低度近视性屈光参差不同矫正方式的调节功能研究

目的:研究分别采用单焦框架眼镜与角膜塑形镜矫正低度近视性屈光参差的儿童单眼及双眼调节的差异。方法:回顾性研究。收集2019-11/2020-04于我院眼科门诊就诊的低度近视性屈光参差(1.0D≤双眼等效球镜差<2.5D)儿童47例94眼,其中配戴框架眼镜者27例54眼作为A组,配戴角膜塑形镜者20例40眼作为B组。分别记录并比较两组患儿矫正1mo后的矫正视力及调节参数调节反应(AR)、调节灵活度(AF)、调节幅度(AMP)]的差异。结果:两组患儿AR测量值均为正值,表现为调节滞后,A组患儿屈光高度眼调节滞后量显著高于屈光低度眼(0.63±0.21D vs 0.25±0.34D,P<0.001),但B组患儿双眼调节滞后量无差异(P=0.104),且两组患儿屈光高度眼与屈光低度眼单眼矫正视力和单眼AMP均无差异(P>0.05)。A组患儿双眼AR差值高于B组(0.38±0.36D vs 0.10±0.26D,P=0.005),双眼AF低于B组(8.22±1.15c/min vs 9.95±0.89c/min,P<0.001),但两组患儿双眼AMP无明显差异(P=0.280)。结论:低度近视性屈光参差儿童配戴角膜塑形镜比单焦框架眼镜矫正可获得更高的双眼调节灵活度,降低双眼调节反应差值,从而维持更协调的双眼调节功能。

Study of the accommodative difference between wearing orthokeratology lens and frame lens in low myopic anisometropia children

AIM:To investigate the monocular and binocular accommodative difference between wearing orthokeratology lens and frame lens in low myopic anisometropia children.METHODS:Totally 47 children(94 eyes)with low degree myopic anisometropia(1.0D≤binocular equivalent spherical lens difference<2.5D)were involved between November 2019 and April 2020 in the retrospective clinical study.Twenty-seven cases(54 eyes)wore frame lens were used as group A and 20 cases(40 eyes)wore orthokeratology lens were used as group B.The corrected visual acuity and the accommodative parametersthe accommodative response(AR),the accommodative facility(AF),the accommodative amplitude(AMP)]at 1mo after treatment were recorded and compared.RESULTS:In two groups the results of AR were positive,and it meant accommodative lag(AL).AL of the higher myopic eyes was higher than the lower eyes in group A(0.63±0.21D vs 0.25±0.34D,P<0.001),but there was no significant difference of AL in group B(P=0.104).Between two eyes,the difference of the corrected visual acuity and the monocular AMP in two groups were no significant(P>0.05).The binocular AR difference in group A was significantly higher than group B(0.38±0.36D vs 0.10±0.26D,P=0.005),and the binocular AF was lower(8.22±1.15c/min vs 9.95±0.89c/min,P<0.001).There was no statistical difference in binocular AMP(P=0.280).CONCLUSION:Low myopic anisometropia children with orthokeratology lens can obtain higher binocular AF and lower binocular AR difference than that with frame lens,so as to maintain more coordinated binocular accommodation.