低浓度阿托品联合角膜塑形镜矫治近视的临床观察

Clinical observation of low-dose Atropine combined with orthokeratology in the treatment of myopia

目的:观察低浓度阿托品滴眼液联合角膜塑形镜治疗青少年低中度近视的有效性及安全性。方法:选取2016-05/2018-08于我院就诊的青少年低中度近视患者126例126眼(均取右眼数据),使用夜戴型角膜塑形镜1mo后随机进行分组,试验组患者63眼每晚联合应用低浓度(0.01%)阿托品滴眼液1次,对照组患者63眼每晚联合应用聚乙二醇滴眼液1次。随访观察眼轴、等效球镜度、最佳矫正近视力、瞳孔直径、调节幅度、泪膜破裂时间、眼压的情况。结果:联合治疗1a,试验组和对照组低度近视患者眼轴分别增长0.13±0.03、0.22±0.05mm,中度近视患者眼轴分别增长0.12±0.03、0.20±0.05mm;低度近视患者等效球镜度分别增加0.16±0.07、0.21±0.08D,中度近视患者等效球镜度分别增加0.16±0.05、0.20±0.09D,两组之间眼轴和等效球镜度变化均有差异(均P<0.05)。治疗1a后,两组患者最佳矫正近视力、泪膜破裂时间、眼压均无差异(P>0.05),但试验组患者瞳孔直径较对照组明显增大,调节幅度较对照组降低(P<0.05)。结论:0.01%阿托品滴眼液联合角膜塑形镜能更有效控制青少年近视进展,且安全有效。

·AIM:To observe the efficacy and safety of low-dose atropine eye drops combined with orthokeratology in the treatment of low and moderate myopia in adolescents.·METHODS:Totally 126 cases of low and moderate myopia in adolescents(all right eye data,126 eyes)who all wore orthokeratology lens for 1mo were selected from May 2016 to Aug 2018.Then they were randomly divided into the experimental group and the control group.The experimental group(63 eyes)was combined with low-dose(0.01%)atropine eye drops once a night,and the control group(63 eyes)was combined with polyethyleneglycol eye drops once a night.Their AL,SE,BCNVA,PD,AMP,BUT and IOP were observed.·RESULTS:After 1y of treatment,the AL in the low myopia experimental group increased(0.13±0.03mm),while the low myopia control group increased(0.22±0.05mm).The AL in the moderate myopia experimental group increased(0.12±0.03mm),while the moderate myopia control group increased(0.20±0.05mm).The SE in the low myopia experimental group increased(0.16±0.07D),while the low myopia control group increased(0.21±0.08D).The SE in the moderate myopia experimental group increased(0.16±0.05D),while the moderate myopia control group increased(0.20±0.09D).There was statistical difference in AL and SE between the two groups(P<0.05).After 1a of treatment,there was no statistical difference in BCNVA(LogMAR),BUT and IOP between the experimental group and the control group(P>0.05).But the pupil diameter of the experimental group was significantly larger than that of the control group.The accommodation amplitude of the experimental group was lower than that of the control group(P<0.05).·CONCLUSION:0.01%atropine eye drops combined with orthokeratology can control the progression of myopia in adolescents more effectively,which is safe and effective.