摘要
目的评估Toric设计角膜塑形镜对伴轻中度散光青少年近视的控制效果。方法采用非随机对照临床研究方法,收集2016年1月至2017年6月在浙江省荣军医院眼科经扩瞳电脑验光证实为伴轻中度散光的青少年近视且进行角膜塑形镜矫正者80例160眼,根据角膜塑形镜设计方式不同将患者分为球面角膜塑形镜组和Toric角膜塑形镜组,每组40例80眼。2个组患者每晚配戴角膜塑形镜8~10 h,配戴后1 d、1周、1个月、3个月、6个月、12个月和18个月复诊,观察并比较2个组患者配戴过程中的不良反应发生情况;配戴后12个月,测量并比较2个组患者的裸眼视力和角膜地形图中塑形矫治区偏心值;配戴18个月后2个组患者均停戴角膜塑形镜1个月,再扩瞳验光行屈光状态、IOLMaster和角膜地形图检查,测量并比较2个组治疗后等效球镜度数、眼轴长度和散光度数差异。结果2个组患者配戴角膜塑形镜后12个月,Toric角膜塑形镜组塑形矫治区偏心量为(0.86±0.23)mm,明显小于球面角膜塑形镜组的(1.16±0.44)mm,差异有统计学意义(t=5.404,P<0.001);Toric角膜塑形镜组裸眼视力为(0.03±0.08)LogMAR,明显好于球面角膜塑形镜组的(0.09±0.10)LogMAR,差异有统计学意义(t=2.963,P=0.004)。配戴后18个月,Toric角膜塑形镜组等效球镜度数和眼轴长度均小于球面角膜塑形镜组,差异均有统计学意义(t=2.542、2.107,均P<0.05),2个组散光度数比较差异无统计学意义(t=0.821,P=0.413)。随访18个月,发生不良反应者共18眼,均为角膜上皮点状混浊,Toric角膜塑形镜组不良反应发生率为6.26%(5/80),明显低于球面角膜塑形镜组的16.25%(13/80),差异有统计学意义(χ^(2)=3.897,P=0.048)。结论配戴Toric设计的角膜塑形镜对伴轻中度散光青少年近视的控制效果较球面设计角膜塑形镜更好,不良反应更少,能更好地解决常规球面设计角膜塑形镜塑形偏位的情况。
Objective To evaluate the clinical effect of Toric design orthokeratology in myopic teenagers with mild-to-moderate astigmatism.Methods A non-randomized controlled clinical study was conducted.Eighty juvenile myopia patients(160 eyes)diagnosed with mild to moderate astigmatism with myopia after mydriatic computer optometry and received the treatment of orthokeratology at Zhejiang Rongjun Hospital from January 2016 to June 2017 were enrolled.The patients were divided into regular spherical design orthokeratology group and Toric design orthokeratology group,with 80 eyes(40 cases)in each group.The patients wore orthokeratology for 8 to 10 hours every night and were re-examined at 1 day,1 week and 1,3,6,12 and 18 months after wearing,respectively.The visual acuity,refraction,corneal health status and central deviation of the treatment area in the corneal topography map were measured and recorded during the 18-month treatment.The complications during treatment were recorded.After 12-month wearing,the uncorrected visual acuity and the center deviation of the treatment area were compared between the two groups.After 18-month wearing,patients in the two groups stopped wearing the orthokeratology lens for 1 month,and then the refraction examination,IOLMaster and corneal topography were performed to compare the spherical equivalent,axial length and degree of astigmatism.This study protocol adhered to the Declaration of Helsinki and was approved by an Ethics Committee of Zhejiang Rongjun Hospital(No.2020-10).Written informed consent was obtained from guardians prior to any medical examination.Results After 12-month wearing,the center deviation of the shaping treatment area was(0.86±0.23)mm in the Toric design orthokeratology group,which was significantly lower than(1.16±0.44)mm in the regular spherical design orthokeratology group(t=5.404,P<0.001).After 12-month wearing,the uncorrected visual acuity was(0.03±0.08)LogMAR in the Toric design orthokeratology group,which was significantly higher than(0.09±0.10)LogMAR in the
作者
马雅娟
高建波
肖巍
陈林秀
徐雯
Ma Yajuan;Gao Jianbo;Xiao Wei;Chen Linxiu;Xu Wen(Department of Ophthalmology,Zhejiang Rongjun Hospital,Jiaxing 314000,China;Eye Center,Affiliated Second Hospital,School of Medicine,Zhejiang University,Hangzhou 310009,China)
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2021年第12期1065-1069,共5页
Chinese Journal Of Experimental Ophthalmology
基金
嘉兴市科学技术局科技计划项目(2020AD30007)。
