不同矫正方法对儿童眼周边屈光度的影响

目的研究不同屈光矫正方法对儿童眼周边屈光度的影响。方法自身对照横断面研究。15名儿童先后在裸眼、框架眼镜全矫和硬性透气性角膜接触镜（RGPCL）全矫三种状态下，从左侧30°到右侧300注视7个远处视标，用红外自动验光仪分别获取6个周边屈光度和1个中心屈光度，周边屈光度减去中心屈光度即相对周边屈光度，在各个位置对三种状态的相对周边屈光度进行单因素方差分析．如有统计学意义再用Bonferroni检验两两比对。结果被试儿童在裸眼、框架眼镜全矫和RGPCL全矫三种状态下，相对周边屈光度均呈远视（鼻侧10°除外），幅度随周边角度增加而增大，表现为鼻、颞侧不对称，以向颞侧注视时更偏远视。但RGPCL矫正后的相对周边屈光度在颞侧较前两种状态偏近视，差异随角度增加而增大。向颞侧30。注视时，裸眼、框架眼镜矫正和RGPCL矫正后的相对周边屈光度分别达到（1．69±1．03）D、（1．84±0．99）D和（0．81±1．28）D。方差分析发现三种方法之间差异有统计学意义（F=3．79，P=0．031），用Bonferroni检验发现在框架眼镜矫正和RGPCL矫正法之间差异存在统计学意义（P=0．043）。结论配戴RGPCL能改变颞侧周边屈光度，配戴框架眼镜则不能。如果偏近视的相对周边屈光度有利于控制近视进展，RGPCL是一个选择。

Effects of different corrective methods on peripheral refraction in children

Objective To investigate the effects of different corrective methods on ocular pe-ripheral refraction in children. Methods This was a self-controlled cross-sectional study. Fifteen children were required to gaze at 7 successive targets at distances from 30° nasal to 30° temporal, wearing no lenses, fully corrected trim lenses or rigid gas permeable (RGP) lenses. An infrared au-torefractor was used to obtain six peripheral refractions and one central refraction under each condi-tion. The difference between the peripheral refraction and central refraction was calculated as the rel-ative peripheral refraction (RPR). RPRs were compared in each direction among these three conditions using one-way ANOVA. If there was a statistically significant difference, a Bonferroni post-hoc test was used. Results All RPRs were hyperepic under these three conditions (except for those at 10° nasal) and showed asymmetry between nasal and temporal sides, with higher hyperopia in the periph-ery and during temporal gaze. RGP lenses reduced this hyperopia to a relatively small amplitude, that was more evident in the peripheral temporal side. RPR values reached (1.69±1.03)D, (1.84± 0.99)D and (0.81±1.28)D up to 30° temporal with the three respective conditions. These differences were statistically significant (F=3.79, P=0.031). The Bonferroni test also showed a statistically signifi- cant difference between the trial lens and RGP conditions (P=0.043). Conclusion Wearing RGP lenses has the effect of altering temporal peripheral refraction, whereas conventional glasses do not. If converting relative peripheral hyperopia to relative peripheral myopia is a reliable approach for con-trolling myopia progression, wearing RGP lenses is a good alternative.