Short-term effects of overnight orthokeratology on corneal epithelial permeability and biomechanical properties.
Short-term effects of overnight orthokeratology on corneal epithelial permeability and biomechanical properties.
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夜间角膜塑形术对角膜上皮通透性和生物力学特性的短期影响。
DOI：
10.1167/iovs.13-11874
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发表时间：
2013
影响因子：
4.4
通讯作者：
Lin,MengC
中科院分区：
文献类型：
--
作者：
Yeh,ThaoN;Green,HarryM;Zhou,Yixiu;Pitts,Julie;Kitamata-Wong,Britney;Lee,Sophia;Wang,ShiyinL;Lin,MengC
目的：研究30个夜间角膜塑形手术(OOK)对角膜上皮细胞通透性(P-DC)和角膜生物力学特性的影响。访问被安排在基线觉醒后大约4小时，以及治疗后1、5、10、14和30天。在基线和第30天测量角膜生物力学特性和视力(VAS)。结果：39名新生和软性隐形眼镜佩戴者完成了这项研究。基线(ln[P DC][95%可信区间(CI)]=−2.65[−2.80至−2.5 0])与第30天(ln[P DC][CI]=−2.68[−2.85至−2.50])的P-DC差异无统计学意义(P=0.88)。角膜滞后(CH)和角膜阻力因子(CRF)从术前(CH[CI]=10.89[10.59~11.19]mm Hg，CRF[CI]=10.35[9.99~10.72]mm Hg)至第30天(CH[CI]=10.59[10.31~10.87]mm Hg，CRF[CI]=9.58[9.26~9.89]mm Hg)显著降低(P=0.001，P=0.001)。治疗后的VA没有达到基线目标，低对比度字母的差异更大。在大多数情况下，亚洲人(n=18)的视力在第5天明显比非亚洲人(n=21)差，在中间视觉条件下，低对比度字母的差异延续到第14天。第一天达到20/20未纠正的参与者的比例为17%的亚洲人和40%的非亚洲人，在第30天达到69%的亚洲人和83%的非亚洲人。结论：30个夜晚的OOK在觉醒后4小时测量时没有改变P-DC。OOK引起CH、CRF下降，但与病例组和术后组比较，差异无统计学意义。根据早期未矫正的视力和过度屈光状态的测量，在本研究中，基线CH较低的亚洲人对OOK的反应较慢。
Purpose.: To investigate the effects of 30 nights of overnight orthokeratology (OOK) on corneal epithelial permeability (P dc) and corneal biomechanical properties.Methods.: BE Retainer and Paragon CRT lenses were used. Visits were scheduled approximately 4 hours after awakening at baseline and after 1, 5, 10, 14, and 30 days of treatment. P dc was measured at baseline and at day 30, whereas corneal biomechanical properties and visual acuities (VAs) were measured at all visits.Results.: Thirty-nine neophytes and soft contact lens wearers completed the study. There was no difference in P dc between baseline (ln [P dc][95% confidence interval (CI)]=− 2.65 [− 2.80 to− 2.50]) and day 30 (ln [P dc][CI]=− 2.68 [− 2.85 to− 2.50])(P= 0.88). Corneal hysteresis (CH) and corneal resistance factor (CRF) reduced significantly from baseline (CH [CI]= 10.89 [10.59–11.19] mm Hg and CRF [CI]= 10.35 [9.99–10.72] mm Hg) to day 30 (CH [CI]= 10.59 [10.31–10.87] mm Hg and CRF [CI]= 9.58 [9.26–9.89] mm Hg)(P= 0.001 for CH and P< 0.001 for CRF). Posttreatment VA did not reach baseline targets, and the difference was worse with low-contrast letters. Asian individuals (n= 18) had significantly worse VA than non-Asian individuals (n= 21) under most conditions through day 5, and the difference extended through day 14 with low-contrast letters under mesopic conditions. The percentage of participants who achieved 20/20 uncorrected was 17% Asian and 40% non-Asian individuals after day 1 and reached 69% Asian and 83% non-Asian individuals at day 30.Conclusions.: Thirty nights of OOK did not alter P dc when measured 4 hours after awakening. OOK caused CH and CRF to decrease, but the changes were not clinically significant compared with diseased and postsurgical cases. Asian individuals, who had lower baseline CH in this study, responded slower to OOK based on early uncorrected VA and overrefraction measurements.