角膜塑形镜控制青少年近视进展的效果和影响因素分析

目的:评价角膜塑形镜对青少年近视的控制效果和相关影响因素.方法:选择2012-01/2014-12在我院眼科门诊就诊的8~17岁低中度近视的患者97例189眼,配镜后随访2a,观察患者视力、角膜曲率、屈光度、眼轴长度的变化,并分析青少年近视进展的影响因素.结果:患者裸眼视力、角膜水平曲率及角膜垂直曲率戴镜1mo后与戴镜前相比,差异均有统计学意义(P<0.001).配戴角膜塑形镜的患者在戴镜2a后等效球镜变化量(-0.51±0.64D,t=10.864,P<0.001),眼轴长度增加(0.33±0.31mm,t=14.879,P<0.001),角膜散光变化量(-0.25±0.43D,t=5.375,P<0.001),差异均有统计学意义.等效球镜变化量相关因素分析显示,年龄、戴镜前球镜、戴镜前等效球镜、基础眼轴与等效球镜变化量均呈负相关(P<0.05).结论:角膜塑形镜可有效提高患者裸眼视力.虽然配戴角膜塑形镜患者的眼轴和屈光度有小幅增加,但仍是一种有效控制近视发展的矫治方法.角膜塑形术对于年龄较大,基础眼轴长,近视度数高的患者,其近视控制效果更好.

Effect of orthokeratology on progression of juvenile myopia and the relative influencing factors

AIM: To evaluate the effect of orthokeratology on progression of juvenile myopia and analysis its influencing factors.

METHODS: Totally 97 patients(189 eyes, aging from 8 to 17 years old)who received orthokeratology lenses treatment in our hospital from January 2012 to December 2014, were followed up for 2a. The visual acuity, corneal curvature, diopter, and ocular axial length were observed. Factors of influencing myopia progress in juvenile were analyzed.

RESULTS: At 1mo after receiving orthokeratology contact lenses, the visual acuity and corneal curvature were changed compared with that of before(P<0.001). After 2a of receiving orthokeratology contact lenses, the difference was significant compared with baseline: spherical equivalence(-0.51±0.64D, t=10.864, P<0.001), axial length(0.33±0.31mm, t=14.879, P<0.001), corneal astigmatism(-0.25±0.43D, t=5.375, P<0.001). Statistic analysis showed that there was a negative correlation between the spherical equivalence and age, baseline of diopter or ocular axial length(P<0.05).

CONCLUSION: Orthokeratology can effectively improve the visual acuity of patients. Although there is slightly progression in diopter and ocular length after 2a of wearing orthokeratology contact lenses. Orthokeratology is an effective treatment on controlling progression of juvenile myopia, especially in the elder children who with the longer basic axial length and the greater diopter.