角膜塑形镜对不同类型近视性屈光参差儿童控制效果  

Study on the control effect of orthokeratology lenses on children with different types of myopic anisometropia

作　　者：刘锦卉 解瑞[2] 袁自由 王莉 LIU Jinhui;XIE Rui;YUAN Ziyou;WANG Li(Department of Child Health,School of Public Health,Shanxi Medical University,Taiyuan 030001,Shanxi Province,China;Department of Ophthalmology,Heping Hospital Affiliated to Changzhi Medical College,Changzhi 046000,Shanxi Province,China;Department of Ophthalmology,Heji Hospital Affiliated to Changzhi Medical College,Changzhi 046000,Shanxi Province,China)

机构地区：[1]山西医科大学公共卫生学院儿少卫生学教研室,山西省太原市030001 [2]长治医学院附属和平医院眼科,山西省长治市046000 [3]长治医学院附属和济医院眼科,山西省长治市046000

出　　处：《眼科新进展》2024年第4期297-301,共5页Recent Advances in Ophthalmology

基　　金：山西省基础研究计划(自由探索类)项目(编号:202203021221302)。

摘　　要：目的 探究角膜塑形镜对不同类型近视性患儿屈光参差的控制效果。方法 纳入2020年9月至2022年11月于长治医学院附属和平医院眼科验配角膜塑形镜并且资料完整的8~16岁近视患儿99例。分为单纯近视性屈光参差组(单眼近视,双眼屈光度差值≥1.00 D)39例和复合近视性屈光参差组(双眼近视,双眼屈光度差值≥1.00D)60例。将两组中双眼间屈光参差量较高(双眼屈光度差值≥2.50 D)的患儿设为高屈光参差亚组(分别为18例和29例),较低(1.00 D≤双眼屈光度差值<2.50 D)的设为低屈光参差亚组(分别为21例和31例)。各组内将屈光度数较高眼设为高度数眼,对侧屈光度数较低眼设为低度数眼。检查并记录两组患儿屈光度、角膜地形图、眼压、角膜内皮、眼轴长度等。比较两组患儿在配戴角膜塑形镜前及戴镜1年后双眼眼轴长度的变化,分析屈光参差程度与双眼眼轴长度变化的相关关系。结果 配戴角膜塑形镜1年后,两组患儿双眼眼轴长度均增长,且均表现为高度数眼的眼轴长度增长量低于低度数眼;在戴镜前及戴镜1年后,两组患儿高度数眼眼轴长度均大于低度数眼,差异均有统计学意义(均为P<0.05)。两组患儿均表现为戴镜1年后双眼间眼轴长度差值缩小;在戴镜前及戴镜1年后,单纯近视性屈光参差组患儿双眼间眼轴长度差值较复合近视性屈光参差组均更大,差异均有统计学意义(t=4.903、2.670,均为P<0.05)。单纯近视性高屈光参差亚组患儿与单纯近视性低屈光参差亚组患儿戴镜前后双眼眼轴长度差值变化量均分别大于复合近视性高屈光参差亚组与复合近视性低屈光参差亚组,差异均有统计学意义(均为P<0.05)。单纯近视性屈光参差组与复合近视性屈光参差组中,屈光参差程度与戴镜前后1年双眼间眼轴长度变化量均呈正相关(r=0.423、0.510,均为P<0.05)。结论 角膜塑形镜可有效减少近视性屈光�Objective To explore the effect of the orthokeratology lenses on the control of different types of anisometropia in myopic children.Methods A total of 99 myopic children aged 8 to 16 years who got the orthokeratology lenses at the Department of Ophthalmology,Heping Hospital Affiliated to Changzhi Medical College from September 2020 to November 2022 with complete data were included.These children were divided into the simple myopic anisometropia group(monocular myopia,binocular diopter difference≥1.00 D,n=39)and the compound myopic anisometropia group(binocular myopia,binocular diopter difference≥1.00 D,n=60).The children with higher anisometropia(binocular diopter difference≥2.50 D)in the two groups were set as the high anisometropia subgroup(n=18 and 29,respectively),and children with lower anisometropia(1.00 D≤binocular diopter difference<2.50 D)were set as the low anisometropia subgroup(n=21 and 31,respectively).In each group,eyes with a higher diopter were set as the high diopter eyes,and the contralateral eyes with a lower diopter were set as the low diopter eyes.Diopter,corneal topography,intraocular pressure,corneal endothelium and axial length of children in the two groups were examined and recorded.The changes in axial length before and after wearing orthokeratology lenses for 1 year were compared between the two groups,analyzing the correlation between the degree of anisometropia and changes in the binocular axial length.Results After wearing orthokeratology lenses for 1 year,children in both groups had an increase in the axial length with a lower increase in the axial length of the high diopter eyes compared to the low diopter eyes;before and 1 year after wearing orthokeratology lenses,the axial length of high diopter eyes was greater than that of the low diopter eyes in both groups,and the differences were statistically significant(all P<0.05).Both groups of children showed a decrease in the binocular axial length difference after wearing the orthokeratology lenses for 1 year;before and 1 year

关 键 词：角膜塑形镜 屈光参差 近视 眼轴长度 

分 类 号：R778.1[医药卫生—眼科]