角膜塑形术矫治近视的安全性和有效性研究进展
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摘要
目的角膜塑形术矫治近视是目前矫正视力和控制近视增长的重要手段。近年来随着角膜塑形镜镜片的设计和材料不断改进,验配过程不断规范,该技术逐步成熟化,已经成为一种矫正视力和控制近视增长安全有效的方法。但由于角膜塑形镜的夜戴方式以及对角膜的塑形作用,临床问题也可能会随之产生,因此该技术的安全性、有效性仍不容忽视,仍需大量临床研究来证实。本文结合目前国内外的研究进展,就其矫治近视的安全性和有效性进行综述。
The treatment of myopia with orthokeratology is an important means to correct vision and control the progression of myopia. In recent years,with the continuous improvement of the design and materials of orthokeratology lens and the standardization of the matching process,this technology has gradually matured and become a safe and effective method to correct vision and control the growth of myopia.However,due to the night wearing mode and its shaping effect on the cornea,clinical problems may also arise. Therefore,the safety and effectiveness of this technology cannot be ignored and still needs a lot of clinical research to confirm. This paper summarized the safety and effectiveness of orthokeratology for the treatment of myopia based on the current research progress at home and abroad.
The treatment of myopia with orthokeratology is an important means to correct vision and control the progression of myopia. In recent years,with the continuous improvement of the design and materials of orthokeratology lens and the standardization of the matching process,this technology has gradually matured and become a safe and effective method to correct vision and control the growth of myopia.However,due to the night wearing mode and its shaping effect on the cornea,clinical problems may also arise. Therefore,the safety and effectiveness of this technology cannot be ignored and still needs a lot of clinical research to confirm. This paper summarized the safety and effectiveness of orthokeratology for the treatment of myopia based on the current research progress at home and abroad.
引文
[1]中华医学会眼科学分会眼视光学组.角膜塑形术的临床风险防控指南(2017)[J].中华眼视光学与视觉科学杂志,2017,19(8):449-453.doi:10.3760/cma.j.issn.1674-845X.2017.08.001.
[2]姜珺,陈云云,吴戈,等.不同矫正方式对儿童近视控制的效果[J].中华眼视光学与视觉科学杂志,2014,16(2):73-77.doi:10.3760/cma.j.issn.1674-845X.2014.02.003.
[3]毛欣杰,黄橙赤,陈琳,等.角膜塑形术治疗近视眼安全性的探讨[J].中华眼科杂志,2010,46(3):209-213.doi:10.3760/cma.j.issn.0412-4081.2010.03.004.
[4]Nieto-Bona A,González-Mesa A,Nieto-Bona MP,et al.Long-term changes in corneal morphology induced by overnight orthokeratology[J].Curr Eye Res,2011,36(10):895-904.doi:10.3109/02713683.2011.593723.
[5]栗莉,亢晓丽,王方,等.儿童长期佩戴角膜塑形镜的角膜内皮状态评估[J].中华实验眼科杂志,2013,31(12):1152-1154.doi:10.3760/cma.j.issn.2095-0160.2013.12.012.
[6]杜亚茹,梁秀玮,危清泉,等.角膜塑形镜对青少年中低度近视患者角膜厚度和角膜内皮的影响[J].同济大学学报(医学版),2017,38(3):66-69.doi:10.16118/j.1008-0392.2017.03.013.
[7]王平,姜德咏.青少年儿童角膜内皮细胞随年龄变化规律分析[J].国际眼科杂志,2004,4(3):438-440.doi:10.16118/j.1008-0392.2017.03.013.
[8]冯浩雁,汪芳润.OK镜临床应用中的异常现象分析[J].中国实用眼科杂志,2001,19(4):258-259.doi:10.3760/cma.j.issn.1006-4443.2001.04.007.
[9]李健,董平,王承昕,等.夜戴型角膜塑形镜对角膜形态及泪液的影响[J].国际眼科杂志,2015,15(2):205-207.doi:10.3980/i.issn.1672-5123.2015.2.05.
