目的：基于视力与泪膜功能探究重复低能量红光照射联合视觉训练治疗青少年近视的疗效及安全性。方法：选取2022年1月至2023年7月河北医科大学第二医院收治的青少年近视患者104例208眼，采用随机数字表法分为对照组52例104眼、研究组52例104眼。两组均采取配戴角膜塑形镜治疗，对照组使用视觉训练，研究组在视觉训练基础上使用重复低能量红光照射治疗。随访1 a，比较两组患者治疗前后视力改善情况、脉络膜变化情况、泪膜功能、不良事件及1 a后视力增长情况。结果：治疗6 mo，1 a研究组裸眼视力(LogMAR)、眼轴低于对照组(均P<0.05)； 治疗6 mo，1 a研究组中心凹脉络膜厚度、脉络膜毛细血管血流密度高于对照组(均P<0.05)； 两组不同时间点的泪膜脂质层厚度、泪膜破裂时间无差异(均P>0.05)； 两组治疗期间不良事件发生率无差异(P>0.05)； 治疗1 a摘除角膜塑形镜2 wk后，研究组裸眼视力(LogMAR)与治疗前比较无差异(P>0.05)，对照组裸眼视力较治疗前升高(P<0.05)。结论：重复低能量红光照射联合视觉训练治疗青少年近视可有效改善脉络膜，控制眼轴增长，有效矫正角膜配戴视力，且不影响泪膜功能，安全性较高。

AIM: To explore the efficacy and safety of repeated low-energy red light irradiation combined with visual training for the treatment of adolescent myopia based on vision and tear film function.METHODS: A total of 104 adolescent myopic patients(208 eyes)from the Second Hospital of Hebei Medical University from January 2022 to July 2023 were selected and randomly divided into two groups by random number table method, with 52 cases(104 eyes)in the control group and 52 cases(104 eyes)in the study group. Both groups were treated with orthokeratology lenses, while the control group received visual training and the study group received repeated low-energy red light treatment on top of visual training. Follow-up for 1 a, the improvement of vision, changes in the choroid, tear film function, adverse events, and visual acuity growth after 1 a were compared between the two groups before and after treatment.RESULTS: The uncorrected visual acuity(LogMAR)and axial length of the study group were lower than those of the control group after 6 mo and 1 a of treatment(all P<0.05). The thickness of the choroid under the center recess and the density of choroidal capillary blood flow were higher in the study group than in the control group at 6 mo and 1 a after treatment(all P<0.05); there was no statistically significant difference in the thickness of tear film lipid layer and tear film break-up time between the two groups at different time points(all P>0.05); and the incidence of adverse events during the treatment period of the two groups was not statistically significant(P>0.05). After treatment for 1 a and removing the orthokeratology lens for 2 wk, there was no significant difference in the uncorrected visual acuity(LogMAR)between the study group and the control group before treatment(P>0.05), and the uncorrected visual acuity of the control group was better than that before treatment(P<0.05).CONCLUSION: Repeated low-energy red light combined with visual training can effectively improve the choroid, control the axial length growth, effectively correct the vision of the cornea, and does not affect the tear film function, with high safety.

河北省医学科学研究课题计划项目(No.20231817)