球面设计和Toric设计角膜塑形镜矫治近视散光的比较  

Comparison of spherical design and Toric design orthokeratology for myopic astigmatism

作　　者：黄瑞琴[1] HUANG Ruiqin(Shijiazhuang Aier Eye Hosoital,Shijiazhuang 050000,China)

机构地区：[1]石家庄爱尔眼科医院视光中心,石家庄050000

出　　处：《中国实用眼科杂志》2018年第6期448-451,共4页Chinese Journal of Practical Ophthalmology

摘　　要：目的探讨球面设计及Toric设计角膜塑形镜矫治青少年复合性近视散光的临床疗效。方法回顾性研究。收集2016年2月至2017年2月在石家庄爱尔眼科视光中心门诊就诊的8~14岁复合性近视散光患者62例(119只眼),其中球面角膜塑形镜32例(61只眼),Toric角膜塑形镜30例(58只眼),对其进行矫正。分别测量戴镜前后角膜地形图塑形的位置、平坦(FK)与陡峭(SK)方向的塑形效果、散光(CYL)的变化、以及角膜不对称指数(SAI)的改变。组间比较采用独立样本t检验。结果观察两组患者戴镜后1d、2周、1个月角膜地形图3~5 mm区域前表面FK值及SK值的差异,球面设计FK值降低速率(1.98±0.77、2.56±0.98、2.78±1.21)和SK值降低速率(1.25±0.89、1.86±1.18、2.36±1.47),FK值变化速率较SK值变化明显,散光改变(-0.08±0.51、-0.01±0.60、0.08±0.80),SAI变化(-0.25±0.41、-0.38±0.46、-0.38±0.42);Toric设计FK值降低速率(1.79±1.05、2.49±1.12、2.77±1.19)和SK值降低速率(1.71±0.98、2.82±1.03、2.96±1.26),SK值变化速率较FK值变化明显,散光改变(0.01±0.63、0.40±0.68、0.31±0.98),SAI变化(-0.54±0.65、-0.56±0.75、-0.61±0.74),1d的SAI变化值差异有统计学意义(t=-2.59,P=0.011),两组间SK值变化速率差异有统计学意义(t=2.653,P=0.009;t=2.38,P=0.019;t=2.451,P=0.008)。Toric角膜塑形镜的中心位于瞳孔中心2.0 mm以内,球面角膜塑形镜的中心位于瞳孔中心3.0~4.0 mm以内,Toric塑形定位更佳。结论Toric设计角膜塑形镜改善镜片的定位,提高视觉效果,对散光总体有降低趋势,但散光矫正的范围仍有一定局限。Objective To investigate the clinical effect of spherical design and Toric design of orthokeratology treatment of adolescent compound myopic astigmatism.Methods Retrospective clinical study of 62 patients(119 eyes),including 32 cases of spherical design(61 eyes),30 cases of Toric design(58 eyes)corrected with ortho-k CL.Uncorrected visual acuity,corneal topography,shaping effect of flat(FK)and steep(SK),astigmatism(CYL),and corneal asymmetry index(SAI)were measured before and after orthok CL,wear respectively.T test was used for comparison between two groups.Results The difference of FK and SK in the anterior surface of 3-5mm area of corneal topography wa observed in 1 day,2 weeks and 1 month before and after wearing ortho-k CL,the spherical design FK value decrease rate(1.98±0.77,2.56±0.98,2.78±1.21)and SK value decrease rate(1.25±0.89,1.86±1.18,2.36±1.47),the change rate of FK was more obvious.CYL changes(-0.08±0.51,-0.01±0.60,0.08±0.80),SAI changes(-0.25±0.41,-0.38±0.46,-0.38±0.42);The Toric design FK value decrease rate(1.79±1.05,2.49±1.12,2.77±1.19)and SK value decrease rate(1.71±0.98,2.82±1.03,2.96±1.26),the change rate of SK was more obvious,CYL changes(0.01±0.63,0.40±0.68,0.31±0.98),SAI changes(-0.54±0.65,-0.56±0.75,-0.61±0.74),there were statistically significant differences between the two groups of the change rate of SK and SAI values for 1 day(t=2.653,P=0.009;t=2.38,P=0.019;t=2.451,P=0.008)(t=-2.59,P=0.011),Toric ortho-k CL was located in the center of the pupil center within 2.0mm,the spherical ortho-k CL center was located within the pupil center 3.0 mm-4.0 mm,Toric had better shape positioning.Conclusions Toric design can improve the positioning and visual effect,although there is a downward trend in astigmatism,there is still some limitation in the range of astigmatism correction.

关 键 词：球面设计 Toric设计 角膜塑形镜 角膜参数 

分 类 号：R77[医药卫生—眼科]