角膜塑形镜矫治青少年近视的远期效果观察

Observation of long-term effects of orthokeratological lens on correction of juvenile myopia

目的探讨角膜塑形镜矫治青少年近视的临床疗效及并发症。方法我科门诊收治近视患者175例,年龄9~20岁,近视球镜范围-1.00^-6.00 D,柱镜范围≤-1.50 D,矫正视力均能达到1.0。随机分成两组,治疗组85例,戴角膜塑形镜矫治;对照组90例,戴框架眼镜,分别在配戴后1 d、1 w、1个月、3个月、6个月、1年、2年及3年,观察两组视力、屈光度数、角膜地形图(K值)、眼轴长度的变化及并发症。结果在戴镜3年后,与对照组和戴镜前比较,治疗组近视度数增长、角膜地形图(K值)及眼轴长度的改变均具有显著差异,近视矫治效果显著。治疗组常见并发症有结膜轻度充血、角膜上皮点状脱落、个别角膜上皮片状剥脱及复视,多可自愈或暂时停戴角膜塑形镜后消失,不影响治疗效果。结论角膜塑形镜能有效控制或减缓青少年近视发展速度,具有快速、安全、无创、有效及塑形可逆等特点,是目前矫治青少年近视安全可靠的医疗技术之一。

To explore the clinical effects and complications of orthokeratological lens on correction of juvenile myopia. Total 175 patients of 9-20 years old with myopia and with myopia sphere ranging from -1.00 to -6.00 D, cylinder sphere≤ -1.50 and corrected visual acuity of 1.0 to receive treatment in our department were selected. They were divided randomly into treatment group（n=85） and control group（n=90）. The two groups were corrected and cured with orthokeratological lens or frame glasses, respectively. The visions, refractive diopters, corneal topographies （K value）, changes in the eye axial lengths and the complications in the two groups on the 1st day, after the first week, after the first, third and sixth month and after the first, second and third year since they wore the lens or glasses were observed and compared each other. Compared with the control group and the original situations, the treatment group obtained significant improvement in myopia degree decrease, corneal topographies （K value） and eye axial lengths after they had worn the lens for three years. The common complications in the treatment group included slight hyperaemia of conjunctiva, punctate detachment of corneal epithelium, lamellar detachment of corneal epithelium （only individually） and diplopia, but most of them were cured naturally or disappeared after orthokeratological lens were temporarily removed and did not influence the curative effects. Orthokeratological lens can effectively hold back or slow down the development speed of juvenile myopia and have such advantages as quickness, safety, noninvasiveness, effectiveness and reversibility, so it is deemed as a safe and reliable medical technology to correct and cure juvenile myopia.