角膜塑形镜、周边离焦眼镜、单光眼镜对儿童近视控制的一年效果

目的 评价角膜塑形镜、周边离焦眼镜、单光眼镜控制儿童近视进展的一年效果。设计 前瞻性非随机临床对照研究。研究对象 北京市眼科研究所、北京同仁验光配镜中心、北医眼视光远程视觉服务中心的近视儿童321例，其中141例（43.9%，141/321）完成一年随访。平均年龄（11.41±2.29）岁。方法 所有儿童配镜前进行视力、睫状肌麻痹后验光、裂隙灯、Lenstar眼生物参数测量及彩色眼底照相视盘旁萎缩弧分析。根据患者及监护人要求分别选择单光眼镜（single vision spectacle lenses, SV）、角膜塑形镜（orthokeratology, OK）、周边离焦眼镜（peripheral defocus spectacel lenses, PD）三种不同的矫正方式。观察三组间屈光度进展、眼轴增长及视盘旁萎缩弧扩大率的差异。主要指标 配镜前后屈光度、眼轴长度和视盘旁萎缩弧的改变。结果 完成一年随访者SV组47例、 OK镜组70例、PD组24例。平均等效球镜度（-2.89±1.34）D，平均眼轴长度（24.92±0.34）mm。最后随访时，3组儿童眼轴长度均增长，其中OK镜组增长（0.13±0.16）mm，明显低于其他两组（F=48.820，P<0.001）。SV组屈光度增长（-0.77±0.79）D，PD组屈光度增长（-0.94±0.47）D（t=1.080，P=0.283）。SV组、PD组、OK镜组视盘旁萎缩弧扩大率分别为66.7%、38.6%和15.0%（?字2=28.341，P<0.001）。结论 随访一年的结果表明，与单光眼镜、周边离焦眼镜相比，角膜塑形镜控制屈光度进展、眼轴增长、视盘旁萎缩弧扩大的效果最佳。（眼科，2016，25： 302-306）

Effect of orthokeratology lenses,peripheral defocus spectacle lenses,single vision spectacles of optic correction on myopia control

Objective To assess the effect of myopia control with single vision spectacle lenses(SV), orthokeratology lenses(OK), and peripheral defocus spectacle lenses(PD). Design Prospective, non-randomized case control study. Participant Three hundred and twenty one children were enrolled in the study from Beijing Institute of Ophthalmology, Tongren Eye Care Center and Beijing Beiyi Optometry & Ophthalmology Center. 141 children (43.9%, 141/321) completed the follow up, with a mean age of 11.41±2.29 years. Methods All children received a comprehensive examination, including visual acuity, cycloplegia refraction, slit lamp, Lenstar ocular biometry, color fundus photographs and were followed up one year later. Parents selected the types of correction on their own. Main Outcome Measures Change of refraction, axial length and parapapillary atrophy before and after wearing. Results The mean equivalent spherical(SE) and axial length(AL) of 141 children at baseline were -2.89±1.34 D and 24.92±0.34 mm, respectively. At one-year follow-up visit, elongation of AL in children with OK was 0.13±0.16 mm, significantly less than the other two groups (F=48.820, P<0.001). Progression of myopia was -0.77±0.79 D and -0.94±0.47 D in SV group and PD group respectively. There was no significant difference between groups (t=1.080, P=0.283). Presence of enlargement of parapapillary atrophy in OK group was 15.0%, significantly lower than SV group (66.7%) and PD group (38.6%). Conclusions Compared to single vision spectacle lenses and peripheral defocus spectacle lenses, orthokeratology is most effective for myopia control. (Ophthalmol CHN, 2016, 25: 302-306)