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高度近视-部分降低角膜塑形术的方案研究

Regimen Study of High Myopia-Partial Reduction Orthokeratology.

作者信息

Lyu Tianbin, Wang Liya, Zhou Lutan, Qin Jian, Ma Hui, Shi Menghai

机构信息

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.

出版信息

Eye Contact Lens. 2020 May;46(3):141-146. doi: 10.1097/ICL.0000000000000629.

Abstract

OBJECTIVE

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.

METHODS

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.

RESULTS

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).

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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)。

结论

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。

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