高度近视儿童配戴硬性透气性角膜接触镜临床观察

Clinical observation of rigid gas permeable contact lenses for children with high myopia

目的探讨6岁以下高度近视儿童配戴硬性透气性角膜接触镜(rigid gas permeable contact lens,RGPCL)2a的临床应用效果。方法在角膜地形图指导下对16例(32眼)3～6岁高度近视儿童进行RGPCL配戴,观察患儿的RGPCL配戴和适应情况,比较最佳框架眼镜和RGPCL矫正视力。随访2a观察并发症的发生情况、屈光度发展及视力提高情况。结果配戴框架眼镜矫正视力与RGPCL比较差异有统计学意义(t=-4.558,P<0.05);配戴RGPCL2a前后矫正视力差异有统计学意义(t=6.027,P<0.05),2a后屈光度增长(-0.17±0.42)D、眼轴长度增长(0.07±0.02)mm。所有患儿均1次配戴成功,配戴试戴镜5min后患儿能正常视物、玩耍,1周内均能适应全天日戴。随访期间,1例患儿因家长没有时间为孩子配戴而弃戴,其余均能日戴,镜片需患儿家长清洗、为患儿配戴,5例患儿能独立摘镜片;所有病例均未发现角膜缘新生血管,无角膜擦伤或角膜溃疡等严重并发症。结论近视性屈光参差及高度近视儿童配戴RGPCL矫正屈光不正安全、有效。

Objective To investigate the effect of rigid gas permeable contact lens（RGPCL） for high myopia in children less than six years old for 2 years.Methods With guidance of corneal topography,16 children（32 eyes） ranging from 3 to 6 years old with high myopia were fitted into RGPCL.RGPCL condition and adaption were observed.The best glass and RGPCL corrected vision were compared.All children were followed up for 2 years.The incidence of complications,diopter and improvement of vision were observed.Results There was statistical difference in corrected vision between wearing glasses and RGPCL（t=-4.558,P0.05）,also in corrected vision before and at 2 years after wearing glasses（t=6.027,P0.05）.After 2 years,the diopter increased（-0.17±0.42）D,and the ocular length increased（-0.07±0.02）mm.All the children were worn glasses successfully once.These all can see and play normally at 5 minutes after wearing try-in glasses,and worn all the day within one week.During following up time,all the children can wear RGPCL all the day except one child for the parents having no time to help him wearing glasses.Parents had to clean glasses and help children to wear.Five children could wear glasses independently.No severe complication was observed,as corneal neovascularization,corneal abrasion,keratohelcosis and so on.Conclusion RGPCL is safe and effective for high myopia and myopic anisometropia in children.