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影响儿童角膜塑形术治疗近视控制效果的因素:一项回顾性分析。

Factors affecting myopia control outcomes with orthokeratology treatment in children: a retrospective analysis.

作者信息

Wang Fengjiao, Wang Wenwen, Yin Chengqiang, Yang Shiqi, Zhan Xiaomin, Chen Huan, Deng Jun

机构信息

School of Ophthalmology and Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, China.

Hangzhou Xihu Zhijiang Eye Hospital, Hangzhou, China.

出版信息

Front Med (Lausanne). 2025 Jun 4;12:1580023. doi: 10.3389/fmed.2025.1580023. eCollection 2025.

Abstract

PURPOSE

This retrospective observational cohort study aimed to analyze the factors influencing the effectiveness of orthokeratology (OrthoK) lens treatment in controlling myopia in children.

METHODS

Medical records of 200 children aged 8-15 years, with spherical equivalent refraction (SE) ranging from -1.00 to -6.00 diopters (D) and binocular anisometropia less than 1.00 D, were analyzed. The data included baseline age, SE, keratometry readings (Kf and Ks), corneal eccentricity, asymmetry indices, pupil size, and corneal diameter. Multivariate linear regression analysis was used to identify factors associated with axial length (AL) changes over a 1 year period. Additional analyses explored the relationship between treatment outcomes and lens centration parameters.

RESULTS

The mean axial length (AL) growth after 1 year was 0.20 ± 0.16 mm. Multivariate analysis identified baseline age (β = -0.725, < 0.001) and baseline SE (β = 1.289, < 0.001) as significant predictors of AL change. Subgroup analyses showed that children older than 11 years with baseline SE greater than -3.00 D exhibited the most favorable treatment outcomes. Lens decentration patterns were significantly correlated with treatment efficacy ( < 0.05).

CONCLUSION

Orthokeratology treatment outcomes are significantly influenced by baseline age and refractive error. The findings suggest that patient age and the severity of initial myopia should be considered when predicting treatment outcomes. Further prospective studies are required to validate these findings and investigate the role of lens centration in treatment efficacy.

摘要

目的

本回顾性观察队列研究旨在分析影响角膜塑形术(OrthoK)镜片治疗儿童近视控制效果的因素。

方法

分析了200名年龄在8至15岁之间、等效球镜度(SE)在-1.00至-6.00屈光度(D)之间且双眼屈光参差小于1.00 D的儿童的病历。数据包括基线年龄、SE、角膜曲率读数(Kf和Ks)、角膜偏心率、不对称指数、瞳孔大小和角膜直径。采用多元线性回归分析来确定与1年内眼轴长度(AL)变化相关的因素。额外的分析探讨了治疗结果与镜片中心定位参数之间的关系。

结果

1年后平均眼轴长度(AL)增长为0.20±0.16毫米。多因素分析确定基线年龄(β=-0.725,<0.001)和基线SE(β=1.289,<0.001)是AL变化的显著预测因素。亚组分析表明,基线SE大于-3.00 D的11岁以上儿童表现出最有利的治疗结果。镜片偏心模式与治疗效果显著相关(<0.05)。

结论

角膜塑形术的治疗结果受基线年龄和屈光不正显著影响。研究结果表明,在预测治疗结果时应考虑患者年龄和初始近视的严重程度。需要进一步的前瞻性研究来验证这些发现,并研究镜片中心定位在治疗效果中的作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91fb/12174107/dcf5b94eadb8/fmed-12-1580023-g001.jpg

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