目的 探讨角膜塑形镜矫治前后眼客观视觉质量变化.方法 本研究采用前瞻性、自身对照设计.选取2013年1至6月在青岛眼科医院行角膜塑形镜矫治的近视眼儿童患者25例(48只眼),采用双通道客观视觉质量分析系统(OQASⅡ)测量矫治前、矫治1周、1个月及3个月客观视觉质量参数,包括客观散射指数(OSI)、调制传递函数(MTF)截止频率、客观对比度视力、客观泪膜质量变化;并采用角膜地形图检测角膜散光及e值.采用单因素方差分析对组内数据进行统计学比较,如差异有统计学意义,同时行LSD校正进行两组间对比.结果 矫治前及矫治1周、1个月、3个月球镜度数分别为(-3.65 ±1.75)、(-0.30 ±0.64)、(-0.08 ±0.20)、(-0.05±0.22)D,柱镜度数分别为(-0.39±0.39)、(-0.65±0.57)、(-0.79±0.56)、(-0.81±0.53)D,UCVA分别为3.97±0.51、4.95±0.12、5.00±0.06、5.00±0.05,组内比较差异均有统计学意义(F=79.9,6.1,74.4;P＜0.05).角膜地形图指标e值矫治前后分别为0.37±0.24、-0.23±0.42、-0.29±0.39、-0.30±0.37,矫治后e值变为负数,且与矫治前差异有统计学意义(F=33.3,P＜0.01).3 mm范围角膜散光度数矫治前后差异无统计学意义(F=0.06,P≥0.05).MTF截止频率分别为(36.6±12.0)、(34.2±8.9)、(27.9±12.6)、(27.7±11.6)周/度,矫治后MTF截止频率下降,1个月、3个月时与矫治前有统计学差异(P＜0.05).OSI为0.59±0.47、0.99±0.66、1.47±1.17、1.49±1.03,矫治后OSI上升,与矫治前有统计学差异(P＜0.05).100％、20％及9％对比度视力矫治后虽有轻微下降,但与矫治前相比差异无统计学意义(F=0.68,1.58,2.19;P≥0.05).客观泪膜质量OSI均值1.27±1.12、2.09±1.67、2.07±1.12、2.10±1.33,矫治后上升,与矫治前有统计学差异(F=3.13,P＜0.05).结论 患者配戴角膜塑形镜3个月内,柱镜度数增大,角膜中心散光度数不变;e值变负,OSI上升,MTF截止频率及客观泪膜质量下降;该变化在矫治1个月内随矫治时间延长而明显,1个月后较稳定.经短期角膜塑形治疗,在塑形效果显现的同时亦可引起眼屈光系统光学质量下降,但下降程度轻微.
目的 探討角膜塑形鏡矯治前後眼客觀視覺質量變化.方法 本研究採用前瞻性、自身對照設計.選取2013年1至6月在青島眼科醫院行角膜塑形鏡矯治的近視眼兒童患者25例(48隻眼),採用雙通道客觀視覺質量分析繫統(OQASⅡ)測量矯治前、矯治1週、1箇月及3箇月客觀視覺質量參數,包括客觀散射指數(OSI)、調製傳遞函數(MTF)截止頻率、客觀對比度視力、客觀淚膜質量變化;併採用角膜地形圖檢測角膜散光及e值.採用單因素方差分析對組內數據進行統計學比較,如差異有統計學意義,同時行LSD校正進行兩組間對比.結果 矯治前及矯治1週、1箇月、3箇月毬鏡度數分彆為(-3.65 ±1.75)、(-0.30 ±0.64)、(-0.08 ±0.20)、(-0.05±0.22)D,柱鏡度數分彆為(-0.39±0.39)、(-0.65±0.57)、(-0.79±0.56)、(-0.81±0.53)D,UCVA分彆為3.97±0.51、4.95±0.12、5.00±0.06、5.00±0.05,組內比較差異均有統計學意義(F=79.9,6.1,74.4;P＜0.05).角膜地形圖指標e值矯治前後分彆為0.37±0.24、-0.23±0.42、-0.29±0.39、-0.30±0.37,矯治後e值變為負數,且與矯治前差異有統計學意義(F=33.3,P＜0.01).3 mm範圍角膜散光度數矯治前後差異無統計學意義(F=0.06,P≥0.05).MTF截止頻率分彆為(36.6±12.0)、(34.2±8.9)、(27.9±12.6)、(27.7±11.6)週/度,矯治後MTF截止頻率下降,1箇月、3箇月時與矯治前有統計學差異(P＜0.05).OSI為0.59±0.47、0.99±0.66、1.47±1.17、1.49±1.03,矯治後OSI上升,與矯治前有統計學差異(P＜0.05).100％、20％及9％對比度視力矯治後雖有輕微下降,但與矯治前相比差異無統計學意義(F=0.68,1.58,2.19;P≥0.05).客觀淚膜質量OSI均值1.27±1.12、2.09±1.67、2.07±1.12、2.10±1.33,矯治後上升,與矯治前有統計學差異(F=3.13,P＜0.05).結論 患者配戴角膜塑形鏡3箇月內,柱鏡度數增大,角膜中心散光度數不變;e值變負,OSI上升,MTF截止頻率及客觀淚膜質量下降;該變化在矯治1箇月內隨矯治時間延長而明顯,1箇月後較穩定.經短期角膜塑形治療,在塑形效果顯現的同時亦可引起眼屈光繫統光學質量下降,但下降程度輕微.
