近视儿童配戴离焦软性接触镜与角膜塑形镜的安全性和有效性的观察比较  

Observational Comparison of the Safety and Effectiveness of Myopic Children Wearing Defocus Incorporated Soft Contact Lenses or Orthokeratology Lenses

作　　者：马薇 杨必[1,2,3] 王雪[1,2,3] 刘陇黔[1,2,3] MA Wei;YANG Bi;WANG Xue;LIU Long-qian(Department of Optometry and Visual Science,West China School of Medicine,Sichuan University,Chengdu 610041,China;Laboratory of Optometry and Vision Science,West China Hospital,Sichuan University,Chengdu 610041,China;Department of Ophthalmology,West China Hospital,Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西临床医学院眼视光学系,成都610041 [2]四川大学华西医院眼视光学与视觉科学研究室,成都610041 [3]四川大学华西医院眼科,成都610041

出　　处：《四川大学学报（医学版）》2023年第1期181-185,共5页Journal of Sichuan University(Medical Sciences)

基　　金：四川省科技厅重点研发计划项目(No.22ZDYF1581)资助。

摘　　要：目的对比观察近视儿童配戴离焦软性接触镜与角膜塑形镜控制近视的有效性和安全性。方法回顾性研究2018年1月至2020年9月我院就诊的儿童近视患者临床资料,共75例儿童纳入分析。离焦软镜组:日戴周边离焦软性接触镜的近视儿童30例(60眼),男性10例,女性20例,年龄(9.9±1.00)岁,等效球镜度数(-2.78±0.70)D。角膜塑形镜组:配戴角膜塑形镜的近视儿童45例(90眼),女性30例,男性15例,年龄(9.67±1.11)岁,等效球镜度数(-2.67±0.71)D。两组患儿均已配戴12个月及以上框架眼镜后验配接触镜。随访12个月,对比分析两组近视儿童眼轴变化情况及角膜结膜并发症情况。结果两组近视儿童戴框架眼镜期间眼轴增加较快,OrthoK组配前的框架期眼轴增量(0.34±0.09)mm,DISC组配前的框架期眼轴增量(0.37±0.07)mm;换为接触镜后戴接触镜12个月后,OrthoK组眼轴增量(0.18±0.04)mm;DISC组眼轴增量(0.19±0.05)mm,两组儿童更换近视防控方案后眼轴增量均降低,差异有统计学意义(P<0.05)。两种不同接触镜的眼轴长度增量接近,两者差异无统计学意义(P>0.05)。配戴两种接触镜12个月期间,慢性滤泡性结膜炎发生率角膜塑形镜组为11.20%,离焦软镜组为20.00%,其中离焦软镜组比例略高,但差异无统计学意义(P>0.05)。角膜染色1级发生率角膜塑形镜组为66.70%,离焦软镜组为56.70%;角膜染色2级发生率角膜塑形镜组为17.80%,离焦软镜组为16.70%,其中两种程度的角膜染色角膜塑形镜组比例均略高于离焦软镜,但差异无统计学意义(P>0.05)。接触镜乳头性结膜炎发生率角膜塑形镜组为2.20%,离焦软镜组为10.00%,离焦软镜发生率略高于角膜塑形镜,但差异无统计学意义(P>0.05)。结论离焦软镜与角膜塑形镜均可有效控制近视儿童眼轴长度的进展,其控制效果均优于框架眼镜,两种接触镜对眼轴控制效果接近。两种接触镜的角结膜并发症较少,安全性较�Objective To observe and compare the effectiveness and safety of controlling myopia in children by wearing defocus incorporated soft contact(DISC)lenses or orthokeratology(OrthoK)lenses.Methods A total of 75children who came to our hospital between January 2018 and September 2020 were enrolled for this retrospective study.The DISC group consisted of 30 myopic children(60 eyes)wearing peripheral defocal soft incorporated contact lenses during daytime.There were 10 males and 20 females aged(9.9±1.00)years old in this group and their spherical equivalent refractions were(-2.78±0.70)D.The OrthoK group consisted of 45 myopic children(90 eyes)wearing OrthoK lenses.There were 30 female and 15 males aged(9.67±1.11)and their spherical equivalent refractions were(-2.67±0.71)D.All subjects had previously worn prescription glasses for 12 months or longer before they started wearing contact lenses.The subjects were followed up for 12 months once they started wearing contact lenses.The axial changes and corneal and conjunctival complications of the two groups of myopic children were compared and analyzed.Results Myopic children in both groups experienced relatively rapid increase in ocular axial length while they were wearing prescription glasses,with the ocular axial length increase in the prescription-glass-wearing period being(0.34±0.09)mm in the OrthoK group and(0.37±0.07)mm in the DISC group.In the 12 months of wearing contact lenses,the ocular axial length of children in the OrthoK group increased by(0.18±0.04)mm,while that of the DISC group increased by(0.19±0.05)mm.The increase in ocular axial length was reduced in both groups after the children were switched to the new myopia prevention methods,showing significant difference(P<0.05).The two groups using two different contact lenses had similar axial length increase,showing no significant difference(P>0.05).During the 12-month period while the subjects wore the two types of contact lenses,the incidence of chronic follicular conjunctivitis was 11.20%in the Ortho

关 键 词：周边离焦 离焦软镜 角膜塑形镜 近视 

分 类 号：R778.11[医药卫生—眼科]