Hiraoka Takahiro, Furuya Airi, Matsumoto Yujiro, Okamoto Fumiki, Sakata Norishige, Hiratsuka Kentaro, Kakita Tetsuhiko, Oshika Tetsuro
Matsumoto Eye Clinic, and Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki 305-8575, Japan.
J Cataract Refract Surg. 2004 Jul;30(7):1425-9. doi: 10.1016/j.jcrs.2004.02.049.
To quantitatively assess changes in regular and irregular corneal astigmatism in patients having overnight orthokeratology.
Matsumoto Eye Clinic, Ibaraki, Japan.
A prospective study was conducted of 64 eyes of 39 patients having overnight orthokeratology for myopia. Inclusion criteria were an uncorrected visual acuity (UCVA) of 20/20 or better after treatment and a minimum follow-up of 3 months. Using Fourier series harmonic analysis, videokeratography data were decomposed into spherical component, regular astigmatism, asymmetry (tilt or decentration), and higher-order irregularity.
Orthokeratology significantly reduced the manifest refraction from -2.60 diopters (D) +/- 1.13 (SD) to -0.17 +/- 0.31 D (P<.0001, paired t test) and improved the UCVA from 0.82 +/- 0.30 to -0.11 +/- 0.06 logMAR (P<.0001). Regular astigmatism increased significantly from 0.53 +/- 0.23 D preoperatively to 0.63 +/- 0.40 D postoperatively (P =.0206). The asymmetry component increased significantly from 0.35 +/- 0.22 D to 0.64 +/- 0.40 D (P<.0001). Higher-order irregularity did not change significantly: 0.14 +/- 0.11 D before treatment and 0.17 +/- 0.20 D after treatment (P =.2166). The amount of myopic correction correlated significantly with the increase in the asymmetry component (Pearson correlation coefficient, R = 0.40, P =.0009) but not with the increase in regular astigmatism (R = 0.24, P =.055).
Irregular corneal astigmatism significantly increased, even in clinically successful orthokeratology cases. The effect of the changes on visual function should be studied further.
定量评估接受夜间角膜塑形术患者规则和不规则角膜散光的变化。
日本茨城县松本眼科诊所。
对39例接受夜间近视角膜塑形术的患者的64只眼进行前瞻性研究。纳入标准为治疗后裸眼视力（UCVA）达到20/20或更好，且至少随访3个月。使用傅里叶级数谐波分析，将角膜地形图数据分解为球面成分、规则散光、不对称性（倾斜或偏心）和高阶不规则度。
角膜塑形术使明显屈光不正从-2.60屈光度（D）±1.13（标准差）显著降低至-0.17±0.31 D（P<0.0001，配对t检验），并使UCVA从0.82±0.30提高至-0.11±0.06 logMAR（P<0.0001）。规则散光从术前的0.53±0.23 D显著增加至术后的0.63±0.40 D（P = 0.0206）。不对称成分从0.35±0.22 D显著增加至0.64±0.40 D（P<0.0001）。高阶不规则度无显著变化：治疗前为0.14±0.11 D，治疗后为0.17±0.20 D（P = 0.2166）。近视矫正量与不对称成分的增加显著相关（Pearson相关系数，R = 0.40，P = 0.0009），但与规则散光的增加无关（R = 0.24，P = 0.055）。
即使在临床成功的角膜塑形术病例中，不规则角膜散光也显著增加。这些变化对视觉功能的影响应进一步研究。
