Ma Wei, Yang Bi, Wang Xue, Liu Long-Qian
Department of Optometry and Visual Science, West China School of Medicine, Sichuan University, Chengdu 610041, China.
Laboratory of Optometry and Vision Science, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Da Xue Xue Bao Yi Xue Ban. 2023 Jan;54(1):181-185. doi: 10.12182/20230160207.
To observe and compare the effectiveness and safety of controlling myopia in children by wearing defocus incorporated soft contact (DISC) lenses or orthokeratology (OrthoK) lenses.
A total of 75 children who came to our hospital between January 2018 and September 2020 were enrolled for this retrospective study. The DISC group consisted of 30 myopic children (60 eyes) wearing peripheral defocal soft incorporated contact lenses during daytime. There were 10 males and 20 females aged (9.9±1.00) years old in this group and their spherical equivalent refractions were (-2.78±0.70) D. The OrthoK group consisted of 45 myopic children (90 eyes) wearing OrthoK lenses. There were 30 female and 15 males aged (9.67±1.11) and their spherical equivalent refractions were (-2.67±0.71) D. All subjects had previously worn prescription glasses for 12 months or longer before they started wearing contact lenses. The subjects were followed up for 12 months once they started wearing contact lenses. The axial changes and corneal and conjunctival complications of the two groups of myopic children were compared and analyzed.
Myopic children in both groups experienced relatively rapid increase in ocular axial length while they were wearing prescription glasses, with the ocular axial length increase in the prescription-glass-wearing period being (0.34±0.09) mm in the OrthoK group and (0.37± 0.07) mm in the DISC group. In the 12 months of wearing contact lenses, the ocular axial length of children in the OrthoK group increased by (0.18±0.04) mm, while that of the DISC group increased by (0.19±0.05) mm. The increase in ocular axial length was reduced in both groups after the children were switched to the new myopia prevention methods, showing significant difference ( <0. 05). The two groups using two different contact lenses had similar axial length increase, showing no significant difference ( >0.05). During the 12-month period while the subjects wore the two types of contact lenses, the incidence of chronic follicular conjunctivitis was 11.20% in the OrthoK group and 20.00% in the DISC group, with that of the DISC group being slightly higher without showing significant difference ( >0.05). The incidence of grade-1corneal staining was 66.70% in the OrthoK group and 56.70% in the DISC group, and the incidence of grade-2 corneal staining was 17.80% in the OrthoK group and 16.70% in the DISC group. In other words, the OrthoK group had slightly higher findings, but the difference was not significant ( >0.05). The incidence of contact lens-associated papillary conjunctivitis was 2.20% in the OrthoK group and 10.00% in the DISC group, which was slightly higher than that in the orthokeratology lens group, but the difference was not significant( >0.05).
Both DISC lenses and OrthoK lenses can effectively control the increase in axial length in myopic children, and their have better effects than those of prescription glasses. The two tyes of contact lenses showed similar effects for controlling axial length increase. Both contact lenses have fewer corneal and conjunctival complications and better safety.
观察并比较佩戴离焦软镜(DISC)与角膜塑形镜(OrthoK)控制儿童近视的有效性及安全性。
选取2018年1月至2020年9月来我院就诊的75例儿童进行回顾性研究。DISC组30例近视儿童(60眼),白天佩戴周边离焦软性接触镜,其中男10例,女20例,年龄(9.9±1.00)岁,等效球镜度数为(-2.78±0.70)D。OrthoK组45例近视儿童(90眼),佩戴角膜塑形镜,其中男15例,女30例,年龄(9.67±1.11)岁,等效球镜度数为(-2.67±0.71)D。所有受试者在开始佩戴接触镜前均已佩戴框架眼镜12个月及以上。受试者开始佩戴接触镜后随访12个月,比较分析两组近视儿童眼轴变化及角膜、结膜并发症情况。
两组近视儿童佩戴框架眼镜期间眼轴增长较快,OrthoK组佩戴框架眼镜期间眼轴增长(0.34±0.09)mm,DISC组为(0.37±0.07)mm。佩戴接触镜12个月期间,OrthoK组儿童眼轴增长(0.18±0.04)mm,DISC组增长(0.19±0.05)mm。两组儿童更换为新的近视防控方法后眼轴增长均减缓,差异有统计学意义(P<0.05)。两组使用不同接触镜眼轴增长相近,差异无统计学意义(P>0.05)。在佩戴两种接触镜的12个月期间,OrthoK组慢性滤泡性结膜炎发生率为11.20%,DISC组为20.00%,DISC组略高,但差异无统计学意义(P>0.05)。OrthoK组1级角膜染色发生率为66.70%,DISC组为56.70%;OrthoK组2级角膜染色发生率为17.80%,DISC组为16.70%。即OrthoK组略高,但差异无统计学意义(P>0.05)。OrthoK组接触镜相关性乳头性结膜炎发生率为2.20%,DISC组为10.00%,DISC组略高于角膜塑形镜组,但差异无统计学意义(P>0.05)。
DISC镜与OrthoK镜均能有效控制近视儿童眼轴增长,效果优于框架眼镜。两种接触镜控制眼轴增长效果相近,角膜、结膜并发症较少,安全性较好。