BACKGROUND Myopia,as one of the common ocular diseases,often occurs in adolescence.In addition to the harm from itself,it may also lead to serious complications.Thus,prevention and control of myopia are attracting mor...BACKGROUND Myopia,as one of the common ocular diseases,often occurs in adolescence.In addition to the harm from itself,it may also lead to serious complications.Thus,prevention and control of myopia are attracting more and more attention.Previous research revealed that single-focal glasses and orthokeratology lenses(OK lenses)played an important part in slowing down myopia and preventing high myopia.AIM To compare the clinical effects of OK lenses and frame glasses against the increase of diopter in adolescent myopia and further explore the mechanism of the OK lens.METHODS Changes in diopter and axial length were collected among 70 adolescent myopia patients(124 eyes)wearing OK lenses for 1 year(group A)and 59 adolescent myopia patients(113 eyes)wearing frame glasses(group B).Refractive states of their retina were inspected through multispectral refraction topography.The obtained hyperopic defocus was analyzed for the mechanism of OK lenses on slowing down the increase of myopic diopter by delaying the increase of ocular axis length and reducing the near hyperopia defocus.RESULTS Teenagers in groups A and B were divided into low myopia(0 D--3.00 D)and moderate myopia(-3.25 D--6.00 D),without statistical differences among gender and age.After 1-year treatment,the increase of diopter and axis length and changes of retinal hyperopic defocus amount of group A were significantly less than those of group B.According to the multiple linear analysis,the retinal defocus in the upper,lower,nasal,and temporal directions had almost the same effect on the total defocus.The amount of peripheral retinal defocus(15°-53°)in group A was significantly lower than that in group B.CONCLUSION Multispectral refraction topography is progressive and instructive in clinical prevention and control of myopia.展开更多
Orthokeratology is a reversible technique that temporarily changes the curvature of the cornea with the aim of addressing refractive errors. The United States Food and Drug Administration(FDA) granted approval for usi...Orthokeratology is a reversible technique that temporarily changes the curvature of the cornea with the aim of addressing refractive errors. The United States Food and Drug Administration(FDA) granted approval for using reverse geometry contact lenses to correct myopia without any age restriction. Information from the pre-market applications to the FDA was rated as level Ⅱ evidence. Another unapproved use of overnight orthokeratology is for the prevention of myopic progression. Although orthokeratology is advocated to reduce myopic progression, there are limited long-term studies with substantial evidence of its benefits. Much of this evidence comes from non-robust experimental studies using historical or self-selected controls with relative high dropout rates. Although some positive results have been published in temporarily reducing the myopic refractive error and its progression, the use of these lenses can be associated with serious complications such as microbial keratitis. Microbial keratitis is a potentially vision-threatening adverse response associated with contact lens wear. In fact, contact lens wearhas been shown to be the predominant risk factor of microbial keratitis in some developed countries. Most of the published cases on overnight orthokeratology related microbial keratitis occurred in children or adolescents. Parents considering orthokeratology must make an informed decision about its temporary benefit and its potential for permanent loss of vision. The ophthalmic community should be reminded of the potential complications of orthokeratology.展开更多
Background:This retrospective study was designed to investigate the sole influence of orthokeratology(OK)lens fitting decentration on the Zernike coefficients of the reshaped anterior corneal surface.Methods:This stud...Background:This retrospective study was designed to investigate the sole influence of orthokeratology(OK)lens fitting decentration on the Zernike coefficients of the reshaped anterior corneal surface.Methods:This study comprised a review of 106 right eyes and measurements of corneal topography both before OK and at 1-month follow-up visit.A routine was designed to calculate local corneal surface astigmatism and assist the determination of OK lens fitting decentration from pupil center.The pupil-centered corneal Zernike coefficients of baseline(PCCB)and post-treatment(PCCP)were calculated.Meanwhile,the OK-lens-centered corneal Zernike coefficients of post-treatment(OCCP)were also calculated and considered