CN113940811A

CN113940811A - Method for controlling myopia by adjusting peripheral high-order aberration and optical equipment

Info

Publication number: CN113940811A
Application number: CN202010681718.7A
Authority: CN
Inventors: 宋久德
Original assignee: Jingmou Biotechnology Shanghai Co ltd
Current assignee: Jingmou Biotechnology Shanghai Co ltd
Priority date: 2020-07-15
Filing date: 2020-07-15
Publication date: 2022-01-18

Abstract

The invention provides a method for controlling myopia by adjusting peripheral high-order aberration and an optical apparatus, and relates to the field of optics, wherein the method comprises the following steps: preliminarily determining an optical phase plate according to the optometry data of the eye; step 2: measuring high order aberration data of the eye by a fast scanning HS wavefront sensor and correcting the optical phase plate according to the high order aberration data; and step 3: manufacturing diagnosis spherical glasses by cutting through a precision numerical control lathe, and measuring wavefront aberration of the eyes through the diagnosis spherical glasses and the optical phase plate; and 4, step 4: correcting pupil offset and correcting eccentric aberration according to the wavefront aberration measurement data, and finally determining an optical phase plate; and 5: cutting the irregular profile of the front surface formed by the residual high-order aberration on the optical phase plate by using a precision numerically controlled lathe; step 6: a wedge-shaped toric optic zone for myopia control is added to the optical phase plate. The invention realizes the control of myopia progression and axial elongation by measuring and adjusting the high-order aberration around the eye.

Description

Method for controlling myopia by adjusting peripheral high-order aberration and optical equipment

Technical Field

The invention relates to the field of optics, in particular to a method for controlling myopia by adjusting peripheral high-order aberration and an optical apparatus.

Background

Myopia is one of the leading causes of visual impairment worldwide, with its prevalence rising dramatically over the last 50 years. Myopia progression and axial elongation are irreversible and are associated with ocular complications such as: chorioretinal degeneration, retinal detachment, glaucoma, cataract, and the like. Since higher order aberrations degrade retinal image quality and produce optical vergence changes throughout the pupil of the eye, optical signals are provided that help regulate eye growth and refractive error. The magnitude and type of higher order aberrations, among others, will vary with age, refractive error, and duration of work and accommodation. In addition, during myopia control, higher order aberrations can change significantly, for example: when optical glasses, contact lenses, etc. are used to control myopia, high-order aberrations can affect axial elongation, ametropia, etc. of the eyeball.

General optical lenses, contact lenses, and the like cannot correct off-axis aberrations, and also affect peripheral vision when correcting foveal ametropia. Due to the potential role of peripheral vision in the development of central refractive error, according to "peripheral refractive theory", only central vision can be corrected while ignoring peripheral image quality. Since myopia has a periphery that is relatively far sighted, if the corrective lens has the same power across the lens, correcting central myopia will cause peripheral hyperopia to move away, the far vision periphery will continue to guide the axial elongation of the eye, and the progression of myopia will not stop. Thus, if only the lens that corrects central vision is not actually effective, the progression of myopia is even increased.

Based on the "peripheral refraction theory", there are existing soft contact lenses with defocus, see fig. 1, soft contact lenses with multifocal, see fig. 2, and soft contact lenses with progressive multifocal, see fig. 3, which are intended to reduce the effect of hyperopia relative to the periphery. Among them, the defocused optical soft contact lenses, the multifocal soft contact lenses and the progressive multifocal soft contact lenses have a far vision correction area and a treatment area for correcting ametropia, and although the forward refractive power of the soft contact lenses is gradually increased, the control mechanism of myopia cannot completely explain the progress of the soft contact lenses only by the peripheral refraction theory; thus, on the basis of "peripheral refractive theory" a "accommodative lag theory" has been proposed whereby retinal blur due to axial hyperopia caused by ciliary muscle contraction accommodative lag during myopic work can be corrected by central bifocal correction, and bifocal corrective accommodative lag controlled myopic soft contact lenses designed based on this theory include a central zone surrounded by a series of treatments and corrections which together create two planes of focus.

