角膜塑形矫治近视183例随访体会

Follow-up experience of orthokeratology correctional myopia in 183 cases

目的:观察角膜矫形对近视眼的治疗效果,以及各种参数与疗效的关系和治疗中出现的不良反应。方法:对角膜矫形治疗的183例346只眼进行了3~12个月随访观察。对不同屈光度用3种不同的角膜矫形镜做治疗,统计屈光不正患者的不同参数与疗效的关系及各种不良反应出现的时段与频率。结果:角膜矫形治疗后,视力≥4.8的320只眼(92.5%),视力≥5.0的275只眼(79.9%)。治疗前屈光度≥-5.0 D、角膜曲率≥45.0 D、眼轴长≥25 mm的患者以及早期未提供E值的患者,疗效均较差(P<0.01)。13~17岁年龄组疗效较佳(P<0.01)。主要不良反应是角膜上皮损伤(初戴49.7%)和出现重影(3周内41.0%),1例患者出现顽固的视疲劳。结论:角膜矫形技术是一项安全、有效的提高近视眼裸眼视力的方法,对少儿近视的治疗较好,但应注意角膜上皮损伤及重影等不良反应。

Objective:To observe the treatment effect of corneal orthopedic for myopia,and the relationship between various parameters and curative effects,the adverse reactions in the treatment.Methods:183 cases(346 eyes) with corneal orthodontic treatment were given followed up for 3 to 12 months.The different diopters were treated by using three different corneal orthopaedic mirror.The relationships between different parameters and curative effects,the emerging time and frequency of various adverse reactions of patients with ametropia.Results:After corneal orthopedic treatment,320 eyes(92.5%) were visual acuity more than or equal to 4.8,275 eyes(79.9%) were visual acuity more than or equal to 5.0.Before treatment,the patients with the diopter more than or equal to-5.0 D,the corneal curvature more than or equal to 45.0 D,the ocular axial length more than or equal to 25 mm and patients who were not provide E value in early,the curative effects were poor(P<0.01).The curative effect of 13 to 17 years old age group was poor(P<0.01).The main adverse reactions were corneal epithelial injury(first wear 49.7%) and the appearance of double image(41% in 3 weeks),1 patient had persistent eyestrain.Conclusion:Corneal correction technique is a safe and effective method to improve the naked vision of myopia,and the treatment of juvenile myopia is better,but it should pay attention to the adverse reactions such as corneal epithelial injury and double image.