不同矫正方法对儿童眼周边屈光度的影响

Effects of different corrective methods on peripheral refraction in children

目的研究不同屈光矫正方法对儿童眼周边屈光度的影响。方法自身对照横断面研究。15名儿童先后在裸眼、框架眼镜全矫和硬性透气性角膜接触镜（RGPCL）全矫三种状态下，从左侧30°到右侧300注视7个远处视标，用红外自动验光仪分别获取6个周边屈光度和1个中心屈光度，周边屈光度减去中心屈光度即相对周边屈光度，在各个位置对三种状态的相对周边屈光度进行单因素方差分析．如有统计学意义再用Bonferroni检验两两比对。结果被试儿童在裸眼、框架眼镜全矫和RGPCL全矫三种状态下，相对周边屈光度均呈远视（鼻侧10°除外），幅度随周边角度增加而增大，表现为鼻、颞侧不对称，以向颞侧注视时更偏远视。但RGPCL矫正后的相对周边屈光度在颞侧较前两种状态偏近视，差异随角度增加而增大。向颞侧30。注视时，裸眼、框架眼镜矫正和RGPCL矫正后的相对周边屈光度分别达到（1．69±1．03）D、（1．84±0．99）D和（0．81±1．28）D。方差分析发现三种方法之间差异有统计学意义（F=3．79，P=0．031），用Bonferroni检验发现在框架眼镜矫正和RGPCL矫正法之间差异存在统计学意义（P=0．043）。结论配戴RGPCL能改变颞侧周边屈光度，配戴框架眼镜则不能。如果偏近视的相对周边屈光度有利于控制近视进展，RGPCL是一个选择。

Objective To investigate the effects of different corrective methods on ocular peripheral refraction in children. Methods This was a self-controlled cross-sectional study. Fifteen children were required to gaze at 7 successive targets at distances from 30° nasal to 30° temporal, wearing no lenses, fully corrected trial lenses or rigid gas permeable （RGP） lenses. An infrared autorefractor was used to obtain six peripheral refractions and one central refraction under each condition. The difference between the peripheral refraction and central refraction was calculated as the relative peripheral refraction （RPR）. RPRs were compared in each direction among these three conditions using one-way ANOVA. If there was a statistically significant difference, a Bonferroni post-hoc test was used. Results All RPRs were hyperopic under these three conditions （except for those at 10° nasal） and showed asymmetry between nasal and temporal sides, with higher hyperopia in the periphery and during temporal gaze. RGP lenses reduced this hyperopia to a relatively small amplitude, that was more evident in the peripheral temporal side. RPR values reached （1.69±1.03）D, （1.84± 0.99）D and （0.81±1.28）D up to 30° temporal with the three respective conditions. These differences were statistically significant （F=3.79, P=0.031）. The Bonferroni test also showed a statistically significant difference between the trial lens and RGP conditions （P=0.043）. Conclusion Wearing RGP lenses has the effect of altering temporal peripheral refraction, whereas conventional glasses do not. If converting relative peripheral hyperopia to relative peripheral myopia is a reliable approach for controlling myopia progression, wearing RGP lenses is a good alternative.