青少年近视散光患者长期配戴硬性透气性角膜接触镜临床观察  

Long-term clinical effects of rigid gas permeable contact lens on adolescents with myopia and myopic astigmatism

作　　者：吕燕云[1] 武晶晶[1] 刘立洲[1] 彭丽[1] 王艳霞[1] 焦永红 

机构地区：[1]首都医科大学附属北京同仁医院验光配镜中心,100730 [2]首都医科大学附属北京同仁医院,北京同仁眼科中心,眼科学与视觉科学北京市重点实验室,100730

出　　处：《眼科》2017年第5期303-306,共4页Ophthalmology in China

摘　　要：目的探讨青少年近视散光患者长期配戴硬性透气性角膜接触镜(RGPCL)的临床效果。设计回顾性病例系列。研究对象在北京同仁验光配镜中心验配RGPCL且连续戴镜8年以上的青少年近视散光患者51例(102眼),连续配戴框架眼镜6年以上青少年近视散光患者50例(100眼)。方法观察RGPCL配戴者8年间中央角膜曲率半径、球镜度、柱镜度、角膜散光度的变化情况,对比戴镜前及戴镜8年后各参数的变化。观察配戴框架眼镜6年后球镜度及散光度的变化情况。比较框架及RGPCL配戴者球镜度及柱镜度变化。主要指标中央角膜曲率半径、球镜度、柱镜度、角膜散光度。结果与戴镜前基线数据相比,连续配戴RGPCL 8年后,与戴镜前比患者平均角膜曲率半径增加(0.10±0.17)mm,球镜度增加(-1.88±0.32)D,柱镜度降低(-0.28±0.21)D,角膜散光度减少(-0.40±0.20)D(t=-3.285,-29.536,12.803,10.025;P均<0.001)。框架眼镜配戴者与戴镜前比球镜度增加(-2.73±0.37)D,柱镜度增加(-0.32±0.34)D(t=-35.063,-5.457;P均<0.001)。RGPCL配戴者球镜度及柱镜度增长均低于框架眼镜配戴者(t=-14.036,-14.955;P均<0.001)。结论近视散光青少年长期配戴RGPCL对近视发展具有一定的控制作用,镜片对角膜有轻度塑形作用。Objective To investigate the clinical effects of rigid gas permeable contact lens（RGPCL） on adolescents with myopia and myopic astigmatism.Design Retrospective case series.Participants 101 adolescents（202 eyes） with myopia and myopic astigmatism.Methods 51 adolescents（102 eyes） with myopia and myopic astigmatism were fitted with RGPCL and followed up for 8 years.The changes of the corneal curvature,spherical and cylindrical refractive error and corneal astigmatism were measured every year.The control group consisted of 50 cases（100 eyes） with continuous spectacles wearing for more than 6 years,with the changes of spherical and cylindrical refractive error measured every year.Main Outcome Measures Corneal curvature,spherical refractive error,cylindrical refractive error,corneal astigmatism.Results The mean radius of corneal curvature increased（0.10 ±0.17） mm with RGPCL for 8 years.The spherical refractive error increased by（-1.88 ±0.32） D.The ocular cylindrical refractive error decreased by（-0.28 ±0.21） D,and corneal stigmatism decreased by（-0.40±0.20） D.All the differences were statistically significant（t=-3.285,-29.536,12.803,10.025;all P〈0.001 respectively）.During the 6-year follow up,the ocular spherical and cylindrical refractive error increased by（-2.73 ±0.37） D and（-0.32±0.34） D respectively,and the differences were statistically significant compared to the baseline data（t=-35.063,-5.457;both P〈0.001）.The growth of spherical and cylindrical error in RGPCL wearers was lower than spectacle wearers（t=-14.036,-14.955;both P〈0.001）.Conclusion Myopia progression can be controlled by long-term RGPCL wearing.RGPCL has a mild effect on corneal shape.

关 键 词：硬性透气性角膜接触镜 近视 青少年 

分 类 号：R778.11[医药卫生—眼科]