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中度近视的角膜塑形术:可预测性与安全性研究

Orthokeratology in Moderate Myopia: A Study of Predictability and Safety.

作者信息

Singh Kirti, Bhattacharyya Mainak, Goel Abhishek, Arora Ritu, Gotmare Nikhil, Aggarwal Himshikha

机构信息

Guru Nanak Eye Centre, Maharaja Ranjit Singh Marg, New Delhi, India.

出版信息

J Ophthalmic Vis Res. 2020 Apr 6;15(2):210-217. doi: 10.18502/jovr.v15i2.6739. eCollection 2020 Apr-Jun.

Abstract

PURPOSE

Literature is relatively silent on safety profile and predictability of orthokeratology lenses in terms of myopia correction and prevention of further progression, especially in semi-tropical countries; this study was designed to fill this gap.

METHODS

This prospective, intervention case series enrolled 30 eyes of 30 patients with myopia up to -5.5 diopters (D). Patients were randomized into two groups of 15 each; the study group was prescribed overnight orthokeratology (OK) lenses, while the control group used daily wear conventional soft contact lenses. Follow-up examinations were performed after 1 h and 6 h, and then at 1, 7, 15, 30 days, and 4 months post lens wear. Uncorrected visual acuity (UCVA), contrast sensitivity, keratometry, central corneal thickness (CCT), and tear film break up time (TBUT) were evaluated at each follow-up examination.

RESULTS

All patients attained a visual acuity of 0.00 Logarithm of the Minimum Angle of Resolution (logMAR) after one week of lens use, which was maintained throughout the study period. While patients allotted to the study group had a gain of 8.1 Snellen lines (UCVA), those in the control group gained 8.9 lines (BCVA) at the end of follow-up period. In the OK group, cornea showed a flattening of 0.8 D (mean keratometry) after single overnight usage of OK lens and overall flattening of 1.2 D compared to baseline, at the end of four months. The change in contrast sensitivity, corneal endothelial specular count, axial length and tear film status was not significant in either group.

CONCLUSION

Orthokeratology is an effective and safe modality to correct moderate myopia in motivated young adults. No side effects were encountered after a short-term follow-up in participants who resided in semi-tropical environments.

摘要

目的

在近视矫正及预防进一步进展方面,关于角膜塑形镜的安全性及可预测性,文献报道相对较少,尤其是在半热带国家;本研究旨在填补这一空白。

方法

本前瞻性干预性病例系列纳入了30例近视度数达-5.5屈光度(D)的患者的30只眼。患者被随机分为两组,每组15例;研究组佩戴夜间角膜塑形镜(OK镜),而对照组佩戴日戴型传统软性接触镜。在佩戴镜片后1小时和6小时进行随访检查,然后在佩戴镜片后1天、7天、15天、30天及4个月进行随访检查。每次随访检查时评估裸眼视力(UCVA)、对比敏感度、角膜曲率测量、中央角膜厚度(CCT)及泪膜破裂时间(TBUT)。

结果

所有患者在佩戴镜片1周后视力均达到最小分辨角对数(logMAR)为0.00,且在整个研究期间保持稳定。随访期末,分配至研究组的患者裸眼视力提高了8.1行(UCVA),而对照组患者最佳矫正视力提高了8.9行(BCVA)。在OK镜组,单次夜间佩戴OK镜后角膜平均角膜曲率变平0.8 D,4个月末与基线相比总体变平1.2 D。两组的对比敏感度、角膜内皮细胞镜检计数、眼轴长度及泪膜状态变化均无统计学意义。

结论

角膜塑形术是一种有效且安全的矫正有意愿的年轻成年人中度近视的方法。对半热带环境居住的参与者进行短期随访后未发现副作用。

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