角膜塑形镜治疗青少年中度近视的临床观察

摘要

目的 观察夜戴型角膜塑形镜治疗青少年中度近视的临床疗效,以及戴镜1年后屈光度、角膜厚度和眼轴的变化.方法 前瞻性临床研究.9～15岁的中度近视青少年患者87例(174眼),平均等效球镜度为(-4.13±0.74)D;37例配戴角膜塑形镜,戴镜前和戴镜后1周、1个月、3个月、6个月、1年随访裸眼视力、角膜曲率;测量并比较1年后等效球镜度、角膜厚度及眼轴的变化.50例配戴框架眼镜,测量并比较1年后等效球镜度、眼轴的变化.对相关数据进行重复测量的方差分析和独立样本￡检验.结果 角膜塑形镜组戴镜1年后停戴1个月等效球镜度为(-4.69±0.57)D;框架眼镜组戴镜1年后为(-4.72±0.80)D,塑形镜组和框架组1年等效球镜度分别增加(0.31±0.21)D、(0.77±0.46)D,两者比较差异有统计学意义(t=30.109,P＜0.01);眼轴增加分别为(0.11±0.26)mm、(0.26±0.60)mm,两者比较差异有统计学意义(t=18.565,P＜0.01).角膜塑形镜组戴镜前与1年后角膜厚度无差异.结论 角膜塑形镜治疗青少年中度近视效果确切;与框架眼镜相比,可明显减少近视增长,有效控制眼轴变长,一定程度上可以控制近视发展.%Objective To assess the clinical efficacy of orthokeratology in the treatment of adolescents with moderate myopia; to assess the changes in refraction,corneal thickness and axial length after 1 year of wear.Methods This was a prospective study.Thirty-seven young myopia patients (9-15 years old) were fitted with orthokeratology lenses and refraction,visual acuity,and corneal curvature were measured.Patients wore the ortokeratology lenses for one year and then were required to discontinue wearing the lenses.Fifty patients (9-15 years old) were fitted with spectacles for the same time period.The changes in refraction and axial length were measured one month after the discontinuation of lens wear.Data were analyzed using repeated measured ANOVA and independent t test.Results After 1 year,the spherical equivalent refractions were-4.69±0.57 D in the orthokeratology lens group and-4.72±0.80 D in the spectacle group.Increases in spherical equivalent refraction were 0.31±0.21 D and 0.77±0.46 D,respectively,in the two groups,indicating a statistically significant difference (t=30.109,P＜0.01).The axial length increases were 0.11±0.26 mm and 0.26±0.60 mm,respectively,in the two groups,indicating a statistically significant difference (t=18.565,P＜0.01).The corneal thickness in orthokeratology group before and 1 year after lens wear was insignificantly different.Conclusion Orthokeratology treatment for moderate myopia in adolescents can significantly improve visual acuity.The progression of myopia can be controlled to a certain extent.And the increase in axial length can be effectively controlled.