摘要
目的观察青少年配戴角膜塑形镜的疗效及并发症，评估青少年配戴角膜塑形镜的安全性和有效性。方法临床病例系列研究。分析2010年到2013年在第三军医大学西南眼科医院使用角膜塑形镜矫治近视的青少年176例321只眼，男72例123只眼，女104例198只眼，年龄7～19（11．34±0．31）岁。戴镜后1周，1、3、6个月，1、2年随访。观察配戴角膜塑形镜前后裸眼视力（UCVA），屈光度数，角膜曲率，矫正视力（VACC），眼轴长度，裂隙灯检查眼部的健康状况。结果（1）戴镜前的裸眼视力为0．16±0．11，戴镜1周，1、3、6个月，1、2年后为0．78±0．12，0．79±0．13，0．88±0．12，0．89±0．10，0．90±0．12，0．89±0．13，与戴镜前相比差异均有统计学意义（t=23．452，-32．046，-30．129，-26．116，-25．618，-28．987；均P=0．000）；戴镜后1周，1、3、6个月，1、2年的屈光度等值球镜明显下降，与戴镜前相比差异有统计学意义（t=17．737，18．485，18．419，18．152，18．184，18．826；均P=0．000）；角膜水平曲率与戴镜前相比差异有统计学意义（t=15．204，22．037，21．038，27．595，28．156，23．915；均P=0．000）；角膜垂直曲率与戴镜前相比差异有统计学意义（t=17．844，20．564，19．316，21．247，21．763，19．838；均P=0．000）。（2）戴镜后1周，1、3、6个月，1、2年的矫正视力与戴镜前相比差异无统计学意义（t=1．093，0．912，0．097，0．700，0．946，1．372；P=0．280，0．366，0．923，0．487，0．349，0．176）；眼轴长度虽有波动，但与戴镜前相比差异无统计学意义（t=6．801，4．510，3．242，3．561，3．750，3．194；P=0．061，0．072，0．068，0．074，0．073，0．076）。（3）配戴过程中并发症有：角膜上皮损伤，结膜炎，重影及眩光，角膜炎，角膜后沉着物（keratic precipitates，KP），角膜云翳。其中角膜上皮损伤有65只眼占20．2％（65／321），结膜炎有31只眼占9．7％（31／321），重影及眩光有8只眼占2．5％（8／321），角膜炎、KP、角膜云翳各有1只眼占0．3％（1／321）。结论配戴角膜塑形镜后裸眼视力明显提升，矫治近视效果明显。配戴过程中未出现严重并发症，安全性较高。
Objective To observe the efficacy and complications of adolescents wearing orthoker- atology lens, and to evaluate its safety and effect. Methods A total of 176 cases （321 eyes） aged from 7 to 19 years who received orthokeratologic therapy from 2010 to 2013 in Southwest Eye Hos- pital Third Military Medical University were analyzed. They were followed up at 1 week, 1 month, 3 and 6 months, 1 year, 2 years. Before and after wearing orthokeratlogy lens they were observed with the uncorrected visual acuity （UCVA）, diopter, corneal curvature, corrected visual acuity （VACC）, axial length, slit lamp examination of eye health. Resttlts At 1 week, 1 month, 3 and 6 months, 1 year, 2 years after wearing glasses, UCVA increased from 0.16±0.11 before wearing glass- es to 0.78±0.12, 0.79±0.13, 0.88±0.12, 0.89±0.10, 0.90±0.12, 0.89±0.13 respectively, the differences were significant （t =-23.452,-32.046,-30.129,-26.116,-25.618,-28.987; P =0.000）. Diopter was sig- nificantly decreased after wearing glasses, there was significant difference compared with before wear- ing glasses （t =17.737, 18.485, 18.419, 18.184, 18.826; P =0.000）. There was significant difference compared with before wearing glasses in corneal horizontal curvature （t =15.204, 22.037, 21.038, 27.595, 28.156, 23.915; P =0.000）. There was significant difference compared with before wearing glasses in corneal perpendicular curvature （t =17.844, 20.564, 19.316, 21.247, 21.763, 19.838; P = 0.000）. At 1 week, 1 month, 3 and 6 months, 1 year, 2 years after wearing glasses, there was signif- icant difference compared with before wearing glasses in CVA （t =1.093, 0.912, 0.097, 0.700, 0.946, 1.372; P =0.280, 0.366, 0.923, 0.487, 0.349, 0.176）. Axial length had a little changed after wearing glasses, but there was no significant difference （t =6.801, 4.510, 3.242, 3.561, 3.750, 3.194; P = 0.061, 0.072, 0.068, 0.074, 0.073, 0.076）. Complications in the wearing process were： corneal epitheli- al injury, conjunctivitis, keratitis, ghosting and glare, keratic precipitates, corneal nebula. The corneal epithelial injury was 65 eyes accounted for 20.2%（65/321）, conjunctivitis 31 eyes accounted for 9.7% （31/321）, ghosting and glare 8 eyes accounted for 2.5%（8/321）, the keratitis and keratic precipitates and corneal leucoma was 1 eye each accounted for 0.3%（1/321）. Conclusions After wearing ortho- keratology, UCVA improved obviously. Orthokeratology treatment of juvenile myopia is effective. No serious complications occurred in the process of wearing glasses, the safety is higher.
出处
《中国实用眼科杂志》
2015年第2期132-136,共5页
Chinese Journal of Practical Ophthalmology
关键词
角膜塑形镜
近视
并发症
Orthokeratology
Myopia
Complication
