低浓度阿托品联合角膜塑形镜对低中度近视青少年裸眼视力、角膜曲率、球镜度数的影响OACSTPCD
Effects of low-concentration atropine combined with orthokeratology on uncorrected visual acuity,corneal curvature and spherical equivalent in adolescents with low to moderate myopia
目的 探讨低浓度阿托品联合角膜塑形镜对低中度近视青少年裸眼视力、角膜曲率、球镜度数的影响.方法 回顾性病例对照研究.选取2020年8月至2023年1月收治的低中度近视青少年患者90例作为研究对象,按照随机数字表法分为阿托品组、角膜塑形镜组和联合组,每组各30例.阿托品组给予低浓度阿托品治疗,角膜塑形镜组给予角膜塑形镜治疗,联合组给予低浓度阿托品联合角膜塑形镜治疗,观察比较治疗前后三组患者的裸眼视力、角膜曲率、等效球镜度、眼压、眼轴长度、屈光度、角膜内皮变化,并统计不良反应率.结果 治疗后,联合组角膜曲率、等效球镜度低于角膜塑形镜组、阿托品组,裸眼视力高于角膜塑形镜组、阿托品组(F=17.980、F= 5.192、F=29.760、均P<0.05);治疗后,联合组眼压、眼轴长度、屈光度低于角膜塑形镜组、阿托品组(F=3.667、F= 18.731、F=5.118、均P<0.05);治疗前和治疗后,三组患者角膜内皮细胞密度(CD),内皮细胞六边形比例(HEX),内皮细胞变异系数(CV)比较,差异均无统计学意义(P>0.05);三组患者总不良反应比较,差异无统计学意义(P>0.05).结论 低浓度阿托品联合角膜塑形镜可有效改善低中度青少年的裸眼视力和屈光度,增强眼轴长度、眼压的控制能力,且对角膜内皮细胞无明显影响,安全性高.
Objective To explore the effects of low-concentration atropine combined with orthokeratology on uncorrected visual acuity UCVA,corneal curvature and spherical equivalent in adolescents with low to moderate myopia.Methods A prospective case-control study.A total of 90 adolescent patients with low to moderate myopia from August 2020 to January 2023were enrolled.According to the random number table method,they were divided into the atropine group,orthokeratology group and combination group,30 cases in each group.The atropine group was treated with low-concentration atropine,the orthokeratology group was treated with orthokeratology,and the combination group was treated with low-concentration atropine and orthokeratology.The changes of UCVA,corneal curvature,spherical equivalent,intraocular pressure,ocular axial length,diopter and corneal endothelium before and after the treatment were observed and compared among the three groups.The incidence of adverse reactions was statistically analyzed.Results After the treatment,corneal curvature and spherical equivalent in the combination group were lower than those in the orthokeratology group and atropine group,while UCVA was higher than that in the orthokeratology group and atropine group(F=17.980、F=5.192、F=29.760、P<0.05).After the treatment,the intraocular pressure,ocular axial length and diopter in the combination group were lower than those in the orthokeratology group and atropine group(F=3.667、F=18.731、F=5.118、P<0.05).There was no significant difference in corneal endothelial cell density(CD),hexagonal cell ratio(HEX)or coefficient of variation(CV)between the two groups before and after the treatment(P>0.05).There was no significant difference in the total incidence of adverse reactions among the two groups(P>0.05).Conclusions Low-concentration atropine combined with orthokeratology can effectively improve UCVA and diopter,enhance the control ability of axial length and intraocular pressure in adolescents with low to moderate myopia.There were no significant effects on corneal endothelial cells,with high safety.
刘姗;刘璐;田沫;王海伟;岳岩坤
100045 北京,首都医科大学附属复兴医院眼科100045 北京,首都医科大学附属复兴医院眼科100045 北京,首都医科大学附属复兴医院眼科100045 北京,首都医科大学附属复兴医院眼科100045 北京,首都医科大学附属复兴医院眼科
阿托品角膜塑形镜低中度近视
AtropineOrthokeratologyLow to moderate myopia
《临床眼科杂志》 2024 (2)
107-111,5
北京市自然科学基金项目(7192080)北京市西城区优秀人才培养专项经费资助项目(202039)
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