角膜塑形镜对近视眼调节微波动幅度和调节滞后的影响

目的 研究近视眼配戴角膜塑形镜后调节微波动幅度和调节滞后的改变。方法 横断面研究。选取在视光门诊规范验配、随诊、配戴角膜塑形镜者15例作为观察组，框架眼镜者15例作为对照组；使用开放视野型红外验光仪（WAM-5500） 测量两组在0~4 D的调节刺激下的调节反应，计算相应的调节微波动幅度、调节滞后值和调节误差指数。对两组相关数据进行独立样本t检验。结果 在0、1、2、3、4 D调节刺激下，角膜塑形镜组的调节微波动幅度均大于框架眼镜组，且差异有统计学意义（t=3.704、3.277、2.365、2.179、2.591，P均<0.05）。角膜塑形镜组的调节滞后值均小于框架眼镜组，在2，3和4 D调节刺激下，两组差异有统计学意义（t=-2.208，-2.244，-2.098，P均＜0.05）；而在0和1 D调节刺激下，两组差异无统计学意义（t=-1.974、-1.758，P＞0.05）。角膜塑形镜组的调节误差指数小于框架眼镜组，且差异有统计学意义（t=-2.098，P<0.05）。结论 近视眼配戴角膜塑形镜后，调节微波动幅度增大；在高调节需求时，调节滞后值减小，这为其延缓近视的进展提供了一定依据。

An investigation of the effects of wearing orthokeratology lenses on the magnitude of accommodative microfluctuations and accommodative lag

Objective To investigate the effects of wearing orthokeratology lenses on the magnitude of accommodative microfluctuations and accommodative lag. Methods In this cross-sectional study， 15 myopic subjects who wore orthokeratology lenses regularly and 15 myopic subjects who wore spectacles regularly were enrolled. Accommodative response （AR） was measured with an open field infrared autorefractor （WAM-5500） using an accommodative stimulus （AS） of 0~4 D. The magnitude of accommodative microfluctuations， accommodative lag， and accommodative error index （AEI） were calculated. The data from the two groups were analyzed by using an independent sample t test. Results With an AS of 0 D， 1 D， 2 D， 3 D and 4 D， the magnitudes of accommodative microfluctuations of the orthokeratology lens group were all larger than the spectacle group， and the differences were statistically significant （t=3.704， 3.277， 2.365， 2.179， 2.591， P<0.05）. The accommodative lags of the orthokeratology lens group were smaller than the spectacle group. There were statistically significant differences with an AS of 2 D， 3 D and 4 D （t=-2.208， -2.244， -2.098， P<0.05）， while there were no significant differences with an AS of 0 D and 1 D（t=-1.974， -1.758， P＞0.05）. The AEIs of the orthokeratology lens group were also smaller than the spectacle group， and the difference was statistically significant （t=-2.098， P<0.05）. Conclusion Compared to spectacles， the magnitudes of accommodative microfluctuations were larger after myopes wore orthokeratology lenses， while the accommodative lags were smaller at high accommodative demands. This supports the claim that orthokeratology lenses can slow myopia progression.