青少年高度近视配戴角膜塑形镜后视觉质量及安全性分析  

The visual quality and safety analysis of Teenagers with high myopia after wearing orthokeratology

作　　者：纪惠芳[1] 陈洁[1] 杨积文 高倩 

机构地区：[1]温州医科大学附属眼视光医院,浙江省325035 [2]沈阳爱尔眼视光医院,辽宁省110003

出　　处：《中国实用眼科杂志》2016年第6期546-550,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的观察角膜塑形镜矫正青少年高度近视的临床效果及安全性。方法临床病例回顾性研究。选取2014年1月至2015年2月在沈阳爱尔眼视光医院自愿接受角膜塑形术并连续配戴1年以上的青少年高度近视患者30例60只眼，年龄11-16岁，近视-6．00—8．00D，平均球镜度（-6．31±0．37）D，回顾性分析其配戴角膜塑形镜后1年内的裸眼视力、角膜曲率的改变、像差的变化、视觉干扰症状及角膜并发症的发生情况。结果戴镜1d、1周、1个月、3个月、1年后裸眼视力分别为（0．48±0．20）、（0．13±0．11）、（0．09±0．08）、（O．08±0．06）、（0．08±0．05）logMAR。戴镜3个月后角膜平坦K值和陡峭K值较戴镜前分别减少（4．34±0．90）D，（2．61±2．67）D，差异有统计学意义（P〈0．05）；Pentacam角膜地形图Zernike像差分析，角膜前表面低阶、高阶像差较戴前分别增加（3．772±3．085）μm、（2．030±0．529）μm，差异均有统计学意义（P〈0．05）；角膜后表面低阶、高阶像差较戴前分别增加（0．269±0．206）μm、（0．149±0．140）μm，差异均有统计学意义（P〈0．05）。1年内复查夜间眩光占6．67％（4／60），下午视物模糊占13．33％（8／60），镜片黏附占23．33％（14／60）。角膜点染在戴镜1d、1周、1个月、3个月、1年的发生率分别为35％（21／60）、23．33％（14／60）、6．67％（4／60）、3．33％（2／60）、5％（3／60）；无菌性角膜上皮浸润1例1只眼。结论青少年高度近视（-6．00—8．00D）患者在临床经验丰富的验配医师的验配指导下，配戴角膜塑形镜可以明显提高其裸眼视力，安全且有效；根据平坦K值并不能准确评估塑形后的视力；高度近视患者配戴角膜塑形镜后角膜前后表面像差均增大，提示角膜后表面在高度近视的角膜塑形过程中也起到一定的作用。Objective To observe the clinical effect and security of orthokeratology for teenagers high myopia correction. Methods Thirty teenagers with high myopia （60 eyes） were chosen that vol- untarily accepted and continuously wear orthokeratology more than one year, aged 11 to 16 years old （-6.00-8.00D）, the average diopter of （-6.31±0.37）D. The naked eye sight, changes in corneal curvature, the change of aberration symptoms, visual disturbance and corneal complications were analyzed during one year wearing orthokeratology, retrospectively. Results After wearing lens 1 day, 1 week, 1 month, 3 months and I year, the naked eye eyesight （logMAR） were 0.48±0.20, 0.13±0.11, 0.09±0.08, 0.08±0.06, and 0.08±0.05. The corneal flat and steep K values reduced after 3 months wearing lens compared to not wearing, it was （4.34±0.90）D, （2.61±2.67）D （P 〈0.05）, the difference was statistically significant. The corneal surface low-order and high-order aberration increased respectively after wearing lens by Pentacam corneal topography Zernike aberration analysis than before wearing （3.772±3.085）μm, （2.030±0.529）μm, （P 〈0.05）, the differences were statistically significant. Corneal surface after low-order and high-order aberration increased respectively than wearing before （0.269±0.206）μm, （0.149±0.140）μm, （P 〈0.05）, differences were statistically significant. During 1 year review, existing glare at night was 6.67%（4/60）, of the afternoon blurred vision 13.33%（8/60）, the lens adhesion by 23.33%（14/60）. The incidence of cornea touched in the lens wearing 1 day, 1 week, l month, 3 months, a year were 35%（21/60）, 23%（14/60）, 6.67%（4/60）, 3.33%（2/60）, 5%（3/ 60）, respectively. Aseptic corneal epithelium infiltrating had 1 case （1 eye）. Conclusions Adolescent patients with high myopia （-6.00--8.00D） wearing orthokeratology under the guidance of physicians can obviously improve the naked eye vision. It is safe and effective. The visi

关 键 词：角膜塑形镜 高度近视 视力 安全 像差 

分 类 号：R778.110.5[医药卫生—眼科]