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在患有中度至高度角膜散光的近视儿童中,比较复曲面和球面周边设计角膜塑形术的近视控制效果。

Comparison of myopia control between toric and spherical periphery design orthokeratology in myopic children with moderate-to-high corneal astigmatism.

作者信息

Zhang Yu, Chen Yue-Guo

机构信息

Department of Ophthalmology, Peking University Third Hospital, Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Beijing 100191, China.

出版信息

Int J Ophthalmol. 2018 Apr 18;11(4):650-655. doi: 10.18240/ijo.2018.04.19. eCollection 2018.

Abstract

AIM

To compare clinical results between toric and spherical periphery design orthokeratology (ortho-k) in myopic children with moderate-to-high corneal astigmatism.

METHODS

This retrospective study enrolled 62 eyes of 62 subjects using toric ortho-k lenses. These subjects were assigned to the toric group. Based on the one-to-one match principle (same age, proximate spherical equivalence and corneal astigmatism), 62 eyes of 62 subjects were enrolled and included in the spherical group. At one-year follow-up visit, visual acuity, corneal astigmatism, treatment zone decentration, axial elongation and adverse reaction were compared between these two groups.

RESULTS

At the one-year visit, corneal astigmatism was significantly lower in the toric group (1.22±0.76 D) than in the spherical group (2.05±0.85 D) (=0.012). The mean magnitude of the treatment zone decentration was 0.62±0.42 mm in the toric group and 1.07±0.40 mm in the spherical group (=0.004). Axial elongation was significantly slower in the toric group (0.04±0.13 mm) than in the spherical group (0.09±0.13 mm) (=0.001). The one-year axial elongation was significantly correlated with initial age (=-0.487, <0.001) and periphery design of ortho-k lens (=0.315, <0.001). The incidence of corneal staining was lower in the toric group (8.1%) than in the spherical group (19.4%) (<0.001).

CONCLUSION

Toric periphery design ortho-k lenses may provide lower corneal astigmatism, better centration, slower axial elongation and lower incidence of corneal staining in myopic children with moderate-to-high corneal astigmatism.

摘要

目的

比较复曲面和球面周边设计的角膜塑形术(ortho-k)在中高度角膜散光近视儿童中的临床效果。

方法

本回顾性研究纳入了62例使用复曲面ortho-k镜片的受试者的62只眼。这些受试者被分配到复曲面组。根据一对一匹配原则(年龄相同、球镜等效度和角膜散光相近),纳入62例受试者的62只眼并将其纳入球面组。在一年的随访中,比较两组之间的视力、角膜散光、治疗区偏心、眼轴伸长和不良反应。

结果

在一年随访时,复曲面组的角膜散光(1.22±0.76 D)显著低于球面组(2.05±0.85 D)(P=0.012)。复曲面组治疗区偏心的平均幅度为0.62±0.42 mm,球面组为1.07±0.40 mm(P=0.004)。复曲面组的眼轴伸长(0.04±0.13 mm)显著慢于球面组(0.09±0.13 mm)(P=0.001)。一年眼轴伸长与初始年龄显著相关(r=-0.487,P<0.001)以及与ortho-k镜片的周边设计相关(r=0.315,P<0.001)。复曲面组角膜染色的发生率(8.1%)低于球面组(19.4%)(P<0.001)。

结论

复曲面周边设计的ortho-k镜片在中高度角膜散光近视儿童中可能提供更低的角膜散光、更好的中心定位、更慢的眼轴伸长和更低的角膜染色发生率。

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