青少年配戴硬性角膜接触镜与框架镜1a后的调节滞后比较

Comparison of accommodative lag between rigid gas permeable contact lens and spectacles in adolescents after 1 year

目的：探讨青少年近视眼配戴硬性透气性角膜接触镜（ rigid gas permeable contact lens,RGPCL）与框架眼镜1a后在不同调节刺激下的调节滞后量的差异性。 方法：选取年龄10-16岁的85例近视眼患者,经过双眼视功能检测、医学验光、角膜地形图检查、眼部健康检查等常规检查程序,依据检查结果及家长的依从性,选择41例配戴RGPCL,其余44例配戴框架眼镜,两组均在MPMVA （最大正镜最佳视力）的基础上采用动态检影法进行调节滞后量的测定,在配戴期间每3mo 复查一次,1a 后在MPMVA的基础上,采用动态检影法对两组再次进行调节滞后量的测定,并比较调节滞后量的差异性。同时在配戴1 a后,对 RGPCL 组和框架眼镜组的度数增加值进行比较。 结果：两组初始调节滞后量的差异无统计学意义（P〉0.05）。配戴1 a后, RGPCL组的调节滞后量与初始滞后量的差异无统计学意义（P〉0.05）,框架眼镜组的调节滞后量与初始滞后量的差异有统计学意义（P〈0.05）。配戴1a后,在2D,3D,4D的刺激下,两组调节滞后量的差异均有统计学意义（P〈0.05）,且各组的调节滞后量均随着调节刺激的增大而增加。配戴1a后,RGPCL组的度数增长小于框架眼镜组,且差异有统计学意义（P〈0.05）。 结论：配戴RGPCL 及框架眼镜1 a 后,在高调节刺激下, RGPCL组的调节滞后低于框架眼镜组,对延缓青少年近视的加深有一定作用,两组的调节滞后量都随着调节刺激的增大而增加,建议青少年注意阅读距离,保持良好的阅读习惯。

AIM： To discuss the differences in accommodative lag of different stimulation between the adolescent myopes who wore rigid gas permeable contact lens （ RGPCL ） and spectacles for one year. METHODS： Totally 85 myopes between 10-16y were enrolled in the study. Every subject was examined with the visual function test, medical optometry, corneal topography and ocular health check etc. of eyes. According to the above measurements and the compliance of children and their parents, 41 subjects were selected to wear RGPCL, 44 subjects were chosen to wear spectacles. Based on maximum plus to maximum visual acuity （ MPMVA） , accommodative lag was determined by dynamic retinoscopy method in two groups. The subjects were examined once every 3mo, accommodative lag was measured again using the same method for comparative analysis after one year. Wearing a year later, myopia progression of the two groups was measured and compared. RESULTS： There was no significant difference between two groups of initial accommodative lag （P〉0. 05）. After wearing one year, there was also no significant differencebetween the accommodative lag examined and the initial lag in RGPCL group （P〉0. 05）, the results demonstrate significant difference between the accommodative lag examined after wearing one year and the initial lag in spectacles group （ P 〈 0. 05 ）. One year later, the differences were significant in accommodative lag between RGPCL and spectacles wearers stimulated by 2D, 3D and 4D （ P 〈 0. 05 ）, and the accommodative lag increased with increasing stimulation in both groups. After wearing a year, the myopia progression of RGPCL group was less than spectacles wearers, and the differences were significant （P〈0. 05）. CONCLUSION：After wearing RGPCL and spectacles one year in high accommodative stimulus, there is an obviously decreased in accommodative lag in RGPCL group, which suggests that RGPCL can control the progression of myopia in adolescents. The accommodative lag of the two groups increase obviously with increasing stimulation, which suggest that the adolescents need keeping good habits of reading.