不同直径后表面光学区角膜塑形镜对儿童青少年近视眼轴控制的疗效及影响因素  

Efficacy and Influencing Factors of Orthokeratology Lenses with Different Back Optic Zone Diameters in Controlling Myopia Axial Elongation in Children and Adolescents

作　　者：袁超群 王其吉 孟雪 郭锐 Chaoqun Yuan;Qiji Wang;Xue Meng;Rui Guo(Department of Ophthalmology,Jiangsu Province Hospital of TCM,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210004,China)

机构地区：[1]南京中医药大学附属医院,江苏省中医院眼科,南京210004

出　　处：《中华眼视光学与视觉科学杂志》2024年第11期824-830,共7页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：江苏省中医院创新发展基金专项课题(Y2021CX07)

摘　　要：目的:探讨2种不同后表面光学区直径(BOZD)分别为5.5 mm及6.0 mm设计的角膜塑形镜对近视儿童青少年眼轴控制的效果,并分析其影响因素。方法:前瞻性队列研究。连续纳入2021年9月至2023年2月期间在南京中医药大学附属医院眼科首次适配角膜塑形镜行近视矫正的111例近视儿童青少年。通过计算机随机法将患者分为小光学区组和常规光学区组,分别配戴BOZD为5.5 mm及6.0 mm的角膜塑形镜。采集患者的基线参数,包括性别、年龄、散瞳后验光数据等,并进行IOL Master700及Pentacam角膜地形图检查。记录适配时及随访3、6、9、12个月时的眼部参数,包括中央区角膜厚度、前房深度、眼轴长度、瞳孔直径等。采用重复测量方差分析进行组间比较,采用多因素Logistic线性回归分析2组内眼部参数对眼轴增长量的影响因素。结果:最终共99例近视儿童青少年右眼数据被纳入统计分析。小光学区组(48例)和常规光学区组(51例)在基线数据上差异无统计学意义(P>0.05)。随访3、6、9、12个月时,小光学区组眼轴增长量分别为(0.01±0.07)(0.05±0.09)(0.07±0.12)(0.11±0.13)mm,而常规光学区组眼轴增长量分别为(0.05±0.05)(0.13±0.09)(0.20±0.10)(0.28±0.13)mm,2组之间的差异有统计学意义(F_(时间)=138.66,P<0.001;F_(组别)=37.52,P<0.001;F_(交互)=19.52,P<0.001。)。两组内相关性分析显示,在配戴镜片12个月后,2组眼轴增长与瞳孔直径、适配时等效球镜度以及初始眼轴长度和角膜厚度之间无明显相关性(P>0.05),而常规光学区组眼轴长度的增加与配镜时年龄呈负相关关系(β=-0.373,95%CI:-0.053~0.009,t=-2.81,P=0.007)。结论:5.5 mm的BOZD角膜塑形镜对儿童青少年近视眼轴控制效果更好,且有效性与角膜、瞳孔等眼部参数无明显相关性。Objective:To explore the efficacy of two orthokeratology lenses with different back optic zone diameters(BOZD)of 5.5 mm and 6.0 mm in controlling the axial length of myopia in children and adolescents,and to analyze the factors influencing the efficacy of myopia control.Methods:A prospective cohort study.A total of 111 myopic children and adolescents who underwent the first orthokeratology fitting for myopia correction in the Department of Ophthalmology of the Affiliated Hospital of Nanjing University of Chinese Medicine from September 2021 to February 2023 were continuously included.The patients were randomly assigned into the small optic zone group and the conventional optic zone group using the computerized randomization method,and wore orthokeratology lenses with BOZD of 5.5 mm and 6.0 mm respectively.Baseline parameters including gender,age,refraction data after pupil dilation,as well as IOL Master700 and Pentacam corneal topography measurements were collected.Ocular parameters such as central corneal thickness,anterior chamber depth,axial length,pupil diameter,etc.,were recorded at the time of fitting and during follow-up visits at 3 months,6 months,9 months,and 12 months.Repeated measures analysis of variance was used for inter-group comparisons,and multivariate logistic linear regression analysis was used to analyze the influencing factors of ocular parameters on the increase of axial length in the two groups.Results:Finally,the right eye data of 99 myopic children and adolescents were included in the analysis.There was no statistically significant differences in the baseline data between the small optic zone group and the conventional optic zone group(P>0.05).At the 3-month,6-month,9-month,and 12-month follow-ups,the axial length increase in the small optic zone group was 0.01±0.07 mm,0.05±0.09 mm,0.07±0.12 mm and 0.11±0.13 mm,respectively,while the axial length increase in the conventional optic zone group was 0.05±0.05 mm,0.13±0.09 mm,0.20±0.10 mm and 0.28±0.13 mm,respectively,and the differenc

关 键 词：角膜塑形术 后表面光学区直径 近视 眼轴长度 影响因素 

分 类 号：R778.1[医药卫生—眼科]