[10]Swarbrick HA.Orthokeratology(corneal refractive therapy):what is it and how does it work?[J].Eye Contact Lens,2004,30(4):181-185.doi:10.1097/01.ICL.0000140221.41806.6E.
[11]Kang P,Swarbrick H.Time course of the effects of orthokeratology on peripheral refraction and corneal topography[J].Ophthalmic Physiol Opt,2013,33(3):277-282.doi:10.1111/opo.12027.
[12]Cho P,Cheung SW,Edwards M.The longitudinal orthokeratology research in children(LORIC)in Hong Kong:a pilot study on refractive changes and myopic control[J].Curr Eye Res,2005,30(1):71-80.doi:10.1080/02713680590907256.
[13]谢培英.角膜塑形术的“8A工程”[J].中华眼视光学与视觉科学杂志,2013,15(2):65-68.doi:10.3760/cma.j.issn.1674-845X.2013.02.001.
[14]周籽秀,徐珊珊,易省平.角膜塑形镜矫治青少年近视散光的疗效及对角膜内皮细胞的影响[J].国际眼科杂志,2016,16(8):1525-1527.doi:10.3980/j.issn.1672-5123.2016.8.32.
[15]丁磊,王华德,张清生.角膜塑形术对近视患者立体视觉和调节参数及眼生物学参数的影响[J].国际眼科杂志,2018,18(5):901-903.doi:10.3980/j.issn.1672-5123.2018.5.33.
[16]牛燕,李斌,姬娜.角膜塑形镜治疗青少年中度近视的临床观察[J].中华眼视光学与视觉科学杂志,2014,16(2):92-94.doi:10.3760/cma.j.issn.1674-845X.2014.02.008.
[17]于青,吴江秀,张静,等.角膜塑形镜的临床疗效及安全性[J].中华眼视光学与视觉科学杂志,2016,18(2):93-97.doi:10.3760/cma.j.issn.1674-845X.2016.02.007.
[18]谢培英,王志昕,迟蕙.少年儿童近视的长期角膜塑形疗效和安全性观察[J].中国斜视与小儿眼科杂志,2008,16(4):145-152.doi:10.3969/j.issn.1005-328X.2008.04.001.
[19]Lee YC,Wang JH,Chiu CJ.Effect of orthokeratology on myopia progression:twelve-year results of a retrospective cohort study[J].BMC Ophthalmol,2017,17(1):243.doi:10.1186/s12886-017-0639-4.
[20]吴杨杨.角膜塑形镜对高度近视患者矫正效果的Meta分析[J].国际眼科杂志,2016,16(4):647-650.doi:10.3980/j.issn.1672-5123.2016.4.14.
[21]Charm J,Cho P.High myopia-partial reduction ortho-k:a 2-year randomized study[J].Optom Vis Sci,2013,90(6):530-539.doi:10.1097/OPX.0b013e318293657d.
[22]吕天斌,王丽娅,覃建,等.角膜塑形镜配戴矫治高度近视的回顾性队列研究[J].中华实验眼科杂志,2018,36(2):144-149.doi:10.3760/cma.j.issn.2095-0160.2018.02.014.
[23]雷蕾,张建华,郑磊,等.正视及低中度、高度近视人群明暗环境对比敏感度分析[J].眼科新进展,2008,28(8):604-606.doi:10.3969/j.issn.1003-5141.2008.08.013.
[24]Guo HC,Jin WQ,Pan AP,et al.Changes and diurnal variation of visual quality after orthokeratology in myopic children[J].J Ophthalmol,2018:1-10.doi:10.1155/2018/3174826.
[25]黄杨利,陈丽,金红燕,等.夜戴型角膜塑形镜对青少年近视对比敏感度的影响[J].国际眼科杂志,2015,15(11):1967-1969.doi:10.3980/j.issn.1672-5123.2015.11.35.
