Li Fabiao, Mai Xueting, Li Quwen, Mai Xueyu
Optometry Center, Foshan Fosun Chancheng Hospital, Foshan City, China.
Ophthalmology Center, The Second People's Hospital of Foshan, Foshan City, China.
BMC Ophthalmol. 2025 May 30;25(1):320. doi: 10.1186/s12886-025-04151-3.
The longitudinal evaluation of the dual treatment protocol combining orthokeratology (Ortho-K) lenses and 0.01% atropine eye drops focused on assessing tear film stability, corneal epithelial alterations, and visual function in pediatric myopia control. This prospective, randomized study enrolled 100 participants aged 8 to - 18 years, categorized into Group A (Ortho-K + 0.01% atropine) and Group B (Ortho-K monotherapy). The subjects were followed for 12 months, with assessments at 1, 3, 6, and 12 months. The key parameters analyzed included axial length progression, spherical equivalent refraction, best-corrected visual acuity (BCVA), corneal topography, corneal epithelial thickness, corneal endothelial cell density, intraocular pressure (IOP), tear break-up time (TBUT), Schirmer's test results, and ocular surface integrity determined via fluorescein and lissamine green staining. Compared with Group B (Δ0.5 ± 0.07 mm, p < 0.05), Group A exhibited superior myopia control, with a significant reduction in axial elongation (Δ0.3 ± 0.05 mm, p = 0.04). BCVA improved more in Group A (-0.1 ± 0.04 LogMAR, p = 0.03) than in Group B (-0.15 ± 0.04 LogMAR, p < 0.05). However, tear film stability decreased in Group A, as evidenced by a greater reduction in TBUT (Δ1.5 ± 0.3 s, p = 0.04) than in Group B (Δ0.7 ± 0.2 s, p = 0.05). Corneal epithelial thinning was more pronounced in Group A (Δ2.5 ± 0.5 μm, p = 0.05) than in Group B (Δ1.0 ± 0.3 μm, p = 0.07). No significant differences in Schirmer's test, endothelial cell density, or IOP were noted between the groups. Patient adherence was greater in Group A than in Group B (93% vs. 91%), and both groups reported high patient satisfaction scores. These findings suggested that dual therapy enhances myopia control while maintaining corneal and ocular surface integrity, although tear film stability and epithelial health require careful long-term monitoring. Further longitudinal studies with larger cohorts are necessary to confirm the long-term safety and efficacy of this combined approach.
对角膜塑形术（Ortho-K）镜片与0.01%阿托品滴眼液联合治疗方案的纵向评估，着重于评估儿童近视控制中的泪膜稳定性、角膜上皮改变及视觉功能。这项前瞻性随机研究纳入了100名8至18岁的参与者，分为A组（角膜塑形术+0.01%阿托品）和B组（角膜塑形术单一疗法）。对受试者进行了12个月的随访，在第1、3、6和12个月进行评估。分析的关键参数包括眼轴长度进展、等效球镜度、最佳矫正视力（BCVA）、角膜地形图、角膜上皮厚度、角膜内皮细胞密度、眼压（IOP）、泪膜破裂时间（TBUT）、泪液分泌试验结果以及通过荧光素和丽丝胺绿染色确定的眼表完整性。与B组（Δ0.5±0.07mm，p<0.05）相比，A组近视控制效果更佳，眼轴伸长显著减少（Δ0.3±0.05mm，p=0.04）。A组的最佳矫正视力改善程度（-0.1±0.04 LogMAR, p=0.03）高于B组（-0.15±0.04 LogMAR, p<0.05）。然而，A组的泪膜稳定性下降，泪膜破裂时间的减少幅度（Δ1.5±0.3秒，p=0.04）大于B组（Δ0.7±0.2秒，p=0.05）即为证明。A组角膜上皮变薄比B组更明显（Δ2.5±0.5μm，p=0.05），B组为（Δ1.0±0.3μm，p=0.07）。两组间泪液分泌试验、内皮细胞密度或眼压无显著差异。A组患者依从性高于B组（93%对91%），且两组患者满意度评分均较高。这些发现表明，联合治疗在增强近视控制的同时能维持角膜和眼表完整性，尽管泪膜稳定性和上皮健康需要长期仔细监测。需要进一步开展更大样本队列的纵向研究，以确认这种联合方法的长期安全性和有效性。
