METHODS: This prospective study consecutively included 20 juveniles (20 right eyes) who had undergone overnight orthokeratology for a minimum of one year and were willing to discontinue the treatment. The study measured and compared epithelial and corneal curvature using optical coherence tomography and Medmont topographer at the first day of cessation and 1 month after cessation. In addition, changes in uncorrected visual acuity and refractive error before and after the cessation of the treatment were analyzed.
RESULTS: The study found a significant increase in the thickness of the epithelium in the central 2-mm area after the cessation of the treatment (t = -4.807, P <0.001). Moreover, the stroma in the paracentral area (2-5 mm) and peripheral area (5-6 mm) showed a general thinning trend ( P =0.016, P =0.016). Regarding the correlation analysis, the change in central epithelial thickness (ΔCET) was significantly correlated with the change in paracentral corneal curvature (ΔPCCC) (r=0.610, P =0.007) and the change in peripheral corneal curvature (ΔPCC) (r=0.597, P =0.009). Similarly, the change in central stromal thickness (ΔCST) was significantly correlated with the change in central corneal curvature (ΔCCC) (r=0.500, P =0.035), ΔPCCC (r=0.700, P =0.001), and ΔPCC (r=0.635, P =0.005).
CONCLUSIONS: The study found that the corneal remodeling induced by orthokeratology was reversible after the cessation of the treatment. Specifically, changes in the epithelium were found to be more prominent in the central area, while changes in the stroma were more pronounced in the paracentral and peripheral areas. In addition, the study established a significant correlation between central corneal remodeling and changes in curvature.
方法:这项前瞻性研究连续纳入了20名青少年(20只右眼),他们接受了过夜角膜塑形术至少一年,并愿意停止治疗。该研究在停止的第一天和停止后1个月使用光学相干断层扫描和Medmont地形图仪测量并比较了上皮和角膜曲率。此外,分析了停止治疗前后未矫正视力和屈光不正的变化。
结果:研究发现,停止治疗后,中央2mm区域的上皮厚度显着增加(t=-4.807,P<0.001)。此外,中心旁区域(2-5mm)和外围区域(5-6mm)的基质呈总体变薄趋势(P=0.016,P=0.016)。关于相关性分析,中央上皮厚度(ΔCET)的变化与中央旁角膜曲率(ΔPCCC)的变化(r=0.610,P=0.007)和周边角膜曲率(ΔPCC)的变化(r=0.597,P=0.009)显着相关。同样,中央基质厚度(ΔCST)的变化与中央角膜曲率(ΔCCC)的变化显著相关(r=0.500,P=0.035),ΔPCCC(r=0.700,P=0.001),和ΔPCC(r=0.635,P=0.005)。
结论:研究发现角膜塑形术诱导的角膜重塑在停止治疗后是可逆的。具体来说,发现上皮的变化在中央区域更为突出,而基质的变化在中心旁和周围区域更为明显。此外,该研究建立了中央角膜重塑和曲率变化之间的显著相关性。