[26]Hiraoka T,Okamoto C,Ishii Y,et al.Time course of changes in ocular higher-order aberrations and contrast sensitivity after overnight orthokeratology[J].Invest Ophthalmol Vis Sci,2008,49(10):4314-4320.doi:10.1167/iovs.07-1586.
[27]林思思,陈镇国,王建勇,等.角膜塑形术后光学治疗区大小及偏心对光学及视觉质量的影响[J].中华眼视光学与视觉科学杂志,2018,20(9):530-535.doi:10.3760/cma.j.issn.1674-845X.2018.09.004.
[28]陈茹茹,陈岩,廉恒丽.角膜像差与角膜前表面Q值对角膜塑形术近视控制的影响[J].中华眼视光学与视觉科学杂志,2016,18(2):78-82.doi:10.3760/cma.j.issn.1674-845X.2016.02.004.
[29]Hiraoka T,Kakita T,Okamoto F,et al.Influence of ocular wavefront aberrations on axial length elongation in myopic children treated with overnight orthokeratology[J].Ophthalmology,2015,122(1):93-100.doi:10.1016/j.ophtha.2014.07.042.
[30]Hiraoka T,Mihashi T,Okamoto C,et al.Influence of induced decentered orthokeratology lens on ocular higher-order wavefront aberrations and contrast sensitivity function[J].J Cataract Refract Surg,2009,35(11):1918-1926.doi:10.1016/j.jcrs.2009.06.018.
[31]李晓柠,王琳琳,陈兆,等.光学治疗区偏心对角膜塑形镜配戴后角膜高阶像差及眼轴发育的影响[J].中华眼视光学与视觉科学杂志,2017,19(9):540-547.doi:10.3760/cma.j.issn.1674-845X.2017.09.005.
[32]吴从霞,毛欣杰,林惠玲,等.角膜塑形镜对近视眼调节微波动幅度和调节滞后的影响[J].中华眼视光学与视觉科学杂志,2013,15(2):75-78.doi:10.3760/cma.j.issn.1674-845X.2013.02.004.
[33]任秋锦,岳辉,周清.角膜塑形镜对调节滞后及调节性集合与调节的比值的影响[J].中南大学学报:医学版,2016,41(2):169-173.doi:10.1 1817/j.issn.1672-7347.2016.02.009.
[34]蓝方方,赵武校,甘露.角膜塑形镜对青少年近视眼调节参数的影响[J].中国临床新医学,2017,10(1):15-18.doi:10.3969/j.issn.1674-3806.2017.01.0.
[35]刘维锋,胡爱梅,徐志红,等.角膜塑形术对眼视觉质量、调节功能的动态影响[J].眼科新进展,2015,35(12):1177-1180.doi:10.13389/j.cnki.rao.2015.0322.
[36]Schmid KL,Strang NC.Differences in the accommodation stimulus response curves of adult myopes and emmetropes:a summary and update[J].Ophthalmic Physiol Opt,2015,35(6):613-621.doi:10.1111/opo.12255.
[2]姜珺,陈云云,吴戈,等.不同矫正方式对儿童近视控制的效果[J].中华眼视光学与视觉科学杂志,2014,16(2):73-77.doi:10.3760/cma.j.issn.1674-845X.2014.02.003.
[3]毛欣杰,黄橙赤,陈琳,等.角膜塑形术治疗近视眼安全性的探讨[J].中华眼科杂志,2010,46(3):209-213.doi:10.3760/cma.j.issn.0412-4081.2010.03.004.
[4]Nieto-Bona A,González-Mesa A,Nieto-Bona MP,et al.Long-term changes in corneal morphology induced by overnight orthokeratology[J].Curr Eye Res,2011,36(10):895-904.doi:10.3109/02713683.2011.593723.
[5]栗莉,亢晓丽,王方,等.儿童长期佩戴角膜塑形镜的角膜内皮状态评估[J].中华实验眼科杂志,2013,31(12):1152-1154.doi:10.3760/cma.j.issn.2095-0160.2013.12.012.
