中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2014年
1期
9-13
,共5页
接触镜%长期医疗%近视%内皮,角膜%角膜厚度测量
接觸鏡%長期醫療%近視%內皮,角膜%角膜厚度測量
접촉경%장기의료%근시%내피,각막%각막후도측량
Contact lenses%Long-term care%Myopia%Endothelium,corneal%Corneal pachmetry
目的 观察青少年近视眼患者长期配戴角膜塑形镜总体角膜厚度及角膜内皮的变化.方法 回顾性病例系列研究.对2000年到2005年间在北京北医眼视光学研究中心验配角膜塑形镜且连续配戴7年及以上并可按时复查的30例青少年近视眼患者,均选择右眼进行研究统计(共30只眼),使用A超、角膜内皮显微镜等进行连续追踪检查,采集角膜厚度,角膜内皮细胞的细胞密度、平均细胞面积、变异系数、六角形细胞比率,角结膜并发症发生率等检测数据.选取其中22例患者分为两组,中低度组12例(24只眼),屈光度数≤-4.00 D;偏高度组10例(20只眼),屈光度数≥-5.00 D,比较两组间各项指标的差异.对戴镜前及戴镜后6个月、1年、3年、5年和7年的各参数进行单因素方差分析,同时对中低度和偏高度患者之间各参数进行方差分析.结果 戴镜前角膜中央厚度检测值平均为(549.45±33.72) μm,戴镜7年后为(538.97±34.28) μm,差异无统计学意义(F=1.749,P=0.076).鼻侧、上方、颞侧、下方的角膜厚度初诊与戴镜7年检测值比较,差异均无统计学意义.戴镜前角膜内皮细胞密度检测值为(3188.53 ±272.25)个/mm2,戴镜7年后为(3186.64±278.69)个/mm2,差异无统计学意义(F=2.204,P=0.088).戴镜前六角型细胞比率检测值为66.18％ ±6.42％,戴镜7年后为64.65％ ±8.03％,差异无统计学意义(F=2.097,P=0.085).戴镜7年期间平均细胞面积、变异系数变化均无统计学意义(F=2.143,2.114;P＞0.05).中低度和偏高度近视眼患者长期配戴角膜塑形镜内皮细胞及总体角膜厚度亦无明显差异.戴镜期间1或2级角膜表层点染(发生率＜7％)等轻度角结膜并发症发生率较低,无严重并发症发生.结论 青少年近视眼患者长期科学配戴设计合理的高透氧系数角膜塑形镜对角膜厚度及角膜内皮各项指标无明显影响,是一种安全的治疗方法.
目的 觀察青少年近視眼患者長期配戴角膜塑形鏡總體角膜厚度及角膜內皮的變化.方法 迴顧性病例繫列研究.對2000年到2005年間在北京北醫眼視光學研究中心驗配角膜塑形鏡且連續配戴7年及以上併可按時複查的30例青少年近視眼患者,均選擇右眼進行研究統計(共30隻眼),使用A超、角膜內皮顯微鏡等進行連續追蹤檢查,採集角膜厚度,角膜內皮細胞的細胞密度、平均細胞麵積、變異繫數、六角形細胞比率,角結膜併髮癥髮生率等檢測數據.選取其中22例患者分為兩組,中低度組12例(24隻眼),屈光度數≤-4.00 D;偏高度組10例(20隻眼),屈光度數≥-5.00 D,比較兩組間各項指標的差異.對戴鏡前及戴鏡後6箇月、1年、3年、5年和7年的各參數進行單因素方差分析,同時對中低度和偏高度患者之間各參數進行方差分析.結果 戴鏡前角膜中央厚度檢測值平均為(549.45±33.72) μm,戴鏡7年後為(538.97±34.28) μm,差異無統計學意義(F=1.749,P=0.076).鼻側、上方、顳側、下方的角膜厚度初診與戴鏡7年檢測值比較,差異均無統計學意義.戴鏡前角膜內皮細胞密度檢測值為(3188.53 ±272.25)箇/mm2,戴鏡7年後為(3186.64±278.69)箇/mm2,差異無統計學意義(F=2.204,P=0.088).戴鏡前六角型細胞比率檢測值為66.18％ ±6.42％,戴鏡7年後為64.65％ ±8.03％,差異無統計學意義(F=2.097,P=0.085).戴鏡7年期間平均細胞麵積、變異繫數變化均無統計學意義(F=2.143,2.114;P＞0.05).中低度和偏高度近視眼患者長期配戴角膜塑形鏡內皮細胞及總體角膜厚度亦無明顯差異.戴鏡期間1或2級角膜錶層點染(髮生率＜7％)等輕度角結膜併髮癥髮生率較低,無嚴重併髮癥髮生.結論 青少年近視眼患者長期科學配戴設計閤理的高透氧繫數角膜塑形鏡對角膜厚度及角膜內皮各項指標無明顯影響,是一種安全的治療方法.