Current products only consider the effect of mitigating relative peripheral hyperopia and further correcting off-axis aberrations on peripheral optics that help understand the design of the eye, and in order to obtain a determination of how peripheral refractive errors and image quality vary in the field of view, require actual measurements of the eye through special phase plates and modern adaptive optics. Peripheral refractive correction multiple studies have shown that the dioptric brightness of presbyopia and emmetropia is often also associated with foveal myopia. From far distances, the image shell of an extended object is more curved than the retinal surface, resulting in an increased amount of myopic blur at greater retinal eccentricities, a condition known as "myopic field curvature" or "relative peripheral myopia". In contrast, myopic eyes tend to have less myopic power in the peripheral field of view than the central eye, and therefore, the eye has an increased amount of hyperopic blur at larger retinal eccentricities relative to the foveal zone refractive error, a condition referred to as "hyperopic curvature" or "relative peripheral hyperopia". The basic principle that peripheral refraction affects the occurrence of refractive error: if the peripheral retina is relatively hyperopic, such relatively hyperopic defocus results in axial elongation of the eyeball, regardless of the refractive state of the foveal region. As described above, the steady state signal from the far vision periphery will guide the axial elongation of the eyeball. If the foveal retina is an emmetropic or myopic eye, the steady state signal from the central retina will guide the axial elongation of the eyeball. The two signals from the central and peripheral retina will attempt to maintain balance. Although the neuron density in the middle is higher than that of the peripheral retina, considering that the total area of the central retina is small, the steady-state signal from the peripheral retina that guides the axial elongation of the eyeball will be stronger than the signal from the central retina. If these signals have room to guide the eye to reduce elongation, the mechanical constraint of eye growth also causes axial elongation of the foveal region, which is also evidenced by local retinal mechanisms.

Both general Soft Contact Lenses (SCL) and high oxygen permeability hard contact lenses (RGP) can reduce the far field curvature present in myopic eyes, but only RGP can reduce the relative amount of image blur on the peripheral retina. Although caused by the problem of myopia, the results are also related to the perceived quality of peripheral vision. The visual advantage of improved image contrast for peripheral vision obtained by RGP lenses should exceed that of SCL. A tradeoff between decreasing field curvature and increasing peripheral astigmatism requires RGP correction, which limits the net improvement in image blur on the peripheral retina, which in turn may limit the effectiveness of RGP in improving vision or controlling myopia progression in high oxygen permeability hard contact lenses. The results thus show that the axial growth mechanism, which depends on retinal image quality, is more affected by RGP than SCL lenses, and thus it is known that contact lenses increase higher order aberrations in the peripheral field of view. RGP lenses improve the peripheral image quality of objects located at the foveal distant point, and increased corneal Higher Order Aberrations (HOAS) corrected by contact lenses reduce the image quality, depending on the initial image quality of the eye. If the eye initially has good image quality, the change in HOAS will have a large impact on the image quality. However, if the initial image quality of the eye is poor, HOAS has relatively little effect on the image quality. HOAS plays a major role in the asymmetric sensitivity to ambient defocus and the effect of applying negative and positive defocus is more symmetric when correcting HOAS. I.e. HOAS, will also increase the surrounding depth of focus. The asymmetry of defocus is only found in myopic eyes. These results suggest that not only do optical devices (including but not limited to optical lenses, contact lenses, etc.) that control the progression of myopia, including but not limited to reducing relative peripheral hyperopia, increasing negative defocus of myopia, require increased ability to correct HOAS (both central and peripheral), but must also provide optimal spherical correction to the eye over the entire field of view at the same time.

Disclosure of Invention

In view of the above-mentioned shortcomings of the prior art, it is an object of the present invention to provide a method and an optical apparatus for controlling myopia by adjusting peripheral higher order aberrations, which enables control of myopia progression and axial elongation by measuring and adjusting the higher order aberrations around the eye.

The invention provides a method for adjusting peripheral high-order aberration to control myopia, which comprises the following steps:

step 1: preliminarily determining an optical phase plate according to the optometry data of the eye;

step 2: measuring high order aberration data of the eye by a fast scanning HS wavefront sensor and correcting the optical phase plate according to the high order aberration data;

and step 3: manufacturing a diagnosis spherical lens by cutting through a precision numerical control lathe, and measuring wavefront aberration of an eye through a diagnosis spherical lens and an optical phase plate;

and 4, step 4: correcting pupil offset and correcting eccentric aberration according to the wavefront aberration measurement data, and finally determining an optical phase plate;

and 5: cutting the irregular profile of the front surface formed by the residual high-order aberration on the optical phase plate by using a precision numerically controlled lathe;

step 6: a wedge-shaped toric optic zone for myopia control is added to the optical phase plate.

