成年人配戴彩色隱形眼鏡對於眼睛前表面影響性

摘要目的： 本次研究確認市售的彩色隱形眼鏡其色素層位置，瞭解市售的彩色隱形眼鏡的品質；針對配戴不同色素層位置的彩色隱形眼鏡，評估其淚液品質和眼睛前表面的影響性以及配戴者對於彩色隱形眼鏡配戴和摘除後的主觀感受。方法： 本次研究利用擦拭測試（The rubbed off test）和前段傅立葉域光學相干斷層掃描（AS-OCT）來檢視市售16款日拋彩色隱形眼鏡的色素層位置。 本次研究採取隨機「單盲」研究設計，受試者分成2組，Ⅰ組其色素層位於鏡片夾層中靠近前表面的位置與Ⅱ組其色素層位於鏡片前表面的位置，一天配戴6小時以上，為期7天，評估彩色隱形眼鏡與對於淚液品質以及眼睛前表面的影響性，另外，填寫對於彩色隱形眼鏡配戴和摘除後的主觀感受問卷。結果： 使用擦拭測試（The rubbed off test）和前段傅立葉域光學相干斷層掃描（AS-OCT）檢測彩色隱形眼鏡的色素層位置，發現兩種測驗的結果是呈現一致性，高達10款日拋彩色隱形眼鏡，其色素層位於鏡片前表面的位置，僅有2款日拋彩色隱形眼鏡，其色素層位於鏡片夾層中靠近前表面的位置。 配戴彩色隱形眼鏡前後的結果，根據淚液品質評估顯示Ⅰ組配戴彩色隱形眼鏡後的眨眼頻率（p = 0.000）和淚液分泌量（p = 0.045）明顯增加，而Ⅱ組配只有眨眼頻率（p = 0.006）明顯增加；另外，針對Ⅰ組與Ⅱ組配戴彩色隱形眼鏡後的結果，顯示Ⅱ組的淚膜破裂時間明顯少於Ⅰ組（p = 0.004）。 配戴彩色隱形眼鏡前後的結果，根據眼睛前表面評估顯示Ⅰ組配戴彩色隱形眼鏡後的球結膜充血分級（p = 0.000）、輪部充血分級（p = 0.000）和內眼瞼泛紅程度（p = 0.043），其嚴重程度有明顯增加，而Ⅱ組配戴彩色隱形眼鏡後的球結膜充血分級（p = 0.000）、輪部充血分級（p = 0.000）、內眼瞼泛紅程度（p = 0.006）以及角膜表皮細胞受損分級（p = 0.000），其嚴重程度有明顯增加；另外，針對Ⅰ組與Ⅱ組配戴彩色隱形眼鏡後的結果，顯示Ⅱ組的鼻側球結膜充血分級（p = 0.018）、鼻側輪部充血分級（p = 0.016）、顳側輪部充血分級（p = 0.049）、內眼瞼平滑程度（p = 0.024）以及角膜表皮細胞受損分級（p = 0.001），其嚴重程度明顯高於Ⅰ組。 根據Ⅰ組與Ⅱ組配戴彩色隱形眼鏡後主觀感受問卷的結果，顯示出在配戴以及摘除後彩色隱形眼鏡後，兩組之間的主觀感受是沒有顯著差異（p > 0.05）。結論： 目前市售的日拋彩色隱形眼鏡，以其色素層位於鏡片前表面的位置的鏡片為主；配戴色素層位於鏡片前表面的位置，其淚膜破裂時間明顯少於色素層位於鏡片夾層中靠近前表面的位置的彩色隱形眼鏡，而配戴兩種鏡片皆會使眨眼頻率明顯增加；配戴彩色隱形眼鏡後其眼睛前表面各項數值其嚴重程度明顯提高，而配戴色素層位於鏡片前表面的位置，其嚴重程度明顯高於色素層位於鏡片夾層中靠近前表面的位置的彩色隱形眼鏡；配戴兩種隱形眼鏡的主觀感受是沒有顯著差異。

AbstractPurpose.This study was to test the location of the pigment layer of commercially available tinted contact lenses. For tinted contact lenses with different location of the pigment layer, which the tear quality and the influence of the ocular surface properties and the subjective feelings of the wearer after wearing and removing the lenses were evaluated.Methods.In this study, the rubbed off test and the anterior segment Fourier-domain optical coherence tomography were used to examine the position of the pigment layer of 16 commercially available disposable tinted contact lenses.The study was conducted in a randomized “single-blind” study. The subjects were divided into two groups. The pigment layer of group I was embedded within the matrix, in which close to the front surface and the pigment layer of group II was located on the front surface. Thirty healthy participants were randomly assigned to wear one brands of tinted contact lenses for six hours a day for seven days and evaluated the influence of tinted contact lenses on the quality of the tears and the ocular surface properties. In addition, subjects filled out the subjective feeling questionnaire after wearing and removing the tinted contact lenses.Results.Up to ten brands of tinted contact lenses were the location of the pigment layer on the front surface and there were only two brands of the pigment layer of tinted contact lenses was embedded within the matrix, in which close to the front surface. The results of the rubbed off test and the anterior segment Fourier-domain optical coherence tomography were consistent.The results before and after wearing tinted contact lenses showed that the blink frequency (p = 0.000) and the amount of tear secretion (p = 0.045) in group I after wearing tinted contact lenses increased significantly, while the group II only had the blink frequency (p = 0.006) significantly increased. In addition, the result of wearing tinted contact lenses for groups I and II showed that the tear burst time of group II was significantly less than that of group I (p = 0.004).According to the result of the ocular surface properties before and after wearing tinted contact lenses, including the bulbar conjunctiva redness levels (p = 0.000), the limbal redness levels (p = 0.000) and the eyelid redness levels (p = 0.043), the severity of which was significantly increased after group I wearing tinted contact lenses. The bulbar conjunctiva redness levels (p = 0.000), the limbal redness levels (p = 0.000), the eyelid redness levels(p = 0.006) and corneal staining levels (p = 0.000), the severity of which was significantly increased after group II wearing tinted contact lenses. In addition, the results of group I and group II wearing tinted contact lenses showed the nasal bulbar conjunctiva redness levels of group II (p = 0.018), the limbal redness levels (temporal: p = 0.016 and nasal: p = 0.049), the eyelid smoothness levels (p = 0.024) and corneal staining levels (p = 0.001) was significantly higher than that of group I.The results of subjective questionnaire was shown that there was no significant difference in subjective feelings between the two groups after wearing and removing the tinted contact lenses (p > 0.05).Conclusion.Currently, commercially available daily tinted contact lenses were mainly lenses with the location of the pigment layer on the front surface.The tinted contact lenses of the location of the pigment layer on the front surface, which of the tear burst time was significantly less than the location of the pigment layer was embedded within the matrix. Both tinted contact lenses significantly increased the frequency of blinking. After wearing the tinted contact lens, the severity of the ocular surface properties was significantly increased. The severity of the ocular surface properties on the location of the front surface was significantly higher than the location of the pigment layer was embedded within the matrix.There was no significant difference in the subjective questionnaire of wearing two groups.