角膜塑形镜与框架眼镜对青少年近视患者眼部参数的影响

Orthokeratology lens and conventional frame glasses for ocular parameters of myopia adolescent

摘要:

目的：探讨夜戴型角膜塑形镜与常规框架眼镜对青少年近视患者屈光度、裸眼视力及眼球参数的影响。

方法：选取2014-04/2017-04在我院眼科就诊的青少年近视患者102例204眼，随机分为观察组和对照组，各51例102眼，对照组仅给予常规框架眼镜配戴治疗，观察组给予夜戴型角膜塑形镜治疗。观察两组患者戴镜前和戴镜1wk，1、3、6mo，1a后屈光度和裸眼视力(UCVA)； 戴镜前和戴镜1a后眼球参数情况； 随访1a，观察两组患者并发症发生情况。

结果：戴镜1wk，1、3、6mo，1a，观察组患者屈光度呈逐渐降低趋势，与戴镜前比较差异均有统计学意义(P<0.05)，对照组患者屈光度与戴镜前比较，差异均无统计学意义(P>0.05)，但两组之间比较，差异均有统计学意义(P<0.05)。戴镜1wk，1、3、6mo，1a，观察组患者UCVA呈逐渐升高趋势，与戴镜前比较差异均有统计学意义(P<0.05)； 对照组患者戴镜6mo，1a UCVA升高趋势不显著，且戴镜6mo，1a，观察组患者UCVA显著高于对照组(P<0.05)。戴镜1a，观察组患者的眼轴长度、角膜内皮细胞密度、中央前房深度及眼压与戴镜前相比，差异均无统计学意义(P>0.05)，而对照组患者的眼轴长度显著长于本组患者戴镜前及观察组患者戴镜1a的眼轴长度，差异均有统计学意义(P<0.05)。随访1a，观察组和对照组患者并发症总发生率分别为10.8%和6.9%，差异无统计学意义(P>0.05)。

结论：夜戴型角膜塑形镜治疗青少年近视，可有效矫正患者近视屈光度，提高裸眼视力，对眼球损伤小，并发症少，临床应用安全可靠。

Abstract:

AIM: To explore the effects of overnight orthokeratology lens and conventional frame glasses on the myopic diopter, uncorrected visual acuity and ocular parameters of myopia adolescent.

METHODS: Totally 102 cases of(204 eyes)of adolescent myopia patients were randomly divided into observation group and control group with 51 cases(102 eyes)in each group during April 2014 to April 2017. Control group was only given conventional frame glasses, and observation group was given overnight orthokeratology lens. The myopic diopter and uncorrected visual acuity(UCVA)before wearing glasses and at 1wk, 1, 3, 6mo and 1a of wearing glasses, and the ocular parameters before wearing glasses and at 1a after wearing glasses were observed in the two groups, and the occurrence of complications was compared between the two groups.

RESULTS: After 1wk to 1a of wearing glasses, the myopic diopter in observation group was gradually decreased(P<0.05), and there was no significant difference in control group(P>0.05), but there was statistically significant difference between-groups at different time points(P<0.05). After 1wk to 1a of wearing glasses, the UCVA in observation group showed a increasing tendency(P<0.05), and the UCVA in observation group after 6mo to 1a of wearing glasses was significantly higher than that in control group(P<0.05). At 1a after wearing glasses, the axial length, corneal endothelial cell density, central anterior chamber depth, and intraocular pressure in observation group were not significantly different from those before wearing glasses(P>0.05), and the axial length in control group was significantly longer than that before wearing glasses and that in observation group(P<0.05). The total incidence rates of complications in observation group and control group were 10.8% and 6.9% respectively(P>0.05).

CONCLUSION: Overnight orthokeratology lens for adolescent myopia can effectively correct the myopic diopter, and improve the uncorrected visual acuity. It is less harmful to the eyes and less complications, and it is safe and reliable in clinical application.