角膜塑形镜对眼球形状参数影响的研究  

The effects on ocular parameters with Orthokeratology lens wearing

作　　者：刘然[1] 毛欣杰[1] 瞿佳[1] 

机构地区：[1]温州医学院眼视光学院,浙江温州325027

出　　处：《中国实用眼科杂志》2013年第5期587-590,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的研究角膜塑形镜矫治近视过程中角膜前后表面形态、厚度、前房深度及眼轴长度的变化情况，探讨过夜配戴角膜塑形镜后引起近视屈光度下降时眼球形状变化可能机制。方法选取33例中低度近视受试者[等效球镜（-3．10±1．10）D]采用夜戴型角膜塑形镜随访一个月，记录戴镜前、戴镜后1天、1周、1月的裸眼视力、矫正视力以及残留屈光度数，用Pentacam测量角膜前后表面形态、角膜厚度（CT），IOL—masteron测量眼轴（AL）和前房（ACD）。根据Munnerlyn公式计算角膜中央3mm矢高（SH）变化。计算眼部各参数的变化量，分析角膜塑形术后各参数变化量所占眼部整体变化量的比例。结果戴镜1dR，近视屈光度为（1．08±1．00）D（P〈0．000），戴镜后1周和1月相比差异无统计学意义。1月后角膜前表面曲率从（43．50±1．31）D到（42．15±1．45）D（P〈0．01），后表面曲率从（-6．26＋0．24）D到（-6．28±0．22）D（P〈0．001）。AL平均缩短0．04±0．04mm（P〈0．000）。ACD缩短在戴镜1周后有统计学意义（P=0．013）。CT没有明显的变化。变化量中，AACD最大，分别为眼轴整体变化量的92％，124％，98％（1d，1周，1月）。结论角膜塑形镜降低近视屈光度主要发生在术后1周内，1周后视力达稳定，角膜前表面变平坦为主要因素。配戴一个月后眼轴长度变短，主要是由于角膜塑形的变化引起前房深度变化引起。角膜塑形镜降低近视屈光度的机制可能还存在角膜的整体弯曲后退。Objective To investigate changes in corneal morphology and corneal thickness, anterior chamber depth, the axial length in 1 month with orthokeratology lens wearing and discusses the mechanism of refractive error reduced by orthokeratology. Methods Thirty-three young myopic subjects wore reverse-geometry OK lenses every night for 1 month. Central corneal morphology and corneal thickness （CT） were measured by Pentacam （HR, Oculus, Inc. GmbH, Wetzlar, Germany）, subjective refraction, and anterior chamber depth （ACD） and the axial length （AL） measured by IOL-Master （Zeiss Meditec, AG） were evaluated within 2 h after lens taken, Baseline and 1 day, 1 week, 1 month follow-up data were collected. The sagittal height of cornea （SH） was calculated according to Munnerlyn formula. Results A day later, subjective refraction significantly decreased 1.08±1.00D （P 〈0.000）, and there was no statistical significance between 1 week and 1 month. The anterior curvature became flattened from 43.50±1.31D to 42.15±1.45D （P 〈0.000）. The posterior curvature became steeped from -6.26±0.24D to -6.28±0.22D （P 〈0.001）. AL shortened 0.04±0.04mm （P 〈 0.000）. ACD experienced a statistically significant reduction after a week （P =0.013）. CT had no clearly statistical significance after treatment. AACD occupied 92%, 124%, 98% of AAL （I day, 1 week, and 1 month, respectively）. Conclusions Orthokeratology lens to reduce myopia occur within 1 week after surgery, visual acuity is stable after 1 week. The anterior corneal surface flattening is the main factor. After one month, the axial length is shorter, mainly due to the change of anterior chamber depth. Orthokeratology lens causes the overall bending of the anterior corneal surface flatten- ing, it may still exist cornea back.

关 键 词：角膜塑形镜 角膜厚度 前房深度 眼轴 角膜形态 

分 类 号：R778.110.5[医药卫生—眼科]