目的：探讨配戴角膜塑形镜矫正近视对角膜形态的变化及影响。

方法：选择2015-01/2016-12期间在我院接受配戴角膜塑形镜矫正近视的90例患者为研究对象，根据配戴方式不同分为观察组(夜戴)45例90眼和对照组(日戴)45例90眼，观察比较两组患者配戴角膜塑形镜前、配戴后1wk，1、3、6mo时的等效球镜度(spherical equivalent，SE)、裸眼视力(uncorrected visual acuity，UCVA)、角膜曲率及角膜中央厚度。

结果：两组患者在戴镜后1wk，1、3、6mo时测量角膜中央厚度均明显低于戴镜前，差异有统计学意义(P<0.05)； 观察组在戴镜后1、3、6mo时测量角膜中央厚度均明显低于对照组，差异有统计学意义(P<0.05)； 两组患者配戴角膜塑形镜后1wk，1、3、6mo时的角膜曲率值均明显低于本组配戴角膜塑形镜前，且配戴前后差异具有统计学意义(P<0.05)。观察组配戴角膜塑形镜6mo时的角膜曲率(40.0±0.5D)明显低于对照组配戴角膜塑形镜6mo时的角膜曲率(41.3±0.9D)，且组间差异具有统计学意义(P<0.05)； 在戴镜3mo时观察角膜上皮染色率，观察组上皮染色率阳性占49%(44/90)，对照组上皮染色率阳性占29%(26/90)，两组均以0级、1级为主； 随着角膜塑形镜配戴时间延长，两组患者的SE水平都呈下降趋势，且均明显低于配戴之前。配戴6mo时观察组SE水平(-0.42±0.20D)明显低于对照组SE水平(-0.52±0.19D)，差异具有统计学意义(P<0.05)； 两组患者配戴角膜塑形镜后UCVA值明显升高，且与配戴前相比差异具有统计学意义(P<0.05)。

结论：配戴角膜塑形镜可降低近视度数，提高视力，且夜间配戴效果相对优于白天配戴。

METHODS: Totally 90 patients were treated with orthokeratology from January 2015 to December 2016. They were divided into observation group(overnight wearing)and control group(daytime wearing), 45 cases(90 eyes)in each. The central corneal thickness, corneal curvature,spherical equivalent(SE), uncorrected visual acuity(UCVA)of both groups were compared before and after wearing orthokeratology lens for 1wk, 1, 3, and 6mo.

RESULTS: The central corneal thickness of two groups before wearing glasses was significantly higher than that of the cornea after wearing glasses 1wk, 1, 3 and 6mo(all P<0.05); the central corneal thickness of the observation group at 1, 3 and 6mo after wearing glasses was significantly lower than that of the control group(P<0.05). The corneal curvature values of the two groups before wearing glasses were significantly higher than that of the cornea after wearing for 1wk, 1, 3 and 6mo(all P<0.05). The corneal curvature of observation group at 6mo was significantly lower than that of the control group(40.0±0.5D vs 41.3±0.9D, P<0.05). The staining rate of corneal epithelium was observed at 3mo after wearing glasses. The positive rate of epithelial staining was 49%(44/90)in the observation group and 29%(26/90)in the comparison group; the grade 0, grade 1 accounted for the majority of the two groups. With the orthokeratology lens wearing longer, the SE level of two groups showed a downward trend. The spherical equivalent of observation group at 6mo was significantly lower than that of the control group(-0.42±0.20D vs -0.52±0.19D, P<0.05). The UCVA value of two groups after wearing glasses significantly increased than that before wearing glasses(all P<0.05).

CONCLUSION: Wearing orthokeratology lens can reduce myopia degree. Wearing it overnight has the better outcome than wearing in the daytime.