Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China.
Eye Institute of Shandong First Medical University, Qingdao Eye Hospital of Shandong First Medical University, China; State Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, China; School of Ophthalmology, Shandong First Medical University, China.
Cont Lens Anterior Eye. 2024 Apr;47(2):102131. doi: 10.1016/j.clae.2024.102131. Epub 2024 Feb 25.
To investigate the influence of corneal parameters on the treatment zone area (TZA) after Corneal Refractive Therapy (CRT) with a 5.0-mm back optical zone diameter (BOZD) were worn and to compare changes in the axial length (AL) with traditional 6.0-mm BOZD lenses.
This retrospective study involved 146 subjects (7-12 years) who wore orthokeratology (ortho-K) lenses for one year: 86 subjects were treated with CRT 5.0-mm lenses, and 60 subjects were treated with CRT 6.0-mm lenses. The TZA was measured after one year of ortho-K treatment. Both TZA and AL elongation after wearing the two kinds of lenses was compared. The parameters were recorded in the CRT 5.0 group: flat K, steep K, corneal toricity, e value, and anterior corneal elevation values at the 3-, 4-, and 5-mm chords along the principal meridians of the superior, inferior, nasal, and temporal sides. The relationships between these data and the TZA were analyzed.
The TZA was 12.90 ± 5.15 mm and 20.61 ± 4.54 mm, and the AL elongation was 0.15 ± 0.18 mm and 0.26 ± 0.18 mm in the CRT 5.0 group and the CRT 6.0 group, respectively (all p < 0.001). The one-year AL elongation was significantly associated with initial age and the TZA (r = - 0.394, 0.393; all p < 0.001) in the CRT 5.0 group. The following corneal parameters were found to have statistically significant correlations with the TZA: the e value, difference in corneal elevation (nasal-temporal at the 3-, 4-, and 5-mm chord), and the absolute value of elevation difference (nasal-temporal at the 3- and 4-mm chord and inferior-superior at the 3-, 4-, and 5-mm chord). The e value was the only relevant factor for the TZA by multiple regression analysis (unstandardized β = 14.219, p = 0.008). In the CRT 6.0 group, the one-year AL elongation was statistically significantly associated only with initial age (r = - 0.605, p = 0.005), but not with the TZA (p = 0.161).
A smaller TZA induced by a smaller BOZD may be beneficial for retarding AL elongation in children undergoing ortho-K treatment. The morphology and eccentricity of the cornea may show effects on the TZA.
研究角膜参数对佩戴 5.0mm 后光学区直径（BOZD）角膜屈光矫正治疗（CRT）的治疗区面积（TZA）的影响，并比较传统 6.0mm BOZD 镜片的眼轴（AL）变化。
本回顾性研究纳入了 146 名（7-12 岁）佩戴角膜塑形镜（ortho-K）一年的患者：86 名患者接受 CRT 5.0mm 镜片治疗，60 名患者接受 CRT 6.0mm 镜片治疗。在 ortho-K 治疗一年后测量 TZA。比较两种镜片佩戴后的 TZA 和 AL 伸长。在 CRT 5.0 组中记录了 TZA 和 AL 伸长：平 K 值、陡 K 值、角膜旋转、e 值以及在上方、下方、鼻侧和颞侧的主要子午线的 3、4 和 5mm 弦线上的前角膜隆起值。分析这些数据与 TZA 的关系。
在 CRT 5.0 组和 CRT 6.0 组中，TZA 分别为 12.90±5.15mm 和 20.61±4.54mm，AL 伸长分别为 0.15±0.18mm 和 0.26±0.18mm（均 p<0.001）。在 CRT 5.0 组中，一年的 AL 伸长与初始年龄和 TZA 显著相关（r=-0.394，0.393；均 p<0.001）。与 TZA 有统计学显著相关性的角膜参数如下：e 值、角膜隆起差异（3、4 和 5mm 弦线上的鼻侧-颞侧）和隆起差异绝对值（3 和 4mm 弦线上的鼻侧-颞侧以及下方-上方的 3、4 和 5mm 弦线上）。e 值是多元回归分析中唯一与 TZA 相关的因素（未标准化β=14.219，p=0.008）。在 CRT 6.0 组中，一年的 AL 伸长仅与初始年龄显著相关（r=-0.605，p=0.005），与 TZA 无关（p=0.161）。
佩戴较小 BOZD 引起的较小 TZA 可能有利于减缓儿童接受 ortho-K 治疗时的 AL 伸长。角膜的形态和偏心度可能会对 TZA 产生影响。
