角膜塑形镜治疗区的长期变化及影响因素。

Long-term variations and influential factors of the treatment zone of wearing orthokeratology lenses.

机构信息

Department of Ophthalmology & Clinical Center of Optometry, Peking University People's Hospital, Beijing 100044, China; College of Optometry, Peking University Health Science Center, Beijing, China; Department of Ophthalmology, Eye Disease and Optometry Institute, Peking University People's Hospital, China; Department of Ophthalmology, Beijing Key Laboratory of Diagnosis and Therapy of Retinal and Choroid Diseases, China.

出版信息

Cont Lens Anterior Eye. 2023 Aug;46(4):101867. doi: 10.1016/j.clae.2023.101867. Epub 2023 Jun 5.

DOI:10.1016/j.clae.2023.101867

PMID:37286433

Abstract

PURPOSE

To investigate the variation trend of the treatment zone (TZ) during 12 months of Orthokeratology (Ortho-K) from the perspective of the treatment zone size (TZS), decentration (TZD) and the weighted Zernike defocus coefficient of the treatment zone (C).

METHODS

94 patients were included in this retrospective study, who were fitted with a 5-curve vision shaping treatment (VST) lens (n = 44) or a 3-zone corneal refractive therapy (CRT) lens (n = 50). The TZS, TZD and C up to 12 months were analyzed.

RESULTS

TZS (F(4,372) = 10.167, P＜0.001), TZD (F(4,372) = 8.083, P＜0.001) and C (F(4,372) = 7.100, P＜0.001) were significantly increased with time during overnight Ortho-K treatment. The TZS increased sharply from 1 week to 1 month of overnight Ortho-K (F = 25.479, P <.001) and stayed smooth then. It showed growing tendency from 6 to 12 months (F = 8.407, P =.005). The TZD (F = 16.637, P <.001) and C (F = 13.401, P <.001) increased significantly until 1 month and kept stable until 12 months (all P＞0.05). The univariant linear regression analysis showed that TZS of the last visit was correlated with baseline myopia (β = 0.219, P =.034). Also, the greater final C was correlated with higher baseline myopia (β = -0.589, P＜0.001) and higher corneal astigmatism (β = -0.228, P =.007) at the onset of lens wear with the multiple linear regression.

CONCLUSION

The TZS, TZD and C kept stable after 1 month of Ortho-K while the TZS had an increasing trend after 6 months. Children with higher myopic eyes or higher corneal astigmatism at baseline tended to have smaller TZS and greater C at 12 months.

摘要

目的

从治疗区大小（TZS）、偏心距（TZD）和治疗区加权泽尼克离焦系数（C）的角度，研究角膜塑形术（Ortho-K）治疗 12 个月期间治疗区（TZ）的变化趋势。

方法

本回顾性研究纳入 94 例患者，他们分别接受 5 曲线视觉塑形治疗（VST）镜片（n=44）或 3 区角膜屈光治疗（CRT）镜片（n=50）治疗。分析治疗区大小、偏心距和 C 直至 12 个月。

结果

TZS（F（4，372）=10.167，P＜0.001）、TZD（F（4，372）=8.083，P＜0.001）和 C（F（4，372）=7.100，P＜0.001）在夜间 Ortho-K 治疗期间随时间显著增加。TZS 在夜间 Ortho-K 治疗 1 周至 1 个月期间急剧增加（F=25.479，P＜0.001），然后保持平稳。从第 6 个月到第 12 个月呈增长趋势（F=8.407，P=0.005）。TZD（F=16.637，P＜0.001）和 C（F=13.401，P＜0.001）在 1 个月内显著增加，直到 12 个月时保持稳定（均 P＞0.05）。单变量线性回归分析显示，末次就诊时的 TZS 与基线近视（β=0.219，P=0.034）相关。此外，较高的最终 C 与较高的基线近视（β=-0.589，P＜0.001）和较高的角膜散光（β=-0.228，P=0.007）相关，与多线性回归相关。