夜戴型角膜塑形镜与常规框架眼镜治疗青少年中高度近视疗效分析

Analysis on the Curative Effects of Overnight Orthokeratology Lens versus Conventional Frame Glasses for Adolescents with Moderate and High Myopia

目的探讨夜戴型角膜塑形镜与常规框架眼镜治疗中高度近视对青少年视力的影响.方法选取105例180眼中高度近视青少年患者为研究对象,根据患者自愿原则分为对照组与观察组,对照组予以普通树脂镜片框架眼镜治疗,观察组予以角膜塑形镜治疗,于佩戴镜片前、佩戴后3,12个月分别检查其视力、屈光度、球镜、柱镜,采用角膜地形图检测角膜曲率,测量眼压,使用眼科A/B超测量眼轴长度,统计其不良反应.结果戴镜前两组的中度、高度近视患者的各项指标比较差异均无统计学意义(P>0.05);戴镜后,对照组中度、高度患者裸眼视力较戴镜前差异无统计学意义(P>0.05),但观察组裸眼视力较治疗前显著增高(P<0.05);戴镜后,对照组中高度近视患者等效球镜、球镜、柱镜比戴镜前显著升高(P<0.05),观察组等效球镜、球镜较戴镜前显著下降(P<0.05),柱镜较戴镜前无显著差异(P>0.05),但观察组各时间点的视力显著高于对照组,等效球镜、球镜、柱镜显著低于对照组(P<0.05);戴镜后,对照组角膜曲率、眼压较戴镜前无显著变化(P>0.05),眼轴较戴镜前显著升高(P<0.05),观察组角膜曲率较戴镜前显著下降(P<0.05),其眼压、眼轴较戴镜前差异无统计学意义(P>0.05),且戴镜后观察组的角膜曲率、眼轴均显著低于对照组(P<0.05).戴镜期间,对照组无不良反应,观察组5例出现不良反应,总发生率为9.4%,与对照组比较差异无统计学意义(P>0.05).结论夜戴型角膜塑形镜较常规框架眼镜可有效缓解中高度近视患者视力下降,且不良反应少,效果安全、可靠.

Objective To discuss the effect of overnight orthokeratology lens and conventional frame glasses on the visual acuity of adolescents with moderate and high myopia. Method A total of 105 adolescents（ 180 eyes）with moderate and high myopia were selected as the subjects. They were divided into the control group and the observation group according to their own intention. The control group was treated with common frame glasses with resin lens while the observation group was treated with orthokeratology lens. The visual acuity,diopter,spherical refraction and cylindrical refraction were examined before wearing lens after 3 months and 12 months of wearing.The corneal curvature was detected with corneal topography,and the intraocular pressure was measured. The ophthalmological A/B ultrasound was used to measure the axial length,and adverse reactions were statistically analyzed. Results There was no significant difference in the indicators of patients with moderate and highmyopia between the two groups before wearing lens（ P〈0.05）. There was no significant difference in the uncorrected visual acuity of patients with moderate or high myopia in the control group before and after wearing lens（ P〈0.05）. However,the uncorrected visual acuity of the observation group improved significantly after wearing lens（ P〈0.05）. After wearing glasses,the equivalent sphere,spherical refraction and cylindrical refraction of patients with moderate or high myopia in the control group significantly increased（ P〈0.05）. The equivalent sphere and spherical refraction of the observation group were significantly lower than those before wearing lens（ P〈0.05）,but there was no significant difference in cylindrical refraction（ P〈0.05）. The visual acuities of the observation group at different time points were significantly higher than those of the control group,while the equivalent sphere,spherical refraction and cylindrical refraction were significantly lower than those of the control group（ P〈0.05）. There was no significant difference in the corneal curvature or intraocular pressure of the control group before and after wearing lens（ P〈0.05）,while the axis oculi significantly increased after wearing lens（ P〈0.05）. The corneal curvature of the observation group significantly decreased after wearing lens（ P〈0.05）,but there was no significant difference in intraocular pressure or axis oculi compared with those before wearing lens（ P〈0.05）. After wearing lens,the corneal curvature and axis oculi of the observation group were significantly lower than those of the control group（ P〈0.05）. There was no adverse reaction in the control group. However,there were 5 cases of adverse reactions in the observation group with the total incidence of 9.4%. The difference between the two groups was not significant（ P〈0.05）. Conclusion Compared with conventional frame glasses,overnight orthokeratology lens can effectively relieve vision loss in patients with moderate and high myopia,with few adverse reactions. It is safe and reliable.