目的 观察青少年配戴角膜塑形镜的疗效及并发症,评估青少年配戴角膜塑形镜的安全性和有效性.方法 临床病例系列研究.分析2010年到2013年在第三军医大学西南眼科医院使用角膜塑形镜矫治近视的青少年176例321只眼,男72例123只眼,女104例198只眼,年龄7～19 (11.34±0.31)岁.戴镜后1周,1、3、6个月,1、2年随访.观察配戴角膜塑形镜前后裸眼视力(UCVA),屈光度数,角膜曲率,矫正视力(VACC),眼轴长度,裂隙灯检查眼部的健康状况.结果 (1)戴镜前的裸眼视力为0.16±0.11,戴镜1周,1、3、6个月,1、2年后为0.78±0.12,0.79±0.13,0.88±0.12,0.89±0.10,0.90±0.12,0.89±0.13,与戴镜前相比差异均有统计学意义(t=-23.452,-32.046,-30.129,-26.116,-25.618,-28.987;均P=0.000);戴镜后1周,1、3、6个月,1、2年的屈光度等值球镜明显下降,与戴镜前相比差异有统计学意义(t =17.737,18.485,18.419,18.152,18.184,18.826;均P =0.000);角膜水平曲率与戴镜前相比差异有统计学意义(t=15.204,22.037,21.038,27.595,28.156,23.915;均P=0.000);角膜垂直曲率与戴镜前相比差异有统计学意义(t=17.844,20.564,19.316,21.247,21.763,19.838;均P=0.000).(2)戴镜后1周,1、3、6个月,1、2年的矫正视力与戴镜前相比差异无统计学意义(t=1.093,0.912,0.097,0.700,0.946,1.372;P=0.280,0.366,0.923,0.487,0.349,0.176);眼轴长度虽有波动,但与戴镜前相比差异无统计学意义(t=6.801,4.510,3.242,3.561,3.750,3.194;P=0.061,0.072,0.068,0.074,0.073,0.076).(3)配戴过程中并发症有:角膜上皮损伤,结膜炎,重影及眩光,角膜炎,角膜后沉着物(keratic precipitates,KP),角膜云翳.其中角膜上皮损伤有65只眼占20.2％ (65/321),结膜炎有31只眼占9.7％ (31/321),重影及眩光有8只眼占2.5％ (8/321),角膜炎、KP、角膜云翳各有1只眼占0.3％ (1/321).结论 配戴角膜塑形镜后裸眼视力明显提升,矫治近视效果明显.配戴过程中未出现严重并发症,安全性较高.
目的 觀察青少年配戴角膜塑形鏡的療效及併髮癥,評估青少年配戴角膜塑形鏡的安全性和有效性.方法 臨床病例繫列研究.分析2010年到2013年在第三軍醫大學西南眼科醫院使用角膜塑形鏡矯治近視的青少年176例321隻眼,男72例123隻眼,女104例198隻眼,年齡7～19 (11.34±0.31)歲.戴鏡後1週,1、3、6箇月,1、2年隨訪.觀察配戴角膜塑形鏡前後裸眼視力(UCVA),屈光度數,角膜麯率,矯正視力(VACC),眼軸長度,裂隙燈檢查眼部的健康狀況.結果 (1)戴鏡前的裸眼視力為0.16±0.11,戴鏡1週,1、3、6箇月,1、2年後為0.78±0.12,0.79±0.13,0.88±0.12,0.89±0.10,0.90±0.12,0.89±0.13,與戴鏡前相比差異均有統計學意義(t=-23.452,-32.046,-30.129,-26.116,-25.618,-28.987;均P=0.000);戴鏡後1週,1、3、6箇月,1、2年的屈光度等值毬鏡明顯下降,與戴鏡前相比差異有統計學意義(t =17.737,18.485,18.419,18.152,18.184,18.826;均P =0.000);角膜水平麯率與戴鏡前相比差異有統計學意義(t=15.204,22.037,21.038,27.595,28.156,23.915;均P=0.000);角膜垂直麯率與戴鏡前相比差異有統計學意義(t=17.844,20.564,19.316,21.247,21.763,19.838;均P=0.000).(2)戴鏡後1週,1、3、6箇月,1、2年的矯正視力與戴鏡前相比差異無統計學意義(t=1.093,0.912,0.097,0.700,0.946,1.372;P=0.280,0.366,0.923,0.487,0.349,0.176);眼軸長度雖有波動,但與戴鏡前相比差異無統計學意義(t=6.801,4.510,3.242,3.561,3.750,3.194;P=0.061,0.072,0.068,0.074,0.073,0.076).(3)配戴過程中併髮癥有:角膜上皮損傷,結膜炎,重影及眩光,角膜炎,角膜後沉著物(keratic precipitates,KP),角膜雲翳.其中角膜上皮損傷有65隻眼佔20.2％ (65/321),結膜炎有31隻眼佔9.7％ (31/321),重影及眩光有8隻眼佔2.5％ (8/321),角膜炎、KP、角膜雲翳各有1隻眼佔0.3％ (1/321).結論 配戴角膜塑形鏡後裸眼視力明顯提升,矯治近視效果明顯.配戴過程中未齣現嚴重併髮癥,安全性較高.
