角膜塑形镜光学区直径对疗效的影响  

Effect of optical zone diameter in orthokeratology contact lenses on the efficacy of treatment

作　　者：张暹梅[1] 陈静[1] 辛延峰[1] Zhang Xianmei;Chen Jing;Xin Yanfeng(Department of Ophthalmology,The Affiliated Hospital of Hangzhou Normal University,Hangzhou 310015,Zhejiang Province,China)

机构地区：[1]杭州师范大学附属医院眼科,杭州310015

出　　处：《中国基层医药》2024年第7期1000-1005,共6页Chinese Journal of Primary Medicine and Pharmacy

基　　金：浙江省杭州市生物医药和健康产业发展扶持科技项目(2022WJC149)。

摘　　要：目的分析角膜塑形镜光学区直径对疗效的影响。方法回顾性纳入杭州师范大学附属医院2020年11月至2022年11月收治的佩戴直径10.5 mm Paragon CRT角膜塑形镜的近视患者100例(196眼)为研究对象。年龄范围8~13岁, 男47例, 女53例, 屈光度:球镜-0.75~-4.00 DS, 柱镜-0.25~-1.50 DC, 矫正视力≥ 0.6, 初始眼轴23.40~25.83 mm, 按照不同光学区直径进行分组, 将其中50例(98眼)角膜塑形镜光学区为5.0 mm的患者纳入5.0组, 另50例(98眼)角膜塑形镜光学区为6.0 mm的患者纳入6.0组。统计两组的一般社会学特征和疾病相关特征, 对于存在差异的资料进行logistic线性回归分析, 得出不同角膜塑形镜光学区直径的疗效。结果佩戴1年后, 两组平均非侵入性泪膜破裂时间(NIKBUTav)比较, 差异无统计学意义(P>0.05);5.0组表面规则性指数(SRI)[(0.35±0.09)]、表面非对称性指数(SAI)[(0.69±0.21)]、眼轴长度(AL)[(0.19±0.04)mm]、相对周边屈光度(RPR)[(-0.65±0.20)D、(-0.84±0.26)D、(-0.48±0.13)D、(-0.76±0.23)D、(-0.77±0.21)D、(-0.56±0.17)D]均显著低于6.0组(t=5.94、3.34、4.64、2.03、2.07、4.23、2.27、2.25、5.55, 均P<0.05), 裸眼视力(UCVA)[(0.71±0.20)LogMAR]、等效球镜度(SE)[(-0.25±0.05)D]均显著高于6.0组(t=3.31、13.64, 均P<0.05)。佩戴1年后, 5.0组光学治疗区直径[(3.35±0.28)mm]、面积[(7.50±1.10)mm^(2)]均显著低于6.0组[(3.68±0.38)mm, (8.50±1.50)mm^(2)](t=6.92、5.32、11.16, 均P<0.05), 5.0组在重叠光学治疗区面积/瞳孔面积比值(TZR)[(0.53±0.16)]显著低于6.0组[(0.81±0.19)](t=11.16, P<0.05)。经logistic线性回归方程、Pearson计算, 发现TZR和选择的角膜塑形镜光学区直径呈现正相关性(P<0.05)。5.0组并发症的发生率[8.16%(8/98)]和6.0组[12.24%(12/98)]比较, 差异无统计学意义(χ^(2)=0.89, P>0.05)。结论一年眼轴动态变化提示, 角膜塑形镜光学区直径为5.0 mm时, 矫正近视的效果更好, 且安全性高。通过统计TZR评�Objective To analyze the effect of optical zone diameter in orthokeratology contact lenses on the efficacy of treatment.Methods A total of 100 myopic patients(196 eyes)who wore Paragon CRT keratoplasty lenses with a diameter of 10.5 mm were retrospectively included in this study.These patients,consisting of 47 males and 53 females,were admitted to The Affiliated Hospital of Hangzhou Normal University between November 2020 and November 2022.Their ages ranged from 8 to 13 years.Their refractive errors ranged from-0.75 DS to-4.00 DS for spherical errors and from-0.25 DC to-1.50 DC for cylindrical errors.The corrected visual acuity was≥0.6,and the initial axes were between 23.40 mm and 25.83 mm.The patients were grouped according to the different diameters of the optical zones of their lenses.Fifty patients(98 eyes)with an optical zone of 5.0 mm were included in the 5.0 group,and another 50 patients(98 eyes)with an optical zone of 6.0 mm were included in the 6.0 group.The general sociological and disease-related characteristics of the two groups were recorded.Logistic linear regression analysis was performed on the data with differences to obtain the therapeutic effect of different optimal zone diameters in orthokeratology contact lenses.Results After 1 year of wearing,there was no statistically significant difference in the average non-invasive tear film break-up time between the two groups(P>0.05).The 5.0 group exhibited significantly lower values for the surface regularity index(0.35±0.09),surface asymmetry index(0.69±0.21),axial length[(0.19±0.04)mm],and relative peripheral refraction[(-0.65±0.20)D,(-0.84±0.26)D,(-0.48±0.13)D,(-0.76±0.23)D,(-0.77±0.21)D,(-0.56±0.17)D]compared with the 6.0 group(t=5.94,3.34,4.64,2.03,2.07,4.23,2.27,2.25,5.55,all P<0.05).Conversely,the uncorrected visual acuity[(0.71±0.20)LogMAR]and spherical equivalent[(-0.25±0.05)D]were significantly higher in the 5.0 group compared with the 6.0 group(t=3.31,13.64,both P<0.05).After 1 year of wearing,the diameter and area of the opti

关 键 词：近视 视觉 眼 屈光 眼 角膜 瞳孔 表面角膜镜片术 角膜塑形术 光学区 

分 类 号：R778.11[医药卫生—眼科]