本文選題：近視　切入點(diǎn)：角膜塑形術(shù)　出處：《浙江大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的臨床觀察應(yīng)用角膜塑形術(shù)(Orthokeratology,OK鏡)一年的近視眼患者角膜形態(tài)、角膜光學(xué)特征的動(dòng)態(tài)變化,應(yīng)用傅立葉分析方法分析在角膜塑形術(shù)后角膜光學(xué)特征的變化。對(duì)象與方法本次研究對(duì)象從2015年7月至12月首診于浙江大學(xué)附屬第一醫(yī)院就診并接受角膜塑形術(shù)的近視眼患者中隨機(jī)選取20名(40眼),平均年齡13.1±2.86歲(年齡范圍8～20歲),平均等效球鏡度-2.94±0.94D。入選患者均行眼科檢查,以排除眼部病變及角膜接觸鏡禁忌癥。所有患者均雙眼佩戴夜戴型角膜塑形鏡行角膜屈光治療,分別在戴鏡前、戴鏡1天、1周、1月、3月、6月、12月時(shí)隨訪觀察,予檢查未矯正視力、驗(yàn)光,應(yīng)用Pentacam眼前節(jié)分析系統(tǒng)測量角膜前表面與后表面的平均曲率、角膜散光及Q值,測量角膜厚度,獲取傅立葉分析中各次傅立葉指數(shù):0次指數(shù)球面部分(最小球面半徑、球面偏心率)、1次指數(shù)非對(duì)稱部分(最大偏心距離)、2次指數(shù)散光部分(中央及外周規(guī)則散光)、傅立葉3次以上高階非規(guī)則散光部分。應(yīng)用SPSS 22.0軟件對(duì)所采的數(shù)據(jù)進(jìn)行統(tǒng)計(jì)分析。p0.05認(rèn)為有統(tǒng)計(jì)學(xué)意義。結(jié)果1.戴鏡前后的未矯正視力及等效球鏡度均發(fā)生明顯變化(p0.001)。與戴鏡前相比未矯正視力均有明顯提高(p0.001),其中前1周內(nèi)提高明顯(p0.001),等效球鏡度均有明顯降低(p0.001),其中前1周內(nèi)下降顯著(p0.001)。2.戴鏡前后的角膜前表面平均曲率、Q值均發(fā)生明顯變化(p0.001),而角膜散光戴鏡前后無明顯變化(p0.05)。與戴鏡前比較,戴鏡后角膜前表面平均曲率均明顯減小(p0.001)。與戴鏡前比較,戴鏡后角膜前表面Q值均有上升(p0.001),戴鏡1周內(nèi)Q值明顯上升(p0.001),戴鏡1周至1月上升減緩(p0.05),戴鏡1月Q值達(dá)到最高,之后稍有下降(p0.05)。角膜后表面平均曲率、后表面散光、Q值在戴鏡前后均未發(fā)生明顯變化(p0.05)。戴鏡前后中心頂點(diǎn)角膜厚度、角膜最薄點(diǎn)厚度、最薄點(diǎn)偏心距離均無明顯差異(p0.05)。3.傅立葉分析:與戴鏡前相比,戴鏡1天、1周、1月、3月、6月、12月最小球面半徑(傅立葉0次指數(shù))均明顯增大(p0.001),其中前3月持續(xù)增大;球面偏心率(傅立葉0次指數(shù))均下降(p0.001),其中前1周明顯下降;最大偏心距離(傅立葉1次指數(shù))均有增加(p0.001),其中前1月持續(xù)增加(p0.05);戴鏡后中央散光均有增大,其中除戴鏡1周外戴鏡前后差異均有統(tǒng)計(jì)學(xué)意義(p0.01),戴鏡1周后外周規(guī)則散光明顯增加(p0.05);與戴鏡前相比高次非規(guī)則散光均明顯增加(p0.05),但戴鏡1天無明顯變化(p0.05)。結(jié)論1.角膜塑形術(shù)對(duì)近視進(jìn)行屈光矯正是通過使角膜前表面變平降低角膜曲率實(shí)現(xiàn)的,這種變化在戴鏡1月內(nèi)明顯,1月后趨于穩(wěn)定。角膜塑形術(shù)對(duì)角膜后表面、角膜厚度及最薄點(diǎn)位置影響不大。2.角膜塑形術(shù)對(duì)傅立葉零次、1次、2次及高次指數(shù)均有影響,其中1月內(nèi)改變明顯,1月后趨于穩(wěn)定。傅立葉分析可以有效反映角膜塑形術(shù)對(duì)角膜光學(xué)特征的變化。
[Abstract]:Objective to observe the dynamic changes of corneal morphology and corneal optical characteristics in myopia patients with orthokeratology (Orthokeratology) for one year. Objects and methods from July 2015 to December, the subjects were first diagnosed at the first affiliated Hospital of Zhejiang University and underwent corneal plastic surgery. Twenty patients with myopia were randomly selected, with an average age of 13.1 鹵2.86 years (age range of 820 years, mean equivalent spherical degree of -2.94 鹵0.94D). All patients were examined by ophthalmology. In order to exclude ocular lesions and contraindication of contact lens, all the patients were treated with corneal refraction by wearing night-wearing keratoplastic lens. The patients were followed up for 1 week, January, March, June and June before wearing the lens, respectively. Uncorrected visual acuity, optometry, mean curvature, corneal astigmatism and Q value, corneal thickness were measured by Pentacam anterior segment analysis system. In Fourier analysis, every Fourier exponent: 0 exponent spherical part (minimum radius of spherical surface) is obtained. The spherical eccentricity is one order exponential asymmetric part (maximum eccentricity distance and 2 times exponential astigmatism) (central and peripheral regular astigmatism, Fourier 3 times or more irregular astigmatism). The data obtained are entered by SPSS 22.0 software. Statistical analysis. P0.05 showed that there was statistical significance. Results 1. The uncorrected visual acuity and equivalent spherical eyesight were significantly changed before and after wearing the mirror. The uncorrected visual acuity was significantly improved compared with that before wearing the mirror, especially within the first week. In the first week, the mean curvature Q value of the anterior surface of the cornea before and after the wear of the lens was significantly changed (p 0.001), but there was no significant change in the corneal astigmatism before and after the wear of the lens (P 0.05N), compared with that before and after the wear of the lens, the mean curvature of the cornea before and after the wear of the lens was significantly decreased. The mean curvature of the anterior surface of the cornea before and after the wear of the lens was significantly different from that before and after the wear of the lens. The mean curvature of the anterior corneal surface decreased significantly after wearing the lens, compared with that before the lens, the Q value of the anterior surface of the cornea increased significantly after wearing the lens, and the Q value of the anterior surface of the cornea increased significantly within one week (P 0.001a), the increase of the lens decreased from 1 week to January, and the Q value of the anterior corneal surface reached the highest on January. The mean curvature of the posterior corneal surface and the Q value of the posterior surface astigmatism did not change significantly before and after the wear of the lens, and the thickness of the central vertex cornea and the thinnest point of the cornea before and after the wear of the lens were not significantly changed. There was no significant difference in the eccentric distance between the thinnest points (p 0.05). Fourier analysis showed that the minimum spherical radius (Fourier exponent 0) in the first day, January, March, June and June increased significantly compared with that before wearing the mirror, and the mean minimum spherical radius (Fourier 0 exponent) was increased continuously before June. The spherical eccentricity (Fourier exponent 0) decreased by p 0.001g, and the maximum eccentric distance (Fourier index I) increased by p0.001g, and the central astigmatism increased after the wear of the mirror. There were significant differences between the two groups before and after wearing the mirror for one week, the regular astigmatism increased significantly after one week, and the irregular astigmatism of high order increased significantly compared with that before wearing the mirror, but there was no significant change in the astigmatism on the first day after wearing the mirror. Conclusion: there is no significant change on the first day after wearing the mirror. Conclusion: compared with before the mirror wear, the irregular astigmatism of the high order increased significantly (p 0.05). 1. Refractive correction of myopia is achieved by flattening the anterior surface of the cornea and reducing the curvature of the cornea. This change was obvious in January and stabilized after January. Corneal remodeling had little effect on the posterior corneal surface, corneal thickness and the position of the thinnest spot. The changes were obvious in January and stabilized after January. Fourier analysis can effectively reflect the changes of corneal optical characteristics in corneal plastic surgery.
【學(xué)位授予單位】：浙江大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R779.6

