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角膜塑形术对近视性屈光参差儿童疗效的临床观察与分析

[Clinical observation and analysis on the effect of orthokeratology in myopic anisometropic children].

作者信息

Lyu Y Y, Wu J J, Guo W, Peng L, Wang Y X, Wu M, Cao K, Jie Y

机构信息

Tongren Vision Care, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University/Beijing Institute of Ophthalmology/Beijing Ophthalmology and Visual Sciences Key Laboratory, Beijing 100730, China.

出版信息

Zhonghua Yu Fang Yi Xue Za Zhi. 2021 Apr 6;55(4):471-477. doi: 10.3760/cma.j.cn112150-20210203-00119.

Abstract

To evaluate the clinical effects of orthokeratology lens on children with myopic anisometropia. Retrospective case series study. The data of 226 myopic anisometropia children, (10.83±1.56)years old, including 95 males and 131 females, fitted with orthokeratology(OK) lens in Beijing Tongren Hospital from June 2017 to June 2019 were collected. According to the lens wearing condition and baseline anisometropia, they were divided into four groups: group A1 with an average age of (10.68±1.66) years (bilateral OK lens wearing with low anisometropia, 1.0 D≤SE difference<2.5 D, 50 males and 61 females), group A2 with an average age of (11.24±1.38) years (bilateral OK lens wearing with moderate and high anisometropia, SE difference≥2.5 D, 10 males and 23 females), group B1 with an average age of (10.79±1.51) years (unilateral OK lens wearing with low anisometropia, 1.0 D≤SE difference<2.5 D, 17 males and 21 females) and group B2 with an average age of (10.97±1.60) years (unilateral OK lens wearing with moderate and high anisometropia, SE difference≥2.5 D, 18 males and 26 females). After wearing OK lens for one year, the changes of axial length(AL) and AL difference were observed and statistically analyzed. (1) AL changes: after wearing OK-lens for one year, AL of each eye increased. In group A1, the AL of the more myopic eyes and the less myopic eyes increased by (0.20±0.21) mm and (0.24±0.22) mm respectively, and the difference was statistically significant (=-3.208, =0.002); in group A2, the AL growth of the more myopic eyes and the less myopic eyes were (0.04±0.11) mm and (0.17±0.14) mm, and the difference was statistically significant (=-5.545, <0.001). In group B1, the AL elongation of the more myopic eyes and the less myopic eyes were (0.14±0.21) mm and (0.39±0.23) mm, and in group B2, the AL growth of the more myopic eyes and the less myopic eyes were (0.11±0.14) mm and (0.54±0.24) mm, with statistically significant differences(=-6.533, -11.643; all <0.001). There was a linear correlation between AL elongation and age of the more myopic eyes and the less myopic eyes in group A1(corrected =0.208, 0.237) and group A2 (corrected =0.169, 0.360). There was no linear correlation of the more myopic eyes and the less myopic eyes between AL change and age or baseline myopia in group B1 (=0.514, 1.205;=0.602, 0.312) and group B2 (=0.841, 0.056; =0.439, 0.946). (2)Change of AL difference: after wearing OK lens for one year, the changes of AL difference in groupA1, A2, B1 and B2 were (-0.04±0.14) mm,(-0.13±0.13) mm,(-0.26±0.24) mm and (-0.43±0.25) mm, and the decrease of AL difference in moderate and high anisometropia groups were greater than that in low anisometropia groups ( =-3.211, -3.180; =0.002, 0.002).There was a linear correlation between the reduction of AL difference and baseline anisometropia in group A1, A2 and B2 (corrected =0.099, 0.149, 0.230), and there was no linear relationship between the decrease of AL difference and the baseline anisometropia in group B1 (=0.014, =0.908). Orthokeratology could effectively control the progression of myopia and to treat anisometropia. The effect of myopia control was better in the older binocular OK lens wearers, and for the patients with greater baseline anisometropia, the treatment effect of anisometropia was better.

摘要

评估角膜塑形镜对儿童近视性屈光参差的临床效果。回顾性病例系列研究。收集2017年6月至2019年6月在北京同仁医院佩戴角膜塑形镜(OK镜)的226例近视性屈光参差儿童的数据,年龄(10.83±1.56)岁,其中男性95例,女性131例。根据镜片佩戴情况和基线屈光参差,将他们分为四组:A1组平均年龄(10.68±1.66)岁(双眼佩戴OK镜且屈光参差低,1.0 D≤球镜等效度差值<2.5 D,男性50例,女性61例),A2组平均年龄(11.24±1.38)岁(双眼佩戴OK镜且屈光参差中高度,球镜等效度差值≥2.5 D,男性10例,女性23例),B1组平均年龄(10.79±1.51)岁(单眼佩戴OK镜且屈光参差低,1.0 D≤球镜等效度差值<2.5 D,男性17例,女性21例),B2组平均年龄(10.97±1.60)岁(单眼佩戴OK镜且屈光参差中高度,球镜等效度差值≥2.5 D,男性18例,女性26例)。佩戴OK镜一年后,观察并统计分析眼轴长度(AL)及AL差值的变化。(1)AL变化:佩戴OK镜一年后,各眼AL均增加。A1组中,近视程度较高眼和近视程度较低眼的AL分别增加(0.20±0.21)mm和(0.24±0.22)mm,差异有统计学意义(=-3.208,=0.002);A2组中,近视程度较高眼和近视程度较低眼的AL增长分别为(0.04±0.11)mm和(0.17±0.14)mm,差异有统计学意义(=-5.545,<0.001)。B1组中,近视程度较高眼和近视程度较低眼的AL伸长分别为(0.14±0.21)mm和(0.39±0.23)mm,B2组中,近视程度较高眼和近视程度较低眼的AL增长分别为(0.11±0.14)mm和(0.54±0.24)mm,差异有统计学意义(=-6.533,-11.643;均<0.001)。A1组和A2组中近视程度较高眼和近视程度较低眼的AL伸长与年龄呈线性相关(校正=0.208,0.237)和(校正=0.169,0.360)。B1组(=

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