对矫正前较差的视网膜图像质量的适应而受到影响。我们在下一个资助期的努力是针对将克服这些限制的研究。Aim1.1将通过雕刻后表面轮廓来匹配角膜的圆锥前表面，从而稳定定制软性隐形眼镜的移动。Aim1.2将通过选择对视力有显著影响但对镜头移动不太敏感的高阶像差来优化矫正性能。Aim 1.3将确定传统硬性透气性(RGP)无法矫正的圆锥角膜眼内光学像差的意义。目标1.4是开发定制的巩膜透镜，使其稳定地位于巩膜而不是角膜上。目标1.5是比较这些新的定制角膜和巩膜隐形眼镜与传统RGP镜片的视觉效果，重点是增强定制镜片的好处并减少其局限性。目的2验证圆锥角膜患者可能不能立即达到个性化矫正的全部益处的假设，因为矫正前视网膜图像质量较差的患者持续存在神经适应。在正常眼睛和接受激光屈光手术的患者中也显示了类似的神经适应，我们将在角膜极度异常的患者中测试这种适应的程度。这类患者可能需要长时间接触改善的光学质量，然后才能获得定制光学矫正的全部视觉好处。因此，我们还将使用大行程自适应光学系统和定制的巩膜透镜进行实验，以研究长期和短期适应高阶像差对这些异常角膜患者视网膜图像质量的影响。与公共卫生相关：圆锥角膜的不规则形状引起的光学缺陷(高阶像差)会随着疾病的进展而导致视觉质量的显著下降。为矫正个别眼睛的像差而设计的定制隐形眼镜可以为患者提供显著改善的视觉表现。

DESCRIPTION (provided by applicant): The long range goal of this translational-engineering research project is to improve the vision of people who have abnormal corneal conditions such as keratoconus. In the previous grant period, we developed the ability to measure wavefront error in these eyes and we also developed customized soft corneal contact lenses that can compensate for their extreme higher-order ocular aberrations. Although these customized lenses can produce substantial improvements in visual performance, more needs to be done to restore acuity to normal values. In particular, the benefit was compromised by the unpredictable translation and rotation of the lens on the cornea, and may have been compromised by neural adaptation to the poor retinal image quality before correction. Our efforts during the next grant period are targeted at research that will overcome these limitations. Aim1.1 will stabilize the movement of customized soft contact lenses by sculpting the back surface profile to match the keratoconic anterior surface of cornea. Aim1.2 will optimize correction performance by selecting higher order aberrations to be corrected that have a significant impact on vision but are less sensitive to lens movements. Aim 1.3 will determine significance of the internal optics aberration in keratoconic eyes that cannot be corrected with conventional rigid gas permeable (RGP). Aim1.4 is to develop customized scleral lenses that sit stably on the sclera rather than cornea. Aim 1.5 is to compare the visual outcomes of these new, customized corneal and scleral contact lenses with conventional RGP lenses focusing on enhancing the benefits and reducing the limitations of the customized lenses. Aim 2 will test the hypothesis that patients with keratoconus may not be able to immediately achieve the full benefit of customized correction because of persisting neural adaptation to the poor retinal image quality before correction. Similar neural adaptation has been shown in normal eyes and in patients who have received laser refractive surgery, and we will test the extent of this adaptation in patients who have lived for years with extremely aberrated corneas. Such patients may require a long period of exposure to improved optical quality before reaping the full visual benefit of a customized optical correction. Therefore, we will also use a large-stroke adaptive optics system and customized scleral lenses for experiments on the effects of short- and long-term adaptation to higher order aberrations on perceived retinal image quality in these abnormal corneal patients. PUBLIC HEALTH RELEVANCE: The optical defects (higher order aberrations) induced by irregular shapes of the cornea with keratoconus cause significant degradation in visual quality as the disease advances. Customized contact lenses designed to correct the aberration of individual eyes can provide the patients with substantially improved visual performance.