协和医学杂志

2011, v.2(02) 155-158

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角膜塑形镜对角膜内皮细胞和角膜厚度的影响
Effects of Orthokeratology Lens on Corneal Endothelium and Corneal Thickness

金玉梅;张玥;李辉;胡伯越;
JIN Yu-mei,ZHANG Yue,LI Hui,HU Bo-yue Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of MedicalSciences & Peking Union Medical College,Beijing 100730,China

摘要(Abstract):

目的探讨配戴夜戴型角膜塑形镜1年对角膜内皮细胞和角膜厚度的影响。方法 观察2008年8月至2009年2月8~14岁在本院配戴角膜塑形镜随诊数据完整者40例(79眼),配戴前与配戴后6个月及1年进行角膜内皮细胞和角膜厚度的测定与比较,同时观察裸眼视力、屈光度和角膜地形图的变化。结果 配戴后6个月及1年与配戴前比较角膜内皮细胞密度均无明显降低(P>0.05)。细胞变异系数和六角形细胞比率在6个月时无明显变化,而在1年时分别轻度增加和减少,与配戴前比较差异均具有统计学意义(P<0.05);角膜厚度在配戴后6个月及1年与配戴前比较无明显改变,差异无显著统计学意义(P>0.05)。配戴后1年裸眼视力、屈光度和角膜地形图(K值)与配戴前比较差异均有显著统计学意义(P<0.01)。结论角膜塑形镜降低近视屈光度、控制近视发展效果明显,但长期配戴对角膜内皮细胞形态有轻度影响,必须严密观察和随诊,以确保长期治疗的有效性和安全性。
Objective To investigate the effects of overnight orthokeratology lens on corneal endothelium and corneal thickness after one year of treatment.Methods Totally 40 patients(79 eyes)aged 8-14 years received orthokeratology lens treatment in our hospital from August 2008 to February 2009 were observed.Corneal endothelium and corneal thickness were assessed before the treatment,6 months and 1 year after the treatment.Uncorrected visual acuity,diopter,and corneal topography were documented at the same time points as well.Results Corneal endothelial cell density showed no significant reduction 6 months and 1 year after the treatment when compared with the baseline level(P>0.05).Cell Variant Index and percentage of hexagonal cells showed no significant change 6 months after the treatment but the former slightly increased and the later decreased after 1 year of the treatment(both P<0.05).Corneal thickness showed no significant change after 6 months or 1 year of treatment(both P>0.05).Uncorrected visual acuity,diopter,and corneal topography significant changed after 1 year of treatment(P<0.01).Conclusion Orthokeratology lens can correct refractive error and control the development of myopia.However,its long-term wear may have slight deformative effect on corneal endothelium.Strictly monitoring and follow-up are required to ensure long-term effectiveness and safety.

关键词(KeyWords): 角膜塑形镜;角膜内皮细胞;角膜厚度
orthokeratology;corneal endothelium;corneal thickness

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作者(Author): 金玉梅;张玥;李辉;胡伯越;
JIN Yu-mei,ZHANG Yue,LI Hui,HU Bo-yue Department of Ophthalmology,Peking Union Medical College Hospital,Chinese Academy of MedicalSciences & Peking Union Medical College,Beijing 100730,China

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