重视青少年角膜塑形镜的规范验配、正确护理及并发症的治疗

doi:10.3877/cma.j.issn.2095-2007.2019.06.001

近年来，我国近视眼患病率不断上升，因为其普遍性和巨大的公共卫生成本，儿童近视眼和高度近视眼逐渐成为影响国民健康的公共卫生问题。角膜塑形镜(Ortho-K)是一种特殊的硬性隐形眼镜，在夜间佩戴以控制近视眼的发展，是目前公认的最有效控制近视眼的方法之一。在我国角膜塑形镜的应用已有10余年历史，因为Ortho-K镜的验配要求比较严格，同时控制效果也受到各种因素的影响。本文中笔者从目前Ortho-K镜的合理处方、验配流程、正确护理及并发症的处理等多个方面对Ortho-K镜的临床应用进行评述，以期实现长期健康的Ortho-K镜治疗。

关键词: 近视眼, 角膜塑形镜, 规范验配, 并发症

In recent years, the prevalence of myopia has been rising in China. Because of its universality and huge public health costs, children′s myopia and high myopia have become public health problems affecting national health. The orthokeratology (Ortho-K) is a special design ridid contact lens which is worn at night to control the development of myopia and was recognized as one of the most effective way for myopic control. In China, the orthokeratology has been used widely for more than 10 years. Also, many domestic and foreign studies have confirmed the effect of the progression of myopia. However, Ortho-K fitting requirements are relatively strict, and the control effect is also affected by various factors. In this review, authors reviews the clinical application of orthokeratology from the current reasonable prescription and fitting methods of Ortho-K, correct nursing and treatment of complications, etc, which is of great benefit to practice long-term treatment plan for Ortho-K.

Key words: Myopia, Orthokeratology, Standard Ortho-K fitting procedure, Complications

图1 戴隐形眼镜时所见的六类浸润性事件示意图　图A显示微生物角膜炎；图B显示接触性角膜溃疡；图C显示隐形眼镜致急性红眼；图D显示渗透性的角膜炎；图E显示无症状浸润性角膜炎；图F显示无症状的渗透。小黄点为弥漫性浸润区，大黄点为局灶性浸润区，绿点为角膜染色区。(引自Clinical Characterization of Corneal InfiltrativeEvents Observed with Soft Contact Lens Wear^[71])

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