角膜塑形镜对角膜有没有伤害?客观方面让您了解
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角膜塑形镜对角膜有没有伤害?客观方面让您了解

2017-2-26 17:58| 发布者: admin| 查看: 232| 评论: 0
摘要: 有很多认认为隐形眼镜这类东西对眼睛还是有一定伤害的。现在我身边有很多同学佩戴角膜塑形镜。很多人都问过我角膜塑形镜对角膜有没有伤害,下面我也不直接说到怎么样,希望各位能通过这篇文章有一个客观的认知.需要提 ...

有很多认认为隐形眼镜这类东西对眼睛还是有一定伤害的。现在我身边有很多同学佩戴角膜塑形镜。很多人都问过我角膜塑形镜对角膜有没有伤害,下面我也不直接说到怎么样,希望各位能通过这篇文章有一个客观的认知.需要提醒各位的是,角膜塑形镜属于三类医疗器械,验配之前需要查看对方是否验配资质!

角膜塑形镜完全是根据患者眼部综合情况来为每一个近视的朋友量身定制的,有大概如下特点:
设计合理:适合华人眼部特点的四区七弧反转几何设计,使得镜片与角膜之间吻合性加强,泪液层分布合理,配戴更加安全、舒适;
材料优质:使用全球评价最好的美国博士顿XO材料,透气性好,湿润角小,弹性模量高,抗沉淀强。透氧高DK大于100(ISO标准)。
制作精密:应用先进的数码技术分析角膜地形参数,确定镜片的各种数据,专业设计,电脑数控技术精密制作;
验配严谨:专业医师个性化服务为每位患者“量眼定制”配适度最佳的镜片,采用试戴片验配法,对不符合条件者,一概不予验配;
配戴方便:使用者只需要夜间睡眠中配戴8小时,白天可恢复裸眼视力。无需配戴眼镜即可满足学习、工作和运动需要;


以下附上一些专业文献及数据介绍
1,这是中华眼科上的一篇关于佩戴OK镜后角膜厚度与角膜内皮的观察。
Title:[Corneal thickness and endothelial observation for youth myopia patients fitted with ortho-k lens for seven years
OBJECTIVE: To observe the changes of the corneal thickness and ednothelial cell for youth myopia patients fitted with long-term orthokeratology (Ortho-K, OK). METHODS: Retrospective case series study. During 2000 to 2005, 30 patients with OK lens wearing more than seven years in the Bei Yi Optometry & Ophthalmology Center had been chose in this study, and all the right eye of each person was selected for retrospective case statistics (30 eyes). the measure instruments, including A scan pachymeter and endothelium microscope, were used to the long-term continuous supervise, which involved the central and para-peripheral corneal thickness, corneal endothelium and corneal conjunctival complications rate. Then the 30 patients were divided into two groups: the moderate-low myopia group is less than -4.00 D with 12 patients (24 eyes), and the high myopia group is more than -5.00 D with 10 patients (20 eyes). And the difference between two groups was involved in this research. The one-way analysis of variance was used to compare before, after six months, after one year, after three years, after five years and after seven years OK lens wearing for the patients. And the variance analysis was used to compare between moderate-low and high myopia groups. 
RESULTS: Corneal thickness analysis during these seven years: the average central corneal thickness before and after seven-years wearing are (549.45 +/- 33.72) and (538.97 +/- 34.28) microm, respectively, and the central corneal thickness had no significant changes (F = 1.749, P = 0.076); The corneal thickness of nasal, superior, temporal and inferior also had no significant changes (P > 0.05). The average corneal endothelial cell densities before and after seven-years wearing are (3188.53 +/- 272.25) and (3186.64 +/- 278.69) num/mm(2), respectively, and the corneal endothelial cell density had no significant changes during seven years wearing (F = 2.204, P = 0.088). The average hexagonal cell ratio before and after seven-years wearing are 66.18% +/- 6.42% and 64.65% +/- 8.03%, respectively, and the hexagonal cell ratio had no significant changes during seven-years wearing (F = 2.097, P = 0.085). The average cell area and coefficient of variation also had no significant change during seven-years wearing (F = 2.143, 2.114; P > 0.05). There was also no statistics significance between moderate-low and high myopia of the endothelial cell and the corneal thickness change with long-term OK lens wearing. The slight corneal conjunctival complication was occurred during seven-year wearing, such as corneal fluorescence stain (less than 7%), and no serious complication was happened during seven-year wearing
CONCLUSIONS: In generally, it is safety for youth with long-term scientific and standardized wearing high Dk material orthokeratology contact lens.
(佩戴高头透氧性(高DK值)的OK镜还是很安全的)

2,关于佩戴前后角膜上皮的厚度的观察,其实这是国人做的一篇,但发在国外的杂志上。
(Qian et al., 2014) journal:Curr Eye Res

