| 张洪波,李树茂,鲁向阳,张惟虓,王碧莹.框架眼镜联合角膜塑形镜矫正青少年高度近视的临床疗效及对角膜内皮细胞和泪膜的影响[J].,2021,(4):645-649 |
| 框架眼镜联合角膜塑形镜矫正青少年高度近视的临床疗效及对角膜内皮细胞和泪膜的影响 |
| Clinical Efficacy of Frame Glasses Combined with Orthokeratology Lens in Correction of High Myopia in Adolescents and Its Influence on Corneal Endothelial Cells and Tear Film |
| 投稿时间：2020-09-08 修订日期：2020-09-30 |
| DOI：10.13241/j.cnki.pmb.2021.04.009 |
| 中文关键词: 框架眼镜 角膜塑形镜 青少年 高度近视 疗效 角膜内皮细胞 泪膜 |
| 英文关键词: Frame glasses Orthokeratology lens Adolescents High myopia Curative effect Corneal endothelial cells Tear film |
| 基金项目:天津市自然科学基金项目（16JONJC12500） |
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| 中文摘要: |
| 摘要 目的：探讨框架眼镜联合角膜塑形镜矫正青少年高度近视的临床疗效及对角膜内皮细胞和泪膜的影响。方法：选取2018年1月~2019年3月期间我院收治的青少年高度近视患者98例（181眼），根据信封抽签法分为对照组49例92眼（框架眼镜配戴治疗）和观察组49例89眼（对照组基础上联合角膜塑形镜治疗）。对比两组裸眼视力、屈光度、眼轴长度、角膜内皮细胞密度和数量、泪膜情况以及并发症发生情况。结果：观察组治疗后1个月、3个月、6个月、1年屈光度呈下降趋势（P<0.05），眼轴长度未见明显变化（P>0.05），治疗后6个月、1年裸眼视力较治疗前，治疗后1个月、3个月增加且治疗后1年裸眼视力高于治疗后6个月（P<0.05）；观察组治疗后1个月、3个月、6个月、1年屈光度低于对照组（P<0.05），治疗后6个月、1年裸眼视力高于对照组，眼轴长度短于对照组（P<0.05）。两组治疗前、治疗后1年角膜内皮细胞密度（ECD）、六角形细胞（HEX）百分比和细胞面积变异系数（CV）组间及组内对比无差异（P>0.05）。观察组治疗后1年泪膜破裂时间（TBUT）、非接触性泪膜破裂时间（NTBUT）较治疗前下降，且低于对照组（P<0.05）。两组治疗前、治疗后1年基础泪液分泌量（Schirmer ）组间及组内对比无差异（P>0.05）。两组并发症总发生率对比无差异（P>0.05）。结论：青少年高度近视的患者在佩戴框架眼镜基础上应用角膜塑形镜，可有效矫正近视屈光度，提高患者裸眼视力，对角膜内皮细胞无明显影响，且不增加并发症发生率，但对人体泪膜稳定性有一定的影响，临床治疗中应加强泪膜情况的戴镜前检查和戴镜后随访。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the clinical efficacy of frame glasses combined with orthokeratology lens in correction of high myopia in adolescents and its influence on corneal endothelial cells and tear film. Methods: 98 cases (181 eyes) adolescent patients with high myopia who were admitted in our hospital from January 2018 to March 2019 were selected, they were divided into control group of 49 cases with 92 eyes (conventional frame glasses wearing treatment)and observation group of 49 cases with 89 eyes (orthokeratology on the basis of the control group) according to envelope drawing method. The uncorrected visual acuity, diopter, axial length, density and quantity of corneal endothelial cells, tear film situation and complications situation were compared between the two groups. Results: The diopter of the observation group decreased after 1 month, 3 months, 6 months, 1 year after treatment (P<0.05), the axial length did not change significantly (P>0.05), and the uncorrected visual acuity increased than those of before treatment, 1 month, 3 months after treatment after 6 months, 1 year of treatment and the uncorrected visual acuity of 1 year after treatment was higher than those of 6 months after treatment（P<0.05）. The diopter of 1 month, 3 months, 6 months, 1 year after treatment of the observation group was lower than that of the control group (P<0.05). The uncorrected visual acuity of the observation group at 6 months, 1 year after treatment was higher than those of the control group, and the axial length was shorter than that of the control group (P<0.05). There was no difference in corneal endothelial cell density (ECD), percentage of hexagonal cells (HEX) and coefficient of variation (CV) of cell area between the two groups before treatment, 1 year after treatment (P>0.05). 1 year tear film rupture time (TBUT), non contact tear film rupture time (NTBUT) of the observation group were lower than those of before treatment, and was lower than the control group (P<0.05). There was no difference in basal tear secretion（Schirmer ）before treatment, 1 year after treatment between the two groups (P>0.05). There was no difference in the incidence of complications between the two groups (P>0.05). Conclusion: Frame glasses combined with orthokeratology lens in adolescent high myopia, it can effectively correct the myopia diopter and improve the uncorrected visual acuity, there is no significant effect on corneal endothelial cells, and does not increase the incidence of complications, but it has a certain influence on the stability of human tear film, which is necessary to strengthen the examination of tear film before wearing glasses and follow-up after wearing glasses in clinical treatment. |
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