摘要
目的探讨角膜塑形镜对青少年近视的治疗效果。方法收集接受角膜塑形镜治疗的8～18岁青少年近视患者59例(118只眼)作为研究对象。按患者配戴角膜塑形镜前等效球镜度数将研究对象分为低度近视组(-0. 75～-3. 00 D)、中度近视组(-3. 25～-5. 00 D)及高度近视组(-5. 25～-9. 00 D)。观察患者配戴角膜塑形镜1、3、6个月及1年后屈光度、眼轴长度、中央角膜厚度、角膜曲率的变化情况,采用方差分析比较不同近视组间屈光度、眼轴长度变化量、中央角膜厚度、角膜曲率的差异。结果各组患者配戴角膜塑形镜1、3、6个月及1年后屈光度、眼轴长度、角膜曲率、中央角膜厚度较配戴前明显降低,差异有统计学意义(P <0. 05)。低度近视组、中度近视组患者配戴角膜塑形镜1、3、6个月及1年后屈光度、眼轴长度变化量、角膜曲率、中央角膜厚度明显低于配戴前,差异有统计学意义(P <0. 05);高度近视组患者眼轴长度变化量、角膜曲率较配戴前明显降低,差异有统计学意义(P <0. 05);屈光度、中央角膜厚度与配戴前相比虽有所降低,但差异无统计学意义(P> 0. 05)。结论角膜塑形镜能有效地矫正低、中度近视患者的视力,对高度近视患者的治疗效果可能与配戴时间有关。长期配戴角膜塑形镜可能控制眼轴增长,降低角膜曲率,使中央角膜变扁平、变薄。
Objective To explore the therapeutic effect of orthokeratology lens on adolesecent myopia and provide scientific basis for the prevention and treatment of adolesecent myopia. Methods According to the inclusion criteria,59 myopia patients who were treated with corneal plastic lens were selected as study objects. According to the patient's degree of equivalent spherical lens before wearing corneal plastic lens,the subjects were divided into low myopia group(-0. 75 ～-3. 00 D),moderate myopia group(-3. 25 ～-5. 00 D) and high myopia group(-5. 25 ～-9. 00 D). Then the changes of diopter,axial length,central corneal thickness and corneal curvature were observed after wearing orthokeratology lens in one month,three months,six months,and one year later. The diopter,axial length variation,central corneal thickness and corneal curvature were compared by ANOVA between the different myopia groups.Results The diopter,axial length variation,corneal curvature and central corneal thickness were significantly decreased after wearing orthokeratology lens for 1 month,3 months,6 months and 1 year later( F = 5. 223,34. 723,114. 47,3. 965; P < 0. 05). There were significant difference of the diopter,axial length variation,corneal curvature and central corneal thickness after wearing orthokeratology lens for1 month,3 months,6 months and 1 year later between low myopia group and moderate myopia group( P < 0. 05). The axial length variation and corneal curvature of the high myopia group were significantly lower than those before wear( P < 0. 05),the diopter and central corneal thickness were lower than those before wear but there were no significant difference( P > 0. 05). Conclusion Orthokeratology lens can effectively correct the visual acuity of low and moderate myopia patients. The therapeutic effect for high myopia patients may be related to the wearing time. Wearing orthokeratology lens for a long time may change the corneal morphology and the intraocular structure which can control the growth of the eye axis,reduce the corneal curvature and make the central cornea flattening and thinning.
引文
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