角膜塑形镜配戴对青少年近视眼角膜表面参数的影响

发布时间：2018-03-03 00:17

本文选题：角膜塑形镜　切入点：角膜后表面　出处：《眼科》2015年02期 　论文类型：期刊论文

【摘要】：目的观察配戴角膜塑形镜后角膜表面曲率、前房深度和前房体积的变化,并探讨角膜生物力学与角膜表面变化的相关性。设计回顾性病例系列。研究对象哈尔滨医科大学附属第一医院眼科医院视光学中心在2013年1-4月间验配角膜塑形镜的患者24例(24眼),年龄8~16岁,等效球镜度-4.0~-5.0 D。方法应用Pentacam眼前节分析系统分别在戴镜前、戴镜1夜和1个月时测量中央角膜厚度(CCT)、角膜前表面平坦K值(Kf)、陡峭K值(Ks),角膜后表面Kf、Ks以及前房深度(ACD)和前房体积(ACV)。眼反应分析仪(ORA)测量角膜滞后量(CH)和角膜阻力因子(CRF)。主要指标等效球镜度(SE),角膜前表面Kf、Ks值,角膜后表面Kf、Ks值,ACD和ACV。结果配戴角膜塑形镜1夜后SE降低(-2.35±0.85)D。角膜前表面变平坦,前表面Kf、Ks值分别减少(1.31±0.64)D、(1.20±0.76)D。戴镜1个月后SE较戴镜前降低(-4.02±0.54)D,前表面Kf、Ks值分别减少(2.54±1.13)D、(2.90±1.01)D。戴镜1夜后,ACD、ACV分别降低(0.02±0.02)mm、(1.71±3.54)mm3,戴镜1个月后分别下降(0.03±0.02)mm、(4.96±2.25)mm3。戴镜1个月时,ACD、ACV与戴镜前和戴镜1天时比较差异有统计学意义(t=23.081,P=0.000;t=8.847,P=0.000;t=8.877,P=0.000;t=10.772,P=0.000)。角膜后表面Kf、Ks值在戴镜1个月后与戴镜前比较均无明显变化(t=-0.365,P=0.718;t=-0.238,P=0.814)。CH、CRF与ACD、ACV的变化无明显相关性(P均0.05),但随着CH、CRF增加,ACD、ACV的变化有减少的趋势。结论角膜塑形镜能有效地矫正近视,戴镜后角膜被整体压平,压平的程度可能受角膜生物力学属性的影响。
[Abstract]:Objective to observe the changes of corneal surface curvature, anterior chamber depth and anterior chamber volume after wearing corneal plastic lens. To explore the correlation between corneal biomechanics and corneal surface changes. A retrospective series of cases was designed. The optooptic center of the first affiliated hospital of Harbin medical university was examined with corneal plastic lens between 2013 and April. Of the 24 patients, 24 eyes, aged 816 years, were diagnosed. Methods the Pentacam anterior segment analysis system was used in front of the mirror. Central corneal thickness (CCT) was measured at 1 night and 1 month after wearing a mirror, the anterior corneal surface was flat K value (K value), steep K value (K value), posterior surface KfU Ks and anterior chamber depth (ACD) and anterior chamber volume (ACVV) were measured. Corneal lag was measured by eye response analyzer (ORAA) and corneal hysteresis (Ch) and cornea were measured. Main outcome measures: equivalent spherical endoscopy, KfP Ks value of the anterior corneal surface, Results after one night of keratoplasty, SE decreased by -2.35 卤0.85 D. the corneal anterior surface flattened, and the corneal surface flattened. The Ks value of the front surface decreased by 1.31 卤0.64g / d 1.20 卤0.76mm / d respectively. After one month of wearing the mirror, SE decreased by -4.02 卤0.54 Dand, and the value of the front surface by 2.54 卤1.13D / s decreased by 2.90 卤1.01Drespectively. The ACV of the anterior surface was decreased by 0.02 卤0.02mm-1 卤3.54mm-1 after one night's wear of mirror, and by 0.03 卤0.02mm 4.96 卤2.25mm / 3after one month respectively. The ACDACV of the front mirror and the anterior mirror and the mirror wear were decreased respectively by 0.03 卤0.02mm 4.96 卤2.25mm 3.After one month, the ACDACV of the anterior surface was decreased by 0.02 卤0.02 卤3.54mm-1 卤3.54mm / d, and that of the anterior surface was decreased by 0.03 卤0.02mm 4.96 卤2.25mm / d respectively after one night's wear of the mirror. There was significant difference in the KfP value of the posterior corneal surface after 1 day compared with that before the mirror wear (t = 23.081). There was no significant correlation between the changes of the KfKs of the posterior surface of cornea and ACDACV (P < 0.05). There was no significant change in the KfP value of the posterior surface of cornea after one month of wearing the lens compared with that before the mirror wear (t = -0.365P = 0.718 / t). There was no significant correlation between the changes of CRF and ACDACV (P = 0.05), but with the increase of CHCRF, the change of ACDA CV was decreased. Conclusion Corneal plastic lens can effectively correct myopia. The degree of corneal flattening may be affected by the biomechanical properties of cornea.
【作者单位】：哈尔滨医科大学附属第一医院眼科视光学中心;
【分类号】：R778.11

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