【摘要】 目的 探讨角膜生物力学性能与角膜塑形术后角膜曲率变化的相关性。方法 前瞻性研究。选取复旦大学附属眼耳鼻喉科医院接触镜室就诊的青少年近视患者29例（57眼），平均年龄（9.7±2.1）岁，等效球镜度范围-1.00~-4.75 D，验配前进行眼科常规检查、屈光检查、Oculus Pentacam三维眼前节分析仪测量角膜地形图、Canon角膜曲率计测量角膜平坦K1及陡峭K2、眼反应分析仪测量角膜生物力学性能包括角膜滞后量（CH）及角膜阻力因子（CRF）。根据角膜中央K值及e值采用经验法进行镜片验配。分别于戴镜1 d及7 d后进行角膜曲率测量，测得角膜平坦K1及陡峭K2。对戴镜前、戴镜后1 d、戴镜后7 d的视力、角膜曲率进行方差分析，并分别对CH及CRF值与戴镜1 d、7 d后角膜曲率变化值相关性进行分析。结果 配戴1 d后角膜曲率平坦K1由（42.76±0.78）D下降到（41.78±0.86）D，戴镜7 d后下降为（40.52±1.26）D（F=71.962，P<0.05），戴镜1 d后陡峭K2由（43.91±0.81）D下降到（43.34±0.89）D，戴镜7 d后下降到（42.14±1.44）D（F=40.602，P<0.05），不同时间点间差异均存在统计学意义。相关性分析结果显示，角膜生物力学参数CH、CRF值与戴镜后1 d、7 d角膜曲率平坦K1、陡峭K2的变化均不存在相关性。结论 角膜生物力学参数CH及CRF值在角膜塑形术角膜重塑过程中所起到的作用未得到证实。
【关键词】 生物力学； 近视； 角膜塑形术； 角膜曲率
DOI：10.3760/cma.j.issn.1674-845X.2014.05.007
作者单位：200031上海，复旦大学附属眼耳鼻喉科医院眼科
通信作者：褚仁远，Email：churenyuan@hotmail.com
Clinical study on the influence of corneal biomechanical properties on early-stage orthokeratology
Zhou Jiaqi， Li Mei， Zhong Yuanyuan， Zhou Xingtao， Chu Renyuan. Department of Ophthalmology， Eye and ENT Hospital， Fudan University， Shanghai 200031， China
Corresponding author：Chu Renyuan，Email：churenyuan@hotmail.com
【Abstract】 Objective To investigate the correlation between corneal biomechanical properties and the changes in corneal curvature when undergoing orthokeratology. Methods Fifty-seven eyes of 29 subjects with -1.00- -4.75 D of myopia wore overnight reverse-geometry rigid gas-permeable lenses were included in this prospective study. The clinical examination included refractive error， uncorrected and best corrected visual acuity， and slit-lamp examination and were recorded in detail. Corneal resistance factor （CRF） and corneal hysteresis （CH） were measured with an ocular response analyzer. Corneal topography was measured with an Oculus Pentacam analysis system at pre-wear. Keratometric curvature （steep and flat K values） was measured pre-wear， and 1 day and 7 days post-wear. A one-way ANOVA and correlation analysis were used for statistical analysis. Results The flat keratometric curvatures （K1） were significantly reduced from 42.76±0.78 D （baseline） to 41.78±0.86 D after one night of wear， and 40.52±1.26 D after 7 nights of wear （F=71.962， P<0.01）. The steep keratometric curvatures （K2） were significantly reduced from 43.91±0.81 D （baseline） to 43.34±0.89 D after one night of wear， and 42.14±1.44 D after 7 nights of wear （F=40.602， P<0.01）. CRF and CH did not correlate significantly with the reduction of K1 and K2， respectively， after 1 and 7 nights of wear. Conclusion This study indicates that the biomechanical properties CRF and CH did not correlate with the changes in corneal curvature while undergoing orthokeratology.
【Key words】 Biomechanics； Myopia； Orthokeratology； Corneal curvature