角膜塑形镜、周边离焦眼镜、单光眼镜对儿童近视控制的一年效果  

Effect of orthokeratology lenses, peripheral defocus spectacle lenses, single vision spectacles of optic correction on myopia control

作　　者：郭寅[1,2] 刘丽娟[2] 郭曦 张嵘[1] 刘玉成[1] 谢小芳 唐萍[1] 吕燕云[1] 谢培英 郭秀花[5] 徐亮[2] GUO Yin LIU Li-juan GUO Xi ZHANG Rong LIU Yu-cheng XIE Xiao-fang TANG Ping LV Yan-yun XIE Pei-ying GUO Xiu-hua XU Liang(Tongren Eye Care Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China Beijing Institute of Ophthalmology, Beijing Key Lab. of Ophthalmology and Visual Science, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China Beijing Beiyi Optometry ＆ Ophthalmology Center, Beijing 100027, China Beijing Zhiliang Optometry Technology Ltd. Corporation, Beijing 100062, China Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China)

机构地区：[1]首都医科大学附属北京同仁医院验光配镜中心,100730 [2]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科研究所眼科学与视觉科学北京市重点实验室,100005 [3]北京北医眼视光学研究中心,100027 [4]北京至亮视光科技有限责任公司,100062 [5]首都医科大学公共卫生学院,100069

出　　处：《眼科》2016年第5期302-306,共5页Ophthalmology in China

基　　金：国家自然科学基金(81400431);北京市教委委托项目(PXM2014_014226_000083)

摘　　要：目的评价角膜塑形镜、周边离焦眼镜、单光眼镜控制儿童近视进展的一年效果。设计前瞻性非随机临床对照研究。研究对象北京市眼科研究所、北京同仁验光配镜中心、北医眼视光远程视觉服务中心的近视儿童321例,其中141例(43.9%,141/321)完成一年随访。平均年龄(11.41±2.29)岁。方法所有儿童配镜前进行视力、睫状肌麻痹后验光、裂隙灯、Lenstar眼生物参数测量及彩色眼底照相视盘旁萎缩弧分析。根据患者及监护人要求分别选择单光眼镜(single vision spectacle lenses,SV)、角膜塑形镜(orthokeratology,OK)、周边离焦眼镜(peripheral defocus spectacel lenses,PD)三种不同的矫正方式。观察三组间屈光度进展、眼轴增长及视盘旁萎缩弧扩大率的差异。主要指标配镜前后屈光度、眼轴长度和视盘旁萎缩弧的改变。结果完成一年随访者SV组47例、OK镜组70例、PD组24例。平均等效球镜度(-2.89±1.34)D,平均眼轴长度(24.92±0.34)mm。最后随访时,3组儿童眼轴长度均增长,其中OK镜组增长(0.13±0.16)mm,明显低于其他两组(F=48.820,P<0.001)。SV组屈光度增长(-0.77±0.79)D,PD组屈光度增长(-0.94±0.47)D(t=1.080,P=0.283)。SV组、PD组、OK镜组视盘旁萎缩弧扩大率分别为66.7%、38.6%和15.0%(χ2=28.341,P<0.001)。结论随访一年的结果表明,与单光眼镜、周边离焦眼镜相比,角膜塑形镜控制屈光度进展、眼轴增长、视盘旁萎缩弧扩大的效果最佳。Objective To assess the effect of myopia control with single vision spectacle lenses（SV）, orthokeratology lenses（OK）, and peripheral defocus spectacle lenses（PD）. Design Prospective, non-randomized case control study. Participant Three hundred and twenty one children were enrolled in the study from Beijing Institute of Ophthalmology, Tongren Eye Care Center and Beijing Beiyi Optometry ＆ Ophthalmology Center. 141 children （43.9%, 141/321） completed the follow up, with a mean age of 11.41±2.29 years. Methods All children received a comprehensive examination, including visual acuity, cycloplegia refraction, slit lamp, Lenstar ocular biometry, color fundus photographs and were followed up one year later. Parents selected the types of correction on their own. Main Outcome Measures Change of refraction, axial length and parapapillary atrophy before and after wearing. Results The mean equivalent spherical（SE） and axial length（AL） of 141 children at baseline were -2.89±1.34 D and 24.92±0.34 mm, respectively. At one-year follow-up visit, elongation of AL in children with OK was 0.13±0.16 mm, significantly less than the other two groups （F=48.820, P〈0.001）. Progression of myopia was -0.77±0.79 D and -0.94±0.47 D in SV group and PD group respectively. There was no significant difference between groups （t=1.080, P=0.283）. Presence of enlargement of parapapillary atrophy in OK group was 15.0%, significantly lower than SV group （66.7%） and PD group （38.6%）. Conclusions Compared to single vision spectacle lenses and peripheral defocus spectacle lenses, orthokeratology is most effective for myopia control. （Ophthalmol CHN, 2016, 25： 302-306）

关 键 词：近视控制 角膜塑形镜 单光眼镜 周边离焦眼镜 

分 类 号：R778.11[医药卫生—眼科]