角膜塑形镜停戴1个月后的角膜形态学观察

Analysis of corneal morphology after one-month discontinuation of orthokeratology treatment

  • 摘要: 目的 观察角膜塑形镜停戴1个月后角膜形态是否恢复至戴镜前水平。方法 选择2015年2月- 2017年10月在我中心眼科进行初次角膜塑形镜验配者的右眼资料进行分析。收集戴镜前(基线)和停戴1个月后(终点)的屈光和Pentacam HR测量资料,包括角膜前表面和后表面的中央8 mm范围内Q值、中央3 mm范围内平均曲率半径(radius of curvature,Rm)、周边曲率半径(radius of curvature in the 7 mm to 9 mm area,Rper)、角膜散光度及其轴向、角膜中央厚度(central corneal thickness,CCT)等。散光分析采用Thibos矢量分析法。比较基线与终点各参数的组间差异,并分析角膜塑形镜品牌与角膜形态恢复的相关性。结果 52例(52眼)纳入本研究,男17例,女35例,中位年龄11(8 ~ 17)岁。年等值球镜(spherical equivalent,SE)变化量(-0.19±0.37) D,年眼轴长度(axial length,AL)变化量0.14(0.09,0.23) mm。与基线相比,角膜前表面和后表面Q值均显著增加(差值平均数0.039、0.055);角膜前表面Rm增加(差值中位数0.060 mm),Rper未见显著差异;角膜后表面Rm显著减小(差值平均数-0.024 mm),后表面Rper显著增加(差值平均数0.039 mm);角膜前后表面散光矢量J0、J45均未见显著差异;CCT减小(差值中位数-6.5μm)。不同的角膜塑形镜品牌之间角膜形态恢复的差异无统计学意义。结论 角膜塑形镜停戴1个月的角膜形态并未完全恢复至戴镜前水平,但差异很小。角膜塑形镜可能导致角膜整体后移,并且同时存在角膜后表面前凸。角膜塑形镜品牌不影响角膜形态恢复。

     

    Abstract: Objective To observe whether the corneal morphology return to the baseline level after one-month treatment of orthokeratology. Methods Clinical data about patients (right eyes) who received orthokeratology treatment in our center from February 2015 to October 2017 were collected and analyzed, including the Q-value (8 mm), Rm (mean radius of curvature), Rper (mean radius of curvature in the 7 mm to 9 mm area), astigmatism, CCT (central corneal thickness), etc. Thibos vector analysis was performed for astigmatism calculation. Data at baseline (before wearing) and endpoint (after one-month of wearing) were compared, and the relationship between the brand of orthokeratology and corneal morphology were analyzed. Results Fifty-two patients (52 eyes) were involved in this study, with 17 males and 35 females, and their median age was 11 years (8-17 years). Annual spherical equivalent (SE) change was (-0.19±0.37) D and annual axial length (AL) change was 0.14 (0.09, 0.23) mm. Compared to baseline data, endpoint anterior and posterior Q-values increased with mean differences of 0.039 and 0.055 (P<0.05). Anterior corneal Rm values also increased with median difference of 0.060 mm, while the posterior corneal Rm values decreased with mean difference of -0.024 mm (P<0.05, respectively). Anterior corneal Rper values showed no significant change, while posterior corneal Rper values increased with mean difference of 0.039 mm (P=0.000). There was no difference regarding anterior or posterior astigmatism vector J0 and J45 (baseline vs endpoint). Decreased CCT values were observed with median difference of -6.5μm. There was no significant difference between the three orthokeratology brands in terms of baseline-endpoint comparisons of anterior Q-value, posterior Q-value, anterior Rm, posterior Rm, posterior Rper, and CCT. Conclusion Corneal morphology after one-month treatment of orthokeratology does not return to the baseline level, but the difference is very small. Orthokeratology may induce entire cornea to move backward, with posterior cornea surface protruding forward. Different brands of orthokeratology do not affect the restoring of corneal morphology.

     

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