摘要
目的 探究不同设计角膜塑形镜治疗青少年近视伴散光的效果及对角膜透明度、曲率、内皮细胞及知觉变化的影响.方法 前瞻性选取2019年4月至2022年4月于中国中医科学院眼科医院就诊的114例近视伴散光青少年患者为观察对象,采用区组随机化法分为观察组57例(114眼)和对照组57例(110眼).对照组采用球面角膜塑形镜进行矫正,观察组使用Toric角膜塑形镜进行矫正.比较两组治疗6个月后临床效果[最佳矫正视力(BCVA)、散光值],比较两组治疗前、治疗6个月后角膜结构学(角膜光密度值、曲率)、角膜内皮细胞计数、视觉质量[对比敏感度函数(CSF)]的变化.结果 治疗6个月后,观察组BCVA为0.72±0.18,显著高于对照组(0.67±0.16),散光值为(1.13± 0.42)D,显著低于对照组[(1.54±0.58)D],差异均有统计学意义(P＜0.05).治疗6个月后,两组角膜光密度值、角膜前表面和后表面中心曲率、眼球内皮细胞计数比较,差异均无统计学意义(P＞0.05).治疗6个月后,观察组不同频段(高、中、低)无眩光下CSF值分别为1.85±0.17、1.66±0.15、1.02±0.21,均显著高于对照组(1.79±0.15、1.61± 0.14、0.89±0.15),差异均有统计学意义(P＜0.05).结论 近视伴散光青少年患者配戴Toric角膜塑形镜能提高视觉质量,显著改善患者视力控制近视的进展,且安全性好,适合临床推广.
Abstract
Objective To explore the effect of different designs of orthokeratology lenses in the treatment of myopia with astigmatism in adolescents and influence on the corneal transparency,curvature,endothelial cells and visual change.Methods A total of 114 patients with myo-pia and astigmatism admitted to the Eye Hospital China Academy of Chinese Medical Sciences from April 2019 to April 2022 were selected as ob-servation subjects,and were divided into observation group(57 cases,114 eyes)and control group(57 cases,110 eyes)by the block randomized method.The control group was corrected by spherical orthokeratology lens,and the observation group was corrected by Toric orthokeratology lens.The clinical effect[best corrected visual acuity(BCVA),astigmatism value]after 6 months of treatment and corneal structure(corneal optical density value,curvature),ocular endothelial cell count and visual quality[contrast sensitivity function(CSF)]before treatment and after 6 months of treatment were compared between the two groups.Results After 6 months of treatment,the BCVA in observation group was 0.72± 0.18,which was significantly higher than that of the control group(0.67±0.16),and the astigmatism value was(1.13±0.42)D,which was significantly lower than that in the control group[(1.54±0.58)D],the differences were statistically significant(P＜0.05).There were statis-tically significant differences between the two groups in terms of central curvature of anterior surface of cornea,central curvature of posterior surface corneal optical density value,and ocular endothelial cell count after 6 months of treatment(P＞0.05).After 6 months of treatment,the CSF val-ues of the observation group in different frequency bands(high,medium,and low)without glare were 1.85±0.17,1.66±0.15,and 1.02±0.21,respectively,which were significantly higher than those of the control group(1.79±0.15,1.61±0.14,0.89±0.15),and the differences were statistically significant(P＜0.05).Conclusion Wearing Toric orthokeratology lens can promote the increases of visual quality and corneal opti-cal density value in adolescent patients with myopia and astigmatism,and significantly improve the progress of vision control of myopia,and it has good safety and is suitable for clinical promotion.
维普
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