基线近视屈光度对角膜塑形镜控制青少年儿童近视进展的影响  

Inf luence of Baseline Myopic Refraction on Myopia Control in Youngsters Wearing Orthokeratology Lenses

作　　者：郑杰[1,2] 张钰 陈跃国[1] 张纯[1] Jie Zheng;Yu Zhang;Yueguo Chen;Chun Zhang(Department of Ophthalmology,Peking University Third Hospital,Beijing 100191,China;Department of Ophthalmology,Beijing He Ping Li Hospital,Beijing 100013,China)

机构地区：[1]北京大学第三医院眼科,100191 [2]北京市和平里医院眼科,100013

出　　处：《中华眼视光学与视觉科学杂志》2018年第10期582-587,共6页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的:探讨基线近视屈光度对角膜塑形镜控制青少年儿童近视进展效果的影响。方法:自身双眼对照及病例对照研究。回顾性分析2009年1月至2017年12月在北京大学第三医院接受角膜塑形镜治疗或框架眼镜矫正的双眼近视性屈光参差青少年儿童。49例接受角膜塑形镜治疗的青少年儿童纳入实验组;32例接受框架眼镜矫正的青少年儿童纳入对照组。根据戴镜前的等效球镜度(SE)将同一患者的双眼分成2个亚组:较高度数眼分别纳入实验A组或对照A组;较低度数眼分别纳入实验B组或对照B组。记录基线双眼角膜地形图、眼轴长度、屈光度及戴镜1年后眼轴长度。采用t检验和Wilcoxon秩和检验分析数据。结果:实验A、B组基线SE分别为(-5.00±1.53)D和(-3.06±1.60)D(t=-20.593,P<0.001);两亚组间基线角膜曲率、角膜散光、角膜E值、角膜厚度及瞳孔直径的差异均无统计学意义。对照A、B组基线SE为(-5.05±1.43)D和-2.81(-2.00,-4.38)D(Z=-4.952,P<0.001)。戴镜1年后,实验A、B组眼轴增长量分别为(0.03±0.14)mm和(0.12±0.16)mm,差异具有统计学意义(t=-4.217,P<0.001)。对照A、B组眼轴增长量分别为0.49(0.07,0.75)mm和0.40(0.17,0.50)mm,差异无统计学意义(Z=-0.510,P=0.610)。实验组基线双眼眼轴差值为(0.72±0.34)mm,戴镜1年后减少为(0.63±0.35)mm,差异有统计学意义(t=-4.217,P<0.001)。对照组基线双眼眼轴差值为(0.74±0.38)mm,戴镜1年后双眼眼轴差值的中位数为0.83(0.38,1.07)mm,差异无统计学意义(Z=-0.510,P=0.610)。结论:基线近视屈光度越高,角膜塑形镜的近视控制效果可能越好。Objective:To evaluate the influence of baseline myopic refraction on controlling the development of myopia using orthokeratology in youngsters.Methods:This was a binocular self-control and case control study.A retrospective analysis of anisomyopic youngsters at Peking University Third Hospital was conducted from January 2009 to December 2017.Patients who wore orthokeratology lenses or spectacles in both eyes were recruited.Forty-nine youngsters(9-17 years old)who wore orthokeratology lenses were enrolled in the experimental group and 32 youngsters who wore spectacles were enrolled in the control group.The more myopic eye of each youngster was assigned to the experimental or control group Max and the less myopic eye of each youngster was assigned to experimental or control group Min.Refraction,corneal topography and axial length were measured at baseline and at the one-year visit.Data were analyzed with t test and Wilcoxon sign-rank test.Results:The mean spherical equivalence was-5.00±1.53 D and-3.06±1.60 D for the eyes in the experimental groups Max and Min,respectively(t=-20.593,P<0.001).There were no significant differences in corneal curvature,corneal astigmatism,corneal E value,corneal thickness or pupil diameter between the two subgroups.The mean baseline spherical equivalence was-5.05±1.43 D for the eyes in control group Max,and-2.81(-2.00,-4.38)D for eyes in control group Min(Z=-4.952,P<0.001).Axial length elongation was 0.03±0.14 mm in experimental group Max and 0.12±0.16 mm in experimental group Min at the one-year visit and the difference was statistically significant(t=-4.217,P<0.001).The median axial length elongation of eyes in control groups Max and Min was 0.49(0.07,0.75)mm and 0.40(0.17,0.50)mm(Z=-0.510,P=0.610),respectively.The mean interocular difference in axial length at the one-year visit(0.63±0.35 mm)was less than that at baseline(0.72±0.34 mm)(t=-4.217,P<0.001).In the control group,the mean interocular difference in axial length was 0.74±0.38 mm at baseline,and the median interocula

关 键 词：角膜塑形镜 近视 影响因素 近视性屈光参差 

分 类 号：R778.11[医药卫生—眼科]