方　民，杨　柳，瞿远珍



·临床研究·

夜戴型角膜塑形镜对青少年近视患者眼球参数的短期影响

方民，杨柳，瞿远珍

Short-term effects of overnight orthokeratology on parameters of eye ballin myopia teenagers

Min Fang, Liu Yang, Yuan-Zhen Qu

Foundation items:High-level Talent Trainning Project of the Beijing Health System (No.2013-03-051);Scientific and Technological Achievements and Appropriate Technology Promotion Project of the Beijing Health and Family Planning Commission(No.TG-2015-15)

Department of Ophthalmology, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100050, China

Correspondence to:Liu Yang. Department of Ophthalmology, Beijing Tian Tan Hospital, Capital Medical University, Beijing 100050, China.yingziyangliu@126.com

Received：2015-12-17Accepted：2016-03-17

Abstract

•AIM: To evaluate the changes of corneal endothelium density, central corneal thickness, corneal curvature and eye axial length for teenager myopia patients after wearing orthokeratology over night for 6mo.

•METHODS: Retrospective case-observational study was adopted.Forty-four myopia teenagers (86 eyes) aged 7～17 wearing overnight orthokeratology contact lens were observed and analyzed using ultrasonic diagnostic apparatus, non-contact corneal endothelial microscope and corneal topography. Changes and relative coefficient of corneal endothelium density, central corneal thickness, corneal curvature and eye axial length were examined before and after wearing overnight orthokeratology contact lens for 6mo.

•RESULTS：After wearing over night orthokeratology contact lens half a year, visual acuity was stable at 1.0～1.2 without serious complications. No significant differences were found in the density of corneal endothelial cells, corneal curvature and depth of anterior chamber comparing to before wearing. Central cornea thickness was smaller and length of eye axis increased after wearing for 6mo and significant differences were seen(P<0.05). The coefficient of variation was observed between density of corneal endothelial cells and length of eye axis(right eye：P=0.005，left eye：P=0.013), central cornea thickness and length of eye axis(right eye：P=0.019，left eye：P=0.006)after wearing orthokeratology contact lens for 6mo.

•CONCLUSION：After wearing overnight orthokeratology for 6mo, eye axis length still increased, corneal endothelial cells density decreased and central cornea thickness thinned.

KEYWORDS:•overnight orthokeratology contact lens;corneal parameters;short-term; teenagers; myopia

Citation:Fang M, Yang L, Qu YZ.Short-term effects of overnight orthokeratology on parameters of eye ball in myopia teenagers.GuojiYankeZazhi(IntEyeSci) 2016;16(4):729-731

摘要

关键词：夜戴型角膜塑形镜；角膜参数；短期；青少年；近视

引用：方民，杨柳，瞿远珍.夜戴型角膜塑形镜对青少年近视患者眼球参数的短期影响.国际眼科杂志2016;16(4):729-731

0引言

角膜塑形镜(orthokerotology)是一种高透氧性材料制成的特殊类型的硬性角膜接触镜，是一种通过非手术途径矫正或控制青少年近视发展的有效方式。通过为青少年配戴夜戴型角膜塑形镜，白天裸眼视力可以达到或接近正常视力[1]。角膜塑形镜控制青少年近视发展的机制之一是近视离焦原理，它采用四区多弧的设计，利用泪液的流体力学效应和眼睑对角膜自然的推拉力学原理，使得角膜中央区逐渐平缓化，合理塑造了角膜的形态，入射光在角膜中央区重新聚焦在视网膜上，从而提高了裸眼视力，通过非手术方式达到矫正或控制近视的发展。本研究旨在观察青少年近视患者配戴夜戴型角膜塑形镜6mo并停戴3wk后，角膜中央厚度、角膜曲率、角膜内皮细胞密度和眼轴长度等参数与戴镜前的变化及各参数之间的相关性。

1对象和方法

1.1对象收集2013-08/2015-08在我院配戴夜戴型角膜塑形镜治疗近视的青少年患者44例86眼，其中男22例42眼(有2眼为平光)，女22例44眼；年龄7～17(平均12.37±3.26)岁；近视屈光度：右眼-1.00～-10.25(平均-4.05±2.15)D，左眼-0.50～-10.25(平均-3.74±2.18)D；散光度：右眼-0.5～-2.25(平均-0.88±0.53)D，左眼-0.5～-1.75(平均-1.03±0.49)D。患者入选标准：(1)年龄≤18岁，经培训后可以熟练自行配戴角膜塑形镜者；……