角膜塑形镜治疗青少年近视眼角膜地形图参数分析  

Assessment of corneal topography indices after orthokeratology correction for pediatric myopia

作　　者：刘兵[1] 茹海霞[1] 王华[1] 陈威[1] 杨春燕[1] 

机构地区：[1]空军总医院眼科,100142

出　　处：《中国斜视与小儿眼科杂志》2014年第3期1-4,共4页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的分析青少年近视眼经角膜塑形镜矫正后角膜前表面的变化。方法回顾性分析青少年近视患者共75人150眼,年龄9~17岁,屈光状态:-4.23±1.82(-8.75^-0.75)Ds/-0.3±0.47(-2~0)Dc,等效球镜度数:-4.34±1.88(-9.13^-0.75)D,应用Tomey TMS-4角膜地形图观察角膜塑形镜治疗前后角膜形态学的改变。结果通过规范验配,150眼裸眼视力均达到1.0,没有严重并发症发生。角膜地形图资料显示平均Ks:41.19±1.73D,Kf:39.67±1.67D,AveK:40.43±1.61D,PVA:-0.01±0.09~0.11±0.08(LogMAR),Es:-0.14±0.47,Em:-0.39±0.34,SRI:0.49±0.33,SAI:0.84±0.60,与治疗前相比差异具有统计学意义。Cyl:1.48±0.96D,与术前差异无统计学意义。波动的平均值如下:Ks:0.82±0.83(0~3.88)D,Kf:0.69±0.75(0.01~4.54)D,Avek:0.71±0.75(0.01~3.51)D,Cyl:0.45±0.48(0.01~2.70)D,Es:0.27±0.31(0~1.14),Em:0.18±0.24(0~1.51),Sri:0.19±0.20(0~1.02),Sai:0.40±0.55(0~3.65)。结论夜戴角膜塑形镜通过改变角膜前表面的角膜曲率和E值,提高青少年近视患者的裸眼视力,角膜的规则散光保持不变,但是角膜的潜视力值降低,角膜的不规则性增强。角膜地形图参数在一定波动范围内可以维持裸眼矫正视力稳定的。Objective To analysis anterior corneal surface shape changes in pediatric myopic overnight or-thokeratology. Methods Retrospective observational case series were observed. Tomey TMS -4 was used to receive corneal topographic data before and after overnight orthokeratology lens wear. Seventy-five pediatric myopic patients （150 eyes, age range： 9-17 years） were included. The myopia was -4.23±1.82 （range：-8.75--0.75） D, the astigmatism was -0.3±0.47 （range： -2-0） D, and spherical equivalent refraction was -4.34±1.88 （range： -9.13--0.75） D. Topog-raphy data was collected and analyzed when uncorrected visual acuity （UCVA） was 1.0. Results After normative or-thokeratology lens correction, UCVAs of one hundred and fifty eyes reached 1.0, and no severe complications were ob-served. The topography parameters showed that mean Ks：41.19±1.73D,Kf：39.67±1.67D,AveK：40.43±1.61D, PVA：-0.01±0.09-0.11±0.08 （LogMAR）, Es：-0.14±0.47,Em：-0.39±0.34,SRI：0.49±0.33,SAI：0.84±0.60, and were significantly different from no lens wear. No significant change was observed in Cyl （1.48±0.96D） before and after lens wear. The fluctuation range above parameters’ means were ks：0.82±0.83 （0-3.88） D,Kf：0.69±0.75 （0.01-4.54） D,Avek：0.71±0.75 （0.01-3.51） D,Cyl：0.45±0.48 （0.01-2.70） D,Es：0.27±0.31 （0-1.14）,Em：0.18±0.24 （0-1.51）,Sri：0.19±0.20 （0-1.02）,Sai：0.40±0.55 （0-3.65） . Conclusions Improved visual acuity after overnight wear of orthokeratology lens can be attributed to changes in anterior corneal curvature and E value. Corneal regular astigmatism remained unchanged, but corneal PVA reduced and corneal irregularity increased. Improved UCVA can be maintained within a certain fluctuation of topography parameters.

关 键 词：近视 角膜塑形 角膜地形图 

分 类 号：R778.3[医药卫生—眼科] R778.11[医药卫生—临床医学]