配戴角膜塑形镜的并发症及安全性观察

目的观察配戴角膜矫形镜（OK）的并发症及安全性。方法102例（204只眼）近视患者，平均屈光度（-3．36±0．07）D（等效球镜），用临床问诊、一般检查、裂隙灯及角膜厚度检查等方式，观察治疗2年后患者角膜厚度变化及出现的并发症，并分析其发生的相关因素。结果戴镜后半年、1年及2年与戴镜前相比，角膜厚度无显著差异，戴镜半年68．1％（139只眼），戴镜1年45．6％（93只眼）。戴镜2年25．5％（52只眼）发生上皮点状着色，其中90％以上为〈Ⅱ级角膜上皮损伤，经停戴及应用促角膜上皮修复眼液后均可消失。37只眼（18．1％）出现角膜镜片压痕，17．6％患者发生重影，26．0％患者发生眩光，可随戴镜时间延长逐渐缓解或经合理用药调整镜片后消失。结论长期配戴角膜塑形镜是安全的。

Observation of the complications and safety of orthokeratologic therapy

Objective To observe the complications and safety of orthokeratologic therapy. Methods There were 102 eyes of 204 myopic patients who received orthokeratologlc therapy enrolled in this study. Average refraction error was - 3.3 ± 0.07 D （ spherical equivalent） before the treatment. Complications and corneal thickness changes after two years were examined. Factors that are potentially associated with any complications were reviewed. Results Corneal thickness did not significantly change after 6 months, 12 months and 2 years of the treatment. The rate of positive corneal fluorescein staining was 68.1% （ 139 eyes） on 6 months, 45.6% （93 eyes） on 1 year, and 25.5 （52 eyes） on 2 years. More than 90% of the abnormal staining were mild corneal epithelial injuries （Ⅱ level or less ） , and most of them disappeared after discontinue wearing lens and tropical medications. Lens indentation occuned in 37eyes （ 18.1% ）, and about 17.6% of patients had double vision and 26.0% of patients reported glare. But these adverse effects were tolerable with. Conclusion Long-term orthokeratology lens is safe.