多区正向离焦镜片与角膜塑形镜对儿童近视延缓效果的Meta分析  

Efficacy of defocus incorporated multiple segments lenses and orthokeratology in controlling myopia progression:a meta-analysis

作　　者：宋德胜 何莉 龙广凤 SONG Desheng;HE Li;LONG Guangfeng(Department of Ophthalmology,Children’s Hospital of Nanjing Medical University,Nanjing 210008,P.R.China)

机构地区：[1]南京医科大学附属儿童医院眼科,南京210008

出　　处：《中国循证医学杂志》2025年第3期289-293,共5页Chinese Journal of Evidence-based Medicine

基　　金：国家自然青年科学基金项目(编号:82100778)。

摘　　要：目的系统评价多区正向离焦镜片(DIMS)与角膜塑形镜(Ortho-K)控制近视的效果。方法计算机检索PubMed、Embase、Cochrane Library、Web of Science、CBM、WanFang Data和CNKI数据库,搜集与研究目的相关的临床研究,检索时限均为2000年1月至2024年6月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入8个随机对照试验(RCT)和7个队列研究。Meta分析结果显示,Ortho-K和DIMS眼轴控制效果[MD=-0.18,95%CI(-0.21,-0.15),P<0.01;MD=-0.21,95%CI(-0.27,-0.15),P<0.01]优于单光镜片;Ortho-K组眼轴一年增长量低于DIMS组[MD=-0.06,95%CI(-0.08,-0.04),P<0.01]。结论当前证据表明,Ortho-K和DIMS的近视控制效果优于单光镜片,OrthoK的近视控制效果优于DIMS,但优势不明显。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。Objective To systematically review the efficacy of defocus incorporated multiple segments(DIMS)spectacle lenses and orthokeratology(Ortho-K)in controlling myopia.Methods The PubMed,Embase,Cochrane Library,Web of Science,CBM,WanFang Data and CNKI databases were electronically searched to collect clinical studies related to the objectives from January 2000 to June 2024.Two reviewers independently screened literature,extracted data and assessed the risk of bias of the included studies.Meta-analysis was then performed by using RevMan 5.3 software.Results A total of 8 RCTs and 7 cohort studies were included.The results of meta-analysis showed that both Ortho-K lens and DIMS had better axial control effects than the single vision control group(MD=−0.18,95%CI−0.21 to−0.15,P<0.01;MD=−0.21,95%CI−0.27 to−0.15,P<0.01).The Ortho-K had a smaller one-year growth in axial length compared to the DIMS(MD=−0.06,95%CI−0.08 to−0.04,P<0.01).Conclusion Current evidence suggests that Ortho-K and DIMS have better myopia control effects than single lens lenses,while Ortho-K has better myopia control effects than DIMS,but the advantages are not significant.Due to the limited quality and quantity of the included studies,more high quality studies are needed to verify the above conclusion.

关 键 词：近视 多区正向离焦镜片 角膜塑形镜 META分析 系统评价 眼轴 

分 类 号：TP3[自动化与计算机技术—计算机科学与技术]