In an embodiment of the present invention, the specific process of step 1 is:

step 1.1: determining a glasses phase plate and a cornea topographic map according to the optometry data of the eye;

step 1.2: inputting the corneal topography into a computer system, and generating a contact lens phase plate by the computer system by using curve fitting simulation;

step 1.3: preliminarily determining an optical phase plate according to the glasses phase plate and the contact lens phase plate;

step 1.4: the optical phase plate is modified according to the clinical diagnostic data, and the contact lens phase plate is modified according to the optical phase plate.

In an embodiment of the present invention, the specific process of step 2 is:

step 2.1: measuring high order aberration data of the eye by fast scanning the HS wavefront sensor;

step 2.2: the high order aberration data is input to a computer system, which corrects the optical phase plate according to the high order aberration data.

In an embodiment of the invention, in the step 3, the wavefront aberration measurement is performed on the eye through the diagnostic spherical glasses and the optical phase plate, so as to obtain the pupil shift measurement data and the translational and rotational shift measurement data.

In an embodiment of the present invention, the specific process of step 4 is:

step 4.1: correcting the pupil shift according to the pupil shift measurement data;

step 4.2: performing matrix transformation on the translational-rotational offset measurement data through the effective matrix, and correcting the eccentric aberration according to the transformation matrix data;

step 4.3: and correcting the optical phase plate according to the pupil deviation correction result and the eccentric aberration correction result, and finally determining the optical phase plate.

In an embodiment of the present invention, the wedge-shaped toric optical zone for myopia control in step 6 includes a positive spherical aberration zone and a third-order vertical comet aberration zone.

The invention provides an optical device for adjusting peripheral high-order aberration to control myopia, which is manufactured by the method and comprises a frame lens, a contact lens, an intraocular lens and an intraocular inlay.

As mentioned above, the method for controlling myopia by adjusting peripheral high-order aberration and the optical apparatus of the present invention have the following advantages: the invention can improve the contrast of the retina image by correcting the eccentric aberration, and can improve the vision around the eyes by correcting the pupil offset; the axial elongation of myopia can be suppressed by correcting the third-order vertical coma aberration around the cornea, and the progression of myopia can be slowed down by correcting the positive spherical aberration around the cornea.

Drawings

FIG. 1 shows a schematic view of an out-of-focus optical soft contact lens disclosed in the prior art of the present invention.

Fig. 2 shows a schematic view of a multifocal soft contact lens disclosed in the prior art.

Fig. 3 shows a schematic view of a progressive addition soft contact lens disclosed in the prior art.

Fig. 4 is a schematic diagram of a fast scanning HS wavefront sensor for measuring peripheral high-order aberrations disclosed in an embodiment of the present invention.

FIG. 5 is a flowchart illustrating a method for adjusting peripheral high-order aberrations to control myopia according to an embodiment of the present invention.

Figure 6 is a schematic view of a wedge-shaped toric optical zone of a prism ballast disclosed in an embodiment of the present invention.

FIG. 7 is a schematic view of a contact lens for adjusting peripheral higher order aberrations to control myopia as disclosed in an embodiment of the invention.

Detailed Description

The embodiments of the present invention are described below with reference to specific embodiments, and other advantages and effects of the present invention will be easily understood by those skilled in the art from the disclosure of the present specification. The invention is capable of other and different embodiments and of being practiced or of being carried out in various ways, and its several details are capable of modification in various respects, all without departing from the spirit and scope of the present invention. It is to be noted that the features in the following embodiments and examples may be combined with each other without conflict.

It should be noted that the drawings provided in the following embodiments are only for illustrating the basic idea of the present invention, and the components related to the present invention are only shown in the drawings rather than drawn according to the number, shape and size of the components in actual implementation, and the type, quantity and proportion of the components in actual implementation may be changed freely, and the layout of the components may be more complicated.

