摘要
目的探讨配戴角膜塑形镜对儿童近视性屈光参差临床防治的效果。方法采用回顾性病例系列研究。收集2017年6月至2019年6月于首都医科大学附属北京同仁医院验配角膜塑形镜并夜戴1年以上,且能够按时随访的226名近视性屈光参差儿童数据,年龄(10.83±1.56)岁,男95名,女131名。根据戴镜情况及基线屈光参差分为:双眼戴镜低度屈光参差组(A1组,111名,双眼戴镜,1.0 D≤双眼SE差值<2.5 D),年龄(10.68±1.66)岁,男50名,女61名;双眼戴镜中高度屈光参差组(A2组,33名,双眼戴镜,双眼SE差值≥2.5 D),年龄(11.24±1.38)岁,男10名,女23名;单眼戴镜低度屈光参差组(B1组,38名,单眼戴镜,1.0 D≤双眼SE差值<2.5 D),年龄(10.79±1.51)岁,男17名,女21名;单眼戴镜中高度屈光参差组(B2组,44名,单眼戴镜,双眼SE差值≥2.5 D),年龄(10.97±1.60)岁,男18名,女26名。采用配对t检验、秩和检验、线性回归等统计学方法,观察戴镜1年后双眼眼轴长度、双眼眼轴差值等参数的变化并进行统计学分析。结果(1)眼轴变化:戴镜1年后,各组双眼眼轴长度均增加。A1组高度数眼及低度数眼眼轴分别增长(0.20±0.21)mm及(0.24±0.22)mm,差异有统计学意义(t=-3.208,P=0.002);A2组高度数眼及低度数眼眼轴分别增长(0.04±0.11)mm及(0.17±0.14)mm,差异有统计学意义(t=-5.545,P<0.001)。B1组高度数眼和低度数眼眼轴增长量分别为(0.14±0.21)mm和(0.39±0.23)mm,B2组高度数眼及低度数眼眼轴分别增长(0.11±0.14)mm和(0.54±0.24)mm,差异均有统计学意义(t=-6.533,-11.643;P均<0.001)。A1组高度数眼及低度数眼1年眼轴增长量均与年龄呈线性相关(校正R2=0.208,0.237),A2组高度数眼及低度数眼1年眼轴增长量均与年龄呈线性相关(校正R2=0.169,0.360)。B1组高度数眼及低度数眼1年眼轴变化量与年龄及基线屈光度不存在线性相关(F=0.514,1.205;P=0.602,0.312),B2组眼轴变化量与年龄及基线屈光度不存在线性相关(F=0.841,0.056;P=0.439,0.946)。(2)双眼眼轴差值变化:戴镜1年后,A1、A2、B1、B2各组双眼眼轴差值变化量分别为(-0.04±0.14)mm、(-0.13±0.13)mm、(-0.26±0.24)mm及(-0.43±0.25)mm。双眼戴镜组及单眼戴镜组中高度屈光参差者较低度屈光参差者眼轴差值变化量更大(t=-3.211,-3.180;P=0.002,0.002)。A1、A2及B2组双眼眼轴差值减少量与基线屈光参差量均呈线性相关(校正R2=0.099,0.149,0.230)。B1组双眼眼轴差值减少量与基线屈光参差量不存在线性关系(F=0.014,P=0.908)。结论配戴塑形镜能有效延缓近视性屈光参差少年儿童眼轴增长并缩小屈光参差。双眼戴镜者年龄较高者近视控制效果较好。基线屈光参差较大者,屈光参差治疗效果更好。
Objective To evaluate the clinical effects of orthokeratology lens on children with myopic anisometropia.Methods Retrospective case series study.The data of 226 myopic anisometropia children,(10.83±1.56)years old,including 95 males and 131 females,fitted with orthokeratology(OK)lens in Beijing Tongren Hospital from June 2017 to June 2019 were collected.According to the lens wearing condition and baseline anisometropia,they were divided into four groups:group A1 with an average age of(10.68±1.66)years(bilateral OK lens wearing with low anisometropia,1.0 D≤SE difference<2.5 D,50 males and 61 females),group A2 with an average age of(11.24±1.38)years(bilateral OK lens wearing with moderate and high anisometropia,SE difference≥2.5 D,10 males and 23 females),group B1 with an average age of(10.79±1.51)years(unilateral OK lens wearing with low anisometropia,1.0 D≤SE difference<2.5 D,17 males and 21 females)and group B2 with an average age of(10.97±1.60)years(unilateral OK lens wearing with moderate and high anisometropia,SE difference≥2.5 D,18 males and 26 females).After wearing OK lens for one year,the changes of axial length(AL)and AL difference were observed and statistically analyzed.Results(1)AL changes:after wearing OK-lens for one year,AL of each eye increased.In group A1,the AL of the more myopic eyes and the less myopic eyes increased by(0.20±0.21)mm and(0.24±0.22)mm respectively,and the difference was statistically significant(t=-3.208,P=0.002);in group A2,the AL growth of the more myopic eyes and the less myopic eyes were(0.04±0.11)mm and(0.17±0.14)mm,and the difference was statistically significant(t=-5.545,P<0.001).In group B1,the AL elongation of the more myopic eyes and the less myopic eyes were(0.14±0.21)mm and(0.39±0.23)mm,and in group B2,the AL growth of the more myopic eyes and the less myopic eyes were(0.11±0.14)mm and(0.54±0.24)mm,with statistically significant differences(t=-6.533,-11.643;all P<0.001).There was a linear correlation between AL elongation and age of the more myopic eyes and the less myopic eyes in group A1(corrected R2=0.208,0.237)and group A2(corrected R2=0.169,0.360).There was no linear correlation of the more myopic eyes and the less myopic eyes between AL change and age or baseline myopia in group B1(F=0.514,1.205;P=0.602,0.312)and group B2(F=0.841,0.056;P=0.439,0.946).(2)Change of AL difference:after wearing OK lens for one year,the changes of AL difference in groupA1,A2,B1 and B2 were(-0.04±0.14)mm,(-0.13±0.13)mm,(-0.26±0.24)mm and(-0.43±0.25)mm,and the decrease of AL difference in moderate and high anisometropia groups were greater than that in low anisometropia groups(t=-3.211,-3.180;P=0.002,0.002).There was a linear correlation between the reduction of AL difference and baseline anisometropia in group A1,A2 and B2(corrected R2=0.099,0.149,0.230),and there was no linear relationship between the decrease of AL difference and the baseline anisometropia in group B1(F=0.014,P=0.908).Conclusions Orthokeratology could effectively control the progression of myopia and to treat anisometropia.The effect of myopia control was better in the older binocular OK lens wearers,and for the patients with greater baseline anisometropia,the treatment effect of anisometropia was better.
作者
吕燕云
武晶晶
郭伟
彭丽
王艳霞
吴敏
曹凯
接英
Lyu Yanyun;Wu Jingjing;Guo Wei;Peng Li;Wang Yanxia;Wu Min;Cao Kai;Jie Ying(Tongren Vision Care,Beijing Tongren Hospital,Capital Medical University,Beijing 100730,China;Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University/Beijing Institute of Ophthalmology/Beijing Ophthalmology and Visual Sciences Key Laboratory,Beijing 100730,China)
出处
《中华预防医学杂志》
CAS
CSCD
北大核心
2021年第4期471-477,共7页
Chinese Journal of Preventive Medicine
关键词
近视
屈光参差
眼轴
角膜塑形镜
Myopia
Anisometropia
Axial length
Orthokeratology