as the presumptive ideal fitting group without decentration.Relationships between lens fitting decentration and the change of Zernike coefficients including(PCCP−PCCB)and(PCCP−OCCP)were analyzed.Results:Patients with a mean age of 11±2.36 years old had an average spherical equivalent refractive error of−3.52±1.06 D before OK.One month after treatment,OK lens fitting decentration from pupil center was 0.68±0.35 mm.RMS of 3rd-order(P<0.05),RMS of 4th-order(P<0.001)and RMS of total high order(P<0.001)corneal Zernike coefficients were increased in PCCP by comparing with OCCP,which was solely caused by lens fitting decentration.Nevertheless,no significant difference was observed in C^(0)_(2)(P>0.05).For the high order corneal Zernike coefficients in(PCCP–OCCP),radial distance of decentration was correlated with C^(−1)_(3)(r=−0.296,P<0.05),C^(1)_(3)(r=−0.396,P<0.001),and C^(0)_(4)(r=0.449,P<0.001),horizontal decentration was significantly correlated with C^(1)_(3)(r=0.901,P<0.001)and C^(1)_(5)(r=0.340,P<0.001),and vertical decentration was significantly correlated with C^(−1)_(3)(r=0.904,P<0.001).Conclusions:OK lens fitting decentration within 1.5 mm hardly influenced the change of corneal spherical power for myopia correction,but significantly induced additional corneal high order Zernike coefficients including C^(−1)_(3),C^(1)_(3),C^(0)_(4),and C^(1)_(5).展开更多
文摘BACKGROUND Myopia,as one of the common ocular diseases,often occurs in adolescence.In addition to the harm from itself,it may also lead to serious complications.Thus,prevention and control of myopia are attracting more and more attention.Previous research revealed that single-focal glasses and orthokeratology lenses(OK lenses)played an important part in slowing down myopia and preventing high myopia.AIM To compare the clinical effects of OK lenses and frame glasses against the increase of diopter in adolescent myopia and further explore the mechanism of the OK lens.METHODS Changes in diopter and axial length were collected among 70 adolescent myopia patients(124 eyes)wearing OK lenses for 1 year(group A)and 59 adolescent myopia patients(113 eyes)wearing frame glasses(group B).Refractive states of their retina were inspected through multispectral refraction topography.The obtained hyperopic defocus was analyzed for the mechanism of OK lenses on slowing down the increase of myopic diopter by delaying the increase of ocular axis length and reducing the near hyperopia defocus.RESULTS Teenagers in groups A and B were divided into low myopia(0 D--3.00 D)and moderate myopia(-3.25 D--6.00 D),without statistical differences among gender and age.After 1-year treatment,the increase of diopter and axis length and changes of retinal hyperopic defocus amount of group A were significantly less than those of group B.According to the multiple linear analysis,the retinal defocus in the upper,lower,nasal,and temporal directions had almost the same effect on the total defocus.The amount of peripheral retinal defocus(15°-53°)in group A was significantly lower than that in group B.CONCLUSION Multispectral refraction topography is progressive and instructive in clinical prevention and control of myopia.
文摘Orthokeratology is a reversible technique that temporarily changes the curvature of the cornea with the aim of addressing refractive errors. The United States Food and Drug Administration(FDA) granted approval for using reverse geometry contact lenses to correct myopia without any age restriction. Information from the pre-market applications to the FDA was rated as level Ⅱ evidence. Another unapproved use of overnight orthokeratology is for the prevention of myopic progression. Although orthokeratology is advocated to reduce myopic progression, there are limited long-term studies with substantial evidence of its benefits. Much of this evidence comes from non-robust experimental studies using historical or self-selected controls with relative high dropout rates. Although some positive results have been published in temporarily reducing the myopic refractive error and its progression, the use of these lenses can be associated with serious complications such as microbial keratitis. Microbial keratitis is a potentially vision-threatening adverse response associated with contact lens wear. In fact, contact lens wearhas been shown to be the predominant risk factor of microbial keratitis in some developed countries. Most of the published cases on overnight orthokeratology related microbial keratitis occurred in children or adolescents. Parents considering orthokeratology must make an informed decision about its temporary benefit and its potential for permanent loss of vision. The ophthalmic community should be reminded of the potential complications of orthokeratology.
