蒋伟+钱晓文

【摘要】 目的：通過研究对比分析青少年轻中度近视患者配戴夜戴型角膜塑形镜及框架眼镜对近视的控制的临床效果，探讨夜戴角膜塑形镜片的有效性以及安全性。方法：利用随机抽样法选取本院2015年2月-2016年2月的92例（184眼）青少年轻中度近视患者，分为角膜塑形镜组和框架眼镜组，各46例（92眼）。角膜塑形镜组配戴夜型戴角膜塑形镜，框架眼镜组配戴普通框架型眼镜。观察使用夜戴型角膜塑形镜组的戴镜时间为8 h左右，测得配戴夜戴型角膜塑形镜后1周内以及1、2、6、12个月患者的角膜曲率、视力、眼轴增长量、裸眼视力的结果，同时记录框架眼镜组46例青少年中度近视患者相应的结果进行对比分析。结果：配戴1周内以及1、2、6、12个月后，角膜塑形镜组患者的裸眼视力显著高于框架眼镜组（P<0.05）。配戴12个月后，角膜塑形组的眼轴增长量明显小于框架眼镜组（P<0.05）。配戴12个月后，角膜塑形镜组的水平曲率、垂直曲率均显著低于配戴前，差异均有统计学意义（P<0.05），且均低于框架眼镜组，差异均有统计学意义（P<0.05）。角膜塑形镜组的角膜上皮点染发生率为27.17%（25/92），高于框架眼镜的4.35%（4/92），差异有统计学意义（P<0.05）。结论：运用佩戴夜戴型角膜塑形镜对控制轻中度近视有着良好的效果，但是同时要严格按照规范进行指导患者及家属，及时到门诊复查，尽量避免验配过程中的风险，通过严谨的验配技术能够确保戴镜安全。

【关键词】 角膜塑形镜； 夜戴； 青少年近视； 角膜厚度； 角膜曲率； 眼轴长度

Clinical Efficacy and Safety of Orthokeratology in the Treatment of Juvenile Mild to Moderate Myopia/JIANG Wei，QIAN Xiao-wen.//Medical Innovation of China，2017，14（27）：052-055

【Abstract】 Objective：To investigate the clinical efficacy of wearing orthokeratology lenses and frame glasses in the treatment of myopia in adolescents with mild to moderate myopia，and to investigate the effectiveness and safety of orthokeratology lenses.Method：A total of 92 patients（184 eyes）with mild to moderate myopia in our hospital from February 2015 to February 2016 were randomly selected，the patients were randomly divided into orthokeratology group and frame glasses group，46 cases（92 eyes）in each group.The orthokeratology group wore a nocturnal orthokeratology lens and the frame glasses group wore plain frame glasses.The time of wearing glasses in the orthokeratology group was about 8 h，measured wearing a night wear type keratoplasty 1 week and after 1，2，6，12 months of patients corneal curvature，visual acuity，axial growth，uncorrected visual acuity，and 46 patients in the frame glasses were compared with the corresponding results.Result：In the 1 week and 1，2，6，12 months，the uncorrected visual acuity in the orthokeratology group were significantly higher than those in frame glasses group （P<0.05）.After wearing 12 months，cthe axial growth of orthokeratology group was significantly smaller than that of frame glasses group（P<0.05）.After wearing 12 months，the horizontal curvature and vertical curvature of orthokeratology group were significantly lower than those before wearing，the differences were statistically significant （P<0.05），and both were lower than those of frame glasses group，the differences were statistically significant（P<0.05）.The incidence of corneal epithelium dianran in orthokeratology group was 27.17%（25/92），higher than 4.35%（4/92） of frame glasses group，the difference was statistically significant（P<0.05）.Conclusion：The use of night wear type corneal plastic mirror to control myopia has a good effect，but also pay attention to fitting the process of risk，in strict accordance with the operating norms to operate，through rigorous fitting technology to ensure wearing glasses safety.endprint

【Key words】 Corneal mirror； Night wear type； Adolescent myopia； Corneal thickness； Corneal curvature； Axial length

First-authors address：Wujin Peoples Hospital of Changzhou，Changzhou 213000，China

doi：10.3969/j.issn.1674-4985.2017.27.015

在临床治疗过程中，从离焦学说导致近视发展的理论出发，普遍认为运用角膜塑形镜将能够有效的预防远视性离焦[1]。角膜塑形镜是一种硬性角膜接触镜，其由高透氧材料制成，治疗原理是重塑角膜形态，将角膜中央区变平，提升角膜曲率半径，降低角膜的屈光度，进而矫治近视[2-3]。但是因为在佩戴的过程中一直对角膜实施机械压迫的状态，会对角膜造成损伤。本研究中对本院接受角膜塑形镜治疗的46例青少年患者及46例戴框架眼镜的青少年患者开展临床观察与分析，探讨角膜塑形镜对矫治青少年轻中度近视的有效性以及安全性，现报道如下。……