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摘要:
目的 探讨配戴夜戴型角膜塑形镜1年对角膜内皮细胞和角膜厚度的影响。 方法 观察2008年8月至2009年2月8~14岁在本院配戴角膜塑形镜随诊数据完整者40例(79眼), 配戴前与配戴后6个月及1年进行角膜内皮细胞和角膜厚度的测定与比较, 同时观察裸眼视力、屈光度和角膜地形图的变化。 结果 配戴后6个月及1年与配戴前比较角膜内皮细胞密度均无明显降低(P > 0.05)。细胞变异系数和六角形细胞比率在6个月时无明显变化, 而在1年时分别轻度增加和减少, 与配戴前比较差异均具有统计学意义(P < 0.05);角膜厚度在配戴后6个月及1年与配戴前比较无明显改变, 差异无显著统计学意义(P > 0.05)。配戴后1年裸眼视力、屈光度和角膜地形图(K值)与配戴前比较差异均有显著统计学意义(P < 0.01)。 结论 角膜塑形镜降低近视屈光度、控制近视发展效果明显, 但长期配戴对角膜内皮细胞形态有轻度影响, 必须严密观察和随诊, 以确保长期治疗的有效性和安全性。 Abstract:Objective To investigate the effects of overnight orthokeratology lens on corneal endothelium and corneal thickness after one year of treatment. Methods Totally 40 patients(79 eyes)aged 8-14 years received orthokeratology lens treatment in our hospital from August 2008 to February 2009 were observed.Corneal endothelium and corneal thickness were assessed before the treatment, 6 months and 1 year after the treatment.Uncorrected visual acuity, diopter, and corneal topography were documented at the same time points as well. Results Corneal endothelial cell density showed no significant reduction 6 months and 1 year after the treatment when compared with the baseline level(P > 0.05).Cell Variant Index and percentage of hexagonal cells showed no significant change 6 months after the treatment but the former slightly increased and the later decreased after 1 year of the treatment(both P < 0.05).Corneal thickness showed no significant change after 6 months or 1 year of treatment(both P > 0.05).Uncorrected visual acuity, diopter, and corneal topography significant changed after 1 year of treatment(P < 0.01). Conclusion Orthokeratology lens can correct refractive error and control the development of myopia.However, its long-term wear may have slight deformative effect on corneal endothelium.Strictly monitoring and follow-up are required to ensure long-term effectiveness and safety. -
Key words:
- orthokeratology /
- corneal endothelium /
- corneal thickness
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表 1 角膜塑形镜配戴前后裸眼视力、屈光度、角膜地形图比较(x±s)
测量时间 裸眼视力 球镜屈光度(D) 柱镜屈光度(D) 角膜地形图 K1 (D) K2 (D) 戴镜前 0. 27±0. 16 -2. 53±1. 06 -0. 44±0. 58 43. 80±1. 21 42. 63±1. 24 戴镜后6个月 1. 07±0. 22* -0. 31±0. 66* -0. 28±0. 55* 42. 36±1. 70* 41. 15±1. 57* 戴镜后1年 1. 11±0. 15* -0. 18±0. 58* -0. 15±0. 40* 42. 31±1. 42* 41. 02±1. 49* 与配戴前比较, *P＜0. 01 
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表 2 角膜塑形镜配戴前后角膜内皮细胞和角膜厚度比较(x±s)
测量时间 角膜内皮细胞密度(cell/mm2) 细胞变异系数 六角形细胞比率(%) 角膜厚度(μm) 戴镜前 3226. 63±289. 47 29. 91±5. 75 67. 52 ± 9. 32 541. 47±41. 16 戴镜后6个月 3163. 80±240. 52 31. 87±6. 42 66. 25±10. 83 541. 16±40. 00 戴镜后1年 3165. 14±233. 28 32. 04±5. 36* 63. 96 ± 9. 67* 540. 99±39. 13 与配戴前比较, *P＜0. 05
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