목적 탐토각막소형경교치전후안객관시각질량변화.방법 본연구채용전첨성、자신대조설계.선취2013년1지6월재청도안과의원행각막소형경교치적근시안인동환자25례(48지안),채용쌍통도객관시각질량분석계통(OQASⅡ)측량교치전、교치1주、1개월급3개월객관시각질량삼수,포괄객관산사지수(OSI)、조제전체함수(MTF)절지빈솔、객관대비도시력、객관루막질량변화;병채용각막지형도검측각막산광급e치.채용단인소방차분석대조내수거진행통계학비교,여차이유통계학의의,동시행LSD교정진행량조간대비.결과 교치전급교치1주、1개월、3개월구경도수분별위(-3.65 ±1.75)、(-0.30 ±0.64)、(-0.08 ±0.20)、(-0.05±0.22)D,주경도수분별위(-0.39±0.39)、(-0.65±0.57)、(-0.79±0.56)、(-0.81±0.53)D,UCVA분별위3.97±0.51、4.95±0.12、5.00±0.06、5.00±0.05,조내비교차이균유통계학의의(F=79.9,6.1,74.4;P＜0.05).각막지형도지표e치교치전후분별위0.37±0.24、-0.23±0.42、-0.29±0.39、-0.30±0.37,교치후e치변위부수,차여교치전차이유통계학의의(F=33.3,P＜0.01).3 mm범위각막산광도수교치전후차이무통계학의의(F=0.06,P≥0.05).MTF절지빈솔분별위(36.6±12.0)、(34.2±8.9)、(27.9±12.6)、(27.7±11.6)주/도,교치후MTF절지빈솔하강,1개월、3개월시여교치전유통계학차이(P＜0.05).OSI위0.59±0.47、0.99±0.66、1.47±1.17、1.49±1.03,교치후OSI상승,여교치전유통계학차이(P＜0.05).100％、20％급9％대비도시력교치후수유경미하강,단여교치전상비차이무통계학의의(F=0.68,1.58,2.19;P≥0.05).객관루막질량OSI균치1.27±1.12、2.09±1.67、2.07±1.12、2.10±1.33,교치후상승,여교치전유통계학차이(F=3.13,P＜0.05).결론 환자배대각막소형경3개월내,주경도수증대,각막중심산광도수불변;e치변부,OSI상승,MTF절지빈솔급객관루막질량하강;해변화재교치1개월내수교치시간연장이명현,1개월후교은정.경단기각막소형치료,재소형효과현현적동시역가인기안굴광계통광학질량하강,단하강정도경미.
Objective To determine the changes of objective optical quality after orthokeratology.Methods Prospective,self-controlled study.Optical quality,including objective scatter index (OSI),modulation transfer function (MTF) cutoff frequency,contrast visual acuity (CVA) and objective tear film quality,was assessed with the OQAS Ⅱ instrument before and 1 week,1 month,and 3 months after orthokeratology.Parameters of corneal astigmatism and e value from topography were also assessed.The data was analyzed using one-way ANOVA.Results Cylinder refraction was (-0.39 ± 0.39) D,(-0.65 ±0.57)D,(-0.79 ±0.56)D,and(-0.81 ±0.53)D,respectively,at the four timepoints,and there was a statistically significant difference between before and after therapy (P ＜ 0.05).Uncorrected visual acuity was 3.97 ±0.51,4.95 ±0.12,5.00 ±0.06,and 5.00 ±0.05,respectively.The e value was 0.37 ±0.24,-0.23 ± 0.42,-0.29 ± 0.39,and-0.30 ± 0.37,respectively.The negative values after therapy were significantly different from the value before therapy (P ＜ 0.01).The corneal astigmatism in 3 mm diameter was (1.27 ±0.75) D,(1.06 ±0.69) D,(1.11 ±0.68) D,and(1.15 ±0.67)D,respectively.There was no significant difference in astigmatism between before and after therapy (P≥0.05).After therapy,the OSI increased from 0.59 ± 0.47 before therapy to 0.99 ± 0.66 at 1 week,1.47 ± 1.17 at 1 month,and 1.49 ± 1.03 at 3 months.The difference between pre-and post-therapy OSI values was statistically significant (P ＜0.05).The MTF cutoff frequency decreased from (36.6 ± 12.0) cpd before therapy to (34.2±8.9) cpdat 1 week,(27.9±12.6) cpd at 1 month,and (27.7±11.6)cpd at 3 months after therapy.The difference in MTF cutoff frequency between before and 1 month after therapy was statistically significant (P ＜0.05).The 100％ CVA,20％ CVA,and 9％ CVA all declined after therapy,but there was no statistically significant difference between before and after therapy.The OSI of tear film quality was 1.27± 1.12,2.09 ± 1.67,2.07 ± 1.12,and 2.10 ± 1.33,respectively,and the difference was statistically significant between before and after therapy (P ＜ 0.05).Conclusions After 3 months of orthokeratology,the corneal central astigmatism remained,and the e value became negative,while OSI increased,and MTF cutoff frequency and tear film quality declined.The alteration was more and more obvious along with the therapy within 1 month,and was not significant within the following month.After short-term corneal reshaping,the ocular optical quality declined in some degree,but the loss was acceptable.
