佩戴角膜塑形镜后离焦环完整性及不同方向偏位对近视青少年眼轴增长的影响

Investigating the influence of the integrity and different decentration of orthokeratology defocus ring on axial length

目的探讨佩戴角膜塑形镜(OK镜)后离焦环完整性及偏位对近视青少年眼轴增(AL)长快慢的影响。方法回顾性病例对照研究。纳入佩戴OK镜的8~18岁儿童青少年110例(210只眼),按离焦环完整与否分成离焦环完整组、离焦环不完整组,对比两组基线参数(年龄、性别、眼别、屈光度)、及1年AL增长量的差异。按不同水平偏位方向分为颞侧组、鼻侧组、居中组,对比三组1年后AL增长量的差异。按照不同垂直偏位方向分为下方组、上方组、居中组,对比三组1年后AL增长量的差异。结果(1)离焦环完整与否组的对比:离焦环完整组(187只眼)与离焦环不完整组(23只眼),基线参数及1年AL增长量差异无统计学意义(均P>0.05);(2)OK镜偏位量与1年AL增长量的相关性分析:皮尔逊相关性分析显示,呈负相关(r=-0.16,P<0.05);(3)不同水平方向偏位对比:颞侧组(155只眼)、鼻侧组(10只眼)、居中组(22只眼)三组间1年AL增长量差异无统计学意义(P>0.05);(4)不同垂直方向偏位对比:上方组(27只眼)较下方组(93只眼)、居中组(67只眼)1年AL增长量较高(均P<0.05),下方组、居中组1年AL增长量差异无统计学意义(P>0.05)。结论近视青少年佩戴OK镜,离焦环不那么完整、轻度水平偏位对OK镜的近视防控效果影响不大,在垂直方向上应尽量避免上方偏位,更利于防控近视。

Objective To retrospectively investigate the influence of the integrity and different decentration of or⁃thokeratology defocus ring on axial length(AL).Methods A prospective case-control study.210 eyes of 110 adolescents aged 8 to 18 years who with wearing overnight orthokeratology(OK)lens in the First Affiliated Hospital of Guangxi Univer⁃sity of traditional Chinese medicine were included.According to the integrity of the defocus ring,it was divided into the com⁃plete group and the incomplete defocus ring group.And the difference of baseline parameters(age,sex,eye difference,re⁃fraction)and 1-year AL growth was compared.According to the different levels of bias direction,the group was divided into temporal group,nasal group and middle group,and the three groups of baseline parameters and the difference of 1-year AL growth were compared.According to different vertical bias directions,they were divided into lower group,upper group and middle group.The baseline parameters of the three groups and the difference of 1-year AL growth were compared.Results(1)In the 210 eyes,187 eyes had complete defocus ring,and the 1-year AL growth was(0.21±0.23)mm.23 eyes had in⁃complete defocus ring,with an increase of(0.21±0.19)mm,and the difference of them and baseline parameter were not statistically significant(all P>0.05).(2)The correlation analysis between the overall deviation and the increase of ocular axis showed that(r=-0.16 P<0.05),there was a negative correlation,but the correlation was low.(3)Horizontal orienta⁃tion:temporal group(155 eyes),nasal group(10 eyes),and middle group(22 eyes).And there was no significant differ⁃ence in 1-year AL growth and baseline parameters in three different horizontal deviation directions(all P>0.05).(4)Com⁃pared with the growth 1-year AL in three different vertical directions,the growth of AL in thesuperior decentration(27 eyes)was higher than that in the inferior(93 eyes)and center position(67 eyes)(all P<0.05).There was no statistically signifi⁃cant between inferior deviation group and center group(P>0.05).Conclusions During the shaping process,the defocus ring may be incomplete,and the slight horizontal deviation has little effect on the myopia prevention and control effect of OK lens.In the vertical direction,the superior deviation should be avoided as far as possible to better prevent and controlmyopia.