Retrospective analysis of the development of myopia in children with orthokeratology lens Combined with defocus lens for reducing peripheral hyperopia
角膜塑形镜配合减少周边远视离焦框架镜对儿童近视发展的回顾性分析

摘要

目的 评价配戴角膜塑形镜配合减少周边远视离焦框架镜使用12个月后对学龄期儿童近视发展的影响。方法 回顾性两组对照研究，纳入2020年7月至2021年7月在深圳市中西医结合医院眼科门诊就诊的8-13岁本地区小学就读的中低度近视眼学龄期儿童适合佩戴角膜塑形镜共60例为研究对象，其中23例（38.3%，23/60）单纯配戴角膜塑形镜（OK）为正常组，37例（61.7%，37/60）配戴角膜塑形镜配合使用减少周边远视离焦框架镜（OK& AMSPL）为暴露组。分析对比12个月后两组配戴前后的屈光度数、眼轴变化情况。结果 配戴前后两组等效球镜度数和眼轴长度差异及其变化量均无统计学意义（P＞0.05）。正常组配戴前和配戴后等效球镜度数之间呈现出0.01水平的显著性（t=2.675，p=0.01），呈现出差异性（p< 0.05）。暴露镜组配戴前和配戴后等效球镜度数之间呈现出0.01水平的显著性（t=5.875，p＜0.010），呈现出差异性（p< 0.05）。暴露组配戴前和配戴后眼轴之间呈现出0.01水平的显著性（t=-3.675，p=0.007），呈现出差异性（p< 0.05）。正常组配戴前和配戴后眼轴之间呈现出0.01水平的显著性（t=-4.951，p＜0.001），呈现出差异性（p< 0.05）。两组之间配戴前后的屈光度变化量及眼轴变化量均无统计学意义（P> 0.05）。结论 中低度近视眼的学龄期儿童配戴角膜塑形镜配合减少周边远视离焦框架镜（OK and AMSPL）和单纯配戴角膜塑形镜（OK）对屈光度及眼轴长度效果相同，学龄期儿童长期的配戴角膜塑形镜会引起生活及学习的不便，为不影响防控效果的情况，角膜塑形镜配合配戴减少周边远视离焦框架镜可作为一种选择方式。

Abstract

Objective: To evaluate the effect of wearing orthokeratology lens with defocus frame lens to reduce peripheral hyperopia for 12 months on the development of myopia in school-age children.
Methods: A retrospective control study of two groups, included 60 school-age children aged 8-13 who wera admitted to the ophthalmology clinic of Shenzhen Hospital of Integrated Traditional Chinese and Western Medicine from July 2020 to July 2021,Among them,23 cases(38.3%,23/60) wearing orthokeratology lens along (OK) were normal group,and 37 cases(61.7%,37/60) wearing orthokeratology lens combine with peripheral hyperopia reduction defocus frame lens (OK& AMSPL) were exposed group. After 12 months, the diopter number and ocular axis of the two groups were analyzed and compared.
Results: There were no statistically significant differences in equivalent spherical resolution and axial length between the two groups(P>0.05).In the normal group, there was a 0.01 level of significance between the equivalent spherical refraction before and after wearing (t=2.675, P=0.01), and there was a heterotropy (P<0.05), In the exposure lens group ,there was a significant difference between the equivalent spherical lens before and after wearing at the level of 0.01(t=5.875,P<0.01), and there was a heterotropy (P<0.05). In the exposed group, there was a 0.01 level of significance between the eye axis before and after wearing(t=-3.675,P=0.007), and there was a travel difference (P<0.05). In the normal group, there was a 0.01 level of significance between the eye axis before and after wearing (t=-4.951, P < 0.001), and there was a travel difference (P <0.05). There were no statistically significant changes in diopter and ocular axis before and after wearing between the two groups (P>0.05).
Conclusion  : Moderate myopia school-aged children wearing corneal shape cooperate to reduce the surrounding farsightedness framework from the focal lens (OK and AMSPL) and pure wearing corneal shape mirror (OK) of diopter and eye axis length, school-age children wearing corneal shape of the mirror for a long time can cause inconvenience, life and learning for not influence the effect of prevention and control, Orthokeratology lens can be used as an option to reduce peripheral hyperopia defocus frame lens.