角膜塑形镜停戴后屈光状态和角膜形态的观察  

Observation of orthokeratology discontinuation

作　　者：杨丽娜 郭曦 谢培英 

机构地区：[1]北京北医眼视光学研究中心,100027

出　　处：《中华眼科杂志》2015年第3期178-182,共5页Chinese Journal of Ophthalmology

摘　　要：目的 探讨角膜塑形镜矫治中短时间或长时间停戴后屈光状态和角膜形态的变化.方法 回顾性研究.收集配戴角膜塑形镜并有停戴史的近视散光患者141例（257只眼）,依近视球镜度数高低先分为2个组（球镜度数≤-4.00 D为Ⅰ组,＞-4.00 D为Ⅱ组）,每组根据停戴时间再分为2个组,停戴时间≥1个月且＜3个月分别为Ⅰ A、ⅡA组,停戴时间≥3个月分别为ⅠB、ⅡB组.4个组在戴镜前及停戴后均进行详细的眼科检查、医学验光、角膜曲率、角膜地形图、角膜内皮细胞、眼轴及中央角膜厚度测量,询间停戴后的屈光矫正方式.对检查结果数据进行配对t检验及单因素方差分析.结果 4个组与戴镜前相比球镜度数变化值：ⅠA组为（-0.31±0.58）D,ⅠB组为（-0.48 ±0.68）D,ⅡA组为（-0.35 ±0.65）D,ⅡB组为（-0.57±0.58）D,差异均有统计学意义（t =3.222,3.404,3.141,5.012;P ＜0.05）;散光度数各组均无明显变化.4个组球镜度数平均年增长量分别为（-0.08±0.17）、（-0.12 ±0.17）、（-0.07±0.19）、（-0.15±0.16）D,组间比较差异无统计学意义（F=1.180,P＞0.05）.客观电脑验光仪角膜曲率测量结果显示ⅠA及ⅡA组与戴镜前有明显差异,ⅠB及ⅡB组与戴镜前无明显差异.长时间停戴组角膜地形图仅SRI（角膜表面规则性指数）值比戴镜前有明显降低ⅡA及ⅡB组平均眼轴长度年增长量为（0.22±0.16）和（0.16±0.10） mm,与戴镜前差异有统计学意义（t=5.813,-7.054,P＜0.05）,两组间无统计学意义（F=1.908,P＞0.05）;角膜中央厚度两组与戴镜前均无统计学意义（t=1.971,2.017;P＞0.05）.长时间停戴后屈光矫正方式：配戴框架眼镜人数占36.7％,RGPCL 占 22.4％,软性接触镜（SCL）占 22.4％,框架眼镜与SCL交替占 12.4％,屈光手术占6.1％.结论 配戴角膜塑形镜停戴3个月及以上角膜形态和角膜中央厚度基本恢复原状;停戴角膜塑形镜后未见近视度�Objective To observe the change of teenagers with short-time and long-time orthokeratology discontinuation,including diopters,corneal curvature,corneal topography,axial length,and central corneal thickness,and to investigate the refractive correction methods after long-time orthokeratology discontinuation.Methods Retrospective study.A total of 141 patients （257 eyes） with a history of wearing and discontinuing wearing orthokeratology lenses in our center were collected.According to the spherical equivalent diopters,the patients were divided into two groups （≤-4.00 D for group Ⅰ and-4.00 D for group Ⅱ）.Each group was further divided into two sub-groups by the discontinuation time （1 to 3 months for sub-group A and more than 3 months for sub-group B）.Four sub-groups were named as Ⅰ A,Ⅱ A,Ⅰ B,and ⅡB.Some optical examinations were performed for the patients before orthokeratology lens wearing and after orthokeratology discontinuation,such as refraction,corneal curvature,corneal topography,corneal endothelial cells,axial length,and central corneal thickness measurement.The refractive correction methods used by patients who had long-term orthokeratology discontinuation were recorled.The observed data were analyzed with paired t-test and one-way ANOVA by SPSS16.Results The statistically significant changes （t =3.222,3.404,3.141,5.012,P ＜0.05） of spherical diopter values were （-0.31 ±0.58） D,（-0.48 ±0.68） D,（-0.35 ±0.65） D,and （-0.57 ±0.58） D for groups Ⅰ A,Ⅰ B,ⅡA,and ⅡB,respectively.astigmatism of the four sub-groups had no significant change （P ＞ 0.05） The average annual spherical growth was （-0.08 ± 0.17） D,（-0.12 ± 0.17） D,（-0.07 ± 0.19） D,and （-0.15 ± 0.16） D,respectively,for the four sub-groups,and there was no statistically significant difference among them （F =1.180,P ＞ 0.05）.Compared to the state before wearing orthokeratology lenses,the corneal curvature measured by an autorefractor was statistically different for groups

关 键 词：接触镜 近视 屈光 眼 角膜地形图 轴长度 眼 角膜厚度测量 

分 类 号：R778.11[医药卫生—眼科]