多区正向设计离焦框架眼镜与角膜塑形镜对儿童近视的延缓效果比较  

Comparison of the effect of delaying progression of myopia in children with defocus incorporated multiple segments spectacle lenses and orthokeratology

作　　者：李秀红[1] 符爱存[1] 姫娜 王卫群[1] 吕勇[1] 李光光 赵兵新 覃建 Li Xiuhong;Fu Aicun;Ji Na;Wang Weiqun;Lyu Yong;Li Guangguang;Zhao Bingxin;Qin Jian(Department of Ophthalmology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China;The Affiliated Eye Hospital of Suzhou Vocational Health College,Suzhou 215000,China;Department of Ophthalmology,Henan Eye Hospital,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学第一附属医院眼科,郑州450000 [2]苏州卫生职业技术学院附属眼视光医院,苏州215000 [3]河南省人民医院眼科、河南省立眼科医院,郑州450003

出　　处：《中华实验眼科杂志》2024年第4期339-346,共8页Chinese Journal Of Experimental Ophthalmology

基　　金：河南省教育厅高等学校重点科研项目(23A320011);河南省科技厅重点研发与推广专项(201801591)。

摘　　要：目的比较配戴多区正向设计离焦(DIMS)框架眼镜和角膜塑形镜对儿童近视进展的延缓效果。方法采用非随机对照临床研究方法,纳入2018年1月至2020年12月于郑州大学第一附属医院就诊的近视儿童390例390眼,等效球镜度(SER)为-0.75~-6.00 D。依据患儿及其监护人意愿将受试者分为DIMS框架眼镜组、角膜塑形镜组和单光框架眼镜组,每组130例130眼,分别给予配戴DIMS框架眼镜、标准型或带散光设计角膜塑形镜及非球面设计的普通单光足矫框架眼镜,分别在戴镜前及戴镜后1年采用全自动电脑验光仪联合主觉验光测定受试眼SER;采用IOLMaster测量眼轴长度(AL)。最终符合纳入及排除标准的随访者共327例327眼,其中DIMS框架眼镜组107例107眼、角膜塑形镜组112例112眼、单光框架眼镜组104例104眼,均取右眼数据纳入分析。比较3个组受试眼戴镜前及戴镜后1年SER和AL及其变化量。DIMS框架眼镜组受试眼AL和SER变化量与基线资料的关系评估采用Pearson线性相关分析。结果DIMS框架眼镜组、角膜塑形镜组、单光框架眼镜组不同时间点SER和AL总体比较差异均有统计学意义(SER:F_(组别)=7.065,P=0.009;F_(时间)=183.730,P<0.001.AL:F_(组别)=6.151,P=0.014;F_(时间)=175.290,P<0.001),戴镜后1年3个组受试眼SER和AL变化量总体比较差异均有统计学意义(F=7.065,P=0.009;F=6.151,P=0.014),其中各组1年后SER和AL均大于基线时,角膜塑形镜组和DIMS框架眼镜组SER和AL及其变化量均明显小于单光框架眼镜组,DIMS框架眼镜组SER和AL及其变化量均大于角膜塑形镜组,差异均有统计学意义(均P<0.05)。与单光框架眼镜相比,配戴角膜塑形镜1年能分别抑制SER和AL进展58.3%和59.0%,配戴DIMS框架眼镜1年能分别抑制SER和AL进展46.9%和43.6%。戴镜1年单光框架眼镜组、角膜塑形镜组和DIMS框架眼镜组SER无变化的眼数占比分别为5.77%(6/104)、24.11%(27/112)和17.76%(19/107),AL无变化�Objective To compare the effect of delaying progression of myopia in children between defocus incorporated multiple segments(DIMS)spectacle lens and orthokeratology.Methods A nonrandomized controlled clinical study was conducted.A total of 390 children(390 eyes)with myopia who were treated in the First Affiliated Hospital of Zhengzhou University from January 2018 to December 2020 were included,with the spherical equivalent(SER)of-0.75 to-6.00 D.According to the willingness of patients and patients'guardians,the subjects were divided into DIMS group,orthokeratology group and single-vision spectacle lens group,with 130 cases(130 eyes)in each group,wearing DIMS spectacle lenses,standard or astigmatic design orthokeratology and conventional single-vision full-correction aspheric spectacle lenses,respectively.The SER of the eyes was measured using an automatic computerized refractometer in combination with subjective refraction before and one year after lens wear,and the axial length(AL)of the eyes was measured using IOLMaster.A total of 327 patients in the three groups met the inclusion and exclusion criteria,including 107 in the DIMS group,112 in the orthokeratology group,and 104 in the single-vision spectacle lens group.All the right eyes were included in this study.The changes in SER and AL before and after wearing lenses for 1 year were compared among the three groups.The relationship between AL and SER changes and baseline data in the DIMS group was evaluated by Pearson linear correlation analysis.The study followed the Declaration of Helsinki,and the study protocol was reviewed and approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University(No.2023-KY-0174-002).The subjects and their guardians were fully aware of the purpose and methodology of the study,and voluntarily signed an informed consent form.Results There were statistically significant overall differences in SER and AL at different time points among the three groups(SER:F_(group)=7.065,P=0.009;F_(time)=183.730,P<0.001.AL:F

关 键 词：近视 儿童 眼轴长度 离焦框架眼镜 角膜塑形镜 等效球镜度 视网膜离焦 

分 类 号：R778.11[医药卫生—眼科]