中高度近视青少年配戴角膜塑形镜联合框架眼镜的疗效和安全性

Effect and safty of overnight orthokeratology combined with eye glasses during the day for juvenile moderate-high myopia correction

目的 观察夜晚配戴角膜塑形镜联合白天配戴框架眼镜矫治中高度青少年近视的临床疗效和安全性.方法 前瞻性观察研究.收集中高度（-4.00 D以上）青少年近视患者38例（75眼）,年龄11～19岁,平均等效球镜度（SE）（-6.76±1.45）D.夜晚配戴角膜塑形镜1个月后,白天采用框架眼镜矫正残余近视度.采用重复测量的方差分析比较戴镜前和戴镜后各参数变化.结果 裸眼视力（UCVA）：配戴角膜塑形镜前和戴镜后ld、1周、1个月、1年分别为3.93±0.27、4.53±0.21、4.85±0.19、4.90±0.11、4.94±0.13;配戴角膜塑形镜前和戴镜1年后散瞳验光的SE差异无统计学意义;IOLMaster测量戴镜前和戴镜1年后眼轴长度分别为（26.88±1.03）mm、（26.91±1.10）mm,差异无统计学意义.随访期间未发生严重并发症.结论 夜晚配戴角膜塑形镜联合白天配戴框架眼镜矫正残余近视度数的方法可以有效提高中高度青少年近视患者UCVA,短期内控制近视度数加深和眼轴增长,无明显的并发症发生.

Objective To evaluate the clinical efficacy and safety of overnight orthokeratology （ortho K） combined with eye glasses during the day for juvenile moderate-high correction.Methods In this prospective study,38 patients （75 eyes） aged 11-19 years with an average spherical equivalent of-6.76±1.45 D,were prescribed OK lenses.Residual refractive errors were corrected with single vision spectacles.The subjects were required to return for assessment regularly.Results Before and after wearing ortho K lenses for 1 day,1 week,1 month and 1 year,UCVA had significantly improved from 3.93±0.27 to 4.53±0.21,4.85±0.19,4.90±0.11 and 4.94±0.13,respectively.After wearing ortho K lenses for 1 year,the average spherical equivalent and axial length 26.88±1.03 mm vs.26.91±1.10 mm,remained stable.No serious complications occurred during follow-up.Conclusion This therapy is successful for moderate-high myopic children with no significant changes in ocular health,best corrected visual acuity,axial length after one year of lens wear.No serious complication occur.