Observation on the Efficacy and Safety of Long-term Orthokeratology Lens Wear in Adolescents
Objective:To observe the effectiveness and safety of long-term wearing of orthokeratology lens in adolescent myopia patients.Methods:From June 2019 to April 2023,30 myopic adolescents(60 eyes)who had been fitted with orthokeratology lens in the ophthalmology department of Xuanwu hospital and had worn them for a long time(≥ 3 years)were reviewed.They were reexamined 1 day,7 days,1 month and 3 month after wearing the glasses.The changes of the axial length and the parameters of corneal endothelioscopy were compared before and after wearing the glasses for 6 months,1 year,2 years and 3 years.Result:A total of 30 cases(60 eyes)were observed in this study,including 13 males and 17 females,aged 7-14 years old,with an average age of 9.77±1.89 years old.The equivalent spherical scope was-5.00-0.75D,with an average of-1.98±0.97 D.Among them,5 cases(8 eyes,13.3％)developed grade 1 corneal staining,but no grade 2-3 staining was observed.2 cases(4 eyes,6.7％)developed allergic conjunctivitis,which was cured after stopping wearing and receiving corresponding treatment.The axial lengths of 6 mon,1 a,2 a,and 3 a before and after wearing glasses were 24.57±0.74 mm,24.67±0.85 mm,24.78±0.96 mm,24.91±0.97 mm,and 25.06±0.85 mm,respectively,showing an overall increasing trend(F=21.904,P＜0.001).There were statistically significant differences in axial lengths between pre and post wearing glasses at various time points,with P values of 0.027,0.001,0.000,and 0.000,respectively.There was a statistically significant difference between 6 mon after wearing glasses and 1 a,2 a,and 3 a after wearing glasses.The P-values were 0.005,0.000,and 0.008,respectively.There was a statistically significant difference(P＜0.001)between 1 year after wearing the mirror and 2 years after wearing the mirror,while there was no statistically significant difference(P＞0.05)between other time points.The coefficient of variation of cell area at 6 mon,1 a,2 a,and 3 a before and after wearing glasses were 25±2.9％,26±3.7％,27±4.1％,27±4.6％,and 27±4.1％,respectively.Overall,F=5.490,P=0.001.Comparing the two groups,it was found that there was a statistically significant difference between the two groups,with P values of 0.012 and 0.008,respectively(P＜0.05).The difference between the two groups was statistically significant(P=0.007),There was no statistically significant difference between other time points(P＞0.05).There was no statistically significant difference in corneal thickness,endothelial cell density,average area,and hexagonal cell ratio at each time point(P＞0.05).Conclusion:Adolescent myopia patients can effectively control the rapid growth of their eye axis by wearing corneal reshaping lenses for a long time.However,comprehensive examination and evaluation must be conducted,qualified and appropriately sized lenses must be wom,standardized operations must be carried out,and follow-up visits must be made on time.If allergies or corneal injuries occur,timely cessation of wearing and corresponding treatment can ensure the safety of long-term wearing.Morphological examination of corneal cells revealed that long-term wearing of glasses showed an increasing trend in the variation of corneal endothelial cell area.
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