近视性屈光参差儿童青少年配戴角膜塑形镜的临床效果

目的:观察青少年近视性屈光参差配戴角膜塑形镜的临床效果。方法:回顾性自身对照研究。收集浙江大学医学院附属第二医院眼科中心从2015年12月至2017年6月之间开始配戴角膜塑形镜的患者32例,年龄8~16(11.2±2.2)岁,随访时间2年。双眼等效球镜度(SE)差值≥1.00 D,滴用睫状肌麻痹剂后的SE范围为-0.75^-6.00 D。分为高屈光度眼组(两眼中屈光度较高眼)和低屈光度眼组(两眼中屈光度较低眼),均配戴角膜塑形镜。观察双眼戴镜前以及戴镜后半年、1年、1.5年,2年的眼轴变化。数据采用配对t检验进行比较。结果:双眼眼轴差值由戴镜前的(0.46±0.24)mm下降到戴镜2年后的(0.33±0.28)mm,差异有统计学意义(t=5.038,P<0.001),高屈光度眼组戴镜2年后眼轴变化量(0.38±0.21)mm]小于低屈光度眼组眼轴变化量(0.51±0.26)mm],差异有统计学意义(t=6.52,P<0.001)。结论:青少年长期配戴角膜塑形镜可以减小近视性屈光参差双眼之间的眼轴差值,减少屈光参差量,可以更有效减缓近视屈光度较高眼的眼轴增长,配戴角膜塑形镜是改善屈光参差的一种有效方式。

Clinical Observation on the Effect of Orthokeratology in Myopic Anisometropic Children and Adolescents

Objective:To investigate the clinical effect of orthokeratology(ortho-k)lens wear on axial length(AL)growth in juvenile myopic anisometropes.Methods:In this retrospective study,32 myopic anisometropic participants,16 males and 16 females with an average age of 11.2±2.2 years,were fitted with ortho-k lenses from December 2015 to June 2017,and followed for about 2 years.Cycloplegic spherical equivalent(SE)was-0.75 D to-6.00 D,and anisometropia≥1.00 D.The eyes with greater myopia were assigned to the High refraction(H)group and the fellow eyes with less myopia to the Low refraction(L)group.Each group involved 32 eyes.All eyes were fitted with ortho-k lenses.Axial length(AL)was measured at the beginning of the study and at 6-,12-,18-,and 24-month follow-up visits.Data were analyzed using paired t test.Results:A significant reduction in the AL difference was found,from the baseline(0.46±0.24 mm)to 24 months(0.33±0.28 mm)(t=5.038,P<0.001).Besides,after wearing ortho-k lens for two years,the H group showed less AL growth than the L group in myopic anisometropic children(0.38±0.21 mm vs.0.51±0.26 mm)(t=6.52,P<0.001).Conclusions:In myopic anisometropic children who wore ortho-k lenses,the AL difference would present a significant reduction.Ortho-k treatment slows AL growth in themore myopic eye of anisometropic patients.Wearing ortho-k lens is an effective clinical method to treatanisometropia.