配戴一年以上的夜用角膜塑形镜停戴后角膜参数的变化

目的 观察夜用角膜塑形镜停戴后角膜参数的变化。设计 回顾性病例系列。研究对象 2010年10月至2013年3月在北京新力眼科验配角膜塑形镜并坚持戴镜且欲停戴重新验配的近视患者26例（49眼）。方法 采用Pentacam眼前节分析仪测量角膜曲率、角膜散光及角膜厚度，观察配戴前、连续戴镜12个月、停戴3~4周后各指标的变化。主要指标 角膜平坦轴曲率、角膜陡峭轴曲率、角膜散光、角膜厚度。结果 角膜平坦轴曲率配戴前、连续戴镜12个月、停戴3~4周后分别为（42.32±1.87）D、（40.18±1.83）D、（41.97±1.86）D，角膜陡峭轴曲率分别为（43.46±1.76）D、（41.46±1.74）D、（43.30±1.90）D，两指标配戴前与停戴后比较均无统计学差异（P=0.534，0.777）。各时间点角膜散光比较无统计学差异。戴镜中角膜厚度略变薄，配戴前及连续戴镜12个月分别为（546.23±24.33）μm、（537.18±27.89）μm，停戴后逐渐恢复至（541.23±22.25）μm，各时间点比较均无统计学差异。塑形效果稳定后每矫正-1.00 D屈光度实际下降K值为（0.52±0.18）D，实际角膜厚度变薄为（2.35±2.23）μm。停戴3~4周后K值恢复程度为（86±15）%，角膜厚度恢复程度为（68±45）%。结论 停戴夜用角膜塑形镜3~4周后各角膜参数恢复至接近戴镜前水平。（眼科，2016, 25： 306-309）

The changes of corneal parameters after stopping wearing orthokeratology for more than one year

Objective To observe the changes of corneal parameters after stopping wearing orthokeratology. Design Retrospective case series. Participants 49 eyes of 26 patients with myopia who had received orthokeratology in Beijing Xinli Eye Clinic from October 2010 to March 2013 and planned to stop wearing orthokeratology in order to change new lens. Methods Corneal curvature, corneal astigmatism and corneal thickness were measured with Pentacam. The changes of corneal parameters were observed in the following time points: before wearing, twelve months after wearing, 3~4 weeks after stopping wearing. Main Outcome Measures Flat corneal curvature, steep corneal curvature, corneal astigmatism, corneal thickness. Results Before wearing, twelve months after wearing, 3~4 weeks after stopping wearing, flat corneal curvature was (42.32±1.87)D, (40.18±1.83)D, (41.97±1.86)D, respectively. Steep corneal curvature was (43.46±1.76)D, (41.46±1.74)D, (43.30±1.90)D, respectively. There was no significant difference before wearing and 3~4 weeks after stopping wearing(P=0.534, 0.777). The corneal astigmatism had no statistical difference between different time points. There was slightly reduction in corneal thickness twelve months after wearing, and corneal thickness gradually recovered 3~4 weeks after stopping wearing. The corneal thickness was (546.23±24.33) μm, (537.18±27.89) μm, (541.23±22.25) μm at the three different time points respectively. But the corneal thickness had no statistical difference among different time points. After the shaping effect was stable, correcting each -1.00 D myopia diopter the K value decreased (0.52±0.18) D and the corneal thickness reduced for (2.35±2.23) μm. After stopping wearing for 3~4 weeks, the recovery of K value was (86±15)% and the recovery of corneal thickness was (68±45)%. Conclusion Stopping wearing orthokeratology for 3~4 weeks, corneal parameters returned to near the level before wearing. (Ophthalmol CHN, 2016, 25: 306-309)