夜戴型角膜塑形镜对视觉质量影响探讨

Clinical research on overnight orthokeratology for vision quality

摘要:

目的：探讨近视患者配戴角膜塑形镜(orthokeratology，Ortho-K镜)前后视觉质量的变化情况。

方法：选取江苏省溧阳市中医院眼科验配角膜塑形镜55例110眼青少年近视患者，在戴镜前、戴镜后7d，1、3、6mo五个时间点利用OQASTMⅡ视觉质量分析系统和Topolyzer角膜地形图进行检测，分别获得各参数：眼散射指数(optical scattering index，OSI)、MTF截止频率(MTF cut off)、斯特列尔比(Strehl ratio)、OQAS值(OV100%、OV20%、OV9%)、高度不对称性指数(index of highest asymmetry，IHA)、高度离心指数(index of highest decentration，IHD)和不规则指数(aberration coefficient，ABR)。

结果：角膜塑形镜戴镜前裸眼视力为0.21±0.13，戴镜后7d，1、3、6mo分别为0.48±0.15、0.72±0.14、0.93±0.13、1.02±0.13，差异有统计学意义(P<0.05)。OSI配戴前与配戴后1、3、6mo比较具有统计学差异(P<0.05)。MTF cut off配戴前与配戴后1、3、6mo比较具有统计学差异(P<0.05)。Strehl ratio配戴前与配戴后1、3、6mo比较具有统计学差异(P<0.05)。OV9%配戴前与配戴后1、3、6mo比较具有统计学差异(P<0.05)。IHA配戴前与配戴后1、3、6mo分别为4.13±3.59 、19.11±15.38、17.78±17.12、34.18±23.34，与配戴前相比差异均有统计学意义(P<0.05)。IHD配戴前与配戴后7d，1、3、6mo分别为0、0.02±0.01、0.02±0.02、0.03±0.02、0.03±0.01，与配戴前相比差异均有统计学意义(P<0.05)。ABR配戴前与配戴后7d，6mo分别为0.29±0.51、1.23±0.71、2.10±0.59，与配戴前相比差异均有统计学意义(P<0.05)。

结论：夜戴型角膜塑形镜可引起视觉质量的下降，但下降程度轻微。角膜塑形镜治疗青少年初发性近视效果确切，角膜塑形镜能快速、有效地提高裸眼视力，在控制青少年近视发展方面是值得肯定的。

Abstract:

AIM:To explore the changes of visual quality in myopic eyes undergoing overnight orthokeratology.

METHODS:Fifty-five myopia adolescents(110 eyes)were recruited. Optical scattering index(OSI),MTF cut off, Strehl ratio, OQAS value(OV100%、OV20%、OV9%), index of highest asymmetry(IHA),index of highest decentration(IHD),aberration coefficient(ABR)were performed before and 1wk,1,3 and 6mo after wearing orthokeratology with OQASTMⅡ and corneal topography.

RESULTS:The uncorrected visual acuity(UCVA)before wearing orthokeratology lens was 0.21±0.13,but at 1wk,1,3 and 6mo after wearing were 0.48±0.15,0.72±0.14,0.93±0.13 and 1.02±0.13,respectively,and there were statistical differences before and after wearing(P<0.05).On OSI after wearing at 1,3 and 6mo compared with that before wearing, there were significant differences(P<0.05).On MTF cut off after wearing at 1,3 and 6mo compared with that before wearing, there were significant differences(P<0.05).On Strehl ratio after wearing at 1,3 and 6 mo compared with that before wearing, there were significant differences(P<0.05).On OV9% after wearing at 1,3,6 mo compared with that before wearing, there were significant differences(P<0.05).IHA were 4.13±3.59, 19.11±15.38, 17.78±17.12, 34.18±23.34 before and 1, 3 and 6 mo after wearing. Compared with that before wearing, IHA significantly increased(P<0.05). IHD were 0, 0.02±0.01, 0.02±0.02, 0.03±0.02, 0.03±0.01 before and 1wk,1, 3 and 6mo after wearing. Compared with that before wearing, IHD were significantly increased(P<0.05). ABR were 0.29±0.51, 1.23±0.71, 2.10±0.59 before and 1wk and 6mo after wearing. Compared with that before wearing, ABR were significantly decreased(P<0.05).

CONCLUSION:Orthokeratology deteriorates vision quality. But the loss is acceptable. Orthokeratology can improve UCVA quickly and effectively. It is worth of affirmation on control of myopia.