中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2014年
1期
14-19
,共6页
朱梦钧%冯浩雁%朱剑锋%瞿小妹
硃夢鈞%馮浩雁%硃劍鋒%瞿小妹
주몽균%풍호안%주검봉%구소매
接触镜%调节,眼%轴长度,眼%近视
接觸鏡%調節,眼%軸長度,眼%近視
접촉경%조절,안%축장도,안%근시
Contact lenses%Accommodation,ocular%Axial length,eye%Myopia
目的 探讨调节幅度对角膜塑形术控制近视眼作用的影响.方法 前瞻性研究.对进行角膜塑形术治疗的49例(49只眼)7 ～14岁低中度青少年近视眼患者,分别进行综合验光、角膜地形图、调节幅度以及眼轴的检查,并按照角膜塑形镜的验配程序予以配戴,并在戴镜后测量患者的眼轴长度及调节幅度.将调节幅度的均值作为分割点将患者分为2组:调节幅度低于均值组和调节幅度高于均值组,比较两组的眼轴增长速度及调节幅度变化.对相关数据进行配对t检验、独立样本t检验、重复测量方差分析以及Pearson相关分析.结果 配戴角膜塑形镜2年内,初始眼轴长度、戴镜1年后及戴镜2年后眼轴长度分别为(24.98±0.75)、(25.13±0.74)及(25.32±0.78)mm,眼轴显著增长(F=75.848,P＜0.001).戴镜2年后的调节幅度为(16.12±2.41)D,较初始调节幅度(13.68±2.65)D显著升高(t=-6.461,P＜0.001),并且调节幅度对眼轴的增长具有显著影响(F=7.395,P =0.009).调节幅度低于均值组与调节幅度高于均值组的眼轴增长分别为(0.23±0.25)和(0.44±0.30) mm,差异有统计学意义(t=-2.719,P=0.009),调节幅度低于均值组的眼轴增长速度仅为调节幅度高于均值组的52.27％.初始调节幅度与2年眼轴增长之间呈显著正相关(r=0.502,P ＜0.001).且得出调节幅度与眼轴增长之间的回归方程:眼轴增长=0.055×调节幅度-0.409(F=15.806,P＜0.001).调节幅度低于均值组2年后的调节幅度为(15.33±2.46)D,而调节幅度高于均值组的调节幅度为(16.88±2.14)D,两组之间的调节幅度改变分别为(4.04±2.16)和(0.91±2.15)D,差异有统计学意义(t=5.084,P＜0.001).结论 配戴角膜塑形镜后,调节幅度低的青少年近视眼患者往往可以获得更好的近视控制效果.调节功能的改善为角膜塑形术延缓近视进展的机制提供了一定依据.
目的 探討調節幅度對角膜塑形術控製近視眼作用的影響.方法 前瞻性研究.對進行角膜塑形術治療的49例(49隻眼)7 ～14歲低中度青少年近視眼患者,分彆進行綜閤驗光、角膜地形圖、調節幅度以及眼軸的檢查,併按照角膜塑形鏡的驗配程序予以配戴,併在戴鏡後測量患者的眼軸長度及調節幅度.將調節幅度的均值作為分割點將患者分為2組:調節幅度低于均值組和調節幅度高于均值組,比較兩組的眼軸增長速度及調節幅度變化.對相關數據進行配對t檢驗、獨立樣本t檢驗、重複測量方差分析以及Pearson相關分析.結果 配戴角膜塑形鏡2年內,初始眼軸長度、戴鏡1年後及戴鏡2年後眼軸長度分彆為(24.98±0.75)、(25.13±0.74)及(25.32±0.78)mm,眼軸顯著增長(F=75.848,P＜0.001).戴鏡2年後的調節幅度為(16.12±2.41)D,較初始調節幅度(13.68±2.65)D顯著升高(t=-6.461,P＜0.001),併且調節幅度對眼軸的增長具有顯著影響(F=7.395,P =0.009).調節幅度低于均值組與調節幅度高于均值組的眼軸增長分彆為(0.23±0.25)和(0.44±0.30) mm,差異有統計學意義(t=-2.719,P=0.009),調節幅度低于均值組的眼軸增長速度僅為調節幅度高于均值組的52.27％.初始調節幅度與2年眼軸增長之間呈顯著正相關(r=0.502,P ＜0.001).且得齣調節幅度與眼軸增長之間的迴歸方程:眼軸增長=0.055×調節幅度-0.409(F=15.806,P＜0.001).調節幅度低于均值組2年後的調節幅度為(15.33±2.46)D,而調節幅度高于均值組的調節幅度為(16.88±2.14)D,兩組之間的調節幅度改變分彆為(4.04±2.16)和(0.91±2.15)D,差異有統計學意義(t=5.084,P＜0.001).結論 配戴角膜塑形鏡後,調節幅度低的青少年近視眼患者往往可以穫得更好的近視控製效果.調節功能的改善為角膜塑形術延緩近視進展的機製提供瞭一定依據.
