摘要
目的探讨单眼近视的青少年配戴角膜塑形镜矫正的有效性及安全性,同时观察健眼屈光状态变化,科学干预近视发展。方法回顾性分析在我院验配角膜塑形镜1年以上、随访资料完整的75例单眼近视青少年患者的病历资料,分为治疗组(75眼)和对照组(75眼),治疗组为患者近视眼,配戴角膜塑形镜治疗,对照组为对侧健眼,未进行任何干预。比较分析2组戴镜前及戴镜治疗后6个月、12个月的等效球镜度数﹑眼轴长度、平均角膜曲率和治疗后12个月角膜内皮细胞密度、中央角膜厚度及泪膜破裂时间,记录治疗后12个月2组患者近视增长率。结果治疗前治疗组等效球镜度数显著大于对照组(P=0.000);治疗后治疗组等效球镜度数显著下降,而对照组等效球镜度数随时间延长呈逐渐上升趋势。治疗后2组眼轴长度均随时间延长而增加;治疗后12个月对照组眼轴长度增加幅度大于治疗组,差异具有统计学意义(t=-5.78,P=0.000)。治疗前2组平均角膜曲率比较,差异无统计学意义(P=0.934),治疗后各时间点治疗组平均角膜曲率均显著低于对照组(P=0.000);与治疗前比较,治疗组治疗后6个月及12个月平均角膜曲率显著降低(P=0.000),但治疗后6个月与12个月比较,差异无统计学意义(P=0.252)。治疗组中央角膜厚度治疗后显著变薄,与治疗前比较差异有统计学意义(t=6.694,P=0.000)。治疗组治疗后12个月角膜内皮细胞密度、泪膜破裂时间与治疗前比较,差异均无统计学意义(P>0.05)。治疗后12个月治疗组近视增长10眼(13.33%),对照组近视增长34眼(45.33%),2组比较差异有统计学意义(P=0.000)。结论角膜塑形镜能安全有效地控制眼轴增长,但对侧健眼具有较高的眼轴增长风险。
Objective To investigate the efficiency and safety of orthokeratology(OK)in the treatment of juvenile monocular myopia and evaluate the refractive state progression of the emmetropic eye,so as to intervene the development of myopia scientifically.Methods Retrospectively analyzed the clinical data of 75 adolescent patients with monocular myopia who had received orthokeratology in our hospital for more than 1 year.For each participant,the myopic eye(the treatment group)received overnight orthokeratology correction,and the contralateral emmetropic eye(the control group)was observed without any intervention.The spherical equivalent,axial length,corneal curvature,endothelial cell density,central corneal thickness and tear break-up time were measured at baseline and 6 and 12 months after treatment.The increase rate of myopia in the two groups were recorded 12 months after treatment.Results Before treatment,spherical equivalent of the treatment group was significantly higher than that of the control group(P=0.000).After treatment,spherical equivalent in the treatment group decreased significantly,while that in the control group increased gradually with the prolongation of time.After treatment,axial length increase d with time in both groups.After 12 months of treatment,the increase amplitude of axial length in the control group was larger than that in the treatment group,and the difference was statistically significant(t=-5.78,P=0.000).The average corneal curvature of the two groups before treatment showed no statistically significant difference(P=0.934),and average corneal curvature of the treatment group was significantly lower than that of the control group at each time point after treatment(P=0.000).Compared with that before treatment,the mean corneal curvature of the treatment group was significantly reduced at 6 months and 12 months after treatment(P=0.000),but there was no statistically significant difference between 6 months and 12 months after treatment(P=0.252).The central corneal thickness of the treatment group was significantly thinner after treatment(t=6.694,P=0.000).Compared with those before treament,the differences of endothelial cell density and tear break-up time of the treatment group 12 months after treatment were not significant(P>0.05).After 12 months of treatment,myopia in the treatment group increased by 10 eyes(13.33%),while that in the control group increased by 34 eyes(45.33%),and the difference between the two groups was statistically significant(P=0.000).Conclusion Orthokeratology can safely and effectively control axial length growth of the juvenile monocular myopic eye.However,the emmetropic eye has a higher risk of axial length growth.
作者
陈利
霍姝佳
刘波
何敏
李尚鹏
熊洁
CHEN Li;HUO Shu-jia;LIU Bo;HE Min;LI Shang-peng;XIONG Jie(Department of Ophthalmology,First Affiliated Hospital,Army Medical University,Chongqing 400038,China)
出处
《局解手术学杂志》
2020年第12期1000-1004,共5页
Journal of Regional Anatomy and Operative Surgery
基金
重庆市科卫联合医学科研项目(2018MSXM024)
陆军军医大学临床科研项目(2018XLC3012)。
关键词
单眼近视
等效球镜度
角膜塑形镜
眼轴
角膜曲率
角膜内皮细胞密度
monocular myopia
spherical equivalent
orthokeratology
axial length
corneal curvature
endothetial cell density
