目的：比较单眼近视儿童配戴多区正向光学离焦眼镜(DIMS)和单焦点框架镜(SV)1 a后屈光度和眼轴的变化量。方法：回顾性病例研究。收集2020年10月至2022年10月在武汉爱尔眼科医院汉口医院验配DIMS镜(52例)和SV镜(49例)的单眼近视儿童，年龄6-14岁，近视眼球镜度数为-4.00--0.50 D，非近视眼球镜度数为0-+1.00 D，散光≤2.00 D。根据屈光状态和矫正方式分为：DIMS组中近视眼为DIMS-近视眼组，非近视眼为DIMS-非近视眼组； SV组中近视眼为SV-近视眼组，非近视眼为SV-非近视眼组。比较各组戴镜1 a前后等效球镜度(SER)、眼轴(AL)的变化量，分析各组双眼间SER和AL差异的变化量。结果：戴镜1 a后，DIMS-近视眼组和DIMS-非近视眼组SER变化量分别为-0.41±0.44、-0.26±0.54 D，AL变化量为0.18±0.20、0.15±0.15 mm； SV-近视眼组和SV-非近视眼组SER变化量为-0.74±0.63、-0.70±0.68 D，AL变化量为0.30±0.28、0.31±0.28 mm。DIMS-近视眼组和DIMS-非近视眼组SER与AL变化均慢于SV组(均P<0.05)。相较于SV镜，配戴DIMS镜近视眼的SER延缓44.6%，非近视眼SER延缓62.9%，近视眼AL延缓40.0%，非近视眼AL延缓51.6%。DIMS-近视眼组和DIMS-非近视眼组的1 a AL变化量≤0.2 mm占比分别为53.9%和65.4%，高于SV-近视眼组和SV-非近视眼组的34.7%和42.9%(均P<0.05)； DIMS-近视眼组和DIMS-非近视眼组的AL变化量>0.4 mm占比分别为17.3%和7.7%，低于SV-近视眼组和SV-非近视眼组的32.7%和28.6%(均P<0.05)。DIMS-近视眼组和DIMS-非近视眼组戴镜1 a后AL变化量与年龄、基线AL无明显相关性(均P>0.05)； SV-近视眼组和SV-非近视眼组AL变化量与年龄呈负相关(r=-0.446，P=0.001； r=-0.312，P=0.029)，与基线AL无明显相关性(均P>0.05)。结论：DIMS镜片对单眼近视儿童的近视眼和非近视眼均有较好的近视控制和预防效果，近视前期儿童可配戴多点离焦镜片预防近视。

AIM:To compare the changes in diopters and axial length after 1 a of wearing defocus incorporated multiple segments(DIMS)lenses or single vision(SV)spectacle lenses in children with monocular myopia.METHODS:In this retrospective case group study, monocular myopia children aged from 6 to 14 years old in Hankou Aier Eye Hospital from October 2020 to October 2022, who were fitted with DIMS lens(n=52)or single-vision(SV)spectacle lenses(n=49)were collected. The spherical degree of myopia eyes ranged from -4.00 D to -0.50 D and the nonmyopic eyes ranged from 0 to +1.00 D, astigmatism in all eyes ranged from 0 to -2.00 D. The DIMS lens group was classified into DIMS-myopia group(the myopic eyes)and DIMS-nonmyopia group(the nonmyopic eyes). The SV lens group was also divided into SV-myopia group and SV-nonmyopia group. The changes in spherical equivalent refraction(SER)and axial length(AL)of each group were compare before and after wearing lenses for 1 a, and variations in SER and AL of both eye among groups were analzed.RESULTS: After wearing lenses for 1 a, the changes of SER in the DIMS-myopic group and the DIMS-nonmyopic group were -0.41±0.44 and -0.26±0.54 D, respectively, and the changes of AL were 0.18±0.20 and 0.15±0.15 mm, respectively. SER changes were -0.74±0.63 and -0.70±0.68 D in SV-myopic group and SV-nonmyopic group, and AL changes were 0.30±0.28 and 0.31±0.28 mm. The changes of SER and AL in the DMS-myopic and non-myopic groups were slower than those in SV group(all P<0.05). Compared with SV lenses, wearing DIMS lenses delayed and 44.6% in myopia eyes, and 62.9% in non-myopia eyes, AL delayed by 40.0% in myopia eyes and 51.6% in non-myopia eyes. The percentage of 1-year AL change ≤0.2 mm in the DIMS-myopic group and non-myopic group was 53.9% and 65.4%, respectively, which was higher than that in the SV myopic group(34.7% and 42.9%, all P<0.05). The percentage of AL change >0.4 mm in the DIMS-myopic group and nonmyopic group was 17.3% and 7.7%, respectively, which was lower than that in the SV myopic group(32.7% and 28.6%, all P<0.05). There was no significant correlation between the change of AL and age and baseline AL in the DIMS-myopic and non-myopic groups after wearing lens for 1 a(all P>0.05); the change of AL in SV-myopic group and non-myopic group was negatively correlated with age(r=-0.446, P=0.001; r=-0.312, P=0.029), and there was no significant correlation with baseline AL(all P>0.05).CONCLUSION: DIMS lens has a good effect on myopia control and prevention in both myopia and non-myopia children with monocular myopia. Children with early pre-myopia can wear DIMS to prevent myopia.

爱尔眼科医院集团科研基金项目(No.AF2108D5)