| ObjectiveFollow up and observe teenagers with different degrees of myopia who wear orthokeratology lens for 1 year,to discuss its effectiveness,safty in correcting and control of myopia,and its influence on visual quality,and provide certain theoretical basis for scientific and reasonable application for orthokeratology.Materials and MethodsSelect 172 cases(316 eyes)with juvenile myopia visited ophthalmology outpatient in our hospital from September 2016 to December 2017,including 84 males(156 eyes)and 88 females(160 eyes).There were 167 right eyes and 149 left eyes.They were divided into 3 groups according to the refractive degree(low myopia group 108 eyes from-1.00 D to-2.75 D,moderate myopia group 144 eyes from-3.00 D to-6.00 D,high myopia group 64 eyes from-6.25 D to-8.00D).Then the patients and their parents were fully informed and willingly divided into the experimental group and the control group.The experimental group was corrected with the same brand of orthokeratology lens,and the control group was corrected with the same brand of single-focus resin spectacles.The observation time was pre-wearing,after wearing 1 day,1 week,1 month,3 months,6 months,1 year.Observe the changes of corneal conjunctival epithelium,visual acuity,tear film breakup time(BUT)and the Schirmer test,spherical equivalent refraction(SE),intraocular pressure(IOP),axial length,corneal curvature,visual quality(including aberration detection and contrast sensitivity,subjective visual function questionnaire investigation).Compare the data differences between the two groups and pre-,after-wearing glasses.Using SPSS21.0 statistical software for data analysis,the measurement data were expressed as x ±s after the normal inspection.The inter-group data were examined equal variances by Levene test.Using repeated measure single factor analysis of variance for comparison of multiple points in time,SNK—q test for multiple comparison of each point in time between the two groups.Using paired t test and independent sample t test for comparison between and in the groups.The influencing factor of OK to control myopia using the Chi-square test(Pearson correlation analysis and linear regression).According to the test level p<0.05 that the difference was statistically significant.Results1.Therewere 6 eyes of Grade?,3 eyes of Grade?and 2 eyes of Grade ? with the corneal epithelium injury in the experimental group,but all cured.It can cause dry eye and tear film's unstably.2.UCVA(uncorrected visual acuity):the experimental group improved significantly,stabilized after 1week,and decreased both in the experimental group(stop wearing for 4weeks)and the control group after 1 year.All the experimental groupsshowed less decline than the control groups.The differences were all statistically significant(p<0.05).3.SE(spherical equivalent): the experimental group decreased significantly in 1week,stabilized after 1week,and increased both in the experimental group(stop wearing for 4weeks)and the control group after 1 year.All the experimental groupsshowed less decline than the control groups.The differences were all statistically significant(p<0.05).4.axial length: increased both in the experimental group(stop wearing for 4weeks)and the control group after 1 year.All the experimental groupshad less increase than the control groups.The differences were all statistically significant(p<0.05).5.corneal curvature: the experimental group decreased significantly,while low and moderate myopia groups tended to be stable after 1week,high myopia group tended to be stable after 1 month.There was no statistically significance between pre-wearing and after 1 year(stop wearing for 4weeks)(p>0.05).6.visual quality:the changes of aberration and CS in experimental group were most obvious in 1 week.Low and moderate myopia groups mainly decreased in the medium spatial frequency(6,12c/d).High myopia mainly decreased in the medium and high spatial frequency(6,12 and 18c/d).The difference between pre-wearing and after was not statistically significant in subjective visual quality(p>0.05).Conclusion1.Orthokeratology has a good control effect on the growth of juvenile myopia in different degrees.No serious complications occurred during the follow-up observation,and the safty was relatively high.2.Orthokeratology may decline the patient's visual quality in the early stage,but long-term follow-up revealed that the overall visual quality had no significant impact on lifelihood and learning,which is a safe and effective mean of correcting myopia. |
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