Li Juan, Yang Cheng, Xie Wenjuan, Zhang Guanrong, Li Xue, Wang Shujun, Yang Xiaohong, Zeng Jin
aDepartment of Ophthalmology, Guangdong Eye Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China bHealth Management Center, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong, China.
Medicine (Baltimore). 2017 Jan;96(2):e5837. doi: 10.1097/MD.0000000000005837.
To investigate the association between pretreatment corneal parameters and orthokeratology lens decentration.
This retrospective study included a total of 108 eyes in 60 myopia patients, who were divided into a lens-decentration and a control group. Various pretreatment corneal parameters were analyzed by receiver operating characteristic curves (ROC curves), including corneal horizontal and vertical curvatures, diopter, corneal eccentricity (E-value), asphericity (Q-value), diameter, and astigmatism, to establish a reliable predictive model for orthokeratology lens decentration.
The temporal and inferior quadrants are preferential sides for lens decentration, which was associated with the occurrence of complications such as ghosting and corneal epithelial staining. By further analysis, we revealed lower corneal horizontal curvature and much higher corneal Q-value differences between the nasal-temporal and superior-inferior quadrants in the lens-decentration group compared to the control group (P < 0.05). ROC curve analysis showed that the sum of Q-value differences between the nasal-temporal and superior-inferior quadrants was more sensitive than any other corneal parameters in predicting lens decentration, with an area under the curve of 0.778 and a truncation point of 0.3 (P < 0.001).
The sum of pretreatment corneal Q-value differences between nasal-temporal and superior-inferior quadrants is a convenient and reliable predictor for orthokeratology lens decentration.
探讨术前角膜参数与角膜塑形镜偏心之间的关联。
这项回顾性研究共纳入60例近视患者的108只眼，将其分为镜片偏心组和对照组。通过受试者操作特征曲线（ROC曲线）分析各种术前角膜参数，包括角膜水平和垂直曲率、屈光度、角膜偏心率（E值）、非球面性（Q值）、直径和散光，以建立角膜塑形镜偏心的可靠预测模型。
颞下象限是镜片偏心的好发部位，这与重影和角膜上皮染色等并发症的发生有关。通过进一步分析，我们发现与对照组相比，镜片偏心组鼻颞象限和上下象限之间的角膜水平曲率更低，角膜Q值差异更高（P<0.05）。ROC曲线分析表明，鼻颞象限和上下象限之间的Q值差异总和在预测镜片偏心方面比任何其他角膜参数更敏感，曲线下面积为0.778，截断点为0.3（P<0.001）。
术前鼻颞象限和上下象限之间的角膜Q值差异总和是角膜塑形镜偏心的便捷可靠预测指标。
