角膜塑形镜联合框架眼镜控制青少年高度近视的疗效及对眼球表面的影响

Efficacy of orthokeratology lens combined with eye glasses for juvenile high myopia

目的探讨角膜塑形镜联合框架眼镜控制青少年高度近视的疗效及其对眼球表面的影响。方法选取高度近视患者51例99眼,按照自愿原则分为角膜塑形镜配戴组30例57眼(治疗组)和单焦点框架眼镜组21例42眼(对照组)。治疗组每晚配戴角膜塑形镜,白天残余屈光度用框架眼镜矫正;对照组仅常规配戴框架眼镜。随访复诊1年,比较两组患者裸眼视力变化、屈光度、眼轴长度变化、角膜点染率和泪膜破裂时间。结果与戴镜前比较,治疗组患者戴镜1年后裸眼视力明显提高(P<0.01),但屈光度及眼轴长度均无明显变化(均P>0.05)。戴镜1年后两组患者裸眼视力、屈光度、眼轴长度变化和角膜点染率比较差异均有统计学意义(均P<0.01),但两组患者泪膜破裂时间比较差异无统计学意义(P>0.05)。结论角膜塑形镜联合框架眼镜能有效控制青少年高度近视的进展且对眼球表面影响较少。

Objective To evaluate the efficacy of orthokeratology lens combined with eye glasses for juvenile high myopia. Methods Fifty one children and teenagers aged 8-15 years with high myopia(99 eyes) were randomly divided into two groups: 30 subjects(57 eyes) in orthokeratology group(study group) and 21 subjects(42 eyes) in single vision spectacles group(control group). The study group worn orthokeratology lens overnight everyday for 1 year, residual refractive errors were corrected with single vision spectacles. The control group used single vision spectacles only. With 1 year follow-up, the changes of visual acuity, diopter, ocular axial length, the incidence of corneal fluorescein staining and the tear break-up time were compared between two groups. Results In the study group, the visual acuity was improved(P <0.01), the diopter and ocular axial length were not progressive compared to those before wearing orthokeratology lens(both P >0.05). After 1 year, there were significant differences in visual acuity, diopter, ocular axial length and the incidence of corneal fluorescein staining between study and control groups(all P <0.01), while there was no significant difference in tear break-up time between two groups(P >0.05). Conclusion Orthokeratology lens combined with eye glasses is effective and safe for reducing the progression of juvenile high myopia.