摘要
目的观察长期配戴硬性透气性角膜接触镜(RGP)后,角膜屈光力及散光的变化。方法前瞻性临床研究。选取2013年1月至2015年12月来我院眼科就诊验配RGP的患者共53例(106只眼),除屈光不正外无任何眼病。根据其角膜散光的大小分为A组(角膜散光〈2.00D)19例(38只眼),B组(角膜散光2.00。4.00D)17例(34只眼),C组(角膜散光〉4.00D)14例(28只眼)。各组患者戴镜前及戴镜24个月后停戴3d、停戴3周时进行角膜地形图检查,比较陡峭子午线角膜屈光力(Ks)、平坦子午线屈光力(1〈f)及柱镜度数(Cyl)的前后变化。对相关数据进行配对t检验及单因素方差分析。结果戴镜24个月并停戴3d时,三组Ks、Cyl数值均较戴镜前有统计学意义的降低(P〈0.05),Kf数值较戴镜均前无明显变化(P〉0.05)。A组、B组、C组的Ks减小量依次增加,分别为(0.146±0.454)D、(0.365±0.383)D、(0.790±0.518)D(F=13.338,P〈0.001),A组与B组.A组与C组,B组与C组之间差异有统计学意义(P=0.022,P〈0.001,P=0.002);Cyl的降低数值亦逐渐增加,分别为(O.165±0.451)D、(0.372±0.403)D、(0.741±0.574)0(F=10.099,P〈0.001)A组与B组,A组与C组.B组与C组之间差异均有统计学意义(P=0.036,P〈0.001,P=-0.008)。各组停戴3周后的Ks、酣结果与停戴3d时的结果接近,差异均无统计学意义(19〉0.05)。结论长期配戴RGP,角膜散光会降低,角膜散光越大降低越多.角膜散光的减小主要与Ks值的降低有关。
OBJECTIVE To observe changes of corneal refractive power and astigmatism after long-term wearing rigid gas permeable contact lens(RGPCL). METHODS This was a prospective study. From January 2013 to December 2015, 53 patients ( 106 eyes) without eye disorders except ametropia, that visited our hospital for RGPCL were included. According to the corneal astigmatism value, the patients were divided into 3 groups : corneal astigmatism value less than 2. 00D in group A (19 patients, 38 eyes), between 2. 00D and 4, 0D in group B (17 patients, 34 eyes), more than 4. 0D in group C (14 patients, 28 eyes)]. All patients were examined by corneal topography before wearing RGPCL and 3 days after 24 months wearing as well as 3 weeks after 24 months wearing. The flatkeratometry (Kt), the steepkeratometry (Ks) and the cylinder (Cyl) values were recorded. The recorded data were analyzed with paired t-test and one-way analysis of variance. RESULTS The third day after 24 months wearing RGPCL, in all groups, the Ks and the Cyl experienced a statistically significant decrease (P 〈 0.05) while the Kf had no significant change (P 〉 0.05) . The Ks of A group, B group and C group reduced increasingly in sequence as 0.146±0.454D, 0.365±0.383D, 0.790±0.518D (F = 13.338, P〈 0.001). And differences between group A and group B, group A and group C, group B and group C were statistically significant (19=0.022, P〈0.001, P=0.002); same happened to Cyl as 0.165±0.451D, 0.372±0.403D, 0.741±0.574D (F=10.099, P〈0.001 ). And differences between group A and group B, group A and group C, group B and group C were statistically significant (P=0.036, P〈0.001, P=0.008). Comparison between the 3rd day and the 3rd week after 24 months wearing showed no difference in terms of Ks, Kf and Cyl (P 〉 0.05). CONCLUSIONS The study showed that the corneal astigmatism can be decreased with long-term wearing RGPCL, in addition, worse corneal astigmatism reduced more sharply. The reduction of corneal astigmatism was mainly related to decrease of Ks value.
作者
林享强
徐丹
LIN Xiangqiang XU Dan(School of Ophthalmology and Optometry, Wenzhou Medical College, Wenzhou 325035, Chin)
出处
《中国中医眼科杂志》
2016年第4期263-266,共4页
China Journal of Chinese Ophthalmology
关键词
硬性高透氧角膜接触镜
角膜散光
角膜曲率
泪液镜
rigid gas permeable contact lens(RGPCL)
corneal astigmatism
corneal curvature
tear lens