多区正向光学离焦设计与高非球面微透镜设计离焦镜片对近视控制的效果比较  

Effectiveness of defocus lenses with multi-zone positive optical defocus design versus high aspheric micro-lens design in controlling myopia

作　　者：梁玲玲 张亚 苏鸣 武艺丹 程琳 宫冬梅 羡迎春 张俊英 邱爽 LIANG Lingling;ZHANG Ya;SU Ming;WU Yidan;CHENG Lin;GONG Dongmei;XIAN Yingchun;ZHANG Junying;QIU Shuang(Department of Ophthalmology,Shijiazhuang Aier Eye Hospital,Shijiazhuang,Hebei,050006)

机构地区：[1]石家庄爱尔眼科医院眼科,河北石家庄050006

出　　处：《实用临床医药杂志》2024年第20期39-43,共5页Journal of Clinical Medicine in Practice

摘　　要：目的比较多区正向光学离焦设计(DIMS)与高非球面微透镜设计(HAL)离焦镜片对近视控制的效果。方法选取2023年1—6月在本院验配离焦眼镜(DIMS、HAL)的儿童及青少年共计214例,其中DIMS 100例,HAL 114例。比较2组受试者佩戴前和6个月后球镜、柱镜、等效球镜(SE)、角膜曲率(K)、眼轴(AL)、双眼视功能调节反应(BCC)、正/负相对调节(PRA/NRA)、远近眼位(DLP/NLP)和调节性集合(AC/A)等参数变化情况,进一步比较DIMS与HAL的近视控制效果。结果戴镜(DIMS、HAL)6个月后,患者眼轴平均增长(0.09±0.14)mm,球镜平均增长(-0.11±0.23)D,散光平均增长(-0.07±0.16)DC,等效球镜平均增长(-0.15±0.24)D,差异均有统计学意义(t=9.24、-7.27、-6.60、-9.03,P均<0.001)。佩戴6个月后,与戴镜前比较,除NRA(t=-0.12,P>0.05)、NLP(t=-0.28,P>0.05)、AC/A(t=0.33,P>0.05)的差异无统计学意义外,其他参数如球镜、柱镜、SE、BCC、PRA、DLP、平均K、AL的差异均有统计学意义(P≤0.001)。2组戴镜6个月后各参数差值比较,除AL差值(t=4.38,P≤0.001)有统计学意义外,其他参数差值均无统计学意义(P>0.05)。结论佩戴离焦眼镜对近视的控制、延缓眼轴的增长、双眼视功能的平衡均有一定的积极作用。Objective To compare the effectiveness of Defocus Incorporated Multiple Segments(DIMS)and High Aspheric Lenslet(HAL)defocus lenses in controlling myopia.Methods A total of 214 children and adolescents who were fitted with defocus lenses(DIMS or HAL)in our hospital from January to June 2023 were selected,including 100 cases in DIMS group and 114 cases in the HAL group.Changes in parameters such as spherical lens power,cylindrical lens power,spherical equivalent(SE),corneal curvature(K),axial length(AL),binocular accommodative response(BCC),positive/negative relative accommodation(PRA/NRA),distance/near latent phoria(DLP/NLP),and accommodative convergence to accommodation ratio(AC/A)were compared between the two groups before wearing and after wearing the lenses for 6 months,and the effectiveness of myopia control between DIMS and HAL was further compared.Results After wearing the lenses(DIMS or HAL)for 6 months,the average increase in axial length was(0.09±0.14)mm,the average increase in spherical lens power was(-0.11±0.23)D,the average increase in astigmatism was(-0.07±0.16)DC,and the average increase in spherical equivalent was(-0.15±0.24)D,with statistically significant differences observed for all these changes(t=9.24,-7.27,-6.60,-9.03,respectively,P<0.001).Compared with parameters before wearing the lenses,statistically significant differences were noted after wearing for 6 months in spherical lens power,cylindrical lens power,SE,BCC,PRA,DLP,average K,and AL(P≤0.001),except for NRA(t=-0.12,P>0.05),NLP(t=-0.28,P>0.05),and AC/A(t=0.33,P>0.05).The differences in parameters between the two groups after wearing the lenses for 6 months showed a statistically significant difference only in the AL difference(t=4.38,P≤0.001),with no statistically significant differences observed for other parameter differences(P>0.05).Conclusion Wearing defocus lenses has a positive effect on controlling myopia,delaying axial length elongation,and maintaining binocular visual function balance.

关 键 词：近视 双眼视功能 眼轴 离焦镜片 控制效果 

分 类 号：R778.3[医药卫生—眼科] R778.1[医药卫生—临床医学] R770.42