角膜塑形镜与框架眼镜对近视儿童眼调节参数的影响

目的：评估配戴夜戴型角膜塑形镜对近视儿童眼调节参数的影响。

方法：连续性分析2015-09/2018-03在我院配戴角膜塑形镜的8～15岁患者临床资料。配戴角膜塑形镜Ortho-k组为研究组，并以年龄、性别、等效球镜及眼轴长度为匹配因素进行1：1的频数匹配同时期配戴单焦点眼镜(SVL)的近视患儿做为对照组。通过测量配镜前及配镜后1、3、6、12mo的调节幅度(AA)，调节灵敏度(AS)，调节滞后(LAG)，负相对调节(NRA)和正相对调节量(PRA)并运用重复测量方差分析来评估两组患儿配镜前与配镜后调节参数的变化情况。

结果：近视儿童54例完成随访：研究组27例，对照组27例。各调节参数组间均无差异(P>0.05)； 矫正时间对两组的各调节参数均有显著影响(F_AA=4.7，F_AS=5.6，F_LAG=10.2，F_NRA=7.06，F_PRA=8.8，均P<0.05)； 矫正时间和矫正方式之间的交互作用对两组的调节参数均有显著影响(F_AA=5.3，F_AS=4.6，F_LAG=11.4，F_NRA=3.4，F_PRA=11.1，均P<0.05)。

结论：配戴角膜塑形镜可以改善近视儿童的调节功能，这可能是塑形镜控制近视的机制之一。

Effect of orthokeratology lenses and frame lens on eye regulation parameters in myopic children

AIM:To study the effect of orthokeratology on accommodation function in myopic children.

METHODS: This was a retrospective clinical study. The clinical data of myopia children in our hospital from September 2015 to December 2018, who wore orthokeratology contact lens(Ortho-k)or single vision lens(SVL)to control myopia were analyzed. 27 cases(54 eyes)with Ortho-k were all selected as the study group, the control group was matched from 108 cases(216 eyes)of the SVL group with the Propensity Score-matching(PSM)function of SPSS software. After matching, 27 cases treated with Ortho-k were compared to 27 cases treated with SVL. Accommodation function were assessed by accommodative amplitude(AA), accommodative sensitivity(AS), accommodative lag(LAG), negative relative accommodation(NRA), and positive relative accommodation(PRA)before and 1, 3, 6 and 12mo after treatment.

RESULTS: There was no statistical significance in the differences of the accommodative parameters between groups(all P>0.05); Wearing time had a significant effect on AA, AS, LAG, NRA and PRA of myopic children in two groups(F_AA=4.7, F_AS=5.6, F_LAG=10.2,F_NRA=7.06, F_PRA=8.8, all P<0.05). Meanwhile, there was an significant interaction effect on the accommodative parameters between wearing time and wearing types of the two groups(F_AA=5.3, F_AS=4.6, F_LAG=11.4, F_NRA=3.4, F_PRA=11.1, all P<0.05).

CONCLUSION: Wearing orthokeratology can improve the accommodation function of myopic children, which may be one of the mechanisms by which they control myopia.