The eye, as an optical instrument, is deficient in focus, and therefore both low-order aberrations (including myopia, hyperopia, astigmatism, etc.) and high-order aberrations (including positive spherical aberration, third-order vertical coma, etc.) are common, and these optical defects affect the image formed on the retina; currently, low order aberrations have been studied for many years, and clinicians are working on these focus errors, but the study of peripheral parallax, which is at the periphery of the retina and therefore greatly reduces the ability to eccentrically discriminate small objects, reducing the contrast of the retinal image due to the presence of eccentric aberrations; since the presence of off-axis aberrations also affects peripheral vision when correcting foveal refractive errors, studies have shown that there is a significant negative correlation between the third-order vertical coma aberration and the axial elongation of myopia, the asymmetric higher-order corneal aberration (HOAS), the third-order vertical coma aberration, inhibits the axial elongation of myopia, and positive spherical aberration slows the progression of myopia.

Furthermore, there is a significant negative correlation between the various components of the corneal shaped higher-order aberration of cornea (HOAS) and the axial elongation of myopia, and therefore, the third-order vertical coma aberration and the corneal shaped higher-order aberration of cornea (HOAS) are negatively correlated with myopia progression, and therefore, the relationship of how the corneal shaped higher-order aberration of cornea (HOAS) slows myopia progression and axial elongation must be considered.

Existing precision numerically controlled lathes are capable of manufacturing optical phase plates of almost any aberration profile and correcting higher order aberrations by using Adaptive Optics (AO), improving the optical performance of the eye, but have the potential limitation of being offset with respect to the pupil, resulting in a correction result that does not achieve the intended effect.

Therefore, in summary, referring to FIG. 5, the present invention provides a method for adjusting peripheral high-order aberrations to control myopia, the method comprising the steps of:

specifically, firstly, determining a spectacle phase plate and a corneal topography according to the optometry data of the eye; inputting the corneal topography into a computer system, and generating a contact lens phase plate by the computer system by using curve fitting simulation; then, according to the glasses phase plate and the contact lens phase plate, an optical phase plate is preliminarily determined; finally, according to clinical diagnosis data (such as clinical reasons of failure to provide proper edge clearance or excessive contact with the cornea), the optical phase plate is corrected by changing the curve generated by the computer system, and the contact lens phase plate is corrected according to the optical phase plate;

wherein, the computer system is provided with Zemax optical design software, and the Zemax optical design software can be used for curve simulation to characterize the high-order aberration compensation effect of the contact lens phase plate.

Step 2: measuring high order aberration data of the eye by a fast scanning HS (Hartmann-Shack) wavefront sensor and correcting the optical phase plate according to the high order aberration data;

specifically, firstly, measuring high-order aberration data of the eye through a fast scanning HS wavefront sensor; then inputting the high-order aberration data into a computer system, constructing a model for correcting peripheral high-order aberration by the computer system according to the high-order aberration data, and correcting the optical phase plate through the model;

zemax optical design software is installed in the computer system, a wavefront map of high-order aberration data can be simulated in a curve mode through the Zemax optical design software, and then the optical phase plate is corrected according to the wavefront map.

Referring to fig. 4, the fast scan HS wavefront sensor includes a microlens array, a pellicle beam splitter, and a wavefront sensor.

And step 3: manufacturing diagnosis spherical glasses by cutting through a precision numerical control lathe, and measuring wavefront aberration of the eyes through the diagnosis spherical glasses and the optical phase plate;

the wavefront aberration measurement is carried out on the eyes through the diagnosis spherical glasses and the optical phase plate, and pupil deviation measurement data and translation and rotation deviation measurement data can be obtained.

specifically, the pupil shift is corrected according to the pupil shift measurement data; then, performing matrix transformation on the translational-rotational offset measurement data through the effective matrix, and correcting the eccentric aberration according to the transformation matrix data; finally, correcting the optical phase plate according to the pupil offset correction result and the eccentric aberration correction result, and finally determining the optical phase plate;

since the optical device is characterized by eccentric aberrations due to the rotation or translation of the human eye, translational-rotational offset correction of the eye is required to specifically capture the residual aberrations. Using Zernike matrices, the translational and rotational offset measurements are developed for analysis to understand how the different phase differences are affected by translation or rotation, which produces the same kind of residual aberration for optimal correction when decentering aberrations are necessary. The Zernike coefficients of the wave front aberration when the axial elongation changes can be obtained again through the rotating and translating transformation matrix; for typical decentration aberration corrections, the correction method using the Zernike matrix can have a 2-4 fold adjustment effect over standard defocus and astigmatism corrections.

