目的：评估3种不同周边微结构设计框架眼镜控制儿童近视进展的临床效果。

方法：回顾性研究。收集2023年1月至2024年8月在遂宁市中心医院视光门诊初次验配框架眼镜并完成1 a随访的6-12岁近视患儿资料，所有患者均取右眼数据纳入分析。根据患儿及家属自主选择的镜片类型分点扩散设计(DOT)、同心环带柱镜(CARE)、高度非球面微透镜(HAL)和单光(SVL)框架眼镜组。观察4组患儿戴镜1 a后眼轴长度(AL)和等效球镜度(SE)较基线的变化以及3种周边微结构设计框架眼镜较单光框架眼镜的变化，分析不同设计框架眼镜对球镜度数、散光度数、角膜曲率、角膜散光、前房深度、晶状体厚度和玻璃体腔深度的影响。

结果：本研究纳入近视患儿118例118眼，DOT组28例28眼\〖年龄10(9，12)岁，男16例，女12例\〗； CARE组26例26眼\〖年龄11(9，12)岁，男12例，女14例\〗； HAL组26例26眼\〖年龄10(9，11)岁，男16例，女10例\〗； SVL组38例38眼\〖年龄11(9，12)岁，男20例，女18例\〗。四组患儿年龄、性别以及戴镜前AL和SE均无差异(均P>0.05)。戴镜1 a后，DOT组患儿AL无增长且略有回退、SE无进展且轻度回退，与戴镜前相比无差异(均P>0.05)； CARE组、HAL组和SVL组患儿AL和SE较戴镜前均有不同程度增长(均P<0.01)。各组间AL和SE变化量比较有差异(F=22.819、30.948，均P<0.001)，DOT组患儿AL和SE变化(-0.034±0.180 mm，0.040±0.243 D)低于CARE组(0.225±0.174 mm，-0.375±0.308 D)和HAL组(0.147±0.130 mm，-0.255±0.256 D)，三组患儿AL和SE变化均明显低于SVL组(0.355±0.240 mm，-0.891±0.592 D)(均P<0.05)。

结论：儿童短期配戴周边微结构设计框架眼镜的近视控制效果优于单光框架眼镜，DOT框架眼镜的短期近视控制效果优于CARE框架眼镜及HAL框架眼镜。

METHODS: Retrospective case analysis was conducted. Children diagnosed with myopia aged 6 to 12 y who were received initial spectacle fitting and completed 1-year follow-up at the Optometry Clinic of Suining Central Hospital between January 2023 and August 2024 were enrolled. Only right eye data of all subjects were included for analysis. Based on the type of spectacle lenses independently selected by the children and their parents/guardians, they were divided into four groups: diffusion optics technology(DOT), cylindrical annular refractive element(CARE), highly aspherical lenslets(HAL), and single-vision lenses(SVL). Changes in axial length(AL)and spherical equivalent(SE)from baseline were observed after 1-year lens wear in four groups. Variations between three peripheral microstructure-designed spectacles and single-vision spectacles were compared. The effects of different lens designs on spherical power, astigmatism, corneal curvature, corneal astigmatism, anterior chamber depth, lens thickness, and vitreous cavity depth were analyzed.

RESULTS:In this retrospective study, a total of 118 eyes from 118 myopic children were included. There were 28 eyes in 28 children in DOT group \〖16 males and 12 females, age 10(9, 12)y\〗. CARE group contained 26 eyes in 26 children, \〖12 males and 14 females, age 11(9, 12)y\〗. HAL group had 26 eyes in 26 children \〖16 males and 10 females, age 10(9, 11)y\〗. SVL group included 38 eyes in 38 children \〖20 males and 18 females, age 11(9, 12)y\〗. There were no significant differences in age, gender, baseline AL, or SE among the four groups(all P>0.05). After 1-year wearing, no increase and slight regression were observed in AL and SE in the DOT group, with no significant differences compared with baseline(all P>0.05). AL and SE increased to varying degrees in the CARE, HAL and SVL groups(all P<0.01). Significant inter-group differences were found in the changes of AL and SE(F=22.820, 30.949, both P<0.001). The mean changes in AL and SE for the DOT group(-0.034±0.180 mm, 0.040±0.243 D)were significantly smaller than those in the CARE group(0.225±0.174 mm, -0.375±0.308 D)and the HAL group(0.147±0.130 mm, -0.255±0.256 D). The changes of AL and SE in the three groups were significantly lower than those in the SVL group(0.355±0.240 mm, -0.891±0.592 D)(all P<0.05).

CONCLUSION: In children, short-term wear of spectacles with peripheral microstructural design demonstrates better myopia control efficacy compared to single-vision spectacles. DOT lenses show superior short-term efficacy compared with CARE and HAL lenses.