角膜塑形镜治疗青少年近视的远期效果

【摘要】 目的 观察角膜塑形镜治疗青少年近视7年的效果。设计 回顾性病例系列。研究对象30例青少年近视患者。方法 对2000-2005年间在北医眼视光学研究中心验配角膜塑形镜且连续配戴7年及以上并可按时复查的30例（60眼）患者，使用综合验光仪、裂隙灯、A超等仪器，分别进行戴镜前及戴镜后6个月，l 、3、5和7年时间点的屈光度、视力、角膜曲率、眼轴长度、前房深度、晶状体厚度等检查的比较，综合各指标评估青少年长期配戴角膜塑形镜的有效性。主要指标 球/柱镜度数、裸眼视力、矫正视力、平均K 值、眼轴长度、前房深度、晶状体厚度。结果 戴镜6个月时，患者裸眼视力从4.26±0.28提高到4.71± 0.36（P=0.00），角膜曲率平均K值从（43.66±1.85）D变平坦到（42.41±1.66）D（P=0.00），球镜屈光度（-4.76±2.20）D明显减小到（-2.06±2.90）D（P=0.00）；戴镜6个月至7年，裸眼视力、球镜度、角膜曲率平均K值分别为4.70、-2.80 D、42.40 D，基本趋于稳定且差异无统计学意义；戴镜前至戴镜7年及以上眼轴长度从（25.59±1.07）mm缓慢增加到（26.28±1.44） mm。结论 科学合理配戴角膜塑形镜7 年的结果显示，其可有效地降低患者近视度，提高患者裸眼视力，控制眼轴增长。（眼科， 2012, 21: 371-374）

The long-term effectiveness of orthokeratology for myopia treatment

Objective To assess the effectiveness of long-term orthokeratology （Orhto-K, OK） for myopia treatment in youth. De- sign Retrospective case series. Participants 30 young myopia patients. Methods During 2000 to 2005, 30 patients （60 eyes） in the BeiYi Optometry ＆ Ophthalmology Center had been prescribed with the Ortho-K contact lens and wore it more than seven years. The refraction, visual acuity, corneal curvature, axial length, anterior chamber depth and lens thickness were examined pre-wearing and post-wearing OK lens at six months, one year, three years, five years and seven years. Main Outcome Measures Refraction （spherical and cylinelrical）, uncorrected visual acuity （UCVA）, corrected visual acuity （CVA）, average K value, axial length, anterior chamber depth, lens thickness. Results At post-wearing OK lens six months, UCVA had been significantly improved from 4.26±0.28 to 4.71±0.36 （P= 0.00）, and average K value of corneal curvature had been apparently flattened from 43.66±1.85 D to 42.41±1.66 D （P=-0.00）. Refraction had been significantly decreased from -4.76±2.20 D to -2.06±2.90 D （P=0.00）. From six months to seven years, the UCVA, refraction and average K value maintained stable （4.70, -2.80 D, 42.40 D）. During the entire seven years, the axial length had slowly increased from 25.59±1.07 man to 26.28±1.44 mm. Conclusions In generally, scientific and standardized long-term Orthokeratology wearing would be effective for controlling myopia and increase of axial length and improving naked vision.