不同光学矫正方式对青少年近视的控制效果研究  

Control effects of different optical correction methods on adolescent myopia

作　　者：李秀红[1] 王敏[2] 吕勇[1] 符爱存[1] 尚丽娜[1] 朱豫[1] 

机构地区：[1]郑州大学第一附属医院眼科,河南省郑州市450052 [2]郑州铁路职业技术学院眼视光系,河南省郑州市450052

出　　处：《眼科新进展》2017年第7期636-639,共4页Recent Advances in Ophthalmology

基　　金：国家自然科学基金-联合培养基金项目(编号:U1204812);河南省医学科技攻关计划项目(编号:201403050)~~

摘　　要：目的比较青少年近视患者配戴角膜塑形镜、硬性透气性角膜接触镜(rigid gas permeable contact lens,RGPCL)及框架眼镜2 a后屈光度及眼轴长度变化,评估不同光学矫正方式对青少年近视的控制效果。方法前瞻性临床研究。收集2012年6月至2014年6月验配角膜塑形镜的近视者50例(99眼)为角膜塑形镜组、RGPCL近视者48例(95眼)为RGPCL组及单光足矫框架眼镜近视者50例(100眼)为框镜组,随访2 a。记录三组患者戴镜前及戴镜2 a后的近视球镜度、柱镜度、等效球镜度(spherical equivalent,SE)、眼轴长度(axial length,AL)及角膜塑形镜组戴镜6个月内每次复查时裸眼视力(uncorrected visual acuity,UCVA)。为准确测量屈光度及AL,角膜塑形镜组和RGPCL组2 a后至少停戴30 d再进行检查。结果戴镜前3组间年龄、屈光状态、AL等比较,差异均无统计学意义(均为P>0.05)。2 a后,三组的AL及SE均有所增加(F=278.43、140.12,均为P<0.01),AL和SE增加分别为:角膜塑形镜组(0.30±0.39)mm、(0.83±0.97)D,RGPCL组(0.55±0.41)mm、(1.55±0.63)D,框镜组(0.59±0.34)mm、(1.73±0.62)D,角膜塑形镜组增加量最少,另两组增加量差异无统计学意义。角膜塑形镜组戴镜后各时间点的UCVA较配戴前均明显提高(F=486.38,P<0.01)。结论角膜塑形镜、RGPCL及框架眼镜3种光学矫正方式对青少年近视进展的控制作用以角膜塑形镜效果最佳,配戴角膜塑形镜还能明显提高近视者的UCVA。Objective To compare the changes of diopter and axial length（AL） in 2 years after wearing orthokeratology lens, rigid gas permeable contact lens （RGPCL） and spectacles in adolescent myopia, and evaluate the control effects of different methods on adolescent myopia. Methods Prospective clinical study. The date of 99 eyes of 50 adolescent myopia cases wearing orthokeratology, 95 eyes of 48 adolescent myopia cases wearing RGPCL,and 100 eyes of 50 adolescent myopia cases wearing full correction single vision spectacles were collected from June 2012 to June 2014： The follow-up time was 2 years. The status of diopter and AL before and wore mirror after 2 years and the uncorrected visual acuity （UCVA） in group of orthokeratology were recorded. The examinations were repeated rafter 2 years without wearing orthokeratology and RGPCL at least 30 days. Results There was no statistical difference in age, refractive status and AL among three groups before wearing the mirror. After wearing for 2 years ,AL and spherical equivalent in three groups were increased （F = 278.43,140. 12 ; all P 〈 0.01 ）. The increase of AL and SE was as follows： orthokeratology group （0.30±0.39 ） nun, （ 0. 83 ± 0.97 ） D; RGPCL group （ 0.55 ± 0.41 ） mm, （ 1.55 ± 0.63 ） D; spectacles group （0. 59 ± 0. 34） mm, （ 1.73 ± 0. 62） D. The increase of orthokeratology group was the least, and there was no statistical difference between the other two groups. UCVA was significantly improved at each time point after wearing orthokeratology（F = 486.38 ,P 〈 0.01 ）. Conclusion In the three optical correction methods of orthokeratology, RGP and spectacles, the ortho-keratology is the best on controlling adolescent myopia, and no difference between the other two. At the same time, wearing orthokeratology can al- so significantly improve UCVA in myopia cases.

关 键 词：角膜塑形镜 硬性透气性角膜接触镜 框架眼镜 眼轴长度 近视 

分 类 号：R778.1[医药卫生—眼科]