目的:观察角膜塑形镜治疗近视的临床效果和并发症,并分析其相关因素。方法:选择由三个眼科中心提供的配戴角膜塑形镜的病历资料,患者共302例601眼,观察戴镜后1wk;1,3mo的裸眼视力、屈光状态、ORBSCAN检查、角膜荧光素染色裂隙灯显微镜检查的情况。所有观察病例的治疗前设为自身对照组。结果:戴镜后1wk;1,3mo的裸眼视力分别与戴镜前裸眼视力比,均有统计学意义(t=-95.920,-77.710,-65.362;P<0.01,<0.01,<0.01);戴镜后1wk;1,3mo的裸眼视力与戴镜前矫正视力1wk;1,3mo比,均无统计学意义(t=-1.364,0.599,0.581;P=0.174,0.550,0.562);戴镜后1wk;1,3mo的角膜前表面水平向曲率与戴镜前角膜前表面水平向曲率比,均有显著统计学意义(t=26.020,20.143,17.476;P<0.01,<0.01,<0.01);戴镜后1wk;1,3,6mo的角膜前表面垂直向曲率与戴镜前角膜前表面垂直向曲率比,均有显著统计学意义(t=22.505,20.626,21.667,25.397;P<0.01,<0.01,<0.01,<0.01);发生角膜上皮点状脱落和角膜中央明显压痕的病例在1wk时占7.5%,1mo时占6%,3mo占9.8%,其中反复出现角膜上皮点染和明显压痕的占2.5%。结论:角膜塑形镜治疗近视具有特有的降低近视度数速度快、效果显著、安全、可逆的优势,但矫正近视度有一定适用范围。

·AIM:To observe the clinical effects and complications of orthokeratology lens for myopia,and to analyze the relevant factors.·METHODS:The medical records of orthokeratology lens wearer 302 cases 601 eyes from three eye centers were analyed and the uncorrected visual acuity,refractive status,Orbscan examination,fluorescein staining 1 week;1 month,3 months after wearing glasses were observed.The condition of all patients before treatment was regarded as control group.·RESULTS:There was significant difference 1 week;1 month,3 months after wearing glasses compared with before wearing glasses in uncorrected visual acuity(t=-95.920,-77.710,-65.362;P<0.01,<0.01,<0.01),the anterior corneal surface horizontal curvature(t=26.020,20.143,17.476;P<0.01,<0.01,<0.01)and there was significant difference 1 week,1 month,3,6 months after wearing glasses compared with before wearing glasses in the anterior corneal surface perpendicular curvature(t=22.505,20.626,21.667,25.397;P<0.01,<0.01,<0.01,<0.01);However,There were no significant difference in uncorrected visual acuity 1 week;1 month,3 months after wearing glasses compared with the corrected visual acuity before wearing glasses.(t=-1.364,0.599,0.581;P=0.174,0.550,0.562);The punctate loss of corneal epithelium and indentation of center cornea appeared in 1 week was 7.5%,1 month 6%,3 months 9.8%,of which recurrence ratio was 2.5%.·CONCLUSION:Orthokeratology has the quick,effective,safe,and reversible advantages for myopia,whereas it has certain applicability for correction of myopia.·

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