2种角膜塑形镜矫治近视复合散光的疗效

Effect of two kinds of orthokeratology lens for compound myopic astigmatism

目的:探究球面塑形镜、环曲面塑形镜在矫治近视复合散光的有效性及安全性。方法:回顾分析宜昌市第一人民医院2016年3月至2018年3月角膜塑形镜治疗青少年近视94例(178眼),按佩戴塑形镜类型分为球面塑形镜组(48例,90眼)与环曲面塑形镜组(46例,88眼)。记录配镜前、佩戴1年后、停戴1周后的视力、角膜散光、眼轴长、球镜屈光度、眼压、泪膜破裂时间及角膜着染率。结果:戴镜1年后,2组组内相比,散光、球镜度数、眼压、泪膜破裂时间均降低,但2组组间相比,仅散光度数差异有统计学意义(P<0.01)。戴镜1年后,两组视力较戴镜前显著提高,停戴后近视度数较佩戴前增加,但组间差异无统计学意义(P>0.05);2种塑形镜角膜着染发生率差异无统计学意义(P>0.05)。结论:2种塑形镜均能够降低近视复合散光患者度数,有效提高患者视力,但并不能完全阻止近视的进展。虽然环曲面塑形镜在矫正散光方面有优势,但总有效性与安全性并不占优势。

Objective:To observe the effectiveness and safety of orthokeratology lens and toric design othokeratology treatment for compound myopic astigmatism.Methods:From March 2016 to March 2018,94 teenagers(178 eyes)were selected as the subjects of study.They were divided into two groups according to the type of orthokeratology:the orthokeratology lens group(48 cases,90 eyes)and the toric design othokeratology group(46 cases,88 eyes).Visual acuity,corneal astigmatism,axial length,spherical lens refraction,intraocular pressure,tear film rupture time and corneal staining rate were recorded before,after 1 year and after 1 week.Results:After 1 year of wearing the lens,astigmatism,spherical lens degree,intraocular pressure and tear film rupture time were all decreased in the 2 groups compared with each other,but only astigmatism degree was statistically significant between the 2 groups compared with each other(P<0.01).After wearing the glasses for 1 year,the visual acuity of the two groups was significantly improved compared with that before wearing the glasses,and the myopia degree was increased after stopping wearing the glasses compared with that before wearing the glasses,but the difference between the two groups was not statistically significant(P>0.05).There was no statistical significance in the incidence of corneal staining between the two types of shaping lenses(P>0.05).Conclusion:Both of the two shaping lenses can reduce the degree of myopic patients with complex astigmatism and effectively improve the visual acuity of patients,but they can not completely prevent the progress of myopia.Although toroidal shaping mirror has advantages in correcting astigmatism,its overall effectiveness and safety are not.