角膜塑型术后角膜内皮细胞及厚度的变化

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目的 :观察配戴角膜塑型镜 (Orthokeratology)后 1年的角膜内皮细胞、角膜厚度的变化。方法 :观察随访了 1年的OK镜治疗者 43例 83眼 ,根据近视屈光度分为 2组 ,Ⅰ组 ( <5 0D) 2 2例 46眼 ;Ⅱ组 (≥ 5 0D) 2 1例 37眼。运用非接触式角膜内皮显微镜、角膜测厚仪分别检查角膜内皮细胞及厚度的变化 ;同时运用Eyesys角膜地形图及A超分别检查角膜曲率及眼轴的变化并记录视力及屈光度的改变。结果 :戴镜后 1年所有患者裸眼视力增加、屈光度减少、角膜中央曲率变平 (P <0 0 0 1)。两组角膜内皮细胞均有轻度减少 (P<0 0 5 ) ,两组内皮细胞损失量对比无显著性差异 (P >0 0 5 )。两组角膜中央区厚度均轻度变薄 (P <0 0 5 ) ,而两组厚度变化量比较在统计学上无显著性差异 (P >0 0 5 )。结论 :角膜塑型术对降低近视屈光度效果明显 ,但长期配戴有可能造成角膜内皮细胞及厚度轻度减少 ,必须作严格全面的临床检查以及时观察 Objective: To observe the change of corneal endothelial cells and corneal thickness one year after wearing Orthokeratology. Methods: A total of 83 eyes of 43 patients with OK lens who were followed up for 1 year were divided into 2 groups according to the refraction of myopia, Ⅰ group (<50D), 22 cases of 46 eyes, Ⅱ group (≥ 50 cases) of 21 cases, 37 eyes . The changes of corneal endothelial cells and thickness were examined by non-contact corneal endothelium microscope and corneal thickness gauge. Meanwhile, the changes of corneal curvature and axial length were examined by Eyesys corneal topography and A-ultrasound, respectively. The changes of visual acuity and refraction were recorded. Results: All patients with uncorrected visual acuity increased, refraction decreased, and central corneal curvature became flat (P <0.01) 1 year after wearing glasses. Corneal endothelial cells in both groups had a slight decrease (P <0.05), and there was no significant difference in endothelial cell loss between the two groups (P> 0.05). The central corneal thickness of both groups were slightly thinned (P <0 05), while there was no statistically significant difference in thickness between the two groups (P> 0.05). CONCLUSION: Orthokeratology is effective in reducing myopia diopter, but long-term wearing may cause a slight decrease of corneal endothelial cells and thickness, so we must make a rigorous and comprehensive clinical examination and timely observation
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