单眼低度近视患儿佩戴角膜塑形镜及框架眼镜对屈光度的影响

Effects of orthokeratology lenses and frame glasses on anisometropia in primary and middle school students with low myopia in one eye

目的探讨单眼低度近视患儿佩戴角膜塑形镜及框架眼镜对近视发展的影响,为科学矫正和规范治疗近视提供科学参考。方法选取云南省第二人民医院2017年1月至2018年1月期间收治的中小学近视单眼患者120例,近视侧眼屈光度为(-1.00~-2.50)D,对侧眼屈光度为(-0.50~0.50)D。依据随机数字分组法分为试验组(单眼配戴角膜塑形镜)和对照组(配戴框架眼镜),每组60例。采取前瞻性研究方法,于戴镜前、戴镜后6个月、戴镜后12个月及停戴1个月后测量患者的眼轴长度(AL)且戴镜前与停戴后1个月还需测量患者的等效球镜度(SE),并进行统计学分析。结果两组患者的基线AL及SE差异均无统计学意义(P值均>0.05);配戴12个月后,试验组戴镜眼AL[(24.91±0.11)mm]较对照组[(25.02±0.09)mm]短,对侧眼AL[(24.58±0.24)mm]较对照组[(24.20±0.13)mm]长。停戴塑形镜1月后,试验组戴镜眼SE[(-2.22±0.78)D]较对照组[(-2.64±0.21)D]高,对侧眼SE[(-0.96±0.84)D]较对照组[(-0.37±0.54)D]低,差异均有统计学意义(t值分别为4.02,-4.58,P值均<0.05)。结论与佩戴框架镜相比,配戴角膜塑形镜可有效抑制单眼近视患儿患眼AL延长、控制患眼近视进展,促进对侧健眼眼轴延长及屈光度增加,降低屈光参差值,在一定程度上解决双眼视轴发育不平衡的问题,促进双眼协调发展。

Objective To investigate the effects of orthokeratology lenses and frame glasses on anisometropia in children with low myopia in one eye. Methods Between January 2017 and January 2018, 120 children of primary and secondary school age with myopic anisometropia low myopia in one eye presenting to the Second People’s Hospital of Yunnan Province were selected as research objects,with average refractive error of(-1.00,-2.50)D in one eye and(-0.50,0.50)D in another eye. Participants were divided into an experimental group and a control group(60 cases per group), according to a random number grouping method. The control group were given frame glasses, while the experimental group were given orthokeratology lenses. A prospective study was conducted to compare and analyze the lengths of the posterior eye axis(AL) and spherical equivalent(SE), measured at different time intervals between the two groups. Results There were some initial differences in AL and SE between the two groups before the experiment began;however, this difference was not statistically significant(P>0.05). After 12 months, participants myopic eyes given the orthokeratology lenses had shorter AL[(24.91±0.11)mm] compared to the control group[(25.02±0.09)mm],participants health eyes had longer AL[(24.58±0.24)mm] compared to the control group[(24.20±0.13)mm]. One month after the subjects stopped wearing plastic mirrors,participants myopic eyes had higher SE[(-2.22±0.78)D] compared to the control group[(-2.64±0.21)D],and had lower that in the control group[(-0.96±0.84)(-0.37±0.54)D](t=4.02,-4.58,P<0.05). Conclusion In children with low myopia in one eye, compared with wearers of frame glasses, wearing corneal shape lenses can effectively restrain AL-extend and control the progression of eye myopia. At the same time, wearing corneal shape lenses can promote contralateral healthy-eye axial extension and an increase in diopter, reduce the anisometropia value, solve the problems of a binocular visual axis development imbalance, and promote coordinated eye development.