taking the optical phase plate subjected to the peripheral aberration correction as a profile model manufactured on a precise numerical control lathe; the horizontal (Ax) eccentricity, vertical (Ay) eccentricity and rotational (Ap) eccentricity of the device relative to the center of the pupil were quantified from the pupil image using the device center of a precision numerically controlled lathe as the origin of the coordinate system using MATLAB software. And then, carrying out diamond turning on the irregular profile of the front surface formed by the residual high-order aberration on the optical phase plate by using a submicron precision numerical control lathe, and carrying out accurate compensation and correction on the high-order aberration on the peripheral wave aberration of the eye.

Step 6: and a wedge-shaped toric optical zone for controlling myopia is added on the optical phase plate, and the wedge-shaped toric optical zone comprises a positive spherical aberration zone and a third-order vertical comet aberration zone.

Since the improved optics must be of multifocal and bifocal design to help control myopia, multifocal yields significantly positive values in the field of view through an optional amount of spherical aberration, e.g., a two-shift range of one positive spherical aberration from 0.125 μm low (+1.50D) to 0.245 μm high (+2.50D) for a 5mm pupil; bifocal points incorporate a positive design, for example, one with a +2.50D at 3mm from the center of the lens at the optical center pupil and another with a circumferential positive refractive offset of +1.50 and +2.00D at 4.5mm, resulting in positive spherical aberration; wherein the latter is used to modulate corneal Higher Order Aberrations (HOAS) because of the dynamic scheduling of human eye work to improve retinal image quality, and wherein the multifocal optics add horizontal coma aberrations due to decentered aberrations, and wherein the decentered aberrations were previously compensated to better align the bifocal optics with the strands in the corneal Higher Order Aberrations (HOAS) and to create more symmetric positive refractive offset optic zones, thereby reducing the effects of pupil size and enhancing control of myopia progression and axial elongation. Besides the positive spherical aberration, the third-order vertical coma aberration and the corneal high-order aberration (HOAS) are negatively related to myopia, and the existence of the third-order vertical coma aberration can enhance and control the axial elongation development of myopia.

Referring to fig. 6, an optical device having a tapered toric optical zone for correcting refractive errors associated with astigmatism, the tapered toric optical zone providing cylindrical correction to compensate for astigmatism. Since astigmatism required to correct vision is often associated with other refractive errors, such as myopia or hyperopia, optical devices that are applied to wedge-shaped toric optic zones are also often provided with a positive spherical correction optic zone to correct myopic astigmatism or hyperopic astigmatism.

Although spherical contact lenses can freely rotate on the eye, wedge-shaped toric contact lenses inhibit rotation of the contact lenses on the eye such that the cylindrical axis of the wedge-shaped toric optical zone remains substantially aligned with the astigmatism axis. The wedge-shaped toric cornea contacts the contact lens with a selected relationship (or offset) between the cylindrical axis of the wedge-shaped toric and the orientation of the ballast. The relationship is expressed as the degree (rotation angle) of the cylindrical axis from the orientation axis of the ballast. Accordingly, wedge-shaped toric contact lenses are typically provided in 5 or 10 degree increments from 0 ° to 180 °. Wedge toric contact lenses will typically specify spherical correction (spherical power), cylindrical correction (cylindrical power) and axial offset to define the optical correction, and lens diameter and base curve to define the fitting parameters. One type of ballast, prism ballast, has proven effective in maintaining the desired rotational orientation of the wedge toric contact lens on the eye. The prism can be obtained in a number of ways, including: the optical zone of the wedge-shaped toric contact lens is decentered vertically downward to achieve a "wedge" of the thickness of the entire optical zone. Or tilting the entire front surface relative to the back surface to achieve a "wedge" of the entire lens thickness. For either approach, the peripheral design of wedge toric contact lenses can achieve better fit and eye comfort. Both of these techniques of introducing prisms limit the ability to control the peripheral area of the lens. Therefore, the invention increases the thickness from the top to the bottom of the wedge-shaped toric contact lens, adjusts the diameters of the front and back optical zones of the aspheric optical zone, balances the vertical thickness profile, optimizes the uniform middle-circumference thickness from the top, the center to the bottom, reduces the thickness variation to the greatest extent, enhances the unique hyperbolic back design with rotational stability, can realize the optimal positioning to provide the optimal stability, in addition, leads the eccentric aberration of the prism Ballast of the optical device to introduce the additional peripheral optical third-order vertical high-order coma aberration to control the myopia, considers the requirement of the astigmatism cylindrical correction which is usually followed by the ametropia of the general human eye, the prism Ballast (Ballast) wedge-shaped toric optical zone refers to FIG. 7, not only increases the third-order vertical high-order coma aberration, but also can provide the optimal spherical correction in the whole visual field range at the same time, improve the image contrast of the peripheral vision field and achieve the purposes of correcting the best vision and controlling the myopia.

