目的：探讨多区正向光学离焦眼镜对青少年近视进展的有效性和安全性，为临床治疗提供理论依据。

方法：回顾性研究。收集2019年1月至2022年1月就诊于我院8-13岁近视儿童560例560眼(选取右眼)。根据配镜方式不同分为多区正向光学离焦眼镜组(DIMS组)180例180眼，角膜塑形镜组(OK镜组)182例182眼，单焦框架眼镜组(SV组)198例198眼。观察DIMS组、OK镜组和SV组近视儿童分别在1、2 a时等效球镜、眼轴变化情况。再分别按照近视程度(A组：等效球镜≥-3.00 D，B组：-6.00 D≤等效球镜<-3.00 D)、年龄(Ⅰ组：8-10岁，Ⅱ组：11-13岁)进行分组，进一步分析近视程度和年龄对治疗效果的影响。

结果：戴镜1、2 a时，DIMS组和SV组等效球镜有差异(均P<0.05)； DIMS组、OK镜组、SV组三组间眼轴有差异(F=21.791、3.576，均P<0.05)。戴镜1、2 a时，A组、B组中，DIMS组和SV组等效球镜变化有差异(均P<0.05)； DIMS组、OK镜组和SV组眼轴增长对比有差异(均P<0.05)。戴镜1、2 a时，Ⅰ、Ⅱ组中DIMS组和SV组等效球镜变化有差异(均P<0.01)； Ⅰ组中DIMS组、OK镜组、SV组眼轴增长对比有差异(均P<0.05)； Ⅱ组患者中，DIMS组与OK镜组眼轴变化无差异，二者在近视防控中疗效相似，DIMS镜在大龄青少年中近视进展延缓，疗效增强。

结论：与SV镜相比，DIMS镜、OK镜均可有效减缓青少年近视的进展。DIMS镜的整体近视控制效果较OK镜略差，但随着患者年龄增长，屈光度增加，DIMS镜延缓近视进展的作用增强。

METHODS:Retrospective study. A total of 560 myopic children(560 eyes)aged 8-13 years who were admitted to our hospital from January 2019 to January 2022 were selected as research subjects, of whom 180 cases(180 eyes)were enrolled in the DIMS group. The orthokeratology(OK lens)group consisted of 182 patients(182 eyes), and the single vision(SV)group consisted of 198 patients(198 eyes). The changes of the spherical equivalent and axial length in the three groups were observed after 1 and 2 a respectively. The myopia degree(group A: spherical equivalent ≥-3.00 D and group B: -6.00 D≤ spherical equivalent <-3.00 D), and age(group Ⅰ: 8-10 years old and group Ⅱ: 11-13 years old)were grouped to further analyze the effect of myopia degree and age on treatment effect.

RESULTS: At 1 and 2 a after wearing lenses, the spherical equivalent in the DIMS and SV groups was statistically significant(all P<0.05); there was statistical significance in the axial length among the DIMS, OK and SV groups(F=21.791, 3.576, all P<0.05). At 1 and 2 a after wearing lenses, there was statistical significance in the changes of spherical equivalent in both the DIMS and SV groups of the groups A and B(all P<0.05); and there was statistical significance in axial length growth of the DIMS, OK and SV groups(all P<0.05). At 1 and 2 a after wearing lenses, there was statistical significance in the changes of spherical equivalent in the DIMS and SV groups of the groups Ⅰ and Ⅱ(all P<0.01); in the group Ⅰ, there was statistical significance in the comparison of axial length growth in the DIMS, OK and SV groups(all P<0.05); in the group Ⅱ, there was no statistical significance in the changes of axial length in the DIMS and OK groups. The efficacy of DIMS and OK in the prevention and treatment of myopia was comparable, and the myopia progression was delayed, and the efficacy was enhanced in those older adolescents wearing DIMS.

CONCLUSION: Compared with SV lens, DIMS and OK lenses effectively slow down the myopia progression in adolescents. The overall myopia control effect of DIMS is slightly inferior to that of OK lens. However, with the increase of age and the degree of refractive error, the delaying effect of DIMS on myopia progression is enhanced.