Santodomingo-Rubido Jacinto, Villa-Collar César, Gilmartin Bernard, Gutiérrez-Ortega Ramón
*OD, PhD, FAAO †MSc, PhD, FAAO ‡PhD, FCOptom, FAAO §MD, PhD Menicon Co., Ltd (Madrid Office) (JS-R); Clínica Oftalmológica Novovision (CV-C, RG-O); and Universidad Europea de Madrid (CV-C), Madrid, Spain; and School of Life and Health Sciences (BG), Aston University, Aston Triangle, Birmingham, United Kingdom.
Optom Vis Sci. 2013 Nov;90(11):1225-36. doi: 10.1097/OPX.0000000000000034.
To examine which baseline measurements constitute predictive factors for axial length growth over 2 years in children wearing orthokeratology contact lenses (OK) and single-vision spectacles (SV).
Sixty-one children were prospectively assigned to wear either OK (n = 31) or SV (n = 30) for 2 years. The primary outcome measure (dependent variable) was axial length change at 2 years relative to baseline. Other measurements (independent variables) were age, age of myopia onset, gender, myopia progression 2 years before baseline and baseline myopia, anterior chamber depth, corneal power and shape (p value), and iris and pupil diameters as well as parental refraction. The contribution of all independent variables to the 2-year change in axial length was assessed using univariate and multivariate regression analyses.
After univariate analyses, smaller increases in axial length were found in the OK group compared to the SV group in children who were older, had earlier onset of myopia, were female, had lower rate of myopia progression before baseline, had less myopia at baseline, had longer anterior chamber depth, had greater corneal power, had more prolate corneal shape, had larger iris diameter, had larger pupil sizes, and had lower levels of parental myopia (all p < 0.05). In multivariate analyses, older age and greater corneal power were associated with smaller increases in axial length in the OK group (both p < 0.05), whereas in SV wearers, smaller iris diameter was associated with smaller increases in axial length (p = 0.021).
Orthokeratology is a successful treatment option in controlling axial elongation compared to SV in children of older age, had earlier onset of myopia, were female, had lower rate of myopia progression before baseline, had lower myopia at baseline, had longer anterior chamber depth, had greater corneal power, had more prolate corneal shape, had larger iris and pupil diameters, and had lower levels of parental myopia.
研究哪些基线测量值可作为佩戴角膜塑形镜(OK)和单焦眼镜(SV)的儿童2年内眼轴长度增长的预测因素。
61名儿童被前瞻性地分配佩戴OK(n = 31)或SV(n = 30),为期2年。主要结局指标(因变量)是2年后相对于基线的眼轴长度变化。其他测量指标(自变量)包括年龄、近视发病年龄、性别、基线前2年的近视进展情况和基线近视度数、前房深度、角膜屈光力和形状(p值)、虹膜和瞳孔直径以及父母的屈光度数。使用单因素和多因素回归分析评估所有自变量对2年眼轴长度变化的影响。
单因素分析后发现,在年龄较大、近视发病较早、为女性、基线前近视进展率较低、基线近视度数较低、前房深度较长、角膜屈光力较大、角膜形状更趋近于长椭圆形、虹膜直径较大、瞳孔尺寸较大以及父母近视度数较低的儿童中,与SV组相比,OK组的眼轴长度增长幅度较小(所有p < 0.05)。多因素分析中,年龄较大和角膜屈光力较大与OK组眼轴长度增长幅度较小相关(均p < 0.05),而在佩戴SV眼镜的儿童中,较小的虹膜直径与眼轴长度增长幅度较小相关(p = 0.021)。
对于年龄较大、近视发病较早、为女性、基线前近视进展率较低、基线近视度数较低、前房深度较长、角膜屈光力较大、角膜形状更趋近于长椭圆形、虹膜和瞳孔直径较大以及父母近视度数较低的儿童,与佩戴单焦眼镜相比,角膜塑形术是控制眼轴伸长的一种成功治疗方法。