中国实用眼科杂志
中國實用眼科雜誌
중국실용안과잡지
CHINESE JOURNAL OF PRACTICAL OPHTHALMOLOGY
2013年
3期
293-298
,共6页
张婷%保金华%郑志利%瞿佳
張婷%保金華%鄭誌利%瞿佳
장정%보금화%정지리%구가
夜戴型角膜塑形镜%未校正视力%角膜曲率%全眼像差%对比敏感度
夜戴型角膜塑形鏡%未校正視力%角膜麯率%全眼像差%對比敏感度
야대형각막소형경%미교정시력%각막곡솔%전안상차%대비민감도
Overnight orthokeratology%Uncorrected visual acuity%Corneal curvature%Ocular aberration%Contrast sensitivity function
目的 观察和分析近视患者配戴夜戴型角膜塑形镜(orthokeratology)后,角膜形态及全眼像差的变化及日间波动情况,评估其对视觉质量的影响.方法 选取温州医学院的17例(34只眼)中低度近视患者,平均等效屈光度为-0.75～-4.50 D.采用夜戴型角膜塑形镜矫治双眼近视,分别在配戴角膜塑形镜前、戴镜后一天、一周、一月进行检查,每次检查均在复查日摘镜后0、4、8h三个时间点进行,项目包括裂隙灯检查、未校正视力、主觉验光,I-trace视觉功能分析仪测量全眼像差,Pentacam眼前节分析系统测量角膜地形图,CSV-1000对比敏感度测试灯箱测量对比敏感度并计算对比敏感度函数曲线下面积值(ALUCSF).结果 未矫正视力(logMAR)与基线水平的(0.91±0.30)相比,戴镜一月后显著提高至(0.02±0.16) (P ＜0.05).角膜3 mm范围平均曲率与基线水平的(43.53±1.11)D相比,戴镜一月后降至(41.39±1.14)D(P ＜0.05).对比敏感度函数曲线下面积值(AULC-SF)与基线水平的(1.43±0.07)相比,一月后降至(1.33±0.14) (P ＜0.05).总的高阶像差、球差、彗差均增高(P＜0.05),而低阶像差降低.配戴角膜塑形镜后,未矫正视力及对比敏感度的日间波动一周后趋于稳定.而角膜形态,总的高阶像差,球差日间波动持续存在统计学差异,彗差的日间波动在戴镜一个月后处于稳定状态.结论 夜戴型角膜塑形镜能快速、有效的降低屈光不正,提高裸眼视力.尽管配戴夜戴型角膜塑形镜一周后角膜形态及像差存在日间回退现象,但日间视觉质量并未受其波动的影响.
目的 觀察和分析近視患者配戴夜戴型角膜塑形鏡(orthokeratology)後,角膜形態及全眼像差的變化及日間波動情況,評估其對視覺質量的影響.方法 選取溫州醫學院的17例(34隻眼)中低度近視患者,平均等效屈光度為-0.75～-4.50 D.採用夜戴型角膜塑形鏡矯治雙眼近視,分彆在配戴角膜塑形鏡前、戴鏡後一天、一週、一月進行檢查,每次檢查均在複查日摘鏡後0、4、8h三箇時間點進行,項目包括裂隙燈檢查、未校正視力、主覺驗光,I-trace視覺功能分析儀測量全眼像差,Pentacam眼前節分析繫統測量角膜地形圖,CSV-1000對比敏感度測試燈箱測量對比敏感度併計算對比敏感度函數麯線下麵積值(ALUCSF).結果 未矯正視力(logMAR)與基線水平的(0.91±0.30)相比,戴鏡一月後顯著提高至(0.02±0.16) (P ＜0.05).角膜3 mm範圍平均麯率與基線水平的(43.53±1.11)D相比,戴鏡一月後降至(41.39±1.14)D(P ＜0.05).對比敏感度函數麯線下麵積值(AULC-SF)與基線水平的(1.43±0.07)相比,一月後降至(1.33±0.14) (P ＜0.05).總的高階像差、毬差、彗差均增高(P＜0.05),而低階像差降低.配戴角膜塑形鏡後,未矯正視力及對比敏感度的日間波動一週後趨于穩定.而角膜形態,總的高階像差,毬差日間波動持續存在統計學差異,彗差的日間波動在戴鏡一箇月後處于穩定狀態.結論 夜戴型角膜塑形鏡能快速、有效的降低屈光不正,提高裸眼視力.儘管配戴夜戴型角膜塑形鏡一週後角膜形態及像差存在日間迴退現象,但日間視覺質量併未受其波動的影響.
목적 관찰화분석근시환자배대야대형각막소형경(orthokeratology)후,각막형태급전안상차적변화급일간파동정황,평고기대시각질량적영향.방법 선취온주의학원적17례(34지안)중저도근시환자,평균등효굴광도위-0.75～-4.50 D.채용야대형각막소형경교치쌍안근시,분별재배대각막소형경전、대경후일천、일주、일월진행검사,매차검사균재복사일적경후0、4、8h삼개시간점진행,항목포괄렬극등검사、미교정시력、주각험광,I-trace시각공능분석의측량전안상차,Pentacam안전절분석계통측량각막지형도,CSV-1000대비민감도측시등상측량대비민감도병계산대비민감도함수곡선하면적치(ALUCSF).결과 미교정시력(logMAR)여기선수평적(0.91±0.30)상비,대경일월후현저제고지(0.02±0.16) (P ＜0.05).각막3 mm범위평균곡솔여기선수평적(43.53±1.11)D상비,대경일월후강지(41.39±1.14)D(P ＜0.05).대비민감도함수곡선하면적치(AULC-SF)여기선수평적(1.43±0.07)상비,일월후강지(1.33±0.14) (P ＜0.05).총적고계상차、구차、혜차균증고(P＜0.05),이저계상차강저.배대각막소형경후,미교정시력급대비민감도적일간파동일주후추우은정.이각막형태,총적고계상차,구차일간파동지속존재통계학차이,혜차적일간파동재대경일개월후처우은정상태.결론 야대형각막소형경능쾌속、유효적강저굴광불정,제고라안시력.진관배대야대형각막소형경일주후각막형태급상차존재일간회퇴현상,단일간시각질량병미수기파동적영향.
ObJective To investigate the changes and daily fluctuation of corneal shape and ocular aberrations in myopic eyes undergoing overnight orthokeratology,and to analyze the relationship among comeal shape,ocular aberrations and vision.Methods Seventeen young myopic subjects (34eyes) were recruited with myopia from-0.75D to-4.50D.Subjective refraction,uncorrected visual acuity,ocular aberrations,corneal curvature,corneal thickness and contrast sensitivity were performed at baseline and 1 day,1 week and 1 month after lens were wom.Except for baseline,all the parameters were collected at three different times during the day,immediately following lens removal and 4,8 hours after lens removal.Results Orthokeratology significantly improved logMAR uncorrected visual acuity from 0.91±0.30 to 0.02±0.16 (P ＜0.05),decreased the corneal curvature of 3mm from 43.53±1.11D to 41.39± 1.14D (P ＜0.05).But significantly increased ocular higher-order aberrations and decreased contrast sensitivity function.The AULCSF decreased from 1.43±0.07 to 1.33±0.14 (P ＜0.05).The daily fluctuations of visual acuity and AULCSF were stable after 1 week.But the significant changes of daily fluctuations on comeal curvature,corneal thickness and ocular aberration were still observed after 1 month (P ＜0.05).Conclusions Overnight orthokeratology is effective in the reduction of myopic refractive error.Although the regression of corneal shape and ocular aberrations existed in the daytime after one month,vision quality changes remain stable.
