角膜塑形术矫正青少年中、低度近视2年临床分析  

Observation clinical changes with orthokeratology in young high myopia for 2 years

作　　者：刘维锋[1] 梅艳[1] 石浔[1] 

机构地区：[1]南昌大学第三附属医院眼科,南昌330000

出　　处：《江西医药》2016年第4期283-286,共4页Jiangxi Medical Journal

基　　金：江西省科技厅青年基金项目;编号2012087

摘　　要：目的探讨角膜塑形术2年后眼结构、屈光的变化和近视控制效果。方法 2009年8月至2013年8月具有戴前和连续2年以上完整资料青少年近视者,角膜塑形镜佩戴者32例62眼为A组,单焦框架眼镜佩戴者13例26眼为B组。对A、B两组屈光度数和眼轴进行对比分析;并对A组内角膜塑形镜佩戴者前、后眼轴、屈光度、角膜参数、前房深度资料进行对比和分布分析。结果⑴A、B组2年后等效球镜增加分别为0.54±0.64DS、1.38±0.84DS,眼轴增加分别为(0.43±0.45)mm、(1.13±0.55)mm,两者比较差异有统计学意义(t=2.56,P=0.00;t=1.56,P=0.01)。⑵A组内塑形镜戴镜前、后等效球镜增长0.54±0.64DS,眼轴增长0.43±0.45mm,两者比较差异有统计学意义(t=3.76,P=0.00;t=-7.24,P=0.00)。A组内戴镜前、戴镜2年后停戴3周后矫正视力、角膜前表面曲率、角膜后表面曲率、角膜最薄厚度、角膜差异值、角膜内皮细胞计数和前房深度比较,差异均无统计学意义(均P>0.05)。⑶A组内2年后眼轴未增长占24.57%、增长0.01-0.5mm占24.57%、增长0.51-1.00mm占47.36%、增长1.01mm以上占3.50%;屈光度未增长占17.74%;增长0.5DS内占22.58%;增长在0.51-1.00DS占24.19%;增长1.01-1.50DS占25.81%;增长1.51-2.0DS占9.68%;眼轴和屈光度分组各组的年龄、眼轴、屈光度之间差异有统计学意义(均P<0.05)。结论角膜塑形术能相对控制青少年近视发展;角膜塑形术2年后眼角膜、前房深度、矫正视力无变化;眼轴和屈光度增加;眼轴增长与屈光度增长呈正比,与年龄呈反比。Objective To evaluate the effectiveness for myopic control and the changes in the eye structure and spherical e- quivalent （SE） after 2 years orthokeratology （ortho-k）. Methods Fourty-five patients with myopia （88 eyes） whose refractive error had been corrected by ortho-k （Group A） or single vision lenses （SVLs） （Group B） were retrospectively enrolled from August 2009 to August 2013 in the Third Hospital affiliated Nanchang University. The vision acuity （VA）, SE, axial length （AL）,the corneal pa- rameter,the anterior champer distance （ACD） before and 24 months after treatment were analyzed. Results SE added 0.54±0.64 DS, 1.38±0.84DS and AL added 0.43±0.45mm, 1.13±0.55mm in group A and B,respectively. There were significant difference in SE and AL between groupA and B. In Group A,There were significant difference in the SE and AL between before and posttreat- ment（t=3.76,P=-0.00;t=-7.24,P=0.00）. There were no significant difference in the the best corrected vision acuity（BCVA）,K-read of anterior surface,posterior surface of cornea,the thinnest corneal thickness.the difference evaluate of cornea,the density of corneal endothelial and ACD beforel and posttreatment （all P〉0.05）. The rate of increase number in 0mm,0.5mm, lmm and over l mm in AL were 24.57% ,24.57%1,47.36% ,3.50% ,respectively. The rate of increase number in 0DS,0.5DS, 1DS, 1.5DS and overl.SDS in SE are 17.74%,22.58%,24.19%,25.81%,9.68%,respectively. There were no significant difference in age,AL,SE a- mong the AL and SE subgroups （all P〈0.05）. Conclusion Ortho-k is more effective in controlling myopic progression than wear- ing SVLs;No changes in corneal parameter,ACD,BCVA, SE and AL increase after OK for 2 years. The more SE and less age,the more AL for OK.

关 键 词：角膜塑形术 单焦框架眼镜 角膜 等效球镜 眼轴 

分 类 号：R778.11[医药卫生—眼科]