单眼近视性屈光参差儿童配戴角膜塑形镜后的眼轴变化

Effect of orthokeratology on axial length changes in children with unilateral myopic anisometropia

目的探讨角膜塑形镜对单眼近视性屈光参差儿童眼轴变化的影响。方法采用回顾性队列研究方法,招募2018年10月至2020年10月在浙江省慈溪市红十字医院就诊的72例144眼单眼近视性屈光参差儿童为研究对象。根据矫正方式将其分为试验组和对照组,试验组34例儿童,单眼配戴角膜塑形镜;对照组38例儿童,配戴单焦点框架镜。随访1年之后,观察两组儿童双眼眼轴长度、双眼眼轴差值等参数的变化并进行统计学处理。结果在近视侧眼中,试验组儿童眼轴长度增长[(0.10±0.08)mm]小于对照组儿童[(0.32±0.16)mm],其差异具有统计学意义(P<0.001);在非近视侧眼中,试验组儿童眼轴长度增长[(0.34±0.13)mm]大于对照组儿童[(0.21±0.11)mm],其差异具有统计学意义(P=0.001)。试验组和对照组儿童年度眼轴差值变化量分别为(-0.22±0.14)mm和(0.13±0.13)mm,其差异具有统计学意义(P<0.001)。两组儿童眼轴差值变化量的绝对值与基线年龄的线性模型均具有统计学意义(均P<0.05)。结论单眼近视性屈光参差儿童配戴角膜塑形镜可以有效延缓近视侧眼眼轴增长并减少双眼间眼轴差值。

Objective To investigate the effect of orthokeratology on axial length changes in children with unilateral myopic anisometropia. Methods Retrospective cohort study was adopted. Totally 72(144 eyes) children with unilateral myopic anisometropia treated in Cixi Red Cross Hospital were recruited from October 2018 to October 2020. According to the correction methods, they were divided into two groups: unilateral myopic anisometropes with monocular orthokeratology lens were set as the experimental group(n=34 cases);unilateral myopic anisometropes with single-vision spectacles were set as the control group(n=38 cases). The changes of binocular axial length(AL) and interocular AL difference between the two groups were observed and statistically analyzed after 1-year follow-up. Results Annual AL elongation of the myopic eyes of the experimental group [(0.10±0.08)mm] were smaller than the control group [(0.32±0.16) mm](P<0.001). However, AL elongation of the non-myopic eyes of the experimental group [(0.34±0.13) mm] were greater than the control group [(0.21±0.11) mm](P=0.001). The annual changes of interocular AL difference in experimental group and control group were(-0.22±0.14) mm and(0.13±0.13) mm respectively(P<0.001). The linear models of the absolute value of interocular AL difference and the baseline age in two groups were statistically significant(all P<0.05).Conclusions Monocular orthokeratology is effective on suppression AL elongation of the myopic eyes and reduce interocular AL difference in children with unilateral myopic anisometropia.