周边离焦框架眼镜与角膜塑形镜对儿童近视进展控制效果及视力相关生存质量的影响

Effect of peripheral defocus spectacle lenses and orthokeratology lenses on myopia progression control and vision-related quality of life in children

目的:探讨周边离焦框架眼镜与角膜塑形镜(OK镜)对儿童近视进展控制效果及视力相关生存质量的影响。方法:前瞻性研究。选取2021-01/2022-01在湖州市中心医院眼科首次诊断为近视的患儿237例,根据不同矫正方式分为:周边离焦框架眼镜组105例105眼,OK镜组132例132眼(所有入组儿童眼部参数均选取右眼数据纳入统计)。使用中小学生视力相关生存质量量表对两组近视患儿进行随访调查,并记录首次就诊及随访1 a时儿童最佳矫正视力(BCVA)、等效球镜度数、眼轴(AL)数据。结果:戴镜1 a后,两组患儿等效球镜度数及AL均增长,但两组间比较均无差异(P>0.05)。周边离焦框架眼镜组患儿等效球镜度数变化量和AL变化量大于OK组(均P=0.001)。戴镜1 a后,两组患儿在中小学生视力相关生存质量量表问卷中,周边离焦框架眼镜组情感维度得分高于OK镜组(P<0.05)。OK镜组患儿情感维度得分变化量大于周边离焦框架眼镜组(P<0.05)。结论:OK镜控制儿童近视进展效果优于周边离焦框架眼镜。两种矫正方式均可显著提升近视患儿视力相关生存质量,OK镜在改善儿童视力相关生存质量量表情感维度上优于周边离焦框架眼镜。

AIM:To explore the effect of the peripheral defocus spectacle lenses and orthokeratology(OK)on the control of myopia progression and the impact on vision related quality of life in children and adolescents.METHODS:Prospective study.A total of 237 children initially diagnosed with myopia in the ophthalmology department of Huzhou Central Hospital from January 2021 to January 2022 were selected and divided into two groups according to different correction methods:peripheral defocus spectacle lenses group(105 cases,105 eyes)and OK lens group(132 cases,132 eyes).The Vision Related Quality of Life Questionnaire for Primary and Secondary School Students was used to follow up the both groups of myopic children,and the best corrected visual acuity(BCVA),spherical equivalent(SE),and axial length(AL)were recorded at the first visit and 1 a of follow-up.RESULTS:After wearing lenses for 1 a,both the peripheral defocus spectacle lenses group and OK lens group showed an increase in SE and AL,but there was no statistical difference between two groups(P>0.05).The changes in SE and AL in the peripheral defocus spectacle lenses group were greater than those in the OK lens group(all P=0.001).After 1 a of follow-up,in the emotional dimension scores,the peripheral defocus spectacle lenses group of children’s vision-related quality of life scales scored higher than in the OK lens group(P<0.05).Compared with the baseline value,the change in the emotional dimension scores of the OK lens group was greater than that in the peripheral defocus spectacle lens group(P<0.05).CONCLUSION:OK lenses are superior to peripheral defocus spectacle lenses in controlling the progression of myopia in children and adolescents.Both correction methods can significantly improve myopic children’s vision-related quality of life,with OK lenses being better at improving the emotional dimension of vision-related quality of life.