角膜塑形镜联合框架眼镜治疗青少年高度近视的临床观察

Clinical observation on orthokeratology combined with frameglass for treating high myopia in teenagers

目的观察夜戴型角膜塑形镜联合白天配戴框架眼镜治疗青少年高度近视的临床疗效。方法回顾分析该院门诊就诊的10~14岁等效球镜度在-6.00^-8.00D的青少年53例(106只眼),其中,角膜塑形镜和框架眼镜联合配戴者23例、单纯配戴框架眼镜组30例,分别于戴镜前、戴镜后6、12、18、24个月测量并比较两组间眼轴长度的变化;同时比较戴镜前及2年后两组的等效球镜度。结果角膜塑形镜联合框架眼镜组戴镜2年后停戴1个月等效球镜度为(-7.28±0.57)D,框架眼镜组2年后为(-7.80±0.68)D,角膜塑形镜联合框架眼镜组、框架眼镜组2年等效球镜度分别增加(-0.29±0.22)、(-1.07±0.41)D,两组比较差异有统计学意义(P<0.01);眼轴增长分别为(0.12±0.04)、(0.37±0.13)mm,两组比较差异有统计学意义(P<0.01)。结论夜戴型角膜塑形镜联合白天配戴框架眼镜能有效减轻高度近视患者的近视增长及眼轴变长,在一定程度上可以控制近视发展。

Objective To investigate the clinical effect of orthokeratology（ortho-k）during night and wearing frameglass during daytime for treating high myopic in teenagers.Methods 53 teenager cases（aged 10-14 years old）of high myopia with spherical equivalent degree-6.00--8.00diopters（D）in our hospital were performed the retrospective analysis,among them,23 cases were the combined wearing of ortho-k and frameglass and 30 cases were simple wearing of frameglass.The changes of eye axial length at 6,12,18 24 months before and after wearing frameglass were measured and compared between the two groups.The spherical equivalent degrees were compared between before wearing frameglass and at 2years after wearing frameglass.ResultsThe spherical equivalent degree after stopping wearing for 1month after 2-year wearing in the ortho-k and frameglass group was（-7.28±0.57）D,which after 2years in the frameglass group was（-7.80±0.68）D,the 2-year spherical equivalent degrees in the ortho-k and frameglass group and the frameglass group were increased by（-0.29±0.22）D and（-1.07±0.41）D respectively,the difference between the two groups was statistically significant（P〈0.01）;the eye axial growths were（0.12±0.04）mm and（0.37±0.13）mms respectively,the difference between the two groups was statistically significant（P〈0.01）.Conclusion The combination of ortho-k during night and frameglass during daytime can effectively relieve the myopia increase and eye axis elongation in the patients with high myopia and control the myopia development to some extent.