近视儿童角膜塑形后角膜屈光力分布与眼轴增长之间的关系  

The Relationship between the Distribution of Corneal Refractive Power after Orthokeratology and Axial Elongation in Myopic Children

作　　者：黄志翾 胡琼文 Huang Zhixuan;Hu Qiongwen(Feiyue Penguin Ophthalmology(Chongqing Tengkang Huiyi Eye Clinic),Chongqing 400020,China)

机构地区：[1]菲越企鹅眼科(重庆腾康汇医眼科诊所),重庆400020

出　　处：《中华眼视光学与视觉科学杂志》2025年第2期120-125,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:评估配戴角膜塑形镜后3个月角膜中央区到周边区轴向曲率变化率与眼轴年增长量之间的关系。方法:系列病例研究。收集2021年至2023年重庆腾康汇医眼科诊所就诊的全部51名8~12岁使用角膜屈光治疗技术的角膜塑形镜儿童右眼的数据,并且随访时间不少于12个月。计算戴镜眼轴年增幅(AAE)。戴镜第3个月,使用角膜地形图仪TMS-4N测量角膜1~25环每个同心圆Placido环的平均屈光力,并计算出中央到中周边最大屈光力范围内的线性相对角膜屈光力分布(RCPD),并对基线数据、RCPD与AAE的关系进行了相关性分析和回归分析。结果:51名近视儿童年龄(9.4±1.3)岁,基线眼轴长为(24.26±0.94)mm,AAE为(0.22±0.14)mm,球镜度为(-1.79±1.13)D,角膜平坦Kf为(42.70±1.42)D,RCPD为(0.71±0.23)D/mm。经单因素线性回归分析发现眼轴(β=-0.06,P=0.004)、RCPD(β=-0.30,P<0.001)与AAE呈负相关关系,Kf(β=0.03,P=0.038)与AAE呈正相关关系。多因素线性回归分析显示RCPD是AAE的影响因素(β=-0.27,P=0.004),AAE<0.2 mm对应的RCPD截点为0.59 D/mm,受试者工作特征曲线下面积为0.776。结论:进行角膜塑形治疗的儿童AAE与配戴后第3个月的RCPD呈负相关关系,当RCPD>0.59 D/mm时,眼轴增长较为缓慢。Objective:Aimed to evaluate the relationship between change in the rate of axial curvature from the central to peripheral zones of the cornea after 3 months of wearing orthokeratology lenses and the annual increase in axial length.Methods:Data were collected from the right eyes of 51 children,aged 8 to 12 years,who were wearing corneal refractive therapy orthokeratology lenses.The axial elongation(AAE)over one year of lens wear was calculated.At the third month of lens wear,the average refractive power of each concentric Placido ring,numbered form 1 to 25 on the cornea was measured using a TMS-4N corneal topographer.Additionally,the linear relative corneal power distribution(RCPD,D/mm)within the maximum refractive power range from the center to the mid-periphery was calculated.Regression and correlation analyses were conducted on baseline data,RCPD,and other independent variables in relation to the dependent variable AAE.Results:The average age of the 51 myopic children was 9.4±1.3 years,with a baseline axial length of 24.26±0.94 mm,an AAE of 0.22±0.14 mm,a spherical lens power of-1.79±1.13 D,and a flat keratometry(K f)of 42.70±1.42 D,RCPD of 0.71±0.23 D/mm.Univariate linear regression analysis revealed that axial length(β=-0.06,P=0.004)and RCPD(β=-0.30,P<0.001)were negatively correlated with AAE,while Kf(β=0.03,P=0.038)was positively correlated with AAE.Multivariate linear regression analysis indicated that RCPD was an influencing factor on AAE(β=-0.27,P=0.004).The cut-off point for RCPD corresponding to an AAE of less than 0.2 mm was 0.59 D/mm,with an area under the ROC curve of 0.776.Conclusion:In children undergoing orthokeratology treatment,AAE is negatively correlated with RCPD after the third month of wear.Specifically,there is a slower annual increase in axial length when RCPD exceeds 0.59 D/mm.

关 键 词：近视 角膜塑形术 角膜屈光力 眼轴 儿童 

分 类 号：R778.1[医药卫生—眼科]