title:Pachymetry map of corneal epithelium in children wearing orthokeratology contact lenses
PURPOSE: To study the pachymetry map of the corneal epithelium in children wearing orthokeratology lenses automatically generated by a Fourier-domain optical coherence tomography.
MATERIALS AND METHOD: The study was conducted on 60 children who had been fitted with myopic orthokeratology lenses. Patients were divided into two groups according to the duration of OK lens treatment (group 1: </=14 days, n = 28; group 2: >14 days, n = 32). The control group consisted of 44 children. An FD-OCT device with a pachymetry module was used to map the central 6-mm corneal epithelial thickness. An epithelial thickness map was automatically generated and divided into three zones: central 2 mm, paracentral 2 to 5 mm (P1) and mid-peripheral 5 to 6 mm (P2). The average epithelial thickness of central (C), the temporal (T1), nasal (N1), superior (S1) and inferior (I1) sectors of P1, and the temporal (T2), nasal (N2), superior (S2) and inferior (I2) sectors of P2 were recorded and compared. The minimum and maximum points of epithelial thickness across the map were also recorded. Munnerlyn's formula was used to model the expected change in refractive error based on Delta(Max-Min) (Delta(Max-Min) = (Max-Min)study-(Max-Min) mean of control). 
RESULTS: The central epithelial thickness was significantly different between individual groups and a significant difference from the control (Group 0) was seen in each treatment group. Both the epithelial thickness measurements of T1 and I1 were thinnest in Group 1. Both the epithelial thickness measurements of S2 and I2 were thickest in Group 2. The difference between maximum and minimum thickness was significantly different between groups with the largest effect in Group 2. The refractive changes predicted by Munnerlyn's formula were less than the actual refractive changes measured in both study groups.
CONCLUSIONS: The epithelial thickness map automatically generated by FD-OCT can provide regional information about corneal epithelium thickness following overnight wearing of OK lenses.
(通过FD-OCT可以很好观察佩戴OK镜后角膜各个位置上皮厚度的变化)

3,关于佩戴塑形镜与使用阿托品散瞳对近视控制作用的比较。
journal:BMC ophthalmology
Title:Overnight orthokeratology is comparable with atropine in controlling myopia
BACKGROUND: Many efforts have been invested in slowing progression of myopia. Among the methods, atropine administration and orthokeratology (OK) are most widely used. This study analyzed the efficacy of atropine and OK lens in controlling myopia progression and elongation of axial length. METHODS: This retrospective study included 105 patients (210 eyes) who wore OK lenses and 105 patients (210 eyes) who applied 0.125% atropine every night during the 3 following period. Student t-test, linear regression analysis, repeated measure ANOVA, and Pearson's correlation coefficient were used for statistical analysis. RESULTS: The change in axial length per year was 0.28 +/- 0.08 mm, 0.30 +/- 0.09 mm, and 0.27 +/- 0.10 mm in the OK lens group, and 0.38 +/- 0.09 mm, 0.37 +/- 0.12 mm, and 0.36 +/- 0.08 mm in the atropine group for years 1, 2, and 3, respectively. Linear regression analysis revealed an increase in myopia of 0.28 D and 0.34 D per year, and an increase in axial length of 0.28 mm and 0.37 mm per year in the OK lens and atropine groups, respectively. Repeated measure ANOVA showed significant differences in myopia (p = 0.001) and axial length (p < 0.001) between the atropine and OK lens groups; in astigmatism, there was no significant difference in these parameters (p = 0.320). Comparison of increases in axial length in relation to baseline myopia showed significant correlations both in the OK lens group (Pearson's correlation coefficient, r = 0.259; p < 0.001) and atropine group (r = 0.169; p = 0.014). High myopia patients benefited more from both OK lenses and atropine than did low myopia patients. The correlation of baseline myopia and myopia progression was stronger in the OK lens group then in the atropine group. 
CONCLUSIONS: OK lens is a useful method for controlling myopia progression even in high myopia patients.(对于高度近视,佩戴OK镜还是可以很好的延缓近视发展的)

4,这是一篇香港做的关于佩戴OK镜后发生角膜炎的文章。
Title:Orthokeratology-Associated Infectious Keratitis in a Tertiary Care Eye Hospital in Hong Kong
PURPOSE: To analyze cases of orthokeratology-associated infectious keratitis managed in a tertiary care eye hospital in Hong Kong between 2003 and 2013. DESIGN: Retrospective study. METHODS: Case records of patients with infectious keratitis attributable to orthokeratology contact lenses were analyzed. Data analyzed included clinical features, microbiological evaluation, and treatment outcomes.
RESULTS: A total of 23 patients were included (16 female, 7 male, mean age: 15.0 +/- 4.2 years; range: 9-23 years). All patients were using overnight orthokeratology for an average of 2.7 +/- 2.8 years (range: 3 months - 10 years) before the onset of infection. Clinical features included corneal infiltrate (n = 14, 60.9%) and corneal perineuritis (n = 12, 52.2%). Fifteen eyes (65.2%) had a positive microbiological culture obtained from corneal scrapings. The most commonly isolated organism was Pseudomonas aeruginosa (n = 6), followed by coagulase-negative Staphylococcus (n = 5) and Acanthamoeba (n = 3). Five cases of Pseudomonas aeruginosa and 5 cases of Acanthamoeba were identified from contact lenses or contact lens solution. The mean duration from disease onset to remission was 31.9 +/- 34.9 days (range: 6-131 days). All patients responded to medical treatment, and no emergency surgical intervention was needed. The best-corrected logMAR visual acuity improved significantly from 0.62 +/- 0.51 (20/83 Snellen) to 0.15 +/- 0.20 (20/28 Snellen) (Wilcoxon signed rank test, P < .001).
CONCLUSIONS: Orthokeratology-associated infectious keratitis continues to be a serious problem, especially in regions with high prevalence of myopia. Early clinical and microbiological diagnosis and intensive treatment can improve final visual outcomes.
(随着镜片质量的提高,严格规范的操作,发病率其实很低的,可见去正规的眼科医院去验配的安全性明显高于在商业机构验配,前期筛查的严格,随诊严格的复查,即便出现问题,有专家主任可以及时的给出治疗,也不会出现大问题。)

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