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非球面基弧角膜塑形镜控制近视的一年期结果:一项前瞻性随机临床试验。

One-year results for myopia control with aspheric base curve orthokeratology lenses: A prospective randomised clinical trial.

作者信息

Liu Tong, Chen Changxu, Ma Wei, Yang Bi, Wang Xi, Liu Longqian

机构信息

Department of Optometry and Vision Science, West China School of Medicine, Sichuan University, Chengdu, China.

Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Ophthalmic Physiol Opt. 2023 Nov;43(6):1469-1477. doi: 10.1111/opo.13213. Epub 2023 Aug 16.

Abstract

PURPOSE

To compare the effect of orthokeratology (ortho-k) using aspheric or spherical base curve (BCA vs. BCS) contact lenses on axial elongation and the relative peripheral refraction change (RPRC) in Chinese children.

METHODS

Children aged 8-12 years with myopia between -0.75 and -4.00 D and astigmatism ≤1.00 D were randomly assigned to the BCA or BCS group. Peripheral refraction was assessed at 10°, 20° and 30° along the temporal and nasal retina at baseline and at the 12-month visit. Axial length (AL) was measured under cycloplegia at baseline and at the 6- and 12-month visits. Only right eye data were analysed. Repeated-measures analysis of covariance was performed to examine the differences in axial elongation and the RPRC between the BCA and BCS groups.

RESULTS

The 1-year results from 31 BCA and 32 BCS subjects were analysed. No significant between-group differences were found at baseline (p ≥ 0.28). At the 12-month visit, the BCA lens produced a greater absolute RPRC along the horizontal meridian than the BCS lens (p < 0.001). Axial elongation was slower in the BCA group (0.19 ± 0.20 mm) than in the BCS group (0.29 ± 0.14 mm; p = 0.03). Axial elongation was correlated with the RPRC at 10° (r = 0.43, p = 0.02) and 20° (r = 0.39, p = 0.03) along the temporal retina in the BCA group; however, these correlations were not observed in the BCS group.

CONCLUSION

The BCA ortho-k lens could improve the efficacy of slowing axial elongation in children. The improved myopia control observed in the BCA group may be the result of a larger myopic shift in relative peripheral refraction within 20° along the temporal retina.

摘要

目的

比较使用非球面或球面基弧(BCA与BCS)角膜塑形镜对中国儿童眼轴伸长及相对周边屈光变化(RPRC)的影响。

方法

将年龄在8至12岁、近视度数在-0.75至-4.00 D之间且散光≤1.00 D的儿童随机分为BCA组或BCS组。在基线期及随访12个月时,沿颞侧和鼻侧视网膜在10°、20°和30°处评估周边屈光。在基线期以及随访6个月和12个月时,在睫状肌麻痹下测量眼轴长度(AL)。仅分析右眼数据。采用重复测量协方差分析来检验BCA组和BCS组在眼轴伸长及RPRC方面的差异。

结果

分析了31例BCA组和32例BCS组受试者的1年结果。基线期两组间无显著差异(p≥0.28)。在随访12个月时,BCA镜片沿水平子午线产生的绝对RPRC大于BCS镜片(p<0.001)。BCA组的眼轴伸长(0.19±0.20 mm)比BCS组(0.29±0.14 mm;p=0.03)更慢。在BCA组中,沿颞侧视网膜在10°(r=0.43,p=0.02)和20°(r=0.39,p=0.03)处眼轴伸长与RPRC相关;然而,在BCS组中未观察到这些相关性。

结论

BCA角膜塑形镜可提高减缓儿童眼轴伸长的效果。在BCA组中观察到的更好的近视控制效果可能是由于沿颞侧视网膜20°范围内相对周边屈光的更大近视性偏移所致。

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