硬性透气性角膜接触镜控制青少年进展性近视的效果

目的 观察Menicon-Z硬性透气性角膜接触镜(RGPCL)控制青少年进展性近视的临床效果.方法 前瞻性自身对照研究.选取18岁以下近视患者76例(148跟),按近视度分为4组(-0.50～-3.00 D,-3.25～-6.00 D,-6.25～-9.00 D,9.25～-20.00 D),分析配戴RGPCL(15.2±5.2)个月后的矫正视力、屈光状态、角膜地形图参数、年近视增长幅度及眼轴长度等项目的变化.采用配对样本t检验、单因素方差分析评价RGPCL控制青少年进展性近视的效果.结果 配戴RGPCL后平曲率(FK)、陡曲率(SK)值均降低,差异均有统计学意义(t=4.80,P＜0.01;t=7.76,P＜0.01)；面球镜度、散光、眼轴长度变化不明显；同原近视增长幅度(-1.10±0.53)D/年]比较,配戴RGPCL后近视增幅(-0.00±0.47)D/年]显著降低(t=-13.95,P＜0.01).不同近视程度组间比较,配戴RGPCL前后近视增长幅度差异有统计学意义(F=4.84,P＜0.01),较高近视度患者配戴RGPCL近视增长幅度最小.结论 长期配戴Menicon-Z RGPCL安全性高,并能有效地延缓青少年不断增长的近视度、角膜曲率及眼轴长度,尤其是对较高近视度者控制的效果更为显著.

Clinical effect of rigid gas permeable contact lenses on myopia progression in adolescents

Objective To evaluate the effect of Menicon-Z gas permeable contact lenses （RGPCLs） in controlling the progression of myopia in adolescents. Methods It was a prospective self-control study. Seventy-six myopia patients under the age of 18 （148 eyes） were recruited for this study. Divided into 4 groups according to the degree of refractive error （-0.50- -3.00 D,-3.25- -6.00 D, -6.25- -9.00 D,-9.25- -20.00 D）. Clinical data included corrected visual acuity, refractive power, corneal curvature, axial length, annual progression rate of myopia and follow-up records for （15.2±5.2）months were analyzed. Data analysis included a paired samples t test and ANOVA on the effect of clinical RGPCLs to control juvenile myopia progression. Results There were significant differences in corneal curvature after wearing RGPCLs （FK t=4.80, P〈0.01 ;SK t=7.76, P〈0.01）. There were no obvious differences in refractive power, astigmatism or axial length. However, there was a significant difference in the range of myopia progression （from -1.10±0.53 D to -0.00±0.47 D） that showed a decrease after wearing RGPCLs for about 1 year （t=-13.95, P〈0.01）. There were statistically significant differences between different refractive power groups （F=4.84, P=0.004）： for higher refractive powers, myopia progression was least. Conclusion Long-term wear of Menicon-Z RGPCLs is safe for adolescents. And it effectively decreases the progression of myopia, corneal curvature and axial length, especially in more severe myopia cases.