| 引用本文： |
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邹爱琪,栗莉,李艳红,等.近视青少年配戴角膜塑形镜3年疗效及安全性评估[J].同济大学学报（医学版）,2022,43(2):195-201. [点击复制]
- ZOU Aiqi,LI Li,LI Yanhong,et al.Efficacy and safety of orthokeratology lens in myopic adolescents： a 3-year study[J].同济大学学报（医学版）,2022,43(2):195-201. [点击复制]
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| 摘要: |
| 目的探讨配戴角膜塑形镜（orthokeratology lens,OK镜）3年防控青少年近视的疗效及安全性。方法回顾性分析同济大学附属第十人民医院眼科视光学部2016年1月—2017年12月配戴OK镜3年的100例（200只眼）青少年近视患者的病历。按初次就诊时散瞳验光后的等效球镜度数（spherical equivalent refraction, SER）分组： A组（77只眼，-2.00 D≤SER≤-0.50 D）、B组（72只眼，-3.50 D≤SER<-2.00 D）和C组（51只眼，-5.00 D≤SER<-3.50 D）。记录、分析入选患者戴镜前、戴镜后1、2、3年的裸眼视力（uncorrected visual acuity, UCVA）、角膜曲率平坦值（flat kerotometry, FK）、眼轴长度(axial length, AL)、角膜中央厚度(central corneal thickness, CCT)、角膜内皮细胞密度及面积、角膜内皮六边形细胞比例及变异系数等。再将入选患者分成低年龄组和高年龄组，进一步观察各个年龄组患者的近视发展情况。结果3组患者戴镜1、2、3年后的UCVA均较戴镜前显著提高（P<0.01）。戴镜1、2、3年后，各组FK较戴镜前均有统计学差异（P<0.01）。戴镜后不同时间点的各组AL与戴镜前比较有统计学差异（P<0.01）；3年间，A组的AL增长值最大。低年龄组近视中速发展的占比高（60.61%），而高年龄组近视缓慢发展的占比高（61.76%）。所有入选患者戴镜后的CCT、角膜内皮细胞密度及面积、角膜内皮六边形细胞比例及变异系数与戴镜前差异均无统计学意义（P＞0.05）。戴镜3年间，A、B、C各组轻度角膜点状着染分别为6.49%、13.89%和9.80%。结论中长期配戴OK镜控制青少年近视发展是安全有效的，尤其对-5.00 D≤SER<-2.00 D的中高度近视、低年龄组效果更好。 |
| 关键词: 青少年近视 角膜塑形镜 眼轴长度 安全性 |
| DOI：10.12289/j.issn.1008-0392.21335 |
| 投稿时间：2021-08-05 |
| 基金项目:上海市自然科学基金面上项目（19ZR1439500） |
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| Efficacy and safety of orthokeratology lens in myopic adolescents： a 3-year study |
| ZOU Aiqi,LI Li,LI Yanhong,YU Jing |
| (School of General Practice and Continuing Education, Capital Medical University, Beijing 100069, China) |
| Abstract: |
| ObjectiveTo evaluate the long-term efficacy and safety of orthokeratology lens in prevention and control of juvenile myopia. MethodsOne hundred juvenile myopia patients(200 eyes), who were treated in Department of Ophthalmology of Shanghai Tenth People’s Hospital from January 2016 to December 2017 and continuously wore orthokeratology lens for 3 years, were enrolled in the study. According to the spherical equivalent refraction(SER), the eyes were divided into three groups： group A(77 eyes, -2.00 D≤SER≤-0.50 D), group B(72 eyes, -3.50 D≤SER<-2.00 D) and group C(51 eyes, -5.00 D≤SER<-3.50 D). Uncorrected visual acuity(UCVA), flat kerotometry(FK), axial length(AL), central corneal thickness(CCT), corneal endothelial cell density, corneal endothelial cell area, corneal endothelial hexagonal cell ratio and corneal endothelial cell area variation coefficient were measured in three groups before and 1, 2, 3 years after wearing orthokeratology lens. The development of myopia was also observed in younger age group(8-11 years) and high age group(12-16 years), respectively. ResultsAfter wearing orthokeratology lens for 1 year, 2 years and 3 years, the UCVA of three groups were significantly better than before(P<0.01). After wearing orthokeratology lens for 1, 2 and 3 years, the FK of each group was significantly different than before(P<0.01). There was a statistically significant difference in AL among 3 groups at different time points after wearing orthokeratology lens than before(P<0.01); during 3 years, the AL increase in group A was the largest. The low-age group has a high proportion of moderate developing myopia(60.61%), while the high-age group has a high proportion of slow developing myopia(61.76%). In terms of safety, there were no significant differences before and after wearing orthokeratology lens in CCT, corneal endothelial cell density, corneal endothelial cell area, corneal endothelial hexagonal cell ratio and corneal endothelial cell variation coefficient (P＞0.05). During 3 years of wearing, mild corneal spotting in groups A, B, and C were 6.49%, 13.89%, and 9.80%, respectively. ConclusionIt is safe and effective to wear orthokeratology lens for middle and long-term controlling the development of adolescent myopia, especially in patients with -5.00 D≤SER<-2.00 D and younger age groups. |
| Key words: adolescent myopia orthokeratology lens axial length safety |
