眼科

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儿童配戴角膜塑形镜后镜片偏心对近视控制的影响

陈敏锋 刘新婷 张芬 王艳丽 毛欣杰   

  1. 温州医科大学附属眼视光医院 325000
  • 收稿日期:2020-04-02 出版日期:2020-09-25 发布日期:2020-09-25
  • 通讯作者: 毛欣杰,Email:364404004@qq.com
  • 基金资助:
    国家重点研发计划(2019YFC1710204)

Effects of orthokeratology decentration on myopia progression in myopia children

Chen Minfeng, Liu Xinting, Zhang Fen, Wang Yanli, Mao Xinjie   

  1. Optometry Hospital of Wenzhou Medical University, Wenzhou 325000, China
  • Received:2020-04-02 Online:2020-09-25 Published:2020-09-25
  • Contact: Mao Xinjie, Email: 364404004@qq.com
  • Supported by:
    National Key Research and Development Project (2019YFC1710204)

摘要: 目的 研究儿童配戴角膜塑形镜后镜片偏心对近视控制效果的影响。设计 回顾性病例系列。研究对象 2016年6月至 2018年10月温州眼视光医院验配OK 镜并坚持戴镜24个月的儿童132例。方法 对比戴镜前和戴镜后2年眼轴变化。通过戴镜前和戴镜3个月的切向图构建切向差异图,将切向差异图导入Matlab描绘塑形圆并定位圆心为塑形区中心,偏心距离为塑形区中心与角膜顶点之间的距离。按偏心量分为低度偏心组(<0.5 mm)、中度偏心组(0.5~1.0 mm)和高度偏心组(>1.0 mm)。分析戴镜2年眼轴变化与镜片偏心程度的相关性。主要指标 基线年龄、基线等效屈光度、镜片偏心距离和眼轴变化值。结果 戴镜2年后眼轴(25.58±0.74)mm,较戴镜前(25.19±0.80)mm增加(t=-12.72,P<0.001),平均偏心距离为(0.67±0.32)mm(0.08~1.69 mm)。不同偏心分组之间的基线年龄、等效屈光度、眼轴、瞳孔面积均无统计学差异。戴镜2年后眼轴增加(0.39±0.32)mm,与基线年龄[(11.49±1.96)岁,r=-0.352,P<0.001]、偏心距离[(0.67±0.32)mm,r=-0.377,P<0.001]和瞳孔面积[(19.78±7.04)mm2,r=-0.180,P=0.039]呈负相关,而与基线等效屈光度[(-3.67±1.26)D,r=0.316,P<0.001]呈正相关。结论 配戴角膜塑形镜镜片不可避免出现偏心,镜片偏心对眼轴的变化会有一定的影响,有可能起到一定的近视控制效果。(眼科, 2020, 29: 345-349)

关键词: 近视, 角膜塑形镜, 偏心

Abstract: Objective To investigate the effects of orthokeratology decentration on myopia progression. Design Retrospective case series. Participants 132 children from June 2016 to October 2018 in the Optometry Hospital of Wenzhou Medical University who met the criteria and insisted on wearing orthokeratology lens for 24 months. Methods The axial length before wearing the lens and after wearing the lens for 2 years was compared. A tangential difference map from the tangential map before the orthokeratology and after wearing for 3 months was built. The tangential difference map was imported into Matlab to depict the shaping circle and locate the center of the circle. The distance between the circle center and corneal vertex was decentration distance. The decentration distance was measured and the direction of decentration was analyzed. According to the orthokeratology lens decentration degree (<0.5 mm, 0.5~1.0 mm, >1.0 mm), it could be divided into low-decentration, medium-decentration and high-decentration groups. The relationship between the elongation of axial length and orthokeratology decentration was measured. Main Outcome Measures Baseline age, baseline spherical equivalent refractive power, orthokeratology decentration, and elongation of axial length. Results After wearing the orthokeratology lenses for 2 years, the axial length (25.58±0.74) mm increased compared with baseline axial length (25.19±0.80) mm, (t=-12.72, P<0.001). There were no significant differences of baseline age, baseline spherical equivalent refractive power, baseline axial length, and pupil area in decentration groups. The changes (0.39±0.32) mm of axial length in this 2 years was negative correlated with the baseline age [(11.49±1.96) years, r=-0.352, P<0.001], decentration distance [(0.67±0.32) mm, r=-0.377, P<0.001] and pupil area [(19.78±7.04) mm2, r=-0.180, P=0.039], but positive correlated with the baseline spherical equivalent refractive power [(-3.67±1.26) D, r=0.316, P<0.001]. Conclusion The decentration was inevitable after wearing orthokeratology. The orthokeratology decentration was negatively correlated with the elongation of axial length; it might show an effect on myopia control. (Ophthalmol CHN, 2020, 29: 345-349)

Key words: myopia, orthokeratology, decentration