目的：探讨离焦硬性透气性角膜接触镜(RGPCL)对比高非球微透镜(HAL)对青少年儿童中高度近视的临床控制效果。

方法：回顾性研究，选取2022年1月至2024年1月于爱尔眼科四川眼科医院就诊的8-17岁近视患者，根据近视矫正方式分为RGPCL组和 HAL组。记录患者戴镜6、12 mo复查时的屈光度、眼轴、角膜曲率、视觉质量情况并进行统计学分析。

结果：纳入患者96 例96眼，其中RGPCL组48例48眼，男8例，女40例，年龄12.00(11.50，15.00)岁； HAL组48例48眼，男14例，女34例，年龄13.00(12.00，14.00)岁。戴镜6 mo时，两组球镜度数较基线无明显变化； 戴镜12 mo时，两组球镜度数均增长，RGPCL组球镜度数变化小于HAL组(P<0.01)。戴镜6、12 mo时，RGPCL 组柱镜度数变化量均高于HAL组(P<0.01)。戴镜6、12 mo时，两组眼轴较基线均有增长，RGPCL组与HAL组眼轴增长无明显差异(P>0.05)。戴镜6、12 mo，HAL组K1、K2较基线无明显变化，RGPCL组K2值较基线数据有明显下降(P<0.0167)。戴镜6、12 mo，RGPCL组在清晰度、物像缩放、眩光感、视野范围4个维度的评分及总分均高于HAL组(均P<0.001)。

结论：离焦RGPCL在提供更良好视觉感受的情况下，控制近视球镜和柱镜度数增长方面优于HAL镜片。

METHODS:A retrospective study was conducted, enrolling patients aged 8-17 y with moderate to high myopia who presented to Sichuan Eye Hospital, Aier Eye Hospital Group between January 2022 and January 2024. Subjects were divided into the RGPCL group and the HAL group according to myopia correction modalities. Refractive diopters, axial length, corneal curvature, and visual quality were examined at 6 and 12 mo after lens wear, and relevant data were statistically analyzed.

RESULTS:A total of 96 eyes from 96 cases were enrolled, with 48 cases(48 eyes, 8 males and 40 females)allocated to the RGPCL group with a median age of 12.00(11.50, 15.00)y, and 48 cases(48 eyes, 14 males and 34 females)to the HAL group with a median age of 13.00(12.00,14.00)y. At the 6-month follow-up, no significant changes in spherical diopters were observed in either group relative to baseline. Spherical diopters increased in both groups at the 12-month visit, with a significantly smaller increment in the RGPCL group(P<0.01). At the 6- and 12-month follow-up visits, the magnitude of changes in cylindrical refractive power was markedly larger in the RGPCL group relative to the HAL group(P<0.01). At the 6-and 12-month follow-up visits, axial length in both groups had increased relative to baseline, and no significant intergroup difference was detected in axial elongation(P>0.05). At 6 and 12 mo of lens wear, no significant difference in K1,K2 was found in the HAL group compared with baseline, while the K2 value decreased significantly in the RGPCL group(P<0.0167). The RGPCL group achieved substantially higher scores in four domains including visual clarity, image scaling, glare tolerance, visual field range and total at both follow-up time points(all P<0.001).

CONCLUSION:Defocus RGPCL yields superior performance in slowing the progression of spherical and cylindrical, as well as providing better overall visual experience, when compared with HAL.