Toric设计角膜塑形镜治疗青少年近视伴较高散光1年临床疗效的观察  

Clinical efficacy observation of Toric orthokeratology in myopic adolescent with moderate to high astigmatism for 1 year

作　　者：王佳颖 杨晨皓 沈李 高路 Wang Jiaying;Yang Chenhao;Shen Li;Gao Lu(Children＇s Hospital of Fudan University,Shanghai 200433,China)

机构地区：[1]复旦大学附属儿科医院眼科,上海200433

出　　处：《中国实用眼科杂志》2017年第8期803-807,共5页Chinese Journal of Practical Ophthalmology

摘　　要：目的 观察Toric角膜塑形镜矫治近视伴有较高散光青少年的临床疗效.方法 回顾性研究.球面塑形镜组（球面组）24例（40只眼）,Toric塑形镜组（Tonc组）11例（18只眼）.比较两组不同设计塑形镜1年眼轴增长.比较Toric组戴镜前及配镜后1周、1月、6月、1年之间的裸眼视力（UC-VA）、角膜散光值、平均角膜曲率.分析角膜地形图上平坦K、角膜直径4 mm、5 mm处角膜曲率（K平、K4、K5）与Toric塑形镜定位弧曲率之间相关性.数据采用配对t检验、独立样本t检验以及单因素方差分析.结果 配镜1年,球面组和Toric组眼轴增长量分别为（0.25±0.14） mm和（0.23±0.28） mm,与戴镜前相比均有统计学差异（t =-10.868,P＜0.05;t=-3.485,P＜0.05）.两组眼轴增长量之间无统计学差异（t =-0.298,P＞0.05）.Toric组配镜1周起裸眼视力显著提高,配镜前后有统计学差异（F=83.185,P＜0.05）.Toric组配镜前后角膜散光值比较无统计学差异（F =1.099,P＞0.05）,平均角膜曲率配镜前为（43.28±1.71）D,配镜1周、1月、6月、1年分别为（41.59±1.96）D、（41.45±2.36）D、（41.35±2.14）D、（40.80±1.91）D,配镜前后比较有统计学差异（F=3.38,P＜0.05）.Toric组定位弧曲率为（41.86±0.76）D,K平、K4、K5分别为（42.20±1.56）D、（41.51±1.59）D、（40.50±1.53）D,定位弧曲率与K平、K4无统计学差异（P＞0.05）,与K5有统计学差异（P＜0.05）.结论 Toric 角膜塑形镜与球面角膜塑形镜对近视青少年眼轴控制程度接近.Toric角膜塑形镜适用于近视伴较高散光患者,配戴期间安全有效,提高裸眼视力降低角膜曲率.Objective To observe the clinical efficacy of Toric design orthokeratology for myopia adolescents with moderate to high astigmatism.Methods A retrospective study.Twenty-four patients （40 eyes,Spherical group）,were fitted with spherical orthokeratology lenses and 11 patients （18eyes,Toric group）,were fitted with Toric design orthokeratology.Comparison of two groups 1 year eye axis of two different design orthokeratology.Patients fitted with Toric design orthokeratology lenses were measured uncorrected visual acuity （UCVA）,comeal astigmatism and mean corneal curvature before lens wear and after wearing the lenses for 1 week,1 month,6 months,and 1 year.The relationship among the orthokeratology alignment zones curvature,flat K,corneal curvature with comeal diameter 5mm,4mm place were analyzed.Date was analyzed with paired t test,independent samples t test and one-way ANOVA.Results After I year,AL increased by 0.2540.14 （mm）,0.23±0.28 （mm） in the Spherical group and Toric group,indicating a statistically significant difference compared with those lens wear （t =-10.868,P 〈0.05;t =-3.485,P 〈0.05）.The two groups AL growth failed to show the significant difference （t =-0.298,P 〉0.05）.The uncorrected visual acuity （UCVA） had a statistically significant difference compared with UCVA before lens wear （F =83.185,P 〈0.05）.The corneal astigmatism in Toric group had no significant difference before and after lens wear （F =1.099,P 〉0.05）.Average corneal curvature had a statistically significant difference before and after lens wear （P 〈0.05）.Toric group＇s alignment zones curvature was 41.86±0.76D.Corneal flat K,5mm,4mm corneal diameter curvature were respectively 42.20±l.56D、41.51±1.59D、40.50± 1.53D.Alignment zones curvature was no significant difference with fiat K and 4mm corneal diameter curvature （P 〉0.05）,while had statistically significant difference with 5mm corneal diameter curvature （P 〈0.05）.Conclusions Toric design and spherical design orth

关 键 词：Toric设计角膜塑形镜 角膜散光 近视 眼轴 

分 类 号：R778.110.5[医药卫生—眼科]