One-Year Outcome of Overnight Orthokeratology in Taiwanese Children and Adolescents

過夜型隱形眼鏡塑型術在臺灣青少年及兒童一年之臨床追蹤結果

王一中(I-Jong Wang) ； 邱正仁(Cheng-Jen Chiou) ； 馮介凡(Jieh-Fang Fung) ； 朱智盟(Je-Men Chu) ； 胡芳蓉(Fung-Rong Hu)

《慈濟醫學雜誌》 17卷1期 (2005/02) Pp. 27-33

https://doi.org/10.6440/TZUCMJ.200502.0027

摘要

隱形眼鏡塑型術是利用高透氧的硬式隱形眼鏡使眼角膜弧度短暫的變平而使近視暫時性的減少，本文是利用回溯性的研究方法探討過夜型隱形眼鏡塑型術對病患之屈光度數的影響。病人與方法：我們將46位病患（其中包括20位男性和26位女性，平均12.1歲）分為輕度近視（-0.75 to -3.5 diopter (D)20位）和中度近視（-3.75 to -7.0 D;26位）二組，他們都接受高透氧的硬式隱形眼鏡(OK-3,Context)，其中病患之左眼在配戴後第一星期，第1、3、6和12個月後接受細隙燈、視力、屈光、垂直和水平偏中心性的臨床檢查。結果：病患之平均球面度數是-3.79±1.50D，平均散光是-0.81±0.64D，為輕度近視病患在12個月時有95%患視力在20/40以上，在中度近視則有72%到這個程度。球面度數下降在三月之內較穩定(-1.55±1.51D)，但是後變化就較大了。散光度數變化在整個時期都較大，在第六個月時平均為-1.15±1.06D，8.7%的病人在第十二個月時最佳短矯正視力下降一行以上。結論：過夜型隱形眼鏡塑型術對中低度數的近視患者能暫時降低度數，但是必需小心其可能的併發症和所造成散光增加的結果。

關鍵字

過度型硬式隱形眼境角膜塑型術 ； 角膜 ； 散光

並列摘要

Objective: Orthokeratology is the programmed temporary reduction in myopia using rigid gas-permeable contact lenses. The current study retrospectively assessed refractive and astigmatic changes in subjects who had undergone overnight orthokeratology. Patients and Methods: Forty-six patients (20 males and 26 females; mean age, 12.1 years) were divided into 2 groups: those with mild myopia (defined as -0.75 to -3.5 diopter (D); n=20) and moderate myopia (defined as -3.75 to -7.0 D; n=26). Subjects received overnight orthokeratology using reverse-geometry rigid contact lenses (OK-3, Context). The left eye from each patient was assessed at 1 week, and at 1, 3, 6, and 12 months following the procedure. Assessment involved slit lamp examination, visual acuity, vertical and horizontal eccentricity, refractive and astigmatic changes, and central and peripheral K readings. Results: The mean baseline sphere was -3.79±1.50 D and the mean astigmatism was -0.81± 0.64 D. In the mildly myopic group, visual acuity improved to 20/40 or better in 95% of patients by 12 months. In the moderately myopic group, 72% of patients achieved this visual acuity. Spherical changes were essentially stable by the third month (-1.55±1.51 D), although slight fluctuations were noted thereafter. Astigmatism reached its maximum by the sixth month (-1.15±1.06 D). The increase in astigmatism over the entire study period was significant. Four patients (8.7%) experienced loss of 1 or more lines of best-corrected visual acuity after 12 months of lens wear. Conclusions: The visual improvement effect of overnight orthokeratology is a treatment modality to temporarily reduce myopia, especially for mildly myopic subjects. Extended use of overnight orthokeratology is cautioned against, however, due to the increased astigmatism that can result.

並列關鍵字

overnight orthokeratology ； myopia ； astigmatism