목적 관찰청소년배대각막소형경적료효급병발증,평고청소년배대각막소형경적안전성화유효성.방법 림상병례계렬연구.분석2010년도2013년재제삼군의대학서남안과의원사용각막소형경교치근시적청소년176례321지안,남72례123지안,녀104례198지안,년령7～19 (11.34±0.31)세.대경후1주,1、3、6개월,1、2년수방.관찰배대각막소형경전후라안시력(UCVA),굴광도수,각막곡솔,교정시력(VACC),안축장도,렬극등검사안부적건강상황.결과 (1)대경전적라안시력위0.16±0.11,대경1주,1、3、6개월,1、2년후위0.78±0.12,0.79±0.13,0.88±0.12,0.89±0.10,0.90±0.12,0.89±0.13,여대경전상비차이균유통계학의의(t=-23.452,-32.046,-30.129,-26.116,-25.618,-28.987;균P=0.000);대경후1주,1、3、6개월,1、2년적굴광도등치구경명현하강,여대경전상비차이유통계학의의(t =17.737,18.485,18.419,18.152,18.184,18.826;균P =0.000);각막수평곡솔여대경전상비차이유통계학의의(t=15.204,22.037,21.038,27.595,28.156,23.915;균P=0.000);각막수직곡솔여대경전상비차이유통계학의의(t=17.844,20.564,19.316,21.247,21.763,19.838;균P=0.000).(2)대경후1주,1、3、6개월,1、2년적교정시력여대경전상비차이무통계학의의(t=1.093,0.912,0.097,0.700,0.946,1.372;P=0.280,0.366,0.923,0.487,0.349,0.176);안축장도수유파동,단여대경전상비차이무통계학의의(t=6.801,4.510,3.242,3.561,3.750,3.194;P=0.061,0.072,0.068,0.074,0.073,0.076).(3)배대과정중병발증유:각막상피손상,결막염,중영급현광,각막염,각막후침착물(keratic precipitates,KP),각막운예.기중각막상피손상유65지안점20.2％ (65/321),결막염유31지안점9.7％ (31/321),중영급현광유8지안점2.5％ (8/321),각막염、KP、각막운예각유1지안점0.3％ (1/321).결론 배대각막소형경후라안시력명현제승,교치근시효과명현.배대과정중미출현엄중병발증,안전성교고.
Objective To observe the efficacy and complications of adolescents wearing orthokeratology lens,and to evaluate its safety and effect.Methods A total of 176 cases (321 eyes) aged from 7 to 19 years who received orthokeratologic therapy from 2010 to 2013 in Southwest Eye Hospital Third Military Medical University were analyzed.They were followed up at 1 week,1 month,3 and 6 months,1 year,2 years.Before and after wearing orthokeratlogy lens they were observed with the uncorrected visual acuity (UCVA),diopter,corneal curvature,corrected visual acuity (VACC),axial length,slit lamp examination of eye health.Results At 1 week,1 month,3 and 6 months,1 year,2 years after wearing glasses,UCVA increased from 0.16±0.11 before wearing glasses to 0.78±0.12,0.79±0.13,0.88±0.12,0.89±0.10,0.90±0.12,0.89±0.13 respectively,the differences were significant (t =-23.452,-32.046,-30.129,-26.116,-25.618,-28.987; P =0.000).Diopter was significantly decreased after wearing glasses,there was significant difference compared with before wearing glasses (t =17.737,18.485,18.419,18.184,18.826; P =0.000).There was significant difference compared with before wearing glasses in corneal horizontal curvature (t =15.204,22.037,21.038,27.595,28.156,23.915; P =0.000).There was significant difference compared with before wearing glasses in corneal perpendicular curvature (t =17.844,20.564,19.316,21.247,21.763,19.838; P =0.000).At 1 week,1 month,3 and 6 months,1 year,2 years after wearing glasses,there was significant difference compared with before wearing glasses in CVA (t =1.093,0.912,0.097,0.700,0.946,1.372; P =0.280,0.366,0.923,0.487,0.349,0.176).Axial length had a little changed after wearing glasses,but there was no significant difference (t =6.801,4.510,3.242,3.561,3.750,3.194; P =0.061,0.072,0.068,0.074,0.073,0.076).Complications in the wearing process were:corneal epithelial injury,conjunctivitis,keratitis,ghosting and glare,keratic precipitates,corneal nebula.The corneal epithelial injury was 65 eyes accounted for 20.2％(65/321),conjunctivitis 31 eyes accounted for 9.7％ (31/321),ghosting and glare 8 eyes accounted for 2.5％(8/321),the keratitis and keratic precipitates and corneal leucoma was 1 eye each accounted for 0.3％(1/321).Conclusions After wearing orthokeratology,UCVA improved obviously.Orthokeratology treatment of juvenile myopia is effective.No serious complications occurred in the process of wearing glasses,the safety is higher.
