长期配戴角膜塑形镜停戴后角膜形态及屈光度变化  

Changes of Corneal Morphological and Refractive after Discontinuation of Long-Term Orthokeratology Lens Wear

作　　者：马晓欢 周堃 申笛[1] 韦伟[1] Xiaohuan Ma;Kun Zhou;Di Shen;Wei Wei(Department of Ophthalmology,Xi′an No.1 Hospital,the First Affiliated Hospital of Northwestern University,Shaanxi Ophthalmology Institute,Shaanxi Key Laboratory of Ophthalmology,Xi'an 710002,China)

机构地区：[1]西安市第一医院,西北大学附属第一医院眼科,陕西省眼科研究所,陕西省眼科重点实验室,西安710002

出　　处：《中华眼视光学与视觉科学杂志》2024年第6期431-436,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:探讨长期配戴角膜塑形镜停戴3个月后角膜形态及屈光度的变化情况。方法:回顾性研究。连续收集2011—2019年在西安市第一医院激光近视治疗中心配戴角膜塑形镜24个月以上并停戴超过3个月的近视患者57例(57眼)。按戴镜前中位数分组:等效球镜度(SE)(分为≥-3.88 D和<-3.88 D)、眼轴长度(AL)(分为≤25.13 mm和>25.13 mm)、初始戴镜年龄(分为≤12岁和>12岁)、戴镜时长(分为≤72个月和>72个月)、停戴时间(分为≤4个月和>4个月)、配戴镜片设计类型(分为球面和环曲面)、离焦环位置(分为正位和偏位)。患者戴镜前和停戴后球镜度(SD)、角膜平坦K值(FK)、陡峭K值(SK)、中央角膜厚度(CCT)的比较采用独立样本t检验,戴镜前和停戴后柱镜度(CD)、角膜散光(CA)、AL的比较采用非参数曼-惠特尼U检验,停戴后和戴镜前的SD变化量(∆SD)及FK变化量(∆FK)采用混合线性模型分析。结果:纳入患者戴镜时长72(24,144)个月,停戴时间4(3,72)个月。停戴后和戴镜前相比SD增加-0.75(-2.00,0)D、CD增加0(-0.50,0.25)D、AL增长(0.52±0.68)mm、CA增加(-0.19±0.59)D、FK变平(-0.31±0.48)D、CCT变薄(-4.79±9.97)μm(均P<0.05),而SK无明显变化(P=0.133)。按初始戴镜年龄≤12岁和>12岁分组后,∆SD分别为-1.25(-2.44,-0.50)D和-0.25(-1.25,0)D,∆FK分别为-0.35(-0.69,-0.13)D和-0.12(-0.42,0.11)D,组间差异均有统计学意义(Z=-2.93,P=0.003;Z=-2.04,P=0.041)。结论:长期配戴角膜塑形镜停戴3个月后角膜FK值变平坦,SK值无明显变化,角膜散光增加。且初始戴镜年龄较小者FK值更平坦。Objective:To explore the changes of corneal morphology and refractive power after three months'discontinuation of long-term orthokeratology lens wear.Methods:This was a retrospective study.Totally 57 myopic patients(57 eyes)who underwent orthokeratology lenses treatment at the Laser Vision Center of Xi'an No.1 Hospital from 2011 to 2019 were included continuously in this study.Patients who have worn lenses for more than 24 months and ceased wearing them for over 3 months were included.Patients were grouped according to the median value before lens wear:spherical equivalent(SE)into two groups:≥-3.88 D and<-3.88 D,axial length(AL)into two groups:≤25.13 mm and>25.13 mm,initial age of lens wear into two groups:≤12 years old and>12 years old,duration of lens wear into two groups:≤72 months and>72 months,discontinuation period into two groups:≤4 months and>4 months.Lens type was also divided into two groups:spherical and toric lenses.Based on whether the decentration of the lens occurs,participant were divided into central and decentered fitting group.The comparison of spherical diopter(SD),flat keratometry value(FK),steep keratometry value(SK),and central corneal thickness(CCT)before and after wearing lenses was conducted using independent sample t-tests.Meanwhile,the comparison of cylinder diopter(CD),corneal astigmatism(CA),and AL before and after discontinuation of lens wear was performed using non-parametric Mann-Whitney U tests.Additionally,the analysis for changes of SD(∆SD)and FK(∆FK)after stopping the use of lenses compared to before their use was conducted using a mixed linear model.Results:The mediam of lens wear was 72(24,144)months,and the mediam period was 4(3,72)months.After discontinuation,SD increased compared to pre-wearing by-0.75(-2.00,0)D,CD increased compared to pre-wearing by 0(-0.50,0.25)D,AL increased by 0.52±0.68 mm,CA increased by-0.19±0.59 D,FK flattened by-0.31±0.48 D,CCT thinned by-4.79±9.97μm(all P<0.05),while changes of SK showed no significant(P=0.133).After grouping

关 键 词：角膜曲率 角膜塑形镜 角膜散光 停戴 

分 类 号：R778[医药卫生—眼科]