| 摘要: | 台灣十二歲學童近視的比例於2010年已高達62 %，目前控制近視方式包括雙光鏡片(bifocal spectacle lenses)、漸進多焦點鏡片(progressive spectacle lenses)、軟式雙光隱形眼鏡(soft bifocal contact lenses)、藥劑(atropine and pirenzepine)以及角膜塑形術，其中角膜塑型術(orthokeratology, Ortho-K)為日間無須配戴鏡片仍可俱有清晰視力之方法。且角膜塑型術已被證實俱有延緩近視進展之效果，但其機制尚待釐清。本研究目的為評估學童配戴角膜塑型鏡片前後之度數改變量，並尋求影響配戴角膜塑型鏡片效果之影響因子。於配戴前測量的基礎數據，與配戴六年後屈光度差異之相關性，並確認何者為角膜塑型鏡片效果之預測因子。52位年齡介於12至18歲且配戴角膜塑形鏡片六年之學童進行本研究回溯型病例分析，其需為近視度數小於-4.00 D (diopters)，散光度數小於-1.50 D之學童，依照配戴鏡片前之基礎參數如性別、年齡高低、等價球面度數高低、角膜弧度高低及角膜偏心率等參數與度數改變量進行比較。研究結果發現，12至18歲學童配戴鏡片後，女性學童控制近視效果較男性學童佳，較高的配戴初始度數學童配戴鏡片後度數改變量較少。根據結果顯示，角膜塑形鏡片控制近視之效果與性別、初始屈光度較有其相關性。
In Taiwan, the percentage of myopia has reached as high as 62%. The current control myopia methods include bifocal spectacle lenses, progressive spectacle lenses, soft bifocal contact lenses, biological agents such as atropine and pirenzepine as well as orthokeratology (Ortho-K).Ortho-K provides clear vision despite of not wearing lenses during daytime. The Ortho-K has been proven to be effective in terms of delaying the development of myopia, but the mechanism behind it still awaits further clarification. The purpose of this study is to evaluate the changes of refractive error in the children who were prescribed with Ortho-K, at the same time to seek for the factors that affect the result of Ortho-K wear. By comparing the refractive values before prescribing Ortho-K and the values 6 years after wearing Ortho-K, find the relationship between the two and then determine the factors that lead to retarding myopia progression of Ortho-K wear. This study analyze52 children of age between 12-18 whom were prescribed with Ortho-K for 6 years, where this selected children have myopia of less than -4.00 D and astigmatism of less than -1.50 D. The data are compared between the basic parameters such as gender, age, spherical equivalent refractive, keratometry and corneal eccentricity with the changes in refractive error. The result shows that after prescription, the females of age 12-18 have better myopic control than the males and the higher the refractive error prior to prescription of Ortho-K, the lesser the change in refractive error after prescription. Age, corneal curvature corneal and eccentricity do not affect the changes in refractive error. According to the result, Ortho-K is more related to factors such as gender, age, initial refractive error and corneal curvature. |
