Lyu Yong, Ji Na, Fu Ai-Cun, Wang Wei-Qun, Wei Li, Qin Jian, Zhao Bing-Xin
Ophthalmology, The First Affiliated Hospital of Zhengzhou University (Y.L., A.-C.F., W.-Q.W., L.W., B.-X.Z.), Zhengzhou, China ; Ophthalmology, The Affiliated Eye Hospital of Suzhou Vocational Health College (N.J.), Suzhou, China ; and Ophthalmology, Provincial People's Hospital (J.Q.), Henan Eye Hospital, Zhengzhou, China .
Eye Contact Lens. 2021 Feb 1;47(2):81-85. doi: 10.1097/ICL.0000000000000699.
To compare the efficacies of 0.02% atropine eye drops and orthokeratology to control axial length (AL) elongation in children with myopia.
In this historical control study, 247 children with myopia whose administration of 0.02% atropine (n=142) or underwent orthokeratology from an earlier study (n=105, control group) were enrolled. Data on AL and other baseline parameters were recorded at baseline and after 1 and 2 years of treatment.
The mean changes in AL in the first and second years of treatment were 0.30±0.21 and 0.28±0.20 mm, respectively, in the 0.02% atropine group and 0.16±0.20 and 0.20±0.16 mm, respectively, in the orthokeratology group. Axial length elongations after 2 years of treatment were 0.58±0.35 and 0.36±0.30 mm (P=0.007) in the 0.02% atropine and orthokeratology groups, respectively. Multivariate regression analyses showed that the AL elongation was significantly faster in the 0.02% atropine group than in the orthokeratology group (β=0.18, P=0.009). In multivariate regression analyses, younger age and shorter baseline AL were associated with a rapid AL elongation in the 0.02% atropine group (βage=-0.04, P=0.01; βAL=-0.17, P=0.03), while younger age, lower baseline spherical equivalent refractive error (SER), and shorter baseline AL were associated with a greater increase in AL in the orthokeratology group (βage=-0.03, P=0.04; βSER=0.06, P=0.03; βAL=-0.11, P=0.009). Faster AL elongation was found in the 0.02% atropine group compared with the orthokeratology group at higher baseline SER (P=0.04, interaction test).
Within the limits of this study design, orthokeratology seems to be a better method for controlling AL elongation compared with administration of 0.02% atropine in children with higher myopia over a treatment period of 2 years.
比较0.02%阿托品滴眼液与角膜塑形术控制近视儿童眼轴长度（AL）增长的疗效。
在这项历史对照研究中，纳入了247名近视儿童，其中142名使用0.02%阿托品（n = 142），另外105名来自早期研究接受角膜塑形术（对照组）。在基线以及治疗1年和2年后记录眼轴长度及其他基线参数的数据。
在0.02%阿托品组中，治疗第1年和第2年眼轴长度的平均变化分别为0.30±0.21和0.28±0.20mm，在角膜塑形术组中分别为0.16±0.20和0.20±0.16mm。0.02%阿托品组和角膜塑形术组治疗2年后的眼轴长度增长分别为0.58±0.35和0.36±0.30mm（P = 0.007）。多因素回归分析显示，0.02%阿托品组的眼轴长度增长显著快于角膜塑形术组（β = 0.18，P = 0.009）。在多因素回归分析中，年龄较小和基线眼轴长度较短与0.02%阿托品组眼轴长度快速增长相关（β年龄=-0.04，P = 0.01；β眼轴=-0.17，P = 0.03），而年龄较小、基线等效球镜度数（SER）较低和基线眼轴长度较短与角膜塑形术组眼轴长度更大的增长相关（β年龄=-0.03，P = 0.04；βSER = 0.06，P = 0.03；β眼轴=-0.11，P = 0.009）。在较高基线SER时，0.02%阿托品组的眼轴长度增长比角膜塑形术组更快（P = 0.04，交互作用检验）。
在本研究设计的范围内，在2年的治疗期内，对于近视程度较高的儿童，与使用0.02%阿托品相比，角膜塑形术似乎是控制眼轴长度增长的更好方法。
