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The purpose of application of confocal microscopy the concept investigation myopia teenagers wearing gas-permeable hard contact lenses (as Rid gas permeable contact lens, referred to as RGPCL) in different periods of corneal tissue changes, objective evaluation of wear gas-permeable hard contact lenses corneal tissue of young people recently the impact. The method selected patients with juvenile myopia Cangzhou Eye Hospital from March 2009 to July 2010 RGPCL orthodontic treatment in 45 cases, all patients are eyes wearing glasses. Divided into two observation group diopter different group I, 27 cases of group for overnight wear, the degree of myopia ≤-5.00D and astigmatism lt; the-1.25D those; Ⅱ group of 18 patients for the day wearing group, the degree of myopia gt; -5.00 D and astigmatism ≤-1.75D. Within six months, two groups of patients wearing glasses regularly line eye examination and confocal microscopy. Before wearing glasses for the control group, after wearing glasses for the experimental group were observed in patients with uncorrected visual acuity, corrected visual acuity and refractive change and corneal confocal microscope to check, take the central cornea and 2mm at the top of the limbal cornea checkpoint, take on Pippo, nerve fiber wave, matrix wave, Nei Pibo complete Z-SCAN image analysis, the scanned images of the respective layers of the cornea through the liquid crystal display synchronized display records, and calculated using built-counting software the cornea layers of cell density and the variation of the thickness of each layer of the cornea. (1) uncorrected visual acuity and refractive error: the Ⅰ group of 54 eyes wearing glasses compared to wearing glasses before June, uncorrected visual acuity improved significantly (t = 30.604; p = 0.000), the diopter is decreased significantly (t = 18.324; p = 0.000 ), the difference was statistically significant; the group Ⅱ 36 wearing glasses and wearing glasses before June compared uncorrected visual acuity was no significant improvement (t = 1.414; p = 0.162), diopter no significant decrease (t = 0.476; p = 0.636), the difference was not statistically significant. (2) the cornea layers of cell density: (1) epithelial cell layer: group I patients with central corneal epithelial cell density after wearing glasses and wearing glasses before, the difference was statistically significant (F = 3.597, p = 0.001) after wearing glasses wearing glasses before February to June, with significantly reduced compared (q = 4.189,4.473,4.642; and p = 0.042,0.031,0.029). Group I patients with peripheral corneal epithelial cell density before and wearing glasses after wearing glasses compared the difference was statistically significant (F = 3.803, p = 0.001), February to June, compared with that before wearing glasses after wearing glasses significantly increased ( q = 4.229,4.505,4.844; p = 0.039,0.030,0.019). Group Ⅱ corneal central and peripheral epithelial cell density before and wearing glasses after wearing glasses compared the difference was not statistically significant (F = 0.736,0.464; p = 0.642,0.860). Group Ⅰ patients wearing glasses after wearing glasses before 皮内朗格罕 cell density on the central and peripheral cornea, the difference was statistically significant (F = 3.733,3.486; p = 0.001,0.001), wearing glasses after March 6 significantly increased compared to before the month wearing glasses (central q = 4.410,4.991; p = 0.036,0.013; surrounding q = 4.439,4.951; p = 0.034,0.015). Central and peripheral cornea 皮内朗格罕 cell density II patients wearing glasses and wearing glasses before, the difference was not statistically significant (F = 1.667,1.381; p = 0.117,0.213) ② superficial stroma: group Ⅰ patients central cornea and the surrounding shallow stroma cell density before and wearing glasses after wearing glasses compared the difference was statistically significant (F = 3.230,3.409; p = 0.002,0.002), February to June, after wearing glasses and wearing glasses before significantly reduced compared the (central q = 4.203,4.373,4.876; p = 0.041,0.039,0.017; the neighboring q = 4.284,4.682,4.981; p = 0.035,0.021,0.014). Wearing glasses group Ⅱ corneal central and peripheral superficial stroma cell density compared with wearing glasses before, the difference was not statistically significant (F = 1.083,0.632; p = 0.374,0.729) ③ deep stroma: Ⅰ group of patients with corneal central After wearing glasses and the surrounding deep stroma cell density compared with wearing glasses before, the difference was not statistically significant (F = 1.176,1.867; p = 0.316,0.074). Group Ⅱ central cornea and the surrounding deep stroma cell density was wearing glasses and wearing glasses before, the difference was not statistically significant (F = 0.746,0.674; p = 0.633,0.694). ④ endothelial cell layer: I patients corneal central and peripheral endothelial cell density was wearing glasses and wearing glasses before, the difference was statistically significant (F = 3.351,3.080; p = 0.002,0.004). The central cornea average cell area, hexagonal cell percentage wearing glasses and wearing glasses before, the difference was statistically significant (F = 3.577,3.911; p = 0.001,0.001) from February to June, especially after wearing glasses and wearing mirror than before, the average cell area increases (q = 4.302,4.467,4.727; p = 0.034,0.032,0.024) hexagonal cell percentage decline (q = 4.267,4.664,5.359; p = 0.036,0.021,0.006) . The group Ⅱ corneal central and peripheral endothelial cell density before and wearing glasses after wearing glasses compared the difference was not statistically significant (F = 0.915,0.658; p = 0.495,0.708). Central cornea average cell area, hexagonal cell percentage wearing glasses and wearing glasses before, the difference was not statistically significant (F = 0.710,0.793; p = 0.663,0.594). (3) changes in corneal thickness (1) epithelial thickness of cortical thickness compared with wearing glasses before wearing glasses the group Ⅰ central cornea, the difference was statistically significant (F = 3.339, p = 0.002), especially after wearing glasses for March 6 significantly thinner than months and wearing glasses before (q = 4.420,4.577; p = 0.035,0.033). Compared to the Ⅰ group of patients with peripheral corneal epithelium thickness wearing glasses and wearing glasses before, the difference was not statistically significant (F = 1.096, p = 0.365). II patients with central and peripheral corneal epithelium thickness compared with wearing glasses before wearing glasses, difference not statistically significant (F = 1.024,0.727; p = 0.414,0.649). ② The stromal thickness the group Ⅰ central and peripheral corneal stromal thickness compared with that before wearing glasses after wearing glasses was no significant difference (F = 0.929,0.729; p = 0.484,0.648). The thickness of the central and peripheral corneal stroma II patients compared with wearing glasses before wearing glasses were not significantly different (F = 0.859,0.461; p = 0.540,0.862). ③ group I patients full thickness central and peripheral corneal thickness wearing glasses and wearing glasses before differences without statistical significance (F = 1.359,0.408; p = 0.221,0.897). The Ⅱ group of patients with central and peripheral corneal thickness wearing glasses with wearing glasses former compared the difference was not statistically significant (F = 1.066,0.577; p = 0.386,0.775). Conclusion 1. ≤-5.00D of the degree of myopia and astigmatism lt;-1.25D) adolescent patients with myopia night wearing RGPCL recently can improve visual acuity, reduce diopter, but interested in corneal morphology cause significant impact. 2 degree of myopia gt;-5.00D and astigmatism ≤-1.75D young patients with myopia day wearing RGPCL not improve in the near future uncorrected visual acuity and reduce diopter, will not cause significant effects on corneal morphology. Application confocal microscopy to evaluate the morphological impact of gas-permeable hard contact lenses on corneal tissue.
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