The optical phase plate is used for completing the compensation and correction of the peripheral aberration of the front surface and the design of the high-order aberration of the rear surface, a precision numerical control lathe equipped with industrial-grade diamond 6000RPM is used as a cutting tool, redundant materials are removed from the rear surface through a series of operations with gradually decreasing depth, and finally the rear surface can be polished by using some fine grinding paste, oil and polishing tools or small polyester cotton balls rotating at high speed to ensure the optical quality. In addition, to maintain the front and back surface axes consistent to avoid the creation of unwanted aberrations, a soluble wax is used as a binder so that the front surface can be cut and polished in the same manner to produce wedge-shaped toric contact lenses that are finished to adjust peripheral higher order aberrations to control myopia.

The present invention provides an optical device for adjusting peripheral high order aberrations to control myopia, including contact lenses made by the above method, and may be extended to optical devices including, but not limited to, frame lenses, intraocular inlays and the like.

In summary, the present invention initially determines an optical phase plate according to the refraction data; and measuring high order aberrations around the eye using a fast HS wavefront sensor, modifying the optical phase plate; manufacturing a diagnosis spherical lens by cutting through a precision numerical control lathe, placing the diagnosis spherical lens on an eye, measuring wavefront aberration by combining the eye and an optical phase plate, compensating central aberration and peripheral high-order aberration, and establishing a model for correcting the peripheral high-order aberration; by selecting an optical phase plate with ideal correction, peripheral high-order aberration is corrected, asymmetry can be reduced, the effects of negative defocus and positive defocus can be more symmetrical, the peripheral focusing depth can be reduced, and myopia progression and axial elongation control can be realized. Therefore, the invention effectively overcomes various defects in the prior art and has high industrial utilization value.

The foregoing embodiments are merely illustrative of the principles and utilities of the present invention and are not intended to limit the invention. Any person skilled in the art can modify or change the above-mentioned embodiments without departing from the spirit and scope of the present invention. Accordingly, it is intended that all equivalent modifications or changes which can be made by those skilled in the art without departing from the spirit and technical spirit of the present invention be covered by the claims of the present invention.

Claims

1. A method of adjusting peripheral higher order aberrations to control myopia, the method comprising the steps of:

2. The method of claim 1, wherein the specific process of step 1 is as follows:

3. The method of claim 2, wherein the specific process of step 2 is:

4. A method of regulating peripheral higher order aberrations to control myopia according to claim 1, wherein: and 3, performing wavefront aberration measurement on the eyes through the diagnosis spherical glasses and the optical phase plate to obtain pupil offset measurement data and translational and rotational offset measurement data.

5. The method of claim 4, wherein said adjusting peripheral higher order aberrations controls myopia, and further comprising: the specific process of the step 4 is as follows:

6. A method of regulating peripheral higher order aberrations to control myopia according to claim 1, wherein: the wedge-shaped toric optical zone for controlling myopia in the step 6 comprises a positive spherical aberration zone and a third-order vertical comet aberration zone.

7. An optical device for adjusting peripheral high order aberrations to control myopia, comprising: the optical device made by the method of claims 1-6, comprising a frame lens, a contact lens, an intraocular lens, and an intraocular inlay.