[1]钱晓文,蒋伟,戴国林.角膜塑形镜配戴后偏心对青少年近视患者视觉质量的影响[J].眼科新进展,2018,38(10):917-920.[doi:10.13389/j.cnki.rao.2018.0217]
　QIAN Xiao-Wen,JIANG Wei,DAI Guo-Lin.Effect of eccentricity after keratoplasty on young patients with myopia[J].Recent Advances in Ophthalmology,2018,38(10):917-920.[doi:10.13389/j.cnki.rao.2018.0217]
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角膜塑形镜配戴后偏心对青少年近视患者视觉质量的影响/HTML
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
38卷
期数:
2018年10期
页码:
917-920
栏目:
近视专题
出版日期:
2018-10-05

文章信息/Info

Title:
Effect of eccentricity after keratoplasty on young patients with myopia
作者:
钱晓文; 蒋伟; 戴国林
213002　江苏省常州市，常州市武进人民医院眼科
Author(s):
QIAN Xiao-Wen; JIANG Wei; DAI Guo-Lin
Department of Ophthalmology，Changzhou Wujin People’s Hospital，Changzhou 213002，Jiangsu Province，China
关键词:
角膜塑形镜; 偏心; 视觉质量; 并发症
Keywords:
orthokeratology; eccentricity; visual quality; complication
分类号:
R778
DOI:
10.13389/j.cnki.rao.2018.0217
文献标志码:
A
摘要:
目的　探讨角膜塑形镜配戴后偏心对青少年近视患者视觉质量的影响及与并发症的相关性。方法　选取于本院配戴角膜塑形镜的130例青少年近视患者为研究对象。分析戴镜前及戴镜后1周、6个月、1 a、2 a患者的偏心距离与OQAS值、调制传递函数截止频率（modulation transfer function cutoff，MTF cutoff）、客观散射指数（objective scatter index，OSI）、斯特列尔比率（strehl ratio，SR）之间的关系。戴镜后每个月对患者进行复诊，对并发症发生情况及首次出现的时间进行记录。应用受试者工作特征（ROC）曲线研究偏心距离对并发症发生的识别能力。采用Spearman相关系数分析偏心距离与并发症发生时间的相关性。结果　130例患者中轻度偏心患者81例，中高度偏心患者49例。戴镜后各个时间的偏心距离比较，差异无统计学意义（P＜0.05）；OQAS值、MTT cut off、SR较戴镜前显著下降，OSI较戴镜前显著升高，差异均有统计学意义（均为P＜0.05）。戴镜后偏心距离和视觉质量指标不同时间点间比较，差异均无统计学意义（均为P＞0.05）。在随访时间内，并发症发生率为40.00%（52/130），其中轻度偏心患者中并发症的发生率为18.52%（15/81），中高度偏心患者为75.51%（37/49），中高度偏心患者并发症的发生率明显高于轻度偏心患者（P＜0.001）。相关性分析显示：总偏心距离与MTT cut off、不同对比度下OQAS值（OV100%、OV20%、OV9%）均呈负相关（均为P＜0.05），与OSI呈正相关（P＜0.05），与SR未见明显相关性（P＞0.05）；ROC曲线分析结果显示，轻度偏心患者的AUC值为0.434（P=0.529），中高度偏心患者的AUC值为0.863（P＜0.001）；偏心距离与患者发生并发症的时间呈负相关（r=-0.711，P＜0.001）。结论　配戴角膜塑形镜后偏心距离与视觉质量各指标以及并发症的发生具有明显的相关性，并且偏心程度大的患者其并发症发生可能性更大。
Abstract:
Objective　To explore the effect of eccentricity after orthokeratology on the visual quality of adolescent visual patients and its correlation with complications.Methods　A total of 130 adolescent myopia patients who underwent orthokeratology were selected as subjects.The relationship between the eccentricity and optical quality analysis system value （OQAS value），modulation transfer function cutoff （MTF cutoff），objective scatter index（OSI），and the strehl ratio （SR） of patients were analyzed with pre- and post-wearing lenses at 1 week，6 months，1 year，2 years after wearing the glasses.Then the patients were reviewed every month after wearing the glasses，and the complications and the time of first occurrence were recorded.The receiver operating characteristic （ROC） curve was used to study the ability of eccentric distance to recognize complications.Spearman correlation coefficient was used to analysis the correlation between eccentric distance and the onset time of complications.Results　Among the 130 patients，81 patients developed mild eccentric distance and 49 were middle and high eccentric patients.There was no significant difference in the eccentric distance at each time after wearing the glasses （P<0.05）.OQAS value，MTF cut off，and SR decreased significantly compared with those before wearing，and OSI was significantly higher than that before wearing the glasses.The differences were statistically significant （all P<0.05）.There was no significant difference in the eccentricity and visual quality indicators among the different time points after wearing the glasses （all P>0.05）.During the follow-up period，the complication rate was 40.00% （52/130）.The incidence of complications in the mild eccentric patients was 18.52% （15/81），and that in the middle eccentric patients was 75.51% （37/49）.The incidence of complications in the middle-high eccentric patients was significantly higher than that in the mild eccentric group （P<0.001）.Correlation analysis showed that the total eccentric distance was negatively correlated with MTF cut off and OQAS values （OV100%，OV20%，OV9%） under different contrasts （all P<0.05），and positively correlated with OSI （P<0.05）.There was no significant correlation with SR （P>0.05）.The ROC curve analysis showed that the AUC value of the mild eccentricity patients was 0.434 （P=0.529），and the AUC value of the middle height eccentricity patients was 0.863 （P<0.001）.The eccentric distance was negatively correlated with the time of complications in the patients （r=-0.711，P<0.001）.Conclusion　After the wearing of Orthokeratology lens，the eccentric distance has a significant correlation with the visual quality indicators and the occurrence of complications.And patients with large eccentricity are more likely to have complications.

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更新日期/Last Update: 2018-09-28