硬性透气性角膜接触镜、渐进多焦镜和单光眼镜对青少年近视进展的延缓作用比较

Comparison of the effect of rigid gas permeable contact lenses, progressive multifocal lenses and single-vision glasses in delaying myopia progression in young people

目的比较硬性透气性角膜接触镜（RGPCL）、渐进多焦镜、单光眼镜对青少年近视发展的延缓作用。方法青少年近视患者85例（170眼），年龄9～14岁，屈光度-1．00～4．OHDD。将这些患者分为3组给予不同矫正方式：RGPCL组30例，散光均低于1／2球镜；渐进镜组30例，均为近距内隐斜伴调节滞后≥＋0．25D；单光镜对照组25例。3组患者基本资料的差异均无统计学意义．均要求每日配戴6h以上。戴镜前和戴镜后1年，对各组眼生物参数进行测量和比较。对屈光度、角膜曲率、眼轴长度、前房深度、晶状体厚度等变化值进行单因素方差分析。结果随访1年后．3组近视患者的等效屈光度均有增长的趋势，RGPCL组增长（-0．48±0．42）D，渐进镜组增长（-0．54±0.36）D，单光镜组增长（-0．93±0．53）D，3组之间差异有统计学意义（F=29．36，，P=0．01），其中单光镜组屈光度增加最多。3组患者的眼轴均有增长，角膜曲率均有变平的趋势，前房深度均有增加，品状体厚度也有变薄的趋势，但各组间变化差异均无统计学意义。结论与单光框架眼镜比较，RGPCL有延缓近视进展的作用，渐进多焦镜能延缓近距内隐斜患者的近视增长，但两者均不能阻止近视进展。

Objective To compare rigid gas permeable contact lenses （RGPCL）, progressive muhifocal lenses, and single-vision glasses in the role of delaying the development of myopia. Methods Eight-five cases （170 eyes） 9 to 14 years old young people with -1.00--4.00 D of myopia were divided into 3 groups. The RGPCL group （30 cases） with astigmatism less than 1/2 of spherical; the multifocal lenses group （30 cases） with near esophoria and accommodative lag ≥＋0.25 D; and the single-vision glasses group （25 cases）. Basic information of the 3 groups showed no significant differences. Patients were required to wear their corrective lenses 6 hours a day. Biological parameters were measured and compared after one year. One-Way ANOVA was used to analyzed the data. Results Myopia progression was found in all 3 groups. The equivalent refractive increase in myopia in the RGPCL group was （-0.48±0.42）D, in the muhifoeal lenses group was （-0.54±0.36）D, and in the single-vision glasses group was （-0.93±0.53）D. Comparisons for the 3 groups differed significantly （F=29.36, P=0.01）. Axial length and anterior chamber depth increased and there was a tendency for the corneal curvature to flatten and the lens to become thinner in all 3 groups. However, the differences in the changes for the groups were not statistically significant. Conclusion Compared to single-vision glasses, progressive multifocal lenses for near esophoria and RGPCL lenses may slow the progression of myopia. But both methods can not prevent myopia progression.