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应用 Corvis ST 评估角膜塑形术后角膜生物力学的变化

Evaluation of changes in corneal biomechanics after orthokeratology using Corvis ST.

机构信息

National Clinical Research Center for Ocular Diseases, Eye Hospital, WenZhou Medical University, Wenzhou 325027, China.

Beijing Institute of Ophthalmology, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

出版信息

Cont Lens Anterior Eye. 2024 Feb;47(1):102100. doi: 10.1016/j.clae.2023.102100. Epub 2023 Dec 9.

Abstract

PURPOSE

To investigate the alterations in corneal biomechanical metrics induced by orthokeratology (ortho-k) using Corvis ST and to determine the factors influencing these changes.

METHOD

A prospective observational study was conducted to analyze various Corvis ST parameters in 32 children with low to moderate myopia who successfully underwent ortho-k lens fitting. Corneal biomechanical measurements via Corvis ST were acquired at six distinct time points: baseline (pre) and 2 h (pos2h), 6 h (pos6h), and 10 h (pos10h) following the removal of the first overnight wear ortho-k, one week (pos1w) and one month (pos1m) subsequent to the initiation of ortho-k.

RESULT

Significant differences were observed in Corvis ST Biomechanical parameters DAR2, IIR, CBI, and cCBI post ortho-k intervention. The integration of covariates (CCT, SimK, and bIOP) mitigated the differences in DAR2, IIR, and cCBI, but not in CBI. Initially, the stiffness parameter at first applanation, SP-A1, did not demonstrate significant variations, but after adjusting for covariates, noticeable differences over time were observed. The Stress-Strain Indeces, SSIv1 and SSIv2, did not manifest considerable changes over time, irrespective of the adjustment for covariates. No significant disparities were identified among different ortho-k lens brands.

CONCLUSION

Corneal biomechanics remained consistent throughout the one-month period of ortho-k lens wear. The observed changes in Corvis ST parameters subsequent ortho-k are primarily attributable to alterations in corneal pachymetry and morphology, rather than actual alterations in corneal biomechanics. The stability of corneal biomechanics post ortho-k treatment suggests the safety of this approach for adolescents from a corneal biomechanics perspective.

摘要

目的

使用角膜生物力学分析仪(Corvis ST)研究角膜塑形术(ortho-k)引起的角膜生物力学参数变化,并确定影响这些变化的因素。

方法

前瞻性观察研究分析了 32 名成功接受角膜塑形镜矫正的低度至中度近视儿童的各种 Corvis ST 参数。在以下六个时间点通过 Corvis ST 进行角膜生物力学测量:基线(pre)和第一次过夜佩戴角膜塑形镜后 2 小时(pos2h)、6 小时(pos6h)、10 小时(pos10h),以及去除角膜塑形镜后的一周(pos1w)和一个月(pos1m)。

结果

在 ortho-k 干预后,Corvis ST 生物力学参数 DAR2、IIR、CBI 和 cCBI 存在显著差异。协变量(CCT、SimK 和 bIOP)的整合减轻了 DAR2、IIR 和 cCBI 的差异,但对 CBI 没有影响。最初,第一次压平的刚性参数 SP-A1 没有表现出显著的变化,但在调整协变量后,随着时间的推移观察到明显的差异。Stress-Strain Indeces,SSIv1 和 SSIv2,无论是否调整协变量,随着时间的推移都没有明显的变化。不同角膜塑形镜品牌之间没有发现显著差异。

结论

在角膜塑形镜佩戴的一个月期间,角膜生物力学保持稳定。 ortho-k 后 Corvis ST 参数的变化主要归因于角膜厚度和形态的改变,而不是角膜生物力学的实际改变。从角膜生物力学的角度来看, ortho-k 治疗后角膜生物力学的稳定性表明该方法对青少年是安全的。

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