Kong Qinghui, Guo Jiang, Zhou Jing, Zhang Yanling, Dou Xiaoyan
Dept. of Ophthalmology, Shenzhen Second Hospital, Shenzhen, Guangdong, China.
Dept. of Teaching and Research, School of Medical Technology and Nursing, Shenzhen, Guangdong, China.
Iran J Public Health. 2017 Sep;46(9):1217-1222.
We aimed to identify factors influencing the therapeutic outcome of orthokeratology on controlling juvenile myopia progression, and the risk factors for complications.
Myopic patients (n=724) in Shenzhen Second Hospital from Jan 2011 to Jan 2016 fitted with orthokeratology lenses and followed-up for 6-65 months were reviewed retrospectively. Univariate and multivariate logistic regression analyses were used to screen for the factors that can improve treatment outcome and prevent the development of complications.
Patients where the orthokeratology treatment was effective displayed a shorter myopia time, smaller diopter and corneal curvature, larger corneal endothelium density, high proportion of overnight wear and longer wearing times compared with patients whose treatments were ineffective. Additionally, wearing Ortho-k for 6 or 12 months yielded improved corrective effect and achieved higher comfort level. Logistic regression analyses showed that myopia time, diopter, corneal curvature e value, corneal endothelium density, time with Ortho-k and corrective effect after wearing Ortho-k for 6 or 12 months were all independent factors influencing the treatment effects. Results showed corneal curvature, anterior chamber depth and central corneal thickness were independent risk factors.
This study systematically identified the factors leading to effective treatments, and those carrying a risk for complications, to provide guidance for the prescription and follow-up of orthokeratology in the treatment of juvenile myopia.
我们旨在确定影响角膜塑形术控制青少年近视进展治疗效果的因素，以及并发症的危险因素。
回顾性分析2011年1月至2016年1月在深圳市第二人民医院佩戴角膜塑形镜并随访6 - 65个月的近视患者（n = 724）。采用单因素和多因素逻辑回归分析筛选可改善治疗效果及预防并发症发生的因素。
与治疗无效的患者相比，角膜塑形术治疗有效的患者近视时间较短、屈光度和角膜曲率较小、角膜内皮细胞密度较大、过夜佩戴比例高且佩戴时间长。此外，佩戴角膜塑形镜6个月或12个月矫正效果更好，舒适度更高。逻辑回归分析表明，近视时间、屈光度、角膜曲率e值、角膜内皮细胞密度、佩戴角膜塑形镜时间以及佩戴6个月或12个月后的矫正效果均为影响治疗效果的独立因素。结果显示角膜曲率、前房深度和中央角膜厚度为独立危险因素。
本研究系统地确定了导致有效治疗的因素以及存在并发症风险的因素，为角膜塑形术治疗青少年近视的处方和随访提供指导。