[6]杜亚茹,梁秀玮,危清泉,等.角膜塑形镜对青少年中低度近视患者角膜厚度和角膜内皮的影响[J].同济大学学报(医学版),2017,38(3):66-69.doi:10.16118/j.1008-0392.2017.03.013.
[7]王平,姜德咏.青少年儿童角膜内皮细胞随年龄变化规律分析[J].国际眼科杂志,2004,4(3):438-440.doi:10.16118/j.1008-0392.2017.03.013.
[8]冯浩雁,汪芳润.OK镜临床应用中的异常现象分析[J].中国实用眼科杂志,2001,19(4):258-259.doi:10.3760/cma.j.issn.1006-4443.2001.04.007.
[9]李健,董平,王承昕,等.夜戴型角膜塑形镜对角膜形态及泪液的影响[J].国际眼科杂志,2015,15(2):205-207.doi:10.3980/i.issn.1672-5123.2015.2.05.
[10]Swarbrick HA.Orthokeratology(corneal refractive therapy):what is it and how does it work?[J].Eye Contact Lens,2004,30(4):181-185.doi:10.1097/01.ICL.0000140221.41806.6E.
[11]Kang P,Swarbrick H.Time course of the effects of orthokeratology on peripheral refraction and corneal topography[J].Ophthalmic Physiol Opt,2013,33(3):277-282.doi:10.1111/opo.12027.
[12]Cho P,Cheung SW,Edwards M.The longitudinal orthokeratology research in children(LORIC)in Hong Kong:a pilot study on refractive changes and myopic control[J].Curr Eye Res,2005,30(1):71-80.doi:10.1080/02713680590907256.
[13]谢培英.角膜塑形术的“8A工程”[J].中华眼视光学与视觉科学杂志,2013,15(2):65-68.doi:10.3760/cma.j.issn.1674-845X.2013.02.001.
[14]周籽秀,徐珊珊,易省平.角膜塑形镜矫治青少年近视散光的疗效及对角膜内皮细胞的影响[J].国际眼科杂志,2016,16(8):1525-1527.doi:10.3980/j.issn.1672-5123.2016.8.32.
[15]丁磊,王华德,张清生.角膜塑形术对近视患者立体视觉和调节参数及眼生物学参数的影响[J].国际眼科杂志,2018,18(5):901-903.doi:10.3980/j.issn.1672-5123.2018.5.33.
[16]牛燕,李斌,姬娜.角膜塑形镜治疗青少年中度近视的临床观察[J].中华眼视光学与视觉科学杂志,2014,16(2):92-94.doi:10.3760/cma.j.issn.1674-845X.2014.02.008.
[17]于青,吴江秀,张静,等.角膜塑形镜的临床疗效及安全性[J].中华眼视光学与视觉科学杂志,2016,18(2):93-97.doi:10.3760/cma.j.issn.1674-845X.2016.02.007.
[18]谢培英,王志昕,迟蕙.少年儿童近视的长期角膜塑形疗效和安全性观察[J].中国斜视与小儿眼科杂志,2008,16(4):145-152.doi:10.3969/j.issn.1005-328X.2008.04.001.
[19]Lee YC,Wang JH,Chiu CJ.Effect of orthokeratology on myopia progression:twelve-year results of a retrospective cohort study[J].BMC Ophthalmol,2017,17(1):243.doi:10.1186/s12886-017-0639-4.
[20]吴杨杨.角膜塑形镜对高度近视患者矫正效果的Meta分析[J].国际眼科杂志,2016,16(4):647-650.doi:10.3980/j.issn.1672-5123.2016.4.14.
[21]Charm J,Cho P.High myopia-partial reduction ortho-k:a 2-year randomized study[J].Optom Vis Sci,2013,90(6):530-539.doi:10.1097/OPX.0b013e318293657d.
