角膜塑形镜矫治对近视儿童角膜形态及视觉质量的影响

Impact of orthokeratology lens corrective therapy on corneal surface shape and visual quality of children with myopia

目的探讨角膜塑形镜矫治对近视儿童的角膜形态及视觉质量影响。方法选取2015年4月～2016年4月期间于我院诊治的200例儿童近视患者,采用回顾性分析方法进行疗效探究,所有患者均采用角膜塑形镜矫正治疗。分别于治疗1d、1周、1月后测定角膜形态变化并进行客观与主观视觉质量测定。结果戴镜后1周、1月等效屈光度、平均曲率、角膜顶点厚度、对比敏感度情况(AULCSF)、四阶球差、三阶慧差与治疗1d比较差异均有统计学意义(P<0.05),但高阶像差异无统计学意义(P>0.05);客观视觉质量中,矫正后1周、1月、3月调制传递函数(MTF)截止频率下降(P<0.05),客观散射指数(OSI)上升(P<0.05),泪膜质量有所降低,但差异无统计学意义(P>0.05),9%对比视力、20%对比视力、100%对比视力稍有下降,但与治疗前相比差异无统计学意义(P>0.05);主观视觉质量中,矫正后1周、1月、3月从明处到暗处适应、夜间骑车、夜间光圈、视力波动、眩光评分与治疗前相比差异有统计学意义(P<0.05),看电脑屏幕、白天骑车、书籍阅读、日常活动、户外运动、视物变形、总体视力评分与治疗前相比差异无统计学意义(P>0.05)。结论角膜塑形镜矫正治疗能显著改善近视儿童的角膜形态,在近视儿童的矫正治疗中具有良好的利用价值,值得临床借鉴。

Objective To discuss impact of orthokeratology lens corrective therapy on corneal surface shape and visual quality of children with myopia.Methods 200 patients with myopia treated in our hospital from April 2015 to April 2016 were selected as the objects and studied for efficacy via retrospective analysis of treatment process.All patients were provided with orthokeratology lens corrective therapy and examined for variation of corneal surface shape at1 day,1 week and 1 month after treatment and examined for objective and subjective visual quality.Results In 1 week and 1 month after wearing lens,the equivalent diopter,mean curvature,thickness of corneal culmination,AULCSF,four order spherical aberration and three order coma were significantly differed from those in 1 day after treatment ( P <0.05).There was no significant change in higher order aberrations ( P >0.05).In objective visual quality,the modulation transfer function (MTF) cut-off frequency in 1 week,1 month and 3 months after corrective therapy decreased ( P <0.05).The objective scattering index (OSI) increased ( P <0.05).The quality of tear film increased ( P <0.05).9% contrast vision,20% contrast vision and 100% contrast vision decreased a little,which had no significantly difference from those before treatment ( P >0.05).In subjective visual quality,the score of light-dark adaptation,riding at night,night aperture,vision fluctuation and glare in 1 week,1 month and 3 months after corrective therapy were significantly differed from those before treatment ( P <0.05).There was no significant difference in watching electronic screen,riding at daytime,reading books,daily activity,outdoor exercise,metamorphopsy and general vision scores before and after treatment ( P >0.05).Conclusion Orthokeratology lens corrective therapy can effectively optimize corneal surface shape.It has utility value in corrective therapy of children with myopia.