定位弧定制镜片在角膜塑形镜中的应用

Effectiveness of AC custom-made Ortho-K lens

目的:观察定位弧定制镜片在夜戴型角膜塑形镜中的临床应用效果。方法:采用前瞻性研究,观察首次夜戴型角膜塑形镜验配案例共84例165眼,随机分成两组,观察组38例76眼为定位弧定制镜片,对照组46例89眼为标准镜片,对照两组在戴镜1mo时裸眼视力、角膜地形图与角膜上皮状况。结果:在戴镜1mo时,观察组73眼、对照组83眼共156眼(94.5%)结果良好,观察组3眼、对照组6眼共9眼(5.5%)评估不佳,需继续观察或重新验配。在各项评估中,观察组74眼、对照组85眼共159眼(96.4%)裸眼视力达到或接近最佳矫正视力;观察组73眼、对照组84眼共157眼(95.2%)角膜地形图为可接受或接近完美;所有患者均未发生严重的角膜上皮损害。采用定位弧定制镜片在裸眼视力、角膜地形图和角膜上皮三项评分中均优于采用标准镜片,差异均具有统计学意义(P<0.05)。结论:夜戴型角膜塑形镜的安全性与有效性均令人满意,配戴定位弧定制镜片在戴镜1mo评估中优于标准镜片。

·AIM:To observe the effectiveness of AC custom-made orthokeratology(Ortho-K)lens in overnight orthokeratology fitting.·METHODS:A prospective study was conducted for 84 patients(165 eyes)with myopia who wore overnight Ortho-K lens for the first time.All patients were randomly divided into two groups with 38 patients(76 eyes)in observation group wearing AC custom-made Ortho-K lens and 46 patients(89 eyes)in control group wearing standard Ortho-K lens.Three items including the uncorrected visual acuity(UCVA),corneal topography,and the complications of corneal epithelium were observed and quantized to be evaluated at 1mo after Ortho-K lens wearing.·RESULTS:The assessment of 156 eyes(94.5%,including 73 eyes in observation group and 83 eyes in control group)in Ortho-K lens fitting were fine or acceptable at 1mo.Only 9 eyes(5.5%,including 3 eyes in observation group and 6 eyes in control group)were not good or unacceptable at that time,so that their Ortho-K lens had to be followed-up ulteriorly or changed instead.In all examination of this study,the UCVA of 159 eyes(96.4%,including 74 eyes in observation group and 85 eyes in control group)could reach one line lower to the BVCA or better in standard logarithmic visual acuity chart.The assessment of 157 eyes(95.2%,including 73 eyes in observation group and 84 eyes in control group)in corneal topography were fine or acceptable and there were no patients that had any serious complications in corneal epithelium.The observation group wearing AC custom-made Ortho-K lens performed better than the control group wearing standard Ortho-K lens in the result of UCVA,corneal topography,and the complications in corneal epithelium(P<0.05).·CONCLUSION:The overnight orthokeratology was effective and satisfying.AC custom-made Ortho-K lens performed better than standard Ortho-K lens in the assessment after wearing for 1mo.