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角膜塑形术与高度非球面微透镜控制青少年近视及离焦效果的比较。

Comparison of the Effects of Orthokeratology and Highly Aspherical Lenselets in Achieving Myopia Control and Defocus in Adolescents.

机构信息

Ming Vision and Ophthalmology (J.Y., Y.Z.), Jianguomen Branch Clinic, Beijing, China; and Eye School of Chengdu University of TCM (Y.G., Y.Z.), Ineye Hospital of Chengdu University of TCM, Chengdu, Sichuan, China.

出版信息

Eye Contact Lens. 2024 Oct 1;50(10):445-454. doi: 10.1097/ICL.0000000000001124. Epub 2024 Sep 4.

Abstract

OBJECTIVES

To compare the control effectiveness and periretinal defocus between orthokeratology (OK) and highly aspherical lenslets (HAL) in adolescents with myopia.

METHODS

In this prospective study, 211 children (211 right eyes) were enrolled in Beijing Ming Vision and Ophthalmology between October 2022 and February 2023. Based on the myopia correction method, participants were divided into three groups: OK, HAL, and single-vision spectacles (SVS). They were further divided into two subgroups according to the spherical equivalent (SE), namely, subgroup A with -1.0≤SE≤-2.0 D and subgroup B with -2.0<SE≤-3.0 D. All children were followed up for 12 months, and the changes in axial length (AL) and periretinal defocus before and after treatment were recorded, and the factors affecting the corneal shaping force for 1-day post-OK were analyzed.

RESULTS

Axial length growth in those with OK lenses and HAL was lower than what was observed for those with SVS after 6, 9, and 12 months. Comparison of the difference in AL change between OK and HAL was not statistically significant with -1.0≤SE≤-2.0 D. The myopic defocus of RDV270° to 300° in group HAL was higher than that in group OK, the difference was statistically significant ( P <0.05), and in other regions, the myopic defocus was higher in the group OK. Em, SRI (corneal regularity index), variation in cell area, and corneal thickness were significantly associated with shaping force.

CONCLUSIONS

Orthokeratology is one of the most effective optical treatments for controlling myopia, and the factors that affect the corneal shaping force under different corneal parameters are different. For mild myopia, HAL can achieve the same effectiveness as OK.

摘要

目的

比较角膜塑形术(OK)和高度非球面透镜(HAL)治疗青少年近视的控制效果和周边离焦量。

方法

前瞻性研究。2022 年 10 月至 2023 年 2 月,北京茗视光眼科共纳入 211 名儿童(211 只右眼)。根据近视矫正方法,将参与者分为 3 组:OK 组、HAL 组和单光眼镜(SVS)组。根据等效球镜(SE)进一步分为 2 个亚组,即 SE 为-1.0≤SE≤-2.0 D 的亚组 A 和 SE 为-2.0<SE≤-3.0 D 的亚组 B。所有儿童均随访 12 个月,记录治疗前后眼轴长度(AL)和周边离焦量的变化,并分析影响 1 天 OK 后角膜塑形力的因素。

结果

6、9 和 12 个月后,OK 组和 HAL 组的眼轴增长低于 SVS 组。当 SE 为-1.0≤SE≤-2.0 D 时,OK 与 HAL 之间的 AL 变化差异无统计学意义。HAL 组 RDV270°至 300°的近视离焦量高于 OK 组,差异有统计学意义(P<0.05),其他区域 OK 组的近视离焦量较高。Em、SRI(角膜规则指数)、细胞面积变异和角膜厚度与塑形力显著相关。

结论

角膜塑形术是控制近视最有效的光学治疗方法之一,不同角膜参数下影响角膜塑形力的因素不同。对于轻度近视,HAL 可以达到与 OK 相同的效果。

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