探讨角膜成形术矫治青少年轻中度近视的临床疗效及角膜形态的变化

Exploring the Clinical Effect of Keratoplasty in the Treatment of Mild to Moderate Myopia in Adolescents and the Changes in Corneal Morphology

目的观察角膜成形术治疗青少年轻中度近视的效果,并分析其对角膜形态变化的影响。方法选择2018年1月—2019年12月68例轻中度近视的青少年患者,所有患者均接受角膜成形术矫治。观察佩戴后1周、1个月、3个月、6个月相关指标变化。结果视力≥1.0的配镜后1周占比62.90%、配镜后1个月占比87.90%,明显高于前一周期(χ^2=142.057、200.909,P<0.05);配镜后3个月与6个月对比,差异无统计学意义(P>0.05)。残余屈光度>-1.00 D的配镜后1周占比5.65%明显低于配镜前(χ^2=217.541,P<0.05);佩戴1个月残余屈光度0^-0.25 D占比85.48%明显高于佩戴1周(χ^2=9.226,P<0.05);而配镜后3个月、6个月0^-0.25 D残余屈光度92.74%、93.55%对比,差异无统计学意义(P>0.05)。配镜后1周患者角膜中央厚度(545.27±40.02)μm与配镜前对比,差异无统计学意义(P>0.05);配镜后1个月角膜中央厚度(532.18±38.19)μm与配镜前对比明显更薄(t=3.234,P<0.05);但配镜后3月、6月与配镜前对比,差异无统计学意义(P>0.05)。配镜后1周和1月患者角膜曲率(41.33±1.20)D、(41.10±1.15)D较配镜前明显下降(t=5.311、6.919,P<0.05);但配镜后3个月、6个月与配镜前对比,差异无统计学意义(P>0.05)。结论角膜成形术矫治青少年轻中度近视有较好的效果,但可能对角膜形态有一定的影响,因此实际验配过程中要注意规范操作,告知患者正确佩戴,以确保安全性。

Objective To observe the effect of keratoplasty on adolescents with mild to moderate myopia,and analyze its effect on corneal morphology.Methods From January 2018 to December 2019,68 adolescent patients with mild to moderate myopia were selected.All patients underwent keratoplasty.Observe the changes of related indicators at 1week,1month,3month,and 6month after wearing.Results The proportion of 1 week with eyesight≥1.0 was 62.90%and 87.90%1month after fitting,which was significantly higher than the previous cycle(χ^2=142.057,200.909,P<0.05);3 month and 6 month after fitting,the difference was not statistically significant(P>0.05).The proportion of 1week with residual diopter>-1.00 D after fitting was 5.65%significantly lower than that before fitting(χ^2=217.541,P<0.05);the proportion of 85.48%with residual diopter 0^-0.25 D for 1month was significantly higher than that of wearing 1week(χ^2=9.226,P<0.05);3 month,6 month 0^-0.25 D residual refractive power 92.74%,93.55%contrast after fitting,the difference was not statistically significant(P>0.05).The central corneal thickness(545.27±40.02)μm of the patient 1 week after the lens was fitted,the difference was not statistically significant(P>0.05);the thickness of the central cornea 1month after the lens was(532.18±38.19)μm was significantly thinner than that before the lens(t=3.234,P<0.05);but the comparison between 3 month and 6 month after fitting and before fitting,the difference was not statisticallysignificant(P>0.05). The corneal curvatures of (41.33±1.20)D and (41.10±1.15)D were significantly lower in patients 1week and 1month after being fitted with glasses(t=5.311, 6.919, P<0.05);but 3month and 6 month after fitting glasses contrast before fitting,and the difference was not statistically significant(P>0.05). Conclusion Keratoplasty has a good effect in the treatment of mild to moderate myopia in adolescents, but it may have a certain impact on the corneal shape. Therefore, it is necessary to pay attention to the standard operation during the actual fitting process and inform the patient to wear it correctly to ensure safety.