摘要
目的比较长期配戴球面和环曲面设计角膜塑形镜后角膜散光的变化是否存在差异,探讨不同设计角膜塑形镜对角膜散光的影响。方法回顾性分析2019年1月-2021年12月在四川大学华西医院眼科隐形眼镜门诊验配球面和环曲面设计角膜塑形镜的青少年近视患者的病历资料,比较长期配戴2种不同设计角膜塑形镜且停戴镜片1个月后角膜散光变化的差异,并分析角膜散光变化的影响因素。结果共纳入患者156例,其中球面设计角膜塑形镜组76例(76只眼),环曲面设计角膜塑形镜组80例(80只眼)。2组患者的年龄、性别、基线近视屈光度、戴镜总时长差异无统计学意义(P>0.05)。球面设计组和环曲面设计组配戴角膜塑形镜前的基线角膜平K值[42.1(41.3,43.3)vs.43.1(42.0,44.1)D]、基线角膜陡K值[(43.4±1.3)vs.(44.6±1.5)D]、基线角膜散光量[(1.1±0.5)vs.(1.6±0.6)D]、基线全眼散光屈光度[-0.6(-1.2,0.0)vs.-1.4(-1.8,-1.0)D]差异有统计学意义(P<0.05)。与基线值相比,2组停戴角膜塑形镜1个月后,角膜平K值均变得更平坦[球面设计组:42.09(41.28,43.34)vs.41.73(40.98,43.16)D,环曲面设计组:43.09(41.95,44.10)vs.42.61(41.52,43.56)D;P<0.05],角膜陡K值变化均无统计学意义(P>0.05),角膜散光值均增加[球面设计组:(1.05±0.49)vs.(1.37±0.56)D,环曲面设计组:(1.62±0.57)vs.(1.99±0.63)D;P<0.05]。2组的角膜平K值变化量、角膜陡K值变化量、角膜散光变化量差异均无统计学意义(P>0.05)。多因素分析结果显示,年龄(P=0.011)和戴镜总时长(P=0.004)是影响角膜散光变化的主要因素。结论长期配戴球面和环曲面设计角膜塑形镜的患者停戴1个月后,角膜平K值变平,角膜陡K值不变,角膜散光增加,球面和环曲面设计的角膜塑形镜对角膜散光的影响无差异。角膜散光的变化与患者年龄和戴镜总时长有关,年龄越小,配戴角膜塑形镜总时长越长,停戴角膜塑形镜后,角膜散光增加越显著。
Objective To compare the changes of corneal astigmatism after long-term spherical and toric orthokeratology wearing,and to investigate the effects of different orthokeratology design on corneal astigmatism.Methods The medical records of myopic adolescent patients who have been prescribed spherical and toric orthokeratology in the contact lens clinic of West China Hospital,Sichuan University between January 2019 and December 2021 were analyzed retrospectively.The differences of corneal astigmatism changes after wearing spherical and toric orthokeratology for a long time and one month discontinuation were compared.The influencing factors of corneal astigmatism changes were analyzed.Results A total of 156 patients were included.There were 76 cases(76 eyes)in spherical orthokeratology group and 80 cases(80 eyes)in toric orthokeratology group.There was no significant difference between the two groups in age,gender,baseline myopia diopter and total lens wearing time(P>0.05).There were statistically significant differences between the spherical orthokeratology group and the toric orthokeratology group in the baseline corneal flat K value[42.1(41.3,43.3)vs.43.1(42.0,44.1)D],baseline corneal steep K value[(43.4±1.3)vs.(44.6±1.5)D],baseline corneal astigmatism[(1.1±0.5)vs.(1.6±0.6)D],and baseline total eye astigmatism[-0.6(-1.2,0.0)vs.-1.4(-1.8,-1.0)D]before wearing the orthokeratology(P<0.05).Compared with the baseline value,1 month after the two groups stopped wearing the orthokeratology,the corneal flat K values became flatter[spherical orthokeratology group:42.09(41.28,43.34)vs.41.73(40.98,43.16)D,toric orthokeratology group:43.09(41.95,44.10)vs.42.61(41.52,43.56)D;P<0.05],the changes of corneal steep K values were not statistically significant(P>0.05),but the corneal astigmatism values increased[spherical orthokeratology group:(1.05±0.49)vs.(1.37±0.56)D,toric orthokeratology group:(1.62±0.57)vs.(1.99±0.63)D;P<0.05].There was no significant difference in the changes of corneal flat K value,corneal steep K value and corneal astigmatism between the two groups(P>0.05).Multivariate analysis showed that age(P=0.011)and the total duration of orthokeratology wearing(P=0.004)were the main factors affecting the changes of corneal astigmatism.Conclusion After 1 month of non-wearing,the flat K value of the cornea becomes flat,the steep K value remains unchanged,and the corneal astigmatism increases.There is no difference in the effect of the spherical and toric orthokeratology on corneal astigmatism.The change of corneal astigmatism is related to the patient’s age and the total duration of wearing the orthokeratology.The younger the age,the longer the duration of orthokeratology wearing,the more significant the increase of corneal astigmatism after stopping wearing the orthokeratology.
作者
杨必
彭益鸿
何元浩
马薇
刘陇黔
YANG Bi;PENG Yihong;HE Yuanhao;MA Wei;LIU Longqian(Department of Optometry and Vision Sciences,West China School of Medicine,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Laboratory of Optometry and Vision Sciences,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China;Department of Ophthalmology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,P.R.China)
出处
《华西医学》
CAS
2022年第11期1666-1671,共6页
West China Medical Journal
基金
四川省科技计划项目(2022YFS0368)。
关键词
球面
环曲面
角膜塑形镜
角膜散光
Spherical
toric
orthokeratology
corneal astigmatism
