角膜塑形镜治疗青少年近视的临床观察

Clinical observation on orthokeratology treatment of juvenile myopia

目的:观察配戴角膜塑形镜治疗青少年近视的疗效。方法:近视患者76例152眼,年龄8～15岁,平均等效球镜度-3.92±1.13D,按照角膜塑形术的验配程序给予配戴角膜塑形镜,采取夜间配戴8～10h,戴镜后1wk;1,3,6mo;1,2a随访,观察裸眼视力(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:戴镜前的UCVA为0.15±0.12,戴镜1wk;1,3,6mo;1,2a后提高至0.60±0.12,0.80±0.10,0.90±0.18,0.88±0.16,0.90±0.15,0.89±0.18,差异均有显著统计学意义(P<0.01);角膜曲率变平,分别降低2.31±0.82,2.41±0.91,2.12±0.75,2.21±1.01,2.51±1.12,2.46±0.98D,差异也均有显著统计学意义(均P<0.01);戴镜1a后眼轴长度较戴镜前增长0.13±0.11mm,2a后眼轴长度较戴镜前增长0.25±0.17mm,与戴镜前比较差异无明显统计学意义;经戴镜满2a者停戴1wk后查近视度数并与戴镜前度数比较,近视度数增加很少,平均每年0.25±0.11D,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效果确切、安全,可以控制近视的发展。

AIM： To observe treatment efficacy of wearing orthokeratology lens for juvenile myopia. METHODS： Seventy-six cases （152 eyes） of myopia, with age of 8-15 years old and the average spherical equivalent degree -3. 92 ± 1. 13D, wore orthokeratology lens, according to the fitting program of orthokeratology, at night for 8-10 hours. They were followed up at 1 week, 1 month, 3, 6 months, 1 year, 2 years after wearing glasses and observed with uncorrected visual acuity （UCVA）, refraction, corneal curvature, axial length, slitlamp examination with or without complications. RESULTS： One week,1 month,3, 6 months, 1 year, 2 years after wearing glasses, UCVA increased from 0.15 ± 0.12 before wearing glasses to 0.60 ± 0.12, 0.80 ± 0.10, 0.90 ± 0.18, 0.88 ± 0.16, 0.90 ± 0.15,0.89 ± 0.18, the differences were statistically significant （ P 〈 0.01 ） ; Corneal curvature flattened and decreased by 2.31 ± 0.82, 2.41 ± 0.91, 2.12 ± 0.75, 2.21 ± 1.01, 2.51 ± 1.12, 2.46 ± 0.98D, differences were statistically significant （all P 〈 0. 001 ） ; 1 year after wearing glasses, axial length increased by 0.13 ± 0.11 mm than that before wearing glasses, 2 years after wearing glasses, the axial length increased by 0.25 ± 0.17mm than that before wearing glasses, and there was no statistically significant difference; Compared myopia degree after full 2 years of wearing glasses and 1 week of stopped wearing with that before wearing glasses, myopia degree increased less with average annual 0. 25 ± 0. 11D. After wearing glasses, a small number of patients with punctate corneal epithelial exfoliation, ghosting, conjunctivitis, etc., could be restored after treatment. CONCLUSION： Orthokeratology treatment of juvenile myopia is effective and safe, which can control the development of myopia.