不同调节幅度对配戴角膜塑形镜轻中度近视儿童控制效果及角膜功能的影响  

Effects of different amplitudes of accommodation of orthokeratology lens on control and cornea of children with mild to moderate myopia

作　　者：宋艳霞 苏鸣 陈璐[1] 王建仓[1] 任生刚 赵敬聪 杨素玲 王伟[1] SONG Yanxia;SU Ming;CHEN Lu;WANG Jiancang;REN Shenggang;ZHAO Jingcong;YANG Suling;WANG Wei(Hebei Children’s Hospital Affiliated to Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学附属河北省儿童医院

出　　处：《山东医药》2019年第34期18-21,25,共5页Shandong Medical Journal

基　　金：河北省科技计划项目(182777187)

摘　　要：目的观察不同调节幅度对配戴角膜塑形镜轻中度近视儿童控制效果及角膜功能的影响。方法选择128例(128眼)轻中度近视儿童作为研究对象,均配戴角膜塑形镜。计算所有患儿戴镜前调节幅度的平均值,根据戴镜前调节幅度是否高于平均值分为两组,其中A组62例(62眼),戴镜前调节幅度低于平均值,B组66例(66眼),戴镜前调节幅度高于平均值。记录并比较两组戴镜前及戴镜12、24个月的调节幅度、眼轴长度、角膜内皮细胞密度、角膜内皮细胞面积。采用Pearson相关分析戴镜前调节幅度与戴镜24个月眼轴长度增长量的相关性。结果所有患儿完成24个月随访。两组戴镜12、24个月的调节幅度均较戴镜前增长(P均<0.05);B组戴镜前及戴镜12、24个月调节幅度均较A组大(P均<0.05),且A组戴镜24个月的调节幅度增长量大于B组(P<0.05)。A组戴镜前及戴镜12、24个月的眼轴长度比较,差异无统计学意义;B组戴镜12、24个月的眼轴长度较本组戴镜前及A组同时点长(P均<0.05)。两组戴镜12、24个月的角膜内皮细胞密度、角膜内皮细胞面积较戴镜前均无明显变化,且两组同时点比较差异均无统计学意义。Pearson相关分析结果显示,戴镜前调节幅度与戴镜24个月眼轴长度增长量呈正相关(r=0.645,P<0.05)。结论调节幅度低的轻中度近视儿童配戴角膜塑形镜后在控制眼轴长度增长上较调节幅度高患儿具有优势,角膜功能未受明显影响,这可能与前者的调节幅度明显改善且调节功能主导近视眼发展有关。Objective To observe the effects of different amplitudes of accommodation on the control and safety of orthokeratology in children with mild to moderate myopia.Methods Totally 128 children(128 eyes)with mild to moderate myopia were selected as the study subjects,and all of them wore orthokeratology lens.We calculated the average of the amplitudes of accommodation of all children before wearing orthokeratology lens.According to whether the amplitude range before wearing the lens is higher than the average,all the children were divided into two groups,and there 62 cases(62 eyes)in the group A,whose amplitudes of accommodation before wearing the lens was lower than the average,and 66 cases(66 eyes)in the group B,whose amplitudes of accommodation before wearing the lens was higher than the average.The amplitudes of accommodation,the axial length,the corneal endothelial cell density,and corneal endothelial cell area before wearing and at 12 and 24 weeks after wearing were recorded and compared.Pearson correlation analysis was used to analyze the correlation between the amplitudes of accommodation before wearing the lens and the increment in axial length of the eye after 24-month wearing.Results All patients underwent optician and completed follow-up.The amplitudes of accommodation of the two groups wearing lens for 12 and 24 months was significantly higher than that before wearing lens(P<0.05);the amplitudes of accommodation of group B before wearing the lens and wearing lens for 12 months and 24 months was significantly higher than that of group A(P<0.05);the increment in amplitudes of accommodation of group A wearing the lens for 24 months was significantly higher than that of group B(P<0.05);no significant difference was found in the length of the axial length of group A between before wearing lens and wearing lens for 12 months and 24 months(P>0.05);the axial length of group B before wearing the lens and wearing the lens for 12 and 24 months was significantly higher than that of the group A at the same time(P<0.05

关 键 词：近视眼 角膜塑形镜 调节幅度 眼轴 儿童 

分 类 号：R778.1[医药卫生—眼科]