Lyu Tianbin, Wang Liya, Zhou Lutan, Qin Jian, Ma Hui, Shi Menghai
Zhengzhou University People's Hospital (T.L., L.W., J.Q., H.M., M.S.), Henan Eye Hospital, Zhengzhou University, Zhengzhou, China; and Zhengzhou Railway Vocation and Technical College (L.Z.), Zhengzhou, China.
Eye Contact Lens. 2020 May;46(3):141-146. doi: 10.1097/ICL.0000000000000629.
This study aims to compare the increase in refractive error and axial length, variation of endothelium cells, and ratio of corneal staining between two regimens of high myopia-partial reduction orthokeratology (ortho-k) in children.
The present clinical prospective study recruited 102 high-myopia subjects (204 eyes). These subjects were randomly divided into three groups: (1) ortho-k group 1, subjects with a target myopia reduction of 6.00 D; (2) ortho-k group 2, subjects with a target myopia reduction of 4.00 D; and (3) control group, the refractive error of subjects was corrected using a pair of single-vision spectacles. Vision acuity, refractive error, and the cornea were examined at baseline, and at 2 days, 1 week, 1, 3, 6, and 12 months after commencing lens wear. The measurement of the axial length of the eyeball and a corneal endothelium examination were performed at baseline and at 12 months.
The uncorrected vision acuities improved in subjects in these groups after treatment with ortho-k. Furthermore, the diopters of myopia and corneal curvature significantly decreased at 1 month, and the values continuously improved at 12 months, when compared with subjects at 1 month (P<0.05). Subjects in the control group had a significant increase in refractive error (0.565±0.313 D) and axial length (0.294±0.136 mm), when compared with subjects in the ortho-k-treated groups (P<0.05). However, there were no significant differences in changes in refractive error and axial length between ortho-k groups 1 (0.101±0.176 mm) and 2 (0.123±0.193 mm) at 12 months (P>0.05). Furthermore, subjects in group 1 (28.97%) had a higher rate of corneal staining, when compared with subjects in group 2 (13.06%) (P<0.05).
The two ortho-k regimens, target reduction of 6.00 D and target of 4.00 D, had similar effects in controlling the increase in axial length and refractive error in high-myopia children. However, subjects with a target myopia reduction of 6.00 D had a higher rate of corneal staining than in subjects with a target myopia reduction of 4.00 D.
本研究旨在比较两种儿童高度近视-部分降低角膜塑形术(ortho-k)方案在屈光不正和眼轴长度增加、内皮细胞变化以及角膜染色率方面的差异。
本临床前瞻性研究招募了102名高度近视受试者(204只眼)。这些受试者被随机分为三组:(1)ortho-k组1,目标近视降低6.00 D的受试者;(2)ortho-k组2,目标近视降低4.00 D的受试者;(3)对照组,受试者的屈光不正使用一副单光眼镜矫正。在基线时以及开始佩戴镜片后的2天、1周、1、3、6和12个月检查视力、屈光不正和角膜。在基线时和12个月时测量眼球的眼轴长度并进行角膜内皮检查。
ortho-k治疗后,这些组中的受试者未矫正视力有所改善。此外,与1个月时的受试者相比,近视度数和角膜曲率在1个月时显著降低,且在12个月时持续改善(P<0.05)。与ortho-k治疗组的受试者相比,对照组的受试者屈光不正(0.565±0.313 D)和眼轴长度(0.294±0.136 mm)显著增加(P<0.05)。然而,12个月时ortho-k组1(0.101±0.176 mm)和组2(0.123±0.193 mm)在屈光不正和眼轴长度变化方面无显著差异(P>0.05)。此外,与组2(13.06%)的受试者相比,组1(28.97%)的受试者角膜染色率更高(P<0.05)。
两种ortho-k方案,目标降低6.00 D和目标降低4.00 D,在控制高度近视儿童的眼轴长度和屈光不正增加方面效果相似。然而,目标近视降低6.00 D的受试者角膜染色率高于目标近视降低4.00 D的受试者。