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 郭雷;張悅;陸新;周爽;劉巖;;Toric設(shè)計(jì)角膜塑形鏡矯治青少年復(fù)合性近視散光的臨床觀察[J];中國實(shí)用眼科雜志;2016年05期

2 吳楊楊;;角膜塑形鏡對(duì)高度近視患者矯正效果的Meta分析[J];國際眼科雜志;2016年04期

3 陳茹茹;陳巖;廉恒麗;;角膜像差與角膜前表面Q值對(duì)角膜塑形術(shù)近視控制的影響[J];中華眼視光學(xué)與視覺科學(xué)雜志;2016年02期

4 梅穎;唐志萍;;熒光評(píng)估作為角膜塑形鏡配適判斷標(biāo)準(zhǔn)的可靠性[J];中華眼視光學(xué)與視覺科學(xué)雜志;2016年02期

5 謝培英;;角膜塑形術(shù)治療高度近視眼及散光值得關(guān)注[J];中華眼科雜志;2015年01期

6 Ming Luo;Shengsheng Ma;Na Liang;;Clinical Efficacy of Toric Orthokeratology in Myopic Adolescent with Moderate to High Astigmatism[J];Eye Science;2014年04期

7 黃橙赤;鄭玲;姚春艷;岳俊野;王新梅;;S型角膜塑形鏡矯正青少年近視的臨床觀察[J];中國實(shí)用眼科雜志;2013年07期

8 王武;毛欣杰;;角膜塑形術(shù)對(duì)角膜表面形態(tài)及角膜像差的影響[J];中華眼視光學(xué)與視覺科學(xué)雜志;2011年04期

9 毛欣杰;黃橙赤;陳琳;呂帆;;角膜塑形術(shù)治療近視眼安全性的探討[J];中華眼科雜志;2010年03期

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