低浓度阿托品联合角膜塑形镜治疗青少年中低度近视的疗效

目的：分析角膜塑形镜联合低浓度阿托品对青少年中低度近视的控制效果。

方法：选取2016-01/06我科收治的中低度近视青少年患者76例152眼，按照自愿原则分为角膜塑形组36例72眼与角膜塑形镜联合低浓度阿托品组40例80眼(联合组)，两组患者均配戴角膜塑形镜，联合组加用0.1g/L阿托品滴眼液点眼，均随访1a，检查戴镜前后裸眼视力、屈光度、眼轴长度、眼压、泪膜功能及角膜各参数的变化，统计并发症发生率。

结果：戴镜前、戴镜1a两组裸眼视力、屈光度、眼轴长度、眼压比较无差异(P>0.05)，联合组戴镜前、戴镜1a裸眼视力变化幅度高于角膜塑形镜组，屈光度及眼轴长度差值低于角膜塑形镜组(P<0.05)； 戴镜前，两组患者泪膜脂质层厚度(LLT)、客观散射指数(OSI)、泪膜破裂时间(BUT)比较无差异(P>0.05)，戴镜1a，联合组LLT、BUT高于角膜塑形镜组，OSI低于角膜塑形镜组(P<0.05)； 戴镜前，两组患者角膜曲率、角膜厚度、前房深度比较无差异(P>0.05)，戴镜1a，联合组角膜曲率、角膜厚度、前房深度变化幅度均低于角膜塑形镜组(P<0.05)； 两组患者并发症发生率比较无差异(P>0.05)。

结论：角膜塑形镜联合低浓度阿托品可改善青少年中低度近视患者裸眼视力，控制屈光度、眼轴增长，对角膜形态及泪膜功能无明显负面影响，安全性高。

Effect of low grade Atropine combined with keratoplasty on middle grade myopia in adolescents

AIM: To analyze the control effect of orthokeratology(OK)combined with atropine of low concentration on moderate to low myopia in adolescents.

METHODS: Totally 76(152 eyes)adolescents with moderate to low myopia who were admitted to the department from January 2016 were enrolled. According to the voluntary principle, they were divided into orthokeratology group(OK group, n=36 cases, 72 eyes)and orthokeratology combined with atropine of low concentration group(combination group, n=40 cases, 80 eyes). The OK glasses were given for the two groups. The combination group was additionally given 0.1g/L atropine eye drops. All were followed up for 1a. The changes of uncorrected visual acuity, diopter, axial length, intraocular pressure, tear film function and corneal parameters were measured before and after wearing glasses. The incidence of complications was statistically analyzed.

RESULTS: There were no significant differences in uncorrected visual acuity, diopter, axial length and intraocular pressure between the two groups before wearing glasses and at 1a of wearing glasses(P>0.05). The change of uncorrected visual acuity before wearing glasses and at 1a of wearing glasses of combination group was higher than that of OK group while the differences in diopter and axial length were lower than those of OK group(P<0.05). Before wearing glasses, there were no significant differences in the lipid layer thickness(LLT), object scattering index(OSI)or tear film rupture time(tear film break-up time, BUT)between the two groups(P>0.05). At 1a of wearing glasses, LLT and BUT of combination group were higher than those of OK group while OSI was lower than that of OK group(P<0.05). Before wearing glasses, there were no significant differences in corneal curvature, corneal thickness or anterior chamber depth between the two groups(P>0.05). At 1a of wearing glasses, the changes of above indexes of combination group were lower than those of OK group(P<0.05). There was no significant difference in the incidence of complications between the two groups(P>0.05).

CONCLUSION:OK glasses combined with atropine of low concentration can improve the uncorrected visual acuity of adolescents with moderate to low myopia, control the increase of diopter and axial length. And there is significant negative influence on corneal morphology and tear film function, and with high safety.