角膜塑形镜矫正近视的疗效及并发症情况

Effect of orthokeratology on myopia and its complications

目的:探讨角膜塑形镜矫正近视的临床效果及并发症情况。方法:选取2014-08/2015-10在我院眼科治疗的青少年近视患者204例408眼,均给予角膜塑形镜矫正,随访检查患者配戴后1、3、6、12mo裸眼视力、角膜曲率、眼轴长度等。结果:患者配戴后裸眼视力较配戴前明显提高,差异有统计学意义(P<0.05),其中配戴后1、3、6、12mo裸眼视力为0.52±0.12、0.64±0.20、0.95±0.15、0.97±0.12;配戴后屈光度较配戴前明显降低(P<0.05),其中配戴后1、3、6、12mo屈光度为1.82±0.40、0.96±0.20、0.40±0.09、0.25±0.06D;患者配戴前后角膜曲率、眼轴长度、角膜内皮细胞密度和中央厚度比较差异无统计学意义(P>0.05);患者配戴后角膜前表面曲率半径较配戴前明显升高,差异有统计学意义(P<0.05),其中配戴后1、3、6、12mo角膜前表面曲率半径为7.90±0.21、8.20±0.22、8.24±0.23、8.30±0.26mm;患者配戴前后角膜后表面曲率半径和前房深度比较差异无统计学意义(P>0.05)。结论:角膜塑形镜矫正近视是安全有效的,对角膜内皮细胞、前房深度等无明显影响,但矫正近视度有一定适用范围要求。

·AIM： To investigate the clinical effect and complication of orthokeratology for myopia. ·METHODS： From August 2014 to October 2015, 204 adolescents （408 eyes） with myopia in our hospital, were treated with orthokeratology, and followed up at 1, 3, 6 and 12mo for visual acuity, corneal curvature, axial length and so on. ·RESULTS： The visual acuity was significantly improved than before wearing （P〈0. 05）. At 1, 3, 6 and 12mo after wearing, the visual acuity were 0. 52±0. 12, 0. 64±0. 20, 0. 95±0. 15 and 0. 97±0. 12; after wearing the diopter significantly decreased than before wearing （P〈0. 05）; at 1, 3, 6 and 12mo after wearing diopter were 1. 82±0. 40D, 0. 96±0. 20D, 0. 40±0. 09D and 0. 25±0. 06D. There was no significant difference in the corneal curvature, axial length, corneal endothelial cell density and central thickness between before and after wearing （ P〉 0. 05 ）. After wearing the anterior corneal surface curvature radius significantly increased than before wearing （P〈0. 05）. At 1, 3, 6 and 12mo after wearing, anterior corneal surface curvature radius were 7. 90±0. 21 mm, 8. 20±0. 22mm, 8. 24±0. 23mm and 8. 30±0. 26mm. There was no significant difference on the posterior corneal surface curvature radius and anterior chamber depth between before and after wearing （P〉0. 05）. ·CONCLUSION： Orthokeratology correcting myopia, is safe and effective with no obvious effect on corneal endothelial cells and anterior chamber depth. There is a certain scope of application for the correction of myopia.