He Mengmei, Du Yaru, Liu Qingyu, Ren Chengda, Liu Junling, Wang Qianyi, Li Li, Yu Jing
Department of Ophthalmology, Shanghai Tenth People's Hospital, School of Medicine, Tongji University, No.301 Middle YanChang Road, ZhaBei District, Shanghai, 200072, China.
Department of First Clinical Medical College, Nanjing Medical University, Nanjing, Jiangsu, China.
BMC Ophthalmol. 2016 Jul 27;16:126. doi: 10.1186/s12886-016-0302-5.
To investigate the effectiveness of orthokeratology (ortho-k) in reducing the development of myopia in Chinese children with low to moderate myopia.
This was a retrospective study. In the ortho-k group, there were141 subjects, and the average age was (9.43 ± 1.10) years. The average spherical equivalent refractive error (SER) was (-2.74 ± 1.15)D, with examinations performed 1, 7, 30, and 90 days and 12 months after the patients started wearing ortho-k lenses. In the control group, there were 130 subjects, and the average age was (9.37 ± 1.00) years. The average SER was (-2.88 ± 1.39)D, with examinations performed every 6 months. Axial elongation, which is an important parameter reflecting the progression of myopia, was measured at baseline from the same IOLMaster each time by the same masked examiner and was compared between the groups after 1 year. The subjects were divided into two sub-groups according to age to further study the development of myopia at different ages. An unpaired t-test, paired t-test, Chi-square test and Spearman test were performed to analyze the data.
After 1 year, the average axial elongation was (0.27 ± 0.17) mm in the ortho-k lens group and (0.38 ± 0.13) mm in the control group, with a significant difference between the groups (P < 0.001). Axial elongation was not correlated with SER but had a negative correlation with initial age (ortho-k group: r s = -0.309, p < 0.01; control group: r s = -0.472, p < 0.01). The percentages of individuals with fast myopic progression (axial elongation > 0.36 mm per year) were 38.0 % among younger children (7.00 to 9.40 years) and 24.3 % among older children (9.40 to 12.00 years), whereas the respective percentages were 76.5 and 12.9 % in the control group. When SER ranged from -5.0D to -6.0D, the axial elongation in the ortho-k group was 57.1 % slower than that in the control group.
Ortho-k lenses are effective in controlling myopic progression in Chinese children, particularly in younger children and in children with higher myopia.
探讨角膜塑形术(ortho-k)对降低中国轻中度近视儿童近视进展的有效性。
这是一项回顾性研究。角膜塑形术组有141名受试者,平均年龄为(9.43±1.10)岁。平均等效球镜度(SER)为(-2.74±1.15)D,在患者开始佩戴角膜塑形术镜片后的1天、7天、30天、90天和12个月进行检查。对照组有130名受试者,平均年龄为(9.37±1.00)岁。平均SER为(-2.88±1.39)D,每6个月进行一次检查。眼轴长度是反映近视进展的一个重要参数,每次均由同一名经过遮蔽的检查者使用同一台IOLMaster在基线时进行测量,并在1年后对两组进行比较。根据年龄将受试者分为两个亚组,以进一步研究不同年龄阶段的近视发展情况。采用非配对t检验、配对t检验、卡方检验和Spearman检验对数据进行分析。
1年后,角膜塑形术镜片组的平均眼轴长度为(0.27±0.17)mm,对照组为(0.38±0.13)mm,两组之间存在显著差异(P<0.001)。眼轴长度与SER无关,但与初始年龄呈负相关(角膜塑形术组:rs=-0.309,p<0.01;对照组:rs=-0.472,p<0.01)。近视进展较快(眼轴长度每年增加>0.36mm)的儿童中,年龄较小者(7.00至9.40岁)的比例为38.0%,年龄较大者(9.40至12.00岁)的比例为24.3%,而对照组中相应的比例分别为76.5%和12.9%。当SER在-5.0D至-6.0D之间时,角膜塑形术组的眼轴长度比对照组慢57.1%。
角膜塑形术镜片对控制中国儿童的近视进展有效,尤其是对年龄较小的儿童和近视程度较高的儿童。