停止配戴角膜塑形镜后眼部参数的变化及相关性

Changes and Relationship Analysis of Ocular Parameters After Short-term Discontinuation of Orthokeratology

【目的】观察配戴角膜塑形镜1年并停戴1月后的屈光状态和角膜前表面参数的恢复情况,并分析屈光度变化的相关因素。【方法】回顾性病例研究。收集66例(66眼)配戴角膜塑形镜并自愿停戴的8~15岁近视儿童,配戴时间约1年,平均13(S=3)月,停戴平均29(S=4)d。观察戴镜前及停戴1月的屈光度、眼轴、眼压、前房深度及角膜地形图参数,采用配对t检验和Pearson相关性分析停戴后的各参数变化及其相关性。【结果】与配戴角膜塑形镜前相比,停戴1月后的等效球镜度增长了-0.13(-0.50~0.00)D(P<0.001),其中柱镜度数增长了0.00(-0.25~0.00)D,(P=0.013)。停戴1月的角膜陡峭K值、平坦K值、平坦和陡峭偏心率较戴镜前分别减少了0.10(-0.10~0.30)D、0.20(0.00~0.48)D、-0.10(-0.30~0.20)D,(P1=0.001、P2<0.001、P3=0.015)。戴角膜塑形镜1年并停戴1月后屈光度增长量(Y)仅与眼轴增长值(X)具有密切联系,并建立回归方程y=-1.294X+0.095(P<0.001)。【结论】儿童停戴角膜塑形镜1月后的屈光状态已经超过戴镜前水平,角膜前表面形态基本恢复到戴镜前的初始形态。

【Objective】To observe and assess the changes of refraction error,axial length,anterior chamber depth, intraocular pressure,and corneal topography parameters 1 month after discontinuation of orthokeratology,and analyse the related factors of refraction error growth.【Methods】This was a retrospective self-control clinical study. A total of 66 children(66 eyes)with a history of wearing orthokeratology lens and voluntary discontinuation,aged 8 to 15 years,were enrolled in this study. They had worn orthokeratology lens for about 1 year,averaged 13(S = 3)months,with about 1 month of discontinuation,averaged 29(S = 4)days. Observation of refraction error,axial length,anterior chamber depth, intraocular pressure,and corneal topography parameters were taken before wearing orthokeratology lens and 1 month after discontinuation,and the changes and correlation were analyzed by paired t test and linear regression analyses.【Results】 Compared with the values at baseline,spherical equivalent refraction error and cylindrical degree increased[-0.13(- 0.50~ 0.00)]D and[0.00(-0.25~0.00)]D,(P = 0.113)after 1 month of discontinuation,respectively. The value of steep Keratometry,and that of flat K,Em and Es both decreased 了 0.10(-0.10~0.30)D,0.20(0.00~0.48)D,-0.10(-0.30~ 0.20)D,(P1 = 0.001,P2 < 0.001,P3 = 0.015). Significantly ,change of refraction error was only strongly correlated with axial elongation(X),and we built a predictive model for growth of refraction error(Y):y =-1.294X+0.095(P < 0.001).【Conclusion】Refractive error exceed to baseline values completely,and corneal power rebounded to baseline values basically after 1 month of discontinuation in children who wore orthokeratology lens for about 1 year.