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不同压迫因子短期角膜塑形术对青少年近视儿童屈光和角膜的影响。

Refractive and corneal responses of young myopic children to short-term orthokeratology treatment with different compression factors.

机构信息

Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.

Centre for Myopia Research, School of Optometry, The Hong Kong Polytechnic University, Kowloon, Hong Kong, China.

出版信息

Cont Lens Anterior Eye. 2020 Feb;43(1):65-72. doi: 10.1016/j.clae.2019.10.134. Epub 2019 Nov 6.

Abstract

PURPOSE

To evaluate changes in refractive and corneal responses in myopic children wearing orthokeratology (ortho-k) lenses with conventional compression factor (CCF, 0.75 D) and increased compression factor (ICF, 1.75 D).

METHODS

This was a double-blind self-controlled study. Subjects were randomly fitted with CCF in one eye and ICF in the fellow eye. Weekly monitoring of refraction, visual acuity (VA), external ocular health, and corneal responses were performed over one month of lens wear and after discontinuation of lens wear until stabilization was achieved.

RESULTS

Twenty-five subjects, aged 9.4 ± 1.0 years, completed one-month lens wear, of whom 23 completed the washout period. The first fit success rates for CCF and ICF were 93% and 96%, respectively. Myopia, unaided VA, central corneal thickness, anterior corneal curvatures (K), apical power (AP), and corneal resistance factor (CRF) all changed significantly during the study period (P <  0.003). Between-eye difference was significant only for myopia reduction (P =  0.001). About 4% and 8% of ICF and CCF eyes were under-corrected. The attempted target was achieved in about 80% of CCF and 60% of ICF eyes at week 4. At the end of the washout period (3 weeks), myopia, K, and AP were significantly different compared to baseline (P <  0.001).

CONCLUSION

Increasing the compression factor did not affect the first fit success rate and external ocular health, but did allow faster correction of refractive error within one month of lens wear. Further investigation is warranted to investigate the long-term effects of ICF on myopia control compared to CCF.

摘要

目的

评估佩戴传统(CCF,0.75D)和高透氧性(ICF,1.75D)角膜塑形镜(ortho-k)的近视儿童的屈光度和角膜变化。

方法

这是一项双盲、自身对照研究。将受试者随机分为 CCF 组和 ICF 组,双眼分别配戴相应的试戴片。每周随访屈光度、视力(VA)、眼表健康及角膜变化,记录镜片配戴 1 月及停戴后角膜塑形效果的稳定性。

结果

25 名受试者(9.4±1.0 岁)完成了 1 个月的镜片配戴,其中 23 名完成了停戴期随访。CCF 和 ICF 的首次适配成功率分别为 93%和 96%。在研究期间,近视度、裸眼视力、中央角膜厚度、角膜前表面曲率(K)、顶点屈光度(AP)和角膜阻力因子(CRF)均有显著变化(P<0.003)。仅在近视减少方面双眼间差异有统计学意义(P=0.001)。约 4%和 8%的 ICF 和 CCF 眼存在欠矫。CCF 组和 ICF 组中,分别约有 80%和 60%的眼在第 4 周达到目标矫正。在停戴 3 周后,与基线相比,近视度、K 和 AP 仍有显著差异(P<0.001)。

结论

增加压缩因子不影响首次适配成功率和眼表健康,但可以在 1 个月的镜片配戴期间更快地矫正屈光不正。需要进一步研究以比较 ICF 与 CCF 对近视控制的长期效果。

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