| 摘要: | 角膜塑型片(OrthoKeratology lens)，簡稱OrthoK，是一種反幾何設計的硬式隱形眼鏡。於睡前配戴，白天起床時卸除，仍可維持視力良好，因此臨床上用於控制近視。本回溯型研究之目的乃在評估配戴OrthoK鏡片對眼角膜曲率、視力、以及球面度數之影響。研究對象納入符合例行性視力檢查並無任何眼睛疾病、近視度數在-0.50~-6.50之間、散光度數在-0.50~-2.00之間，7歲至16歲有配戴OrthoK鏡片的學童共有85名為實驗組，對照組30人則為配戴傳統眼鏡的學童。比較兩組3年以上之近視控制程度，在配戴鏡片後的第1天、第1週、第3個月、第6個月、第1年、第3年、以及停戴2星期後，其角膜曲率、視力、球面度數的變化進行分析比較，以成對-T檢定、ANOVA檢定作分析。結果顯示與基線相比，配戴OrthoK鏡片者，不管近視度數高低，均在配戴後1天的視力、球面度數、角膜曲率有顯著差異(P<0.05)，表示配戴OrthoK鏡片1天即可改善視力。但低度數近視者在配戴OrthoK鏡片1個月後，球面度數顯著減少，表示改善視力的作用已趨平穩。而高度數近視者在則在6個月後才顯著減少(P<0.05)，表示高度數近視者需要較久的時間才能趨於平穩。因此，最終測量球面度數與初始近視高低有其顯著相關性。由本回溯型研究的結果推論：配戴OrthoK鏡片治療近視，在配戴後可顯著降低近視度數，角膜曲率變化明顯由中央移往周邊，持續塑型可以提供白天穩定良好裸視視力。且由停戴OrthoK鏡片2星期後，角膜曲率與初始角膜曲率沒有顯著差異，說明角膜並沒有因為長期塑型而有不可逆性之傷害，故對有近視的學童，配戴OrthoK鏡片是可以考慮的一種選擇
OrthoKeratology lens, or OrthoK, is an anti-geometric hard contact lens. It is worn before going to bed then can be maintained high quality vision during daytime removal. Therefore, it is a good way to clinically control myopia. The purpose of this retrospective study was to evaluate the effect of wearing OrthoK lenses on corneal curvature, visual acuity, and spherical equivalents. Eighty-five subjects in the experimental group were included routine eyesight examination without any eye disease, myopia was between -0.50 D and -6.50 D, astigmatism was between -0.50 D~-2.00 D, and 7 to 16 years old had OrthoK lenses. Another thirty subjects in the control group were wearing traditional glasses. Comparing the degree of myopia control in the two groups for more than 3 years, after the first day, the first week, the third month, the sixth month, the first year, the third year with wearing lenses, and two weeks after the OrthoK lenses were removed. The changes of corneal curvature, visual acuity and spherical equivalents were analyzed and compared by Pair-T test and ANOVA test. The results showed that compared with the baseline, regardless of the degree of myopia, there was a significant difference in visual acuity, spherical equivalents, and corneal curvature after one day with wearing OrthoK lenses (P<0.05), which indicate that the OrthoK lenses were worn for one day can improve vision. However, after OrthoK lenses treatment for one month, the changed degree of spherical surface of the low-degree myopia was slowly, indicating that the effect of improving vision has stabilized. The height of myopia was changed lowly after 6 months OrthoK treatment (P<0.05), indicating that the height of myopia requires a longer time to stabilize. Therefore, the final measurement of the spherical equivalents has a significant correlation with the initial myopia. Inferred from the results of this retrospective study: wearing OrthoK lenses for the treatment of myopia can significantly reduce the degree of myopia after wearing and corneal curvature changes from the central to the periphery, continuous shaping can provide stable and good naked vision during the day. After two weeks of wearing the OrthoK lenses, there was no significant difference between the corneal curvature and the initial corneal curvature, indicating that the cornea was not irreversible damage due to long-term molding. Therefore, for students with myopia, wearing OrthoK lenses is an option to consider. |
