Feng Yuelan, Wang Guangjiang, Wang Yuangyuan, Liang Xueming, Wang Yongsun, Zhang Wei
J Pediatr Ophthalmol Strabismus. 2025 Jul-Aug;62(4):252-257. doi: 10.3928/01913913-20250110-03. Epub 2025 Feb 19.
To observe and analyze the effects of orthokeratology in patients with convergence insufficiency, exophoria, and myopia.
Thirty patients (60 eyes) between 8 and 15 years old with myopia and convergence insufficiency exophoria treated with orthokeratology at the First Affiliated Hospital of the Baotou Medical College from December 2022 to December 2023 were prospectively enrolled. General information was gathered and examinations were performed at baseline and at 2 weeks and 1, 3, and 6 months after switching to orthokeratology lenses. Examinations included assessments of distance/near visual acuity, near point of convergence, distance and near horizontal phoria, near positive fusional vergence, and monocular amplitude of accommodation.
The median age of the participants was 10 years (range: 8 to 15 years), and 40% were female. The baseline refractive error was -2.00 diopters (D) (range: -4.00 and -1.00 D). After 6 months of treatment, we found statistically significant differences in near point of convergence (95% confidence interval: -13.99 to -8.67), positive fusional vergence (95% confidence interval: 15.32 to 11.42), and monocular amplitude of accommodation (95% confidence interval: 6.62 to 4.51) compared with baseline. In addition, the mean pretreatment near horizontal phoria decreased from 6.83 ± 1.44 to -4.90 ± 1.29 prism diopters after the 6 months of treatment (95% confidence interval: -2.92 to -0.94).
This study showed that the use of orthokeratology lenses with an increased compression factor of 1.75 D may improve near point of convergence, positive fusional vergence, and monocular amplitude of accommodation for the treatment of convergence insufficiency with myopia. .
观察和分析角膜塑形术对集合不足、外隐斜和近视患者的影响。
前瞻性纳入2022年12月至2023年12月在包头医学院第一附属医院接受角膜塑形术治疗的30例（60眼）8至15岁近视合并集合不足外隐斜患者。收集一般信息，并在基线时以及更换角膜塑形镜后2周、1、3和6个月进行检查。检查包括远/近视力、集合近点、远近水平隐斜、近正融像性聚散和单眼调节幅度评估。
参与者的中位年龄为10岁（范围：8至15岁），40%为女性。基线屈光不正为-2.00屈光度（D）（范围：-4.00至-1.00 D）。治疗6个月后，我们发现与基线相比，集合近点（95%置信区间：-13.99至-8.67）、正融像性聚散（95%置信区间：15.32至11.42）和单眼调节幅度（95%置信区间：6.62至4.51）有统计学显著差异。此外，治疗6个月后，平均治疗前近水平隐斜从6.83±1.44棱镜度降至-4.90±1.29棱镜度（95%置信区间：-2.92至-0.94）。
本研究表明，使用压缩因子增加至1.75 D的角膜塑形镜可能改善集合不足合并近视患者的集合近点、正融像性聚散和单眼调节幅度。
