三种不同干预方法对近视儿童调节参数及屈光度的影响

Effects of different intervention methods on regulatory parameters and diopter of myopic children

目的:通过观察低浓度阿托品、角膜塑形镜、框架眼镜对包头市近视儿童的控制效果,分析其近视相关调节参数的变化规律,为近视防控提供依据。方法:选取2018-06/12在包头医学院第一附属医院眼科门诊就诊的8~14岁近视儿童120例240眼,分为低浓度阿托品组、角膜塑形镜组和框架眼镜组,并在1、3、6、12mo分别对调节滞后量、正相对调节、负相对调节及屈光度进行随访。结果:随访3、6、12mo,低浓度阿托品组与角膜塑形镜调节滞后量有差异(P<0.05);随访6、12mo时,角膜塑形镜组与框架眼镜组调节滞后量有差异(P<0.05)。随访3、6、12mo时,低浓度阿托品组与角膜塑形镜组、框架眼镜组负相对调节均有差异(P<0.05)。在各随访时间点角膜塑形镜组与低浓度阿托品组、框架眼镜组正相对调节均有差异(P<0.05)。随访6、12mo,低浓度阿托品组与框架眼镜组屈光度有差异(P<0.05);随访12mo,角膜塑形镜组与框架眼镜组屈光度有差异(P<0.05)。结论:角膜塑形镜可以通过降低调节滞后量,解决远视离焦的问题,同时还可以提高正相对调节,但需要长期坚持配戴。低浓度阿托品可以提高负相对调节,但可能有其他途径来控制近视的发展。相较其它组而言,框架眼镜对于各调节指标影响较小,对近视的控制效果并不显著。

AIM:To observe the control effects of low concentration atropines,orthokeratology,and spectacles on children with myopia in Baotou,and to analyze change rules of myopia-related regulatory parameters for providing bases for myopia preventions and controls.METHODS:We selected 120 children with myopia aged 8-14 years old(240 eyes),treated in Ophthalmology Clinic of the First Affiliated Hospital of Baotou Medical College from June 2018 to December 2018.They were divided into three groups as follows:low concentration atropine group,orthokeratology group,and spectacles group.The accommodative lag,positive relative accommodation,negative relative accommodation,and diopter were followed up at 1,3,6,12mo.RESULTS:During the follow ups of 3,6,and 12mo.We observed a statistically significant difference in the accommodative lag between the orthokeratology group and low concentration atropine group spectacles group(P<0.05).At the 6,12mo follow up,there was a statistical difference in the accommodative lag between the orthokeratology group and the spectacles group(P<0.05).During the follow ups of 3,6,and 12mo,there was a statistically significant difference in negative relative accommodations among the low concentration atropine group,orthokeratology group,and spectacles group(P<0.05).The difference in positive relative accommodations was statistically significant among the orthokeratology group,low concentration atropine group,and spectacles group at each time point during the follow ups(P<0.05).During the follow ups of 6,12mo,the difference of equivalent spherical lens was statistically significant among the low concentration atropine group and spectacles group(P<0.05).At the follow up 12mo,the difference between the equivalent spherical lens of the orthokeratology group and the spectacles group was statistically significant(P<0.05).CONCLUSION:The effects of three commonly used methods of controlling myopia on the accommodation parameters of myopic children are as follows:orthokeratology can not only solve the problem of hyperopia defocus by reducing accommodation lags but also improve positive relative accommodations,while it should be worn for a prolonged period.Low concentration atropine can improve the negative relative accommodations.However,there may be other ways to control myopia development.Compared to other groups,the spectacles group exerted fewer effects on each adjustment index,and did not demonstrate a significant effect on myopia control.