目的：探讨角膜塑形镜对单眼近视性屈光参差青少年对侧眼近视化进程的影响。

方法：前瞻性临床对照研究。从2021年1月至2021年8月在南宁爱尔眼科医院诊断为单眼近视并选择单光框架眼镜矫正的患者35例70眼为SV组，选择角膜塑形镜矫正的患者35例70眼为OK镜组，SV组患者双眼依据配镜处方验配单光框架眼镜，OK镜组患者近视眼验配角膜塑形镜，对侧眼未予特殊干预，随访1 a。于戴镜6、12 mo后再次测量两组患者近视眼及对侧眼的眼轴长度，并对数据进行统计学分析。

结果：戴镜6、12 mo后，SV组患者近视眼眼轴分别增长0.18±0.07、0.35±0.12 mm，对侧眼眼轴分别增长0.10±0.05、0.23±0.10 mm，OK镜组患者近视眼眼轴分别增长0.09±0.05、0.16±0.09 mm，对侧眼眼轴分别增长0.19±0.08、0.38±0.13 mm。不同时间点SV组近视眼眼轴增长量均高于OK镜组(t=0.367，P<0.001； t=0.688，P<0.001)，而对侧眼眼轴增长量均低于OK镜组(t=0.074，P<0.001； t=0.170，P<0.001)； 戴镜6、12 mo后，SV组双眼间眼轴长度差值分别增长0.08±0.05、0.12±0.08 mm，而OK镜组双眼间眼轴长度差值分别降低0.10±0.07、0.21±0.12 mm，两组患者在戴镜6、12 mo后双眼间眼轴长度差值变化差异有统计学意义(t=0.111，P<0.001； t=0.084，P<0.001)。

结论：与单光框架眼镜相比，单眼配戴角膜塑形镜能够有效地抑制单眼近视性屈光参差青少年近视眼的眼轴增长并降低双眼屈光参差程度，但存在促进对侧眼眼轴增长、加快对侧眼近视化进程的风险。

METHODS:Prospective clinical control study. From January 2021 to August 2021 at Nanning Aier Eye Hospital, 35 patients(70 eyes)diagnosed with monocular myopia and opting for single vision frame glasses correction were recruited as the SV group, and 35 patients(70 eyes)opting for orthokeratology correction were recruited as the OK group, with 1 year of follow-up. Both eyes in the SV group wore single vision lenses, while the myopic eye in the OK group wore an orthokeratology lens, with no intervention in the contralateral eye. After wearing glasses for 6 and 12 mo, the axial lengths of the myopic and contralateral eyes in both groups were measured again, and the data were statistically analyzed.

RESULTS:After wearing lenses for 6 and 12 mo, the axial length of the myopic eye of patients in the SV group increased by 0.18±0.07 and 0.35±0.12 mm, respectively, and that of the contralateral eye increased by 0.10±0.05 and 0.23±0.10 mm, respectively. In the OK group, the axial length of the myopic eye of patients, increased by 0.09±0.05 and 0.16±0.09 mm, respectively, and that of the contralateral eye increased by 0.19±0.08 and 0.38±0.13 mm, respectively. The axial length growth of the myopic eye in the SV group was higher than that in the OK group at different time points(t=0.367, P<0.001; t=0.688, P<0.001), whereas the axial length growth of the contralateral eye was lower than that in the OK group(t=0.074, P<0.001; t=0.170, P<0.001). After wearing lenses for 6 and 12 mo, the interocular axial length difference values increased by 0.08±0.05 and 0.12±0.08 mm in the SV group, but decreased by 0.10±0.07 and 0.21±0.12 mm in the OK group, respectively. A statistically significant inter-group difference was observed in the change of interocular axial length discrepancy after wearing lenses for 6 and 12 mo(t=0.111, P<0.001; t=0.084, P<0.001).

CONCLUSION:Compared with single vision frame glasses, wearing an orthokeratology lens in the myopic eye can effectively help inhibit the growth of axial length and reduce the degree of anisometropia in adolescents with monocular myopic anisometropia, but there is a potential risk of promoting the growth of axial length in the contralateral eye.