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三种角膜塑形镜与单焦框架镜矫正儿童近视进展的比较。

Comparison of myopia progression between children wearing three types of orthokeratology lenses and children wearing single-vision spectacles.

机构信息

Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto, 602-0841, Japan.

Department of Biostatistics, Graduate School of Medicine, Hokkaido University, Sapporo, Japan.

出版信息

Jpn J Ophthalmol. 2021 Sep;65(5):632-643. doi: 10.1007/s10384-021-00854-4. Epub 2021 Jul 22.

Abstract

PURPOSE

To evaluate factors related to myopia progression in children wearing either orthokeratology (OK) lenses or single-vision spectacles (SVS) for 2 years.

STUDY DESIGN

Pooled-analysis retrospective intervention study.

METHODS

This study involved 105 school-aged children wearing SVS who participated in the multi-center Myovision Study and 89 school-aged children wearing one of 3 OK lens types [Menicon Z Night (M, n = 27), αORTHO-K (A, n = 32), and Emerald (E, n = 30)]. In the OK-lens patients, last examination was performed at ≥ 3-weeks post lens-wear discontinuation. Of the subjects, 102 SVS-Group and 79 OK-Group (M: n = 24, A: n = 28, and E: n = 27) children completed all examinations. A relationship between refractive error (RE) change and 7 factors (correction methods, baseline age, baseline RE, baseline axial length, gender, right or left eye, and follow-up period) was derived by multiple regression modeling. Via those same methods, we investigated the relationship between RE change and 7 factors including 3 OK-lens corrections.

RESULTS

Related influence factors were correction method (0.85 D myopia reduction in the OK Group, P < 0.001), baseline age (0.16 D myopia reduction in older-age patients, P < 0.001), and baseline RE (0.12 D myopia reduction per 1 D myopia, P = 0.01). No relationship was found between RE change and OK-lens type. No serious adverse events occurred.

CONCLUSION

Regardless of OK lens design, myopia progression in school-aged children was suppressed. The effect was examined not only via axial-length elongation but also RE change, and the myopia control effect by OK lenses was found to be 0.85 D over the 2-year period.

摘要

目的

评估佩戴角膜塑形镜(OK)或单焦框架镜(SVS)的儿童 2 年内近视进展的相关因素。

研究设计

汇总分析回顾性干预研究。

方法

本研究涉及参与多中心 Myovision 研究的 105 名学龄期佩戴 SVS 的儿童和 89 名佩戴 3 种 OK 镜类型之一的学龄期儿童[Menicon Z Night(M,n=27)、αORTHO-K(A,n=32)和 Emerald(E,n=30)]。在 OK 镜患者中,末次检查在停戴镜片后至少 3 周进行。其中,102 名 SVS 组和 79 名 OK 组(M:n=24,A:n=28,E:n=27)儿童完成了所有检查。通过多元回归模型,我们根据 7 个因素(矫正方法、基线年龄、基线屈光不正、基线眼轴长度、性别、右眼或左眼和随访时间)推导了屈光不正变化与 7 个因素之间的关系。通过相同的方法,我们研究了屈光不正变化与包括 3 种 OK 镜矫正方法在内的 7 个因素之间的关系。

结果

相关影响因素包括矫正方法(OK 组近视减少 0.85D,P<0.001)、基线年龄(老年患者近视减少 0.16D,P<0.001)和基线屈光不正(每 1D 近视减少 0.12D,P=0.01)。OK 镜类型与屈光不正变化无相关性。未发生严重不良事件。

结论

无论 OK 镜设计如何,学龄儿童的近视进展均得到抑制。该效果不仅通过眼轴伸长来评估,还通过屈光不正变化来评估,并且在 2 年内,OK 镜的近视控制效果为 0.85D。

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