[22]吕天斌,王丽娅,覃建,等.角膜塑形镜配戴矫治高度近视的回顾性队列研究[J].中华实验眼科杂志,2018,36(2):144-149.doi:10.3760/cma.j.issn.2095-0160.2018.02.014.
[23]雷蕾,张建华,郑磊,等.正视及低中度、高度近视人群明暗环境对比敏感度分析[J].眼科新进展,2008,28(8):604-606.doi:10.3969/j.issn.1003-5141.2008.08.013.
[24]Guo HC,Jin WQ,Pan AP,et al.Changes and diurnal variation of visual quality after orthokeratology in myopic children[J].J Ophthalmol,2018:1-10.doi:10.1155/2018/3174826.
[25]黄杨利,陈丽,金红燕,等.夜戴型角膜塑形镜对青少年近视对比敏感度的影响[J].国际眼科杂志,2015,15(11):1967-1969.doi:10.3980/j.issn.1672-5123.2015.11.35.
[26]Hiraoka T,Okamoto C,Ishii Y,et al.Time course of changes in ocular higher-order aberrations and contrast sensitivity after overnight orthokeratology[J].Invest Ophthalmol Vis Sci,2008,49(10):4314-4320.doi:10.1167/iovs.07-1586.
[27]林思思,陈镇国,王建勇,等.角膜塑形术后光学治疗区大小及偏心对光学及视觉质量的影响[J].中华眼视光学与视觉科学杂志,2018,20(9):530-535.doi:10.3760/cma.j.issn.1674-845X.2018.09.004.
[28]陈茹茹,陈岩,廉恒丽.角膜像差与角膜前表面Q值对角膜塑形术近视控制的影响[J].中华眼视光学与视觉科学杂志,2016,18(2):78-82.doi:10.3760/cma.j.issn.1674-845X.2016.02.004.
[29]Hiraoka T,Kakita T,Okamoto F,et al.Influence of ocular wavefront aberrations on axial length elongation in myopic children treated with overnight orthokeratology[J].Ophthalmology,2015,122(1):93-100.doi:10.1016/j.ophtha.2014.07.042.
[30]Hiraoka T,Mihashi T,Okamoto C,et al.Influence of induced decentered orthokeratology lens on ocular higher-order wavefront aberrations and contrast sensitivity function[J].J Cataract Refract Surg,2009,35(11):1918-1926.doi:10.1016/j.jcrs.2009.06.018.
[31]李晓柠,王琳琳,陈兆,等.光学治疗区偏心对角膜塑形镜配戴后角膜高阶像差及眼轴发育的影响[J].中华眼视光学与视觉科学杂志,2017,19(9):540-547.doi:10.3760/cma.j.issn.1674-845X.2017.09.005.
[32]吴从霞,毛欣杰,林惠玲,等.角膜塑形镜对近视眼调节微波动幅度和调节滞后的影响[J].中华眼视光学与视觉科学杂志,2013,15(2):75-78.doi:10.3760/cma.j.issn.1674-845X.2013.02.004.
[33]任秋锦,岳辉,周清.角膜塑形镜对调节滞后及调节性集合与调节的比值的影响[J].中南大学学报:医学版,2016,41(2):169-173.doi:10.1 1817/j.issn.1672-7347.2016.02.009.
[34]蓝方方,赵武校,甘露.角膜塑形镜对青少年近视眼调节参数的影响[J].中国临床新医学,2017,10(1):15-18.doi:10.3969/j.issn.1674-3806.2017.01.0.
[35]刘维锋,胡爱梅,徐志红,等.角膜塑形术对眼视觉质量、调节功能的动态影响[J].眼科新进展,2015,35(12):1177-1180.doi:10.13389/j.cnki.rao.2015.0322.
[36]Schmid KL,Strang NC.Differences in the accommodation stimulus response curves of adult myopes and emmetropes:a summary and update[J].Ophthalmic Physiol Opt,2015,35(6):613-621.doi:10.1111/opo.12255.