目的：探究青少年近视长期配戴角膜塑形镜(orthokeratology，OK)的有效性和安全性。

方法：选取2014-01/2015-08于我院采用长期配戴OK镜进行近视矫正的160例320眼青少年近视患者，所有患者均按要求配戴并完成随访。统计配戴OK镜后2a的角膜、结膜并发症； 采用角膜内皮镜检测配戴OK镜后6mo，1、2a角膜中央最薄点厚度和角膜内皮细胞参数变化； 比较两组患者矫正视力前后屈光度、眼轴长度和裸眼视力。

结果：所有患眼共出现Ⅰ～Ⅱ级角膜点染98眼，Ⅲ～Ⅳ级角膜点染18眼，视觉异常15眼，角膜压痕16眼，结膜充血10眼，角膜无菌性浸染8眼，过敏性结膜炎8眼，经对症干预治疗后缓解。患眼戴镜前和戴镜6mo，1、2a角膜中央最薄点厚度、角膜内皮细胞密度、角膜内皮平均细胞面积、角膜内皮六角型细胞比例、角膜内皮变异系数、角膜前表面水平曲率(HK)及垂直曲率(VK)比较，差异无统计学意义(P>0.05)； 戴镜后6mo，1、2a裸眼视力显著上升，屈光度显著下降，差异有统计学意义(P<0.05)； 戴镜后6mo，1、2a眼轴长度差异无统计学意义(P>0.05)。

结论：青少年近视长期配戴角膜塑形镜能显著提升裸眼视力，改善屈光度，未发生严重的角膜、结膜并发症，对角膜内皮细胞、角膜厚度影响较小。

METHODS: In this study, 160 myopia adolescents(320 eyes)treated in our hospital from January 2014 to August 2015 were retrospectively analyzed and followed up. The corneal and conjunctival complications were recorded and analyzed after continuous wearing OK for 2a.The thickness of thinnest central corneal and the parameters of corneal endothelium were measured by specular microscopy after wearing for 6mo, 1 and 2a. Then the diopter, axial length, and uncorrected visual acuity were compared between the two groups before and after the visual acuity correction.

RESULTS: All affected eyes consisted of 98 eyes with Ⅰ-Ⅱ corneal fluorescence stain, 18 eyes with Ⅲ-Ⅳ corneal fluorescence stain, 16 eyes with corneal indentation, 15 eyes with visual abnormality, 10 eyes with conjunctival hyperemia, 8 eyes with aseptic conjunctiva, 8 cases with allergic conjunctivitis, which achieved remission after symptomatic intervention. The corneal endothelial cell density, corneal thickness, corneal endothelium average cell area, corneal endothelium coefficient of variation, corneal endothelium hexagonal cell ratio, anterior corneal surface curvature ratio of horizontal(HK)and vertical curvature(VK)were not statistically significant before and after wearing for 6mo, 1, and 2a(P>0.05). The uncorrected visual acuity increased significantly, and the diopter decreased significantly after their wearing(P<0.05). There was no significant difference in axial length after wearing OK lens for 6mo, 1, and 2a(P>0.05).

CONCLUSION: The orthokeratology lenses can significantly increase uncorrected visual acuity and improve refractive power for juvenile myopia without severe corneal or conjunctival complications occurred, which has little influence on corneal endothelial cells and corneal thickness with a certain degree of safety.