高度近视儿童青少年配戴多焦点软性接触镜延缓近视进展的有效性研究

目的　评估高度近视儿童青少年配戴多焦点软性亲水性接触镜延缓近视进展的有效性。方法　回顾性研究。纳入2018年11月到2020年2月于天津市眼科医院视光中心配戴多焦点软性亲水性接触镜的近视儿童青少年36例和配戴单光框架眼镜者36例（均选取右眼），年龄为8~15岁，等效球镜度（SE）为-5.00~-10.00 D。记录患者年龄、性别等信息，收集患者基线及戴镜1年后的主觉屈光度、眼轴长度等指标。采用独立样本t检验分析两组患者基线与1年后的SE变化量及眼轴长度变化量，采用多元线性回归分析影响屈光度及眼轴长度变化的因素，二元Logistic回归分析影响进展性近视发展的因素。结果　配戴多焦点软性亲水性接触镜组患儿与单光框架眼镜组患儿相比，两组间1年的SE变化量及眼轴长度变化量差异均有统计学意义（t=5.407，P<0.001；t=-2.763，P=0.007）。多元线性回归分析发现，SE进展的主要影响因素是戴镜组别和基线眼轴长度，回归方程:SE=3.982+0.458×戴镜组别-0.138×基线眼轴长度（R²=0.375，调整R²=0.357）；眼轴变化主要影响因素为戴镜组别，回归方程:AL=0.116+0.120×戴镜组别（R²=0.097，调整R²=0.097）。对于是否成为进展性近视儿童来说，配戴单光框架眼镜组的风险是多焦点软镜的12.571倍。结论　高度近视儿童青少年配戴多焦点软性接触镜能延缓近视进展（65.4%）及眼轴生长（33.3%）。

Effectiveness of multifocal soft contact lenses in slowing myopia progression of adolescents with high myopia

Objective　To evaluate the effectiveness of multifocal soft hydrophilic contact lenses in slowing the progression of high myopia.
Methods　A retrospective study was conducted. A total of 36 myopia adolescents who were fitted with multifocal soft hydrophilic contact lenses (right eye) and 36 adolescents who were fitted with single-vision lenses (right eye) in the Optometric Center, Tianjin Eye Hospital from November 2018 to February 2020 were included. These participants were 8-15 years old and had a spherical equivalent (SE) from -5.00 D to -10.00 D. Age, gender, subjective refraction and axial length (AL) at baseline and 1 year after lens wearing were collected. Independent sample t-test was used to analyze the changes in SE and AL of patients in the two groups at baseline and 1 year after lens wearing, multiple regression analysis was used to analyze the factors influencing diopter and AL changes, and binary logistic regression analysis was carried out to explore the factors affecting progressive myopia.
Results　There were significant differences in the SE and AL changes between adolescents wearing multifocal soft contact lens and adolescents wearing single-vision lenses (t=5.407, P<0.001; t=-2.763, P=0.007). Multiple linear regression analysis demonstrated that the main influencing factors on SE were category of lenses and AL at baseline, and the regression equation was: SE=3.982+0.458×category of lenses-0.138×AL at baseline (R²=0.375, adjusted R²=0.357). The main influencing factor on AL was category of lenses, and the regression equation was: AL=0.116+0.120×category of lenses (R²=0.097, adjusted R²=0.097). The risk of progressive myopia in adolescents wearing single-vision lenses was 12.571 times of adolescents wearing multifocal soft lenses.
Conclusion　Multifocal soft contact lens has a good performance in slowing the degradation of diopter (65.4%) and AL (33.3%) for children with high myopia.