Shanghai Eye Disease Prevention and Treatment Center, Shanghai Eye Hospital, Shanghai Vision Health Center & Shanghai Children Myopia Institute, Shanghai, China.
Department of Ophthalmology, Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Center of Eye Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Jiao Tong University, Shanghai, China.
Acta Ophthalmol. 2023 Nov;101(7):755-765. doi: 10.1111/aos.15662. Epub 2023 Mar 23.
To determine how orthokeratology (ortho-k) affects corneal biomechanical properties in myopia control and whether corneal biomechanical parameters can predict clinical efficacy of ortho-k.
A total of 125 children 7-15 years of age using ortho-k lenses were followed in this clinical practice and data of their right eyes were analysed. Corneal biomechanical parameters and most ocular biometry were measured at baseline, 1 week, and at 1, 3, 6, 12, 18 and 24 months. Axial length (AL) was collected every 6 months after baseline measurements.
During the 2-year follow up, nine corneal biomechanical parameters, including deformation amplitude maximum (DA), varied between baseline and 1 week (p < 0.05) and stabilized during the rest of wearing period (p > 0.05). The mean AL increased from 25.02 ± 0.84 mm to 25.38 ± 0.81 mm and baseline DA strongly correlated with AL progression (Pearson r = 0.37). In the multiple regression models, baseline age, AL and DA were the independent factors for AL progression (R : 0.7849, 0.2180 in low and moderate myopes). The area under the receiver operating characteristic curves using the three variables for predicting excessive AL progression (>0.35 mm during 2 years) in low and moderate myopes was 0.902 and 0.698.
Corneal biomechanics firstly fluctuated before becoming stable with long-term ortho-k use. Corneal biomechanics was associated with AL progression in children wearing ortho-k lenses. DA combined with age and AL at baseline could predict AL progression in low myopes using ortho-k.
确定角膜塑形术（ortho-k）在近视控制中如何影响角膜生物力学特性，以及角膜生物力学参数是否可以预测 ortho-k 的临床疗效。
本临床实践中对 125 名使用 ortho-k 镜片的 7-15 岁儿童进行了随访，并分析了他们右眼的数据。在基线、1 周以及 1、3、6、12、18 和 24 个月时测量了角膜生物力学参数和大多数眼球生物测量值。在基线测量后，每 6 个月测量一次眼轴（AL）。
在 2 年的随访期间，9 个角膜生物力学参数（包括变形幅度最大值（DA））在基线和 1 周之间发生了变化（p<0.05），并且在其余佩戴期间稳定（p>0.05）。平均 AL 从 25.02±0.84mm 增加到 25.38±0.81mm，基线 DA 与 AL 进展强烈相关（Pearson r=0.37）。在多元回归模型中，基线年龄、AL 和 DA 是 AL 进展的独立因素（R：0.7849，低中度近视者为 0.2180）。在低中度近视者中，使用这三个变量预测 AL 过度进展（2 年内>0.35mm）的受试者工作特征曲线下面积为 0.902 和 0.698。
长期使用 ortho-k 后，角膜生物力学首先波动，然后稳定。角膜生物力学与佩戴 ortho-k 镜片的儿童的 AL 进展有关。在低中度近视者中，DA 与基线时的年龄和 AL 相结合，可以预测 ortho-k 治疗的 AL 进展。
