角膜塑形镜和周边离焦框架镜近视控制效果比较

Comparison of the myopia control effects of orthokeratology lens and peripheral defocus spectacles

摘要:

目的：探讨周边离焦框架镜和角膜塑形镜对儿童青少年近视患者眼轴的控制效果。

方法：前瞻性研究。选取2019-06/2021-06在龙岩市第二医院就诊的儿童青少年近视患者71例134眼，配戴周边离焦框架镜12mo后配戴角膜塑形镜。随访观察配戴周边离焦框架镜、角膜塑形镜3、6、12mo的眼轴增长情况。

结果：纳入患者配戴周边离焦框架镜、角膜塑形镜12mo眼轴增长中位数分别为0.35、0.14mm，配戴角膜塑形镜3、6、12mo眼轴增长量均低于周边离焦框架镜(P<0.001)，且眼轴增长速度明显减缓。根据配戴周边离焦框架镜12mo眼轴增长量将纳入患者分为快速进展型组(眼轴增长≥0.4mm，29例54眼)和非快速进展型组(眼轴增长<0.4mm，42例80眼)，两组患者配戴周边离焦框架镜12mo眼轴增长量中位数分别为0.70、0.24mm，配戴角膜塑形镜12mo眼轴增长量中位数分别为0.31、0.09mm，两组患者配戴角膜塑形镜12mo眼轴增长速度分别减缓56%、63%。非快速进展型组患者配戴角膜塑形镜12mo眼轴增长量低于快速进展型组，且不随年龄和屈光度变化。快速进展型组中不同年龄、不同屈光度患者配戴角膜塑形镜12mo眼轴增长量均无显著差异(P>0.05)； 非快速进展型组中7～12岁患者配戴角膜塑形镜12mo眼轴增长量高于13～16岁患者(P<0.05)，但不同屈光度患者配戴角膜塑形镜12mo眼轴增长量无显著差异(P>0.05)。

结论：角膜塑形镜比周边离焦框架镜控制儿童青少年近视患者眼轴增长的效果更显著，且角膜塑形镜对于快速进展型近视的控制效果可观。

Abstract:

AIM: To investigate the effect of peripheral defocus spectacles and orthokeratology lenses on the control of axial length in children and adolescents with myopia.

METHODS: Prospective study. A total of 71 cases(134 eyes)of children and adolescents with myopia who visited the Second Hospital of Longyan from June 2019 to June 2021 were selected. They were fitted with peripheral defocus spectacles for 12mo and then switched to orthokeratology lenses. The growth of axial length was observed at 3, 6, and 12mo after wearing peripheral defocus spectacles and orthokeratology lenses.

RESULTS: The median axial length growth after wearing peripheral defocus spectacles and orthokeratology lenses for 12mo was 0.35 and 0.14mm, respectively. The axial growth at 3, 6, and 12mo after wearing orthokeratology lenses was lower than those after wearing peripheral defocus spectacles(P<0.001), and the growth rate of axial length was significantly reduced. The patients were divided into a rapid progression group(axial growth ≥0.4 mm, 29 cases, 54 eyes)and a non-rapid progression group(axial growth <0.4mm, 42 cases, 80 eyes)according to the axial growth of peripheral defocus spectacles for 12mo. The median axial growth after wearing peripheral defocus spectacles for 12mo in the two groups was 0.70 and 0.24mm, respectively, while the median axial growth after wearing orthokeratology lenses was 0.31 and 0.09mm, respectively. The growth rate was reduced by 56% and 63% respectively in the two groups after wearing orthokeratology lens. The axial growth of cases wearing orthokeratology lenses for 12mo in the non-rapid progression group was lower than that in the rapid progression group, and it did not change with age or diopter. There was no significant difference among different ages and different diopters in the rapid progression group(P>0.05). In the non-rapid progression group, axial growth of cases aged 7-12 years was higher than those aged 13-16 years(P<0.05), but there was no significant difference among different diopters(P>0.05).

CONCLUSION: Orthokeratology lens is more effective than peripheral defocus spectacles in controlling axial growth in children and adolescents with myopia, and the control effect of orthokeratology lens on rapid-progressing myopia is remarkable.