目的：观察数字化角膜地形图验配的角膜塑形镜(OK镜)带来的角膜塑形区偏心量以及早期对角膜高阶像差的影响趋势。

方法：回顾性纵向临床研究。纳入西安市第一医院激光近视治疗中心自2023年以来配戴数字化验配的OK镜患者28例28眼(均取右眼)。纵向研究观察塑形前和后1 wk，1、3 mo有效光学区(TZ)直径、偏心量的变化以及TZ偏心状态，观察戴镜前后角膜高阶像差的变化，分析偏心量与各角膜高阶像差的相关性。

结果：纳入患者平均年龄10.29±2.00岁； 男15例，女13例； 等效球镜为-2.92±0.94 D。戴镜后1 wk，1、3 mo，TZ直径分别为3.64±0.58、3.83±0.57、3.69±0.55 mm，戴镜后1wk TZ直径与戴镜后3 mo比较无差异。戴镜后1 wk，1、3 mo，水平偏心量分别为-0.43±0.28、-0.38±0.33、-0.31±0.37 mm，垂直偏心量分别为-0.33±0.20、-0.33±0.23、-0.36±0.23 mm，偏心方向均为颞下方，戴镜后各时间点水平与垂直偏心量均无差异(F_水平=1.416，P_水平=0.252； F_垂直=0.126，P_垂直=0.882)。戴镜后5 mm角膜总高阶像差、彗差、球差均较戴镜前有显著增大(F=45.695、33.401、45.091，均P<0.001)。戴镜后1 wk，1 mo垂直偏心量与角膜总高阶像差、彗差均呈负相关(均P<0.05)，戴镜后3 mo水平偏心量与球差呈负相关(P=0.037)。

结论：数字化验配的OK镜TZ直径在1 wk后达到稳定，TZ中心呈现颞下方偏位且程度较小。戴镜后早期角膜总高阶像差、球差和彗差均增加，垂直向下偏心可引起角膜总高阶像差、彗差增大，戴镜后3 mo偏心量与角膜高阶像差相关性减弱。

METHODS: A retrospective longitudinal clinical study was conducted on 28 patients(28 right eyes)who were digitally fitted with OK lenses at the Laser Vision Center of Xi'an No.1 Hospital since 2023. Longitudinal measurements were taken at baseline, 1 wk, 1 and 3 mo post-treatment to assess changes in TZ diameter, decentration magnitude and direction. Furthermore, changes in corneal HOAs were observed, and correlations of decentration with each HOAs were also analyzed.

RESULTS: The mean age of patients was 10.29±2.00 years, with 15 males and 13 females, and the average baseline spherical equivalent was -2.92±0.94 D. The average TZ diameters at 1 wk, 1, and 3 mo were 3.64±0.58, 3.83±0.57, and 3.69±0.55 mm, respectively, with no statistically significant differences between 1 wk and 3 mo. Horizontal decentration values were -0.43±0.28, -0.38±0.33, and -0.31±0.37 mm after wearing lenses for 1 wk, 1 and 3 mo, respectively, while vertical decentration values were -0.33±0.20, -0.33±0.23, and -0.36±0.23 mm across the same time points. The TZ consistently decentered inferotemporally, and changes in both horizontal and vertical decentration over time were not statistically significant(F_horizontal=1.416, P_horizontal=0.252; F_vertical=0.126, P_vertical=0.882). Significant increases in total corneal HOAs, coma, and spherical aberration were observed at 5 mm optical zone post-wear(F=45.695, 33.401, and 45.091, all P<0.001). Vertical decentration at 1 wk and 1 mo was negatively correlated with total HOAs and coma(all P<0.05), while horizontal decentration at 3 mo showed a weak negative correlation with spherical aberration(P=0.037).

CONCLUSION: Digitally-fitted OK lenses achieved stable TZ diameter by 1 wk post-wear, with minor inferotemporal decentration. Early post-wear corneal total HOAs, coma and sphercal aberration increased significantly, and vertical downward decentration was associated with elevated total HOAs and coma. However, correlations between decentration and HOAs weakened by 3 mo.