CAJ | 학술논문

目的观察并探讨S型角膜塑形镜对近视度数高(-6.00 D＜等效球镜≤-8.00 D)和角膜曲率低(39.00 D≤平坦K＜41.00 D)的青少年近视矫正和控制的临床效果.方法将青少年近视患者90例(90只眼)分为高度近视组30例(30只眼)、低角膜曲率组30例(30只眼)和常规型角膜塑形镜矫正组30例(30只眼).高度近视组和低角膜曲率组配戴S型角膜塑形镜,常规矫正组配戴普通设计的角膜塑形镜,夜间戴镜8～10 h.观察戴镜后1d,1周,1个月,3个月,6个月患者裸眼视力(UCVA)、屈光度、角膜曲率和眼轴长度的变化情况.对相关数据进行配对样本t检验和随机区组方差分析.结果三组患者戴镜6个月UCVA比戴镜前均显著提高(t=2.012、3.134、4.221;P均＜0.01),常规矫正组戴镜1个月视力达到稳定,高度近视组和低角膜曲率组戴镜3个月视力达到稳定.三组患者戴镜1周屈光度(等效球镜)均比戴镜前降低,差异有统计学意义(t =5.053、7.235、8.123;P均＜0.01),第1周内常规矫正组比高度近视组和低角膜曲率组屈光度降低快.三组患者戴镜1周角膜曲率均比戴镜前降低(t =5.245、14.332、11.223;P均＜0.01),常规矫正组戴镜第1周内下降最快,1个月后变化趋于稳定,高度近视组和低角膜曲率组戴镜1个月内下降最快,3个月后趋于稳定.三组患者戴镜6个月时眼轴长度的改变量之间差异无统计学意义(F =52.123,P＞0.05).结论 S型角膜塑形镜能够安全有效地矫正高度近视和低角膜曲率青少年的近视状态,并能够在一定程度上控制近视进展.
목적 관찰병탐토S형각막소형경대근시도수고(-6.00 D＜등효구경≤-8.00 D)화각막곡솔저(39.00 D≤평탄K＜41.00 D)적청소년근시교정화공제적림상효과.방법 장청소년근시환자90례(90지안)분위고도근시조30례(30지안)、저각막곡솔조30례(30지안)화상규형각막소형경교정조30례(30지안).고도근시조화저각막곡솔조배대S형각막소형경,상규교정조배대보통설계적각막소형경,야간대경8～10 h.관찰대경후1d,1주,1개월,3개월,6개월환자라안시력(UCVA)、굴광도、각막곡솔화안축장도적변화정황.대상관수거진행배대양본t검험화수궤구조방차분석.결과 삼조환자대경6개월UCVA비대경전균현저제고(t=2.012、3.134、4.221;P균＜0.01),상규교정조대경1개월시력체도은정,고도근시조화저각막곡솔조대경3개월시력체도은정.삼조환자대경1주굴광도(등효구경)균비대경전강저,차이유통계학의의(t =5.053、7.235、8.123;P균＜0.01),제1주내상규교정조비고도근시조화저각막곡솔조굴광도강저쾌.삼조환자대경1주각막곡솔균비대경전강저(t =5.245、14.332、11.223;P균＜0.01),상규교정조대경제1주내하강최쾌,1개월후변화추우은정,고도근시조화저각막곡솔조대경1개월내하강최쾌,3개월후추우은정.삼조환자대경6개월시안축장도적개변량지간차이무통계학의의(F =52.123,P＞0.05).결론 S형각막소형경능구안전유효지교정고도근시화저각막곡솔청소년적근시상태,병능구재일정정도상공제근시진전.
Objective To observe and evaluate the effect of S-Curve design for orthokeratology on correction of refractive error for adolescents with high myopia (-6.00D＜equivalent sphere lens≤-8.00D) and low corneal curvature (39.00D≤flat K＜41.00D).Methods In this study,90 teenagers (90 eyes) with myopia were included.They were divided into three groups,high myopia group (30 eyes),low corneal curvature group (30 eyes) and general design for orthokeratology group (30 eyes).High myopia group and low corneal curvature group were corrected by S-Curve design for orthokeratology,general design for orthokeratology group were corrected by general design for orthokeratology.All patients were fitted with overnight orthokeratology for 8-10h.UCVA,diopter,corneal curvature,axial length (AL) were measured at pre-wear and 1 day,1 week,1 month,3 months,6 months after orthokeratology.Data were analyzed with a paired t test and randomized block ANOVA.Results UCVA of three groups increased significantly at 6-month visit (t =2.012,t =3.134,t =4.221; P ＜0.01),general design for orthokeratology group became stable after 1-month lens wearing,the other two groups got stable UCVA at 3-month following.Refraction (equivalent sphere lens) of all wearers decreased at 1-week visit (t =5.053,t =7.235,t =8.123; P ＜0.01),general design for orthokeratology group decreased more quickly.Corneal curvature of all wearers decreased at 1-week visit (t =5.245,t =14.332,t =11.223; P ＜0.01),general design for orthokeratology group decreased fastest within the first week and almost did not change after l-month lens wearing.High myopia group and low corneal curvature group decreased fastest within the first month and reached the stable level at 3-month visit.The changes of AL did not show significant differences among three groups at 6 months after wearing orthokeratology lenses (F =52.123,P ＞0.05).Conclusions S-Curve design for orthokeratology can correct myopia and reduce myopia progression for adolescents with high myopia and low corneal curvature effectively and safely.