两种屈光矫正方式对青少年近视患者调节反应的影响

Comparison of the accommodative response with two refractive corrections for myopic teenagers

目的:观察并比较青少年近视患者在配戴角膜塑形镜和配戴框架眼镜后调节反应的变化情况。方法:选取10~16岁中低度青少年近视患者120例240眼,根据屈光矫正方式不同分为试验组(配戴角膜塑形镜)和对照组(配戴单光框架眼镜),试验组和对照组各60例120眼,随访并比较两组患者戴镜前和戴镜后1、3、6、12mo的调节反应。结果:共有113例患者226眼完成该研究,其中试验组54例108眼,对照组59例118眼。两组患者戴镜前和戴镜后的调节反应均表现为调节滞后,且调节滞后量随着配戴时间的延长逐渐下降;试验组和对照组在戴镜前和戴镜后1、3、6、12mo的调节滞后量分别为(1.22±0.47、0.91±0.39、0.77±0.40、0.65±0.32、0.51±0.22)D、(1.23±0.48、1.05±0.41、0.90±0.49、0.83±0.46、0.69±0.33)D;测量时间对各组调节滞后量的影响均有统计学意义(F=195.229、142.361、323.484,P<0.05),组别与测量时间的交互作用对调节滞后量的影响也有统计学意义(F=11.222,P<0.05),但眼别与测量时间的交互作用对调节滞后量的影响均没有统计学意义(F=0.025、0.023,P>0.05);试验组和对照组戴镜前调节滞后量的差异无统计学意义(t=-0.07,P>0.05),试验组戴镜后1、3、6、12mo的调节滞后量均小于对照组,差异有统计学意义(t=-2.587、-2.241、-3.522、-4.587,P<0.05)。结论:青少年近视患者配戴角膜塑形镜和配戴框架眼镜都能改善调节反应,减少调节滞后量,但配戴角膜塑形镜的效果要优于配戴框架眼镜。

AIM：To observe and compare the accommodative responses of myopic teenagers with orthokeratology lenses and frame glasses.METHODS：One hundred and twenty myopic teenagers（240 eyes） aged 10-16 y were selected and divided into experimemtal group（orthokeratology lens group） and control group（frame glasses group）,with 60 cases（120eyes） in each group.The accommodative response before and after correction of all the cases in the two groups were followed up and compared after 1,3,6 and 12 mo.· RESULTS：A total of 113 patients（226 eyes） completed the experiment,including 54 patients（108 eyes） in the experimental group and 59 patients（118 eyes） in the control group.Both the two groups showed accommodative lag which gradually decreased with the wearing time.The accommodative lag before and after correction in the experimental group and control group were respectively（1.22±0.47,0.91 ±0.39,0.77±0.40,0.65±0.32,0.51±0.22）,（1.23±0.48,1.05±0.41,0.90±0.49,0.83±0.46,0.69 ± 0.33） D.The effects of measurement time on accommodative lag of each group were significant（F=195.229,142.361,323.484,P〈0.05）.The interaction between the group and the measurement time also had significant effects（F=11.222,P〈0.05）.But the interaction between eye and measurement time had no significant effects（F=0.025 0.023,P〉0.05）.The accommodative lags in the orthokeratology group were smaller than the frame glasses group after correction（t=-2.587,-2.241,-3.522,-4.587,P〈0.05）,but no significant difference before correction（t=-0.07,P〉0.05）.CONCLUSION：Both frame glasses and orthokeratology can improve accommodative response and reduce accommodation lag of juvenile myopia,but the effect of wearing orthokeratology is superior to frame glasses.