角膜塑形镜对青少年近视眼调节参数的影响

Effect of orthokeratology on accommodative parameters in juvenile myopia

目的观察分析角膜塑形镜对青少年近视调节各参数的影响及临床意义。方法选取在视光门诊规范验配、随诊、配戴角膜塑形镜的8~16岁青少年近视患者31例(62眼),其中男16例,女15例,平均等效球镜(-3.71±0.90)D。在配戴角膜塑形镜前后,应用综合验光仪对近视患者测定调节参数,包括正相对调节量、负相对调节量、调节幅度、调节反应(调节滞后量)及梯度性AC/A;对配戴前后的相关数据进行配对t检验。结果配戴角膜塑形镜前后调节幅度(AMP)分别为(+7.94±1.44)D和(+7.06±1.19)D(t=7.94,P<0.05);调节滞后量(FCC法)分别为(+0.90±0.21)D和(+0.15±0.26)D(t=13.79,P<0.05);梯度性AC/A分别为(4.05±0.83)和(3.03±0.63)(t=8.07,P<0.05)。结论青少年近视眼配戴角膜塑形镜后调节参数趋于正常,配戴后调节滞后量减少,AC/A值降低,患者的调节与集合的关系更加协调,为延缓近视的进展提供了一定依据。

LAN Fang-fang;ZHAO Wu-xiao;GAN Lu;Department of Optometry,the People＇s Hospital of Guangxi Zhuang Autonomous Region; Objective To study the effect and the clinical significance of orthokeratology on accommodative parameters in juvenile myopia. Methods Thirty-one teenager myopia patients（ 62 eyes） aged 8 ~ 16 years in our center were recruited in this study. Among these subjects there were 16 males and 15 females. The average spherical equivalent refraction was（-3. 71 ± 0. 90） D. Before and after the patients were orthokeratology,their accommodative parameters were measured by phoropter,including positive and negative relative accommodation,accommodative amplitude（ AMP）,accommodative response（ accommodative lag）,and gradient AC / A. Paired t-testing was used to analyze the related data. Results Orthokeratology restored the accommodative parameters in teenager myopia patients.AMP reduced from（ ＋ 7. 94 ± 1. 44） D before wearing orthokeratology to（ ＋ 7. 06 ± 1. 19） D after wearing orthokeratology（ t = 7. 94,P〈0. 05）; Accommodative lag measured by FCC method reduced from（ ＋ 0. 90 ± 0. 21） D before wearing orthokeratology to（ ＋ 0. 15 ± 0. 26） D after wearing orthokeratology（ t = 13. 79,P〈0. 05）. Gradient AC / A reduced from（ 4. 05 ± 0. 83） before wearing orthokeratology to（ 3. 03 ± 0. 63） after wearing orthokeratology（ t =8. 07,P〈0. 05）. Conclusion The accommodative parameters tend to be normal after wearing orthokeratology in teenager myopia patients,which makes the patients＇ accommodation and convergence more harmonious delays the development of teenager myopia.