角膜塑形术矫治青少年近视的短期疗效观察

Short-term curative effects of orthokeratology on young myopia patients

目的探讨夜戴型角膜塑形镜矫治青少年近视的短期疗效。方法 青少年中低度近视患者71例(140眼),年龄8～15岁,平均为(11.38±2.15)岁,等效球镜度数为-8.00～-15.00D,平均为(-3.62±1.55)D,给予夜戴型角膜塑形镜配戴(Boston XO材料),戴镜后1d、1周、1个月、3个月、6个月随访,观察裸眼视力(uncorrected visual acuity,UCVA)、屈光度数、角膜曲率、眼轴长度、裂隙灯检查有无并发症的发生。结果 戴镜1个月、3个月、6个月后,UCVA由戴镜前的0.18±0.12提高至0.93±0.13、0.90±0.19、0.89±0.15,差异均有显著统计学意义(P<0.001);屈光度数(等效球镜)与戴镜前相比分别下降(2.53±1.43)D、(2.13±1.39)D、(2.17±1.96)D,差异也均有显著统计学意义(P<0.001);角膜曲率变平,分别降低(2.01±1.01)D、(2.33±1.24)D、(1.72±1.06)D,差异也均有显著统计学意义(均为P<0.001);戴镜6个月后眼轴长度较戴镜前增长(0.10±0.43)mm,但是与戴镜前比较差异无统计学意义(P=0.086);戴镜后少数患者出现点状角膜上皮剥脱、重影、结膜炎等,经治疗后均可恢复。结论 角膜塑形镜矫治青少年近视近期效果确切、安全,可以控制近视的发展。

Objective To investigate the effects of short-term curative effect of overnight orthokeratology on young myopia patients.Methods One hundred and forty eyes of 71 young myopia patients from 8 years old to 15 years old,the mean equivalent spherical was（-3.62±1.55）D（from-8.00 D to-15.00 D）,were fitted with Ortho-K contact lens with overnight wear.The diopter,uncorrected visual acuity（UCVA）,corneal curvature and axial length were observed at 1 day,1 week,1 month,3 months and 6 months after wearing.The complication was examined by slit-lamp microscope.Results UCVA was improved from 0.18±0.12 at baseline to 0.93±0.13,0.90±0.19,0.89±0.15 at 1 month,3 months and 6 months after wearing,there was significant difference（P0.001）.The diopter decreased（2.53±1.43）D,（2.13±1.39）D,（2.17±1.96）D at 1 month,3 months and 6 months after wearing compared with that before wearing,there was significant difference（P0.001）.The corneal curvature was flattening and decreased（2.01±1.01）D,（2.33±1.24）D,（1.72±1.06）D,there was significant difference（P0.001）.Although the axial length increased（0.10±0.43）mm after 6 months wearing,the difference was not significant compared with that before wearing（P=0.086）.The punctiform corneal epithelial denudation,double image and conjunctivitis appeared in few patients after wearing,and all cured after treatment.Conclusion Short-term curative effect of overnight orthokeratology on young myopia patients is safe and efficient,which can control the development of myopia.