목적 관찰청소년근시안환자장기배대각막소형경총체각막후도급각막내피적변화.방법 회고성병례계렬연구.대2000년도2005년간재북경북의안시광학연구중심험배각막소형경차련속배대7년급이상병가안시복사적30례청소년근시안환자,균선택우안진행연구통계(공30지안),사용A초、각막내피현미경등진행련속추종검사,채집각막후도,각막내피세포적세포밀도、평균세포면적、변이계수、륙각형세포비솔,각결막병발증발생솔등검측수거.선취기중22례환자분위량조,중저도조12례(24지안),굴광도수≤-4.00 D;편고도조10례(20지안),굴광도수≥-5.00 D,비교량조간각항지표적차이.대대경전급대경후6개월、1년、3년、5년화7년적각삼수진행단인소방차분석,동시대중저도화편고도환자지간각삼수진행방차분석.결과 대경전각막중앙후도검측치평균위(549.45±33.72) μm,대경7년후위(538.97±34.28) μm,차이무통계학의의(F=1.749,P=0.076).비측、상방、섭측、하방적각막후도초진여대경7년검측치비교,차이균무통계학의의.대경전각막내피세포밀도검측치위(3188.53 ±272.25)개/mm2,대경7년후위(3186.64±278.69)개/mm2,차이무통계학의의(F=2.204,P=0.088).대경전륙각형세포비솔검측치위66.18％ ±6.42％,대경7년후위64.65％ ±8.03％,차이무통계학의의(F=2.097,P=0.085).대경7년기간평균세포면적、변이계수변화균무통계학의의(F=2.143,2.114;P＞0.05).중저도화편고도근시안환자장기배대각막소형경내피세포급총체각막후도역무명현차이.대경기간1혹2급각막표층점염(발생솔＜7％)등경도각결막병발증발생솔교저,무엄중병발증발생.결론 청소년근시안환자장기과학배대설계합리적고투양계수각막소형경대각막후도급각막내피각항지표무명현영향,시일충안전적치료방법.
Objective To observe the changes of the corneal thickness and ednothelial cell for youth myopia patients fitted with long-term orthokeratology (Ortho-K,OK).Methods Retrospective case series study.During 2000 to 2005,30 patients with OK lens wearing more than seven years in the Bei Yi Optometry & Ophthalmology Center had been chose in this study,and all the right eye of each person was selected for retrospective case statistics (30 eyes).the measure instruments,including A scan pachymeter and endothelium microscope,were used to the long-term continuous supervise,which involved the central and para-peripheral corneal thickness,corneal endothelium and corneal conjunctival complications rate.Then the 30 patients were divided into two groups:the moderate-low myopia group is less than-4.00 D with 12 patients (24 eyes),and the high myopia group is more than-5.00 D with 10 patients (20 eyes).And the difference between two groups was involved in this research.The one-way analysis of variance was used to compare before,after six months,after one year,after three years,after five years and after seven years OK lens wearing for the patients.And the variance analysis was used to compare between moderate-low and high myopia groups.Results Corneal thickness analysis during these seven years:the average central corneal thickness before and after seven-years wearing are (549.45 ± 33.72) and (538.97 ± 34.28) μm,respectively,and the central corneal thickness had no significant changes (F =1.749,P =0.076) ; The corneal thickness of nasal,superior,temporal and inferior also had no significant changes (P ＞ 0.05).The average corneal endothelial cell densities before and after seven-years wearing are (3188.53 ± 272.25) and (3186.64 ± 278.69) num/mm2,respectively,and the corneal endothelial cell density had no significant changes during seven years wearing (F =2.204,P =0.088).The average hexagonal cell ratio before and after seven-years wearing are 66.18％ ± 6.42％ and 64.65％ ± 8.03％,respectively,and the hexagonal cell ratio had no significant changes during seven-years wearing (F =2.097,P =0.085).The average cell area and coefficient of variation also had no significant change during seven-years wearing (F =2.143,2.114;P ＞0.05).There was also no statistics significance between moderate-low and high myopia of the endothelial cell and the corneal thickness change with long-term OK lens wearing.The slight corneal conjunctival complication was occurred during seven-year wearing,such as corneal fluorescence stain (less than 7％),and no serious complication was happened during seven-year wearing.Conclusions In generally,it is safety for youth with long-term scientific and standardized wearing high Dk material orthokeratology contact lens.
