Pauné Jaume, Fonts Silvia, Rodríguez Lina, Queirós Antonio
Centre Marsden de Terapia Visual, Consulta 156, Centro Medico Teknon, Vilana 12, 08022 Barcelona, Spain.
Intitute Visual Clinic Center, Pereira 660002, Colombia.
J Clin Med. 2021 Jan 18;10(2):336. doi: 10.3390/jcm10020336.
We compared the efficacy of controlling the annual increase in axial length (AL) in myopic Caucasian children based on two parameters: the back optic zone diameter (BOZD) of the orthokeratology (OK) lens and plus power ring diameter (PPRD) or mid-peripheral annular ring of corneal steepening. Data from 71 myopic patients (mean age, 13.34 ± 1.38 years; range, 10-15 years; 64% male) corrected with different BOZD OK lenses (DRL, Precilens) were collected retrospectively from a Spanish optometric clinic. The sample was divided into groups with BOZDs above or below 5.00 mm and the induced PPRD above or below 4.5 mm, and the relation to AL and refractive progression at 12 months was analyzed. Three subgroups were analyzed, i.e., plus power ring (PPR) inside, outside, or matching the pupil. The mean baseline myopia was -3.11 ± 1.46 D and the AL 24.65 ± 0.88 mm. Significant ( < 0.001) differences were found after 12 months of treatment in the refractive error and AL for the BOZD and PPRD. AL changes in subjects with smaller BOZDs decreased significantly regarding larger diameters (0.09 ± 0.12 and 0.15 ± 0.11 mm, respectively); in subjects with a horizontal sector of PPRD falling inside the pupil, the AL increased less ( = 0.035) than matching or outside the pupil groups by 0.04 ± 0.10 mm, 0.10 ± 0.11 mm, and 0.17 ± 0.12 mm, respectively. This means a 76% lesser AL growth or 0.13 mm/year in absolute reduction. OK corneal parameters can be modified by changing the OK lens designs, which affects myopia progression and AL elongation. Smaller BOZD induces a reduced PPRDs that slows AL elongation better than standard OK lenses. Further investigations should elucidate the effect of pupillary diameter, PPRD, and power change on myopia control.
我们基于两个参数比较了控制近视白种儿童眼轴长度（AL）年度增长的效果：角膜塑形术（OK）镜片的后光学区直径（BOZD）以及加光环直径（PPRD）或角膜陡峭化的中周边环形区域。我们从一家西班牙验光诊所回顾性收集了71例近视患者（平均年龄13.34±1.38岁；范围10 - 15岁；64%为男性）的数据，这些患者使用了不同BOZD的OK镜片（DRL、Precilens）进行矫正。样本被分为BOZD大于或小于5.00 mm以及诱导的PPRD大于或小于4.5 mm的组，并分析了其与12个月时AL和屈光进展的关系。分析了三个亚组，即加光环（PPR）在瞳孔内、瞳孔外或与瞳孔匹配的情况。平均基线近视度数为-3.11±1.46 D，AL为24.65±0.88 mm。在治疗12个月后，发现BOZD和PPRD在屈光不正和AL方面存在显著差异（<0.001）。与较大直径相比，BOZD较小的受试者的AL变化显著降低（分别为0.09±0.12和0.15±0.11 mm）；在PPRD水平扇形区域落在瞳孔内的受试者中，AL的增加（=0.035）比与瞳孔匹配或在瞳孔外的组分别少0.04±0.10 mm、0.10±0.11 mm和0.17±0.12 mm。这意味着AL增长减少76%或绝对减少0.13 mm/年。可以通过改变OK镜片设计来修改OK角膜参数，这会影响近视进展和AL伸长。较小的BOZD会导致PPRD减小，与标准OK镜片相比，能更好地减缓AL伸长。进一步的研究应阐明瞳孔直径、PPRD和屈光度变化对近视控制的影响。