목적 탐토조절폭도대각막소형술공제근시안작용적영향.방법 전첨성연구.대진행각막소형술치료적49례(49지안)7 ～14세저중도청소년근시안환자,분별진행종합험광、각막지형도、조절폭도이급안축적검사,병안조각막소형경적험배정서여이배대,병재대경후측량환자적안축장도급조절폭도.장조절폭도적균치작위분할점장환자분위2조:조절폭도저우균치조화조절폭도고우균치조,비교량조적안축증장속도급조절폭도변화.대상관수거진행배대t검험、독립양본t검험、중복측량방차분석이급Pearson상관분석.결과 배대각막소형경2년내,초시안축장도、대경1년후급대경2년후안축장도분별위(24.98±0.75)、(25.13±0.74)급(25.32±0.78)mm,안축현저증장(F=75.848,P＜0.001).대경2년후적조절폭도위(16.12±2.41)D,교초시조절폭도(13.68±2.65)D현저승고(t=-6.461,P＜0.001),병차조절폭도대안축적증장구유현저영향(F=7.395,P =0.009).조절폭도저우균치조여조절폭도고우균치조적안축증장분별위(0.23±0.25)화(0.44±0.30) mm,차이유통계학의의(t=-2.719,P=0.009),조절폭도저우균치조적안축증장속도부위조절폭도고우균치조적52.27％.초시조절폭도여2년안축증장지간정현저정상관(r=0.502,P ＜0.001).차득출조절폭도여안축증장지간적회귀방정:안축증장=0.055×조절폭도-0.409(F=15.806,P＜0.001).조절폭도저우균치조2년후적조절폭도위(15.33±2.46)D,이조절폭도고우균치조적조절폭도위(16.88±2.14)D,량조지간적조절폭도개변분별위(4.04±2.16)화(0.91±2.15)D,차이유통계학의의(t=5.084,P＜0.001).결론 배대각막소형경후,조절폭도저적청소년근시안환자왕왕가이획득경호적근시공제효과.조절공능적개선위각막소형술연완근시진전적궤제제공료일정의거.
Objective To evaluate the impact of amplitude of accommodation on controlling the development of myopia in orthokeratology.Methods Forty-nine children aged 7 to 14 years were enrolled in this prospective clinical study.Orthokeratology was performed to correct the refractive errors of these children after measurement of refraction,corneal topography,amplitude of accommodation and axial length.Axial length (AL) and amplitude of accommodation was measured after theatment.The average amplitude of accommodation was calculated and was used as the cutting point for dividing the cohort into " amplitude of accommodation above average" vs." amplitude of accommodation below average".Data were analyzed by paired t-test,independent t-test,repeated measures-ANOVAs and Pearson correlation analysis.Results The AL before and after 1-year and 2-year treatment was (24.98 ± 0.75) mm,(25.13 ± 0.74) mm and (25.32 ± 0.78) mm,respectively.AL increased significantly throughout the observed 24-month period (F =75.848,P ＜0.001).Amplitude of accommodation increased from(13.68 ±2.65)D to(16.12 ±2.41) D in 2 years(t =-6.461,P ＜ 0.001)and amplitude of accommodation significantly affected axial growth (F =7.395,P =0.009).The axial growth of subjects with below average amplitude of accommodation and those with above average amplitude of accommodation was (0.23 ± 0.25) and (0.44 ± 0.30) mm,indicating a statistically difference(t =-2.719,P =0.009).AL change in subjects with below average amplitude of accommodation was 55.81％ that of the subjects with above average amplitude of accommodation.Baseline amplitude of accommodation was positively correlated to axial growth at 24-month visit (r =0.502,P ＜0.001).Linear regression analysis was used between baseline amplitude of accommodation and 2-year axial growth:Axial growth =0.055 · Baseline amplitude of accommodation-0.409 (F =15.806,P ＜ 0.001).The change of amplitude of accommodation for subjects with below average amplitude of accommodation and those with above average amplitude of accommodation after 2-year was (4.04 ± 2.16) D and (0.91 ± 2.15)D,indicating statistically difference(t =5.084,P ＜ 0.001).Conclusions Myopic control effect would be more beneficial to lower amplitude of accommodation children than that to higher amplitude of accommodation children in orthokeratology.The enhancement of accommodation provides some basis for slowing myopia progression with orthokeratology.