基金supported by the Scientific and Technological Program of Wenzhou[Y20160438,G20160033]National Natural Science Foundation of China[61775171]+1 种基金Natural Science Foundation of Zhejiang Province[LY14F050009,LY16H120007]National Key Research and Development Program of China[2016YFC0100200].
文摘Background:This retrospective study was designed to investigate the sole influence of orthokeratology(OK)lens fitting decentration on the Zernike coefficients of the reshaped anterior corneal surface.Methods:This study comprised a review of 106 right eyes and measurements of corneal topography both before OK and at 1-month follow-up visit.A routine was designed to calculate local corneal surface astigmatism and assist the determination of OK lens fitting decentration from pupil center.The pupil-centered corneal Zernike coefficients of baseline(PCCB)and post-treatment(PCCP)were calculated.Meanwhile,the OK-lens-centered corneal Zernike coefficients of post-treatment(OCCP)were also calculated and considered as the presumptive ideal fitting group without decentration.Relationships between lens fitting decentration and the change of Zernike coefficients including(PCCP−PCCB)and(PCCP−OCCP)were analyzed.Results:Patients with a mean age of 11±2.36 years old had an average spherical equivalent refractive error of−3.52±1.06 D before OK.One month after treatment,OK lens fitting decentration from pupil center was 0.68±0.35 mm.RMS of 3rd-order(P<0.05),RMS of 4th-order(P<0.001)and RMS of total high order(P<0.001)corneal Zernike coefficients were increased in PCCP by comparing with OCCP,which was solely caused by lens fitting decentration.Nevertheless,no significant difference was observed in C^(0)_(2)(P>0.05).For the high order corneal Zernike coefficients in(PCCP–OCCP),radial distance of decentration was correlated with C^(−1)_(3)(r=−0.296,P<0.05),C^(1)_(3)(r=−0.396,P<0.001),and C^(0)_(4)(r=0.449,P<0.001),horizontal decentration was significantly correlated with C^(1)_(3)(r=0.901,P<0.001)and C^(1)_(5)(r=0.340,P<0.001),and vertical decentration was significantly correlated with C^(−1)_(3)(r=0.904,P<0.001).Conclusions:OK lens fitting decentration within 1.5 mm hardly influenced the change of corneal spherical power for myopia correction,but significantly induced additional corneal high order Zernike coefficients including C^(−1)_(3),C^(1)_(3),C^(0)_(4),and C^(1)_(5).
文摘目的 探讨不同屈光度近视青少年儿童应用角膜塑形镜的近视控制效果及安全性。方法 选取2021年2月至8月于南京医科大学附属江宁医院接受角膜塑形镜治疗的93例(171眼)近视患者为研究对象,根据等效球镜度数将其分为低度数组(88眼,–0.5D至–3.0D)和中度数组(83眼,–3.0D至–6.0D)。比较两组戴镜前后的裸眼远视力、屈光度、眼轴、泪膜破裂时间(breakup time of tear film,BUT)、角膜内皮细胞计数及并发症。结果 戴镜1年后,低度数组眼轴增长显著大于中度数组(Z=–2.035,P=0.042)。戴镜1年后,两组的裸眼远视力均显著高于本组戴镜前(P<0.05),中度数组的视力增长幅度显著大于低度数组(P<0.05);两组的等效球镜度数均显著小于本组戴镜前(P<0.05),中度数组的等效球镜度数减少幅度显著大于低度数组(P<0.05)。戴镜1年后,两组的BUT均显著短于本组戴镜前,角膜内皮细胞计数均少于本组戴镜前(P<0.05),但两组的BUT和角膜内皮细胞计数比较差异均无统计学意义(P>0.05)。两组患者的并发症发生率比较差异无统计学意义(χ^(2)=2.000,P=0.157)。结论 角膜塑形镜对不同屈光度近视青少年儿童均有良好的控制效果和安全性,而对中度近视的效果更为突出。
