摘要
目的探讨低中度青少年近视患者夜戴角膜塑形镜5年后眼轴(AL)及角膜内皮细胞密度(CD)、内皮六边形细胞比例(HEX)及内皮变异系数(CV)的变化。设计回顾性病例系列。研究对象选取配戴角膜塑形镜且连续戴镜5年以上、依从性好的低中度青少年近视患者68例(135眼)。方法依近视等效球镜度数将患眼分为低度近视组(-0.75^-3.00 D)及中度近视组(-3.25^-5.75 D),观察并比较戴镜前及戴镜1、2、3、4、5年后两组患者AL、CD、HEX及CV等参数的变化。主要指标AL、CD、HEX、CV。结果戴镜前及戴镜后1~5年,两组AL均随时间增长(F=16.863,6.780;P=0.000,0.000)。低度近视组1~5年AL增长量分别为(0.28±0.15)mm、(0.21±0.16)mm、(0.17±0.15)mm、(0.12±0.08)mm及(0.11±0.06)mm,中度近视组1~5年AL增长量分别为(0.25±0.14)mm、(0.16±0.10)mm、(0.15±0.09)mm、(0.10±0.07)mm及(0.08±0.05)mm,两组年AL增长量均随时间降低(F=28.434,21.296;P=0.000,0.000),且5年后中度近视组AL增长较缓(t=6.577,P=0.011)。戴镜前及戴镜1~5年后,低度近视组和中度近视组双眼CD(F=1.239,1.421;P=0.290,0.216)、HEX(F=2.156,2.227;P=0.058,0.051)及CV(F=2.147,2.038;P=0.059,0.073)变化均无统计学意义,同期双眼间比较均无统计学差异(P均>0.05)。结论 5年的随访结果显示角膜塑形镜对中度近视控制效果优于低度近视。长期夜戴角膜塑形镜对角膜内皮细胞无明显影响。
Objective To evaluate the effects and safety of long-term overnight orthokeratology（ ortho-k） in adolescent with low to moderate myopia. Design Retrospective study. Participants 68 myopic juvenile（ 135 eyes） with ortho-k lens wearing more than 5 years. Methods Subjects were divided into lowmyopia（ SE-0. 75 ～-3. 00 D） and moderate-myopia（ SE-3. 25 ～-5. 75 D） groups. Axial length（ AL） was measured at baseline and every year after ortho-k lens wearing. The cell density（ CD）,hexagonal cell ratio（ HEX）,and coefficient of variation（ CV） of the corneal endothelial cell layer were measured at each year. Data were analyzed using repeated one-way ANOVA and t-test analyses. Main Outcome Measures AL,CD,HEX,CV. Results During the five years of observation periods,the AL of both groups increased（ F = 16. 863,6. 780; P = 0. 000,0. 000）. The annual axial growth after ortho-k lens wearing for 1 to 5 years was（ 0. 28 ± 0. 15） mm,（ 0. 21 ± 0. 16） mm,（ 0. 17 ± 0. 15） mm,（ 0. 12 ± 0. 08） mm and（ 0. 11± 0. 06） mm in low-myopia group; and the data of moderate-myopia group was（ 0. 25 ± 0. 14） mm,（ 0. 16 ±0. 10） mm,（ 0. 15 ± 0. 09） mm,（ 0. 10 ± 0. 07） mm and（ 0. 08 ± 0. 05） mm respectively. With time prolonged,the annual axial elongation of both groups decreased（ F = 28. 434,21. 296; both P〈0. 001）,and the moderate-myopia group represented less axial elongation after 5 years（ t = 6. 577; P = 0. 01）. After ortho-k lens wearing for 1 to 5 years,the CD（ F = 1. 239,1. 421; P = 0. 290,0. 216）,HEX（ F = 2. 156,2. 227; P = 0. 058,0. 051） and CV（ F = 2. 147,2. 038; P = 0. 059,0. 073） of the corneal endothelial cell layer remained stable,and there was no significant difference of corneal endothelial cell layer changes between two groups（ all P〉0. 05）. Conclusions Five-year follow-up showed that ortho-k lens has a better effect on myopia control in moderate myopia than low myopia. Long term overnight wearing of ortho-k lens has no significant effect on corneal endothelial cells.
作者
吕燕云
武晶晶
迟蕙
彭丽
王艳霞
谢培英
LV Yan-yun1 , WU Jing-jing1, CHI Hui2 , PENG Li1 , WANG Yan-xia1 , XIE Pei-ying2.(1. Tongren Eye Care Center, Bering Tongren Hospital, Capital Medical University, Beijing 100730, China ; 2. Peking University Optometry ＆ Ophthalmology Center, Beijing 100083, Chin)
出处
《眼科》
CAS
CSCD
2018年第2期141-145,共5页
Ophthalmology in China
关键词
角膜塑形术
近视控制
眼轴
角膜内皮细胞
orthokeratology
myopia control
axial length
corneal endothelial cell
