圆锥角膜患者人口统计学及临床特点分析

目的研究分析圆锥角膜患者人口统计学资料及临床特点。方法对2008年1月至2010年3月在我院就诊的圆锥角膜患者68例进行调查,其中男46例,女22例。收集患者的人口统计学资料、发病及治疗过程、家族史、全身疾病史等,对患者双眼的屈光状态、临床特点等进行比较、分析。结果统计发现该研究人群中圆锥角膜患病比率男性(67.6%)高于女性(32.4%,P<0.05),圆锥角膜确诊时的平均年龄是(26.00±8.91)岁(12.38～51.12岁),10.3%(7/68)的患者发病年龄小于18岁,57.4%(39/68)的患者发病年龄小于30岁;双眼确诊圆锥角膜的患者为39例(57.4%),单眼确诊、另一眼可疑圆锥角膜的患者为25例(36.8%),单眼确诊、另一眼正常的圆锥角膜患者为4例(5.9%);确诊圆锥角膜眼中角膜近中央局部膨出共计58眼,占圆锥角膜眼的59.2%,是最常见的临床体征,Fleischer’s环52眼(53.1%),Vogt’s条纹25眼(25.5%)。圆锥角膜眼的平均柱镜度数(-4.00±2.03)D明显高于可疑圆锥角膜眼(-2.20±1.41)D(P<0.001);LogMAR最佳矫正视力及就诊状态下的视力可疑圆锥角膜眼明显好于圆锥角膜眼(均为P<0.001)。结论本研究显示圆锥角膜多发生于20岁左右的青年;主诉近视度数增长且框架镜不能矫正的患者应引起高度怀疑;可透气硬性角膜接触镜的普及可明显改善圆锥角膜患者的矫正视力,推迟角膜移植时间。

Investigation of clinical characteristics and demography of patients with keratoconus

Objective To investigate the demography and clinical characteristics in patients with keratoconus.Methods A total of 68 patients with keratoconus in our hospital from January 2008 to March 2010,46 males and 22 females,were enrolled and proceeded prospective clinical research.The data of demography,progress of disease and treatment,family history and systemic disease were collected.The refractive state of eyes of patients,clinical characteristics were analyzed and compared.Results Incidence in male was significantly higher than female(67.6% vs 32.4%,P<0.05).In this study,age onset of patients definitely diagnosed with keratoconus was(26.00±8.91)years old(range from 12.38 years to 51.12 years),in which 10.3%(7/68)were smaller than 18 years old,57.6%(39/68) smaller than 30 years old,39 cases(57.4%) were binocular confirmed,while 25 cases(36.8%) were monocular confirmed and the other eye suspected by corneal topography,and 4 cases(5.9%) were monocular confirmed and the other eye were normal.The most common symptom of conical protrusion were seen in 58 eyes(59.2%),Fleischer’s ring in 52 eyes(53.1%),and Vogt’s lines in 25 eyes(25.5%).The mean cylinder in confirmed keratoconus cases(-4.00±2.03) D was significantly higher than suspected cases(-2.20±1.41) D(P<0.001),while best corrected visual acuity of LogMAR in suspected keratoconus cases was better than that in confirmed cases(all P<0.001).Conclusion Keratoconus most appears in young patients around 20 years old,the patients who have the complains of high myopic development and conventional lenses un-correction should be highly suspected,the popularity of RGP can improve the best corrected visual acuity of keratoconus eye and extend the time of corneal transplant.