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角膜塑形术控制儿童近视的效果:一项随机对照试验的荟萃分析。

Orthokeratology in controlling myopia of children: a meta-analysis of randomized controlled trials.

机构信息

Department of nursing, Children's Hospital of Nanjing Medical University, No. 72, Guangzhou Road, Gulou District, Nanjing, China.

出版信息

BMC Ophthalmol. 2023 Oct 31;23(1):441. doi: 10.1186/s12886-023-03175-x.

Abstract

BACKGROUND

Delaying the development and lowering the progression of myopia in children is the focus of current ophthalmology researches. We aimed to evaluate the role of orthokeratology in controlling myopia of children, to provide insights to the clinical treatment and care of children with myopia.

METHODS

Two investigators searched the The Cochrane Library, Embase, Pubmed, China national knowledge infrastructure, China biomedical literature database, WanFang and Weipu databases for randomized controlled trials(RCTs) on the role of orthokeratology in controlling myopia of children up to November 5, 2022. Two researchers independently searched, screened and extracted the studies according to the inclusion and exclusion standards. RevMan5.3 software was used for statistical analysis.

RESULTS

A total of 14 RCTs involving 2058 children were included in this meta-analysis. Synthesized outcomes indicated that orthokeratology improved the uncorrected visual acuity(MD = 0.40, 95%CI: 0.05 ~ 0.74), reduced the diopter change(MD=-3.19, 95%CI: -4.42-1.95), changes of corneal curvature(MD=-3.21, 95%CI: -3.64-2.79), the length of ocular axis (MD=-0.66, 95%CI: -1.27-0.06) and amount of ocular axis change(MD=-0.42, 95%CI: -0.64-0.21) after 1 year of wearing orthokeratology(all P < 0.05). Besides, orthokeratology reduced the diopter change (MD=-3.22, 95%CI: -4.86-1.58), the length of ocular axis (MD=-1.15, 95%CI: -2.25-0.06) and the amount of ocular axis change after 2 year of wearing orthokeratology (MD=-0.53, 95%CI: -0.96~-0.11) after 2 year of wearing orthokeratology (all P < 0.05). No publication biases were found amongst the synthesized outcomes (all P > 0.05).

CONCLUSIONS

Orthokeratology delays the progression of myopia in children, the long-term effects of orthokeratology need further investigations in future studies.

摘要

背景

延缓儿童近视的发展和降低其进展是当前眼科学研究的重点。我们旨在评估角膜塑形术在控制儿童近视中的作用,为儿童近视的临床治疗和护理提供见解。

方法

两名调查员检索了 Cochrane 图书馆、Embase、PubMed、中国知网、中国生物医学文献数据库、万方和维普数据库,以获取截至 2022 年 11 月 5 日关于角膜塑形术控制儿童近视作用的随机对照试验(RCT)。两名研究人员根据纳入和排除标准独立搜索、筛选和提取研究。使用 RevMan5.3 软件进行统计分析。

结果

共有 14 项 RCT 纳入了本 meta 分析的 2058 名儿童。综合结果表明,角膜塑形术可提高未矫正视力(MD=0.40,95%CI:0.050.74),降低屈光度变化(MD=-3.19,95%CI:-4.42-1.95)、角膜曲率变化(MD=-3.21,95%CI:-3.64-2.79)、眼轴长度变化(MD=-0.66,95%CI:-1.27-0.06)和眼轴变化量(MD=-0.42,95%CI:-0.64-0.21)(均 P<0.05)。此外,角膜塑形术还可降低戴镜 1 年后的屈光度变化(MD=-3.22,95%CI:-4.86-1.58)、眼轴长度变化(MD=-1.15,95%CI:-2.25-0.06)和眼轴变化量(MD=-0.53,95%CI:-0.96-0.11)(均 P<0.05)。在综合结果中未发现发表偏倚(均 P>0.05)。

结论

角膜塑形术可延缓儿童近视的进展,其长期效果需要进一步研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/644a/10617145/008baabfeaf0/12886_2023_3175_Fig2_HTML.jpg

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