摘要
目的评估近视儿童角膜塑形镜配戴与框架眼镜配戴1年的临床效果,探讨其对眼球生物学参数的影响。方法采用随机对照研究方法,收集2018年1—8月成都爱尔眼科医院收治的中低度数近视儿童200例200眼,采用随机数字表法将受试者随机分为角膜塑形镜组和框架眼镜组,每组100例100眼,比较2个组受试者戴镜前和戴镜后6、12个月及停戴后1个月的眼轴长度(AL)、中央角膜厚度(CCT)、前房深度(ACD)和晶状体厚度。结果2个组受试者戴镜前后不同时间点AL总体比较差异均有统计学意义(F分组=4.617,P=0.043;F时间=10.939,P=0.023)。与戴镜前比较,2个组受试者戴镜后6、12个月和停戴后1个月AL均变长,差异均有统计学意义(均P<0.05)。角膜塑形镜组受试者停戴后1个月AL与戴镜后12个月比较差异无统计学意义(P>0.05)。与戴镜前相比,戴镜后12个月角膜塑形镜组受试者AL增长量为(0.13±0.06)mm,低于框架眼镜组的(0.29±0.08)mm,差异有统计学意义(t=16.000,P=0.002)。2个组受试者戴镜前后不同时间点CCT比较差异均有统计学意义(F分组=2.297,P=0.013;F时间=11.219,P<0.01),其中戴镜后6个月和12个月角膜塑形镜组CCT较戴镜前和同时间点框架眼镜组明显变薄,差异均有统计学意义(均P<0.05);停戴后1个月,角膜塑形镜组受试者CCT与戴镜前比较差异无统计学意义(P>0.05)。2个组受试者戴镜前后不同时间点ACD比较差异均无统计学意义(F分组=4.226,P=0.051;F时间=3.208,P=0.057)。2个组患者戴镜前后不同时间点晶状体厚度比较差异均有统计学意义(F分组=13.130,P<0.01;F时间=0.804,P=0.047),其中戴镜后6、12个月和停戴后1个月,角膜塑形镜组受试者晶状体厚度较戴镜前和同时间点框架眼镜组变厚,差异均有统计学意义(均P<0.05);角膜塑形镜组受试者停戴后1个月晶状体厚度与戴镜后12个月比较差异无统计学意义(P>0.05)。结论与配戴框架眼镜比较,配戴角膜塑形镜可有效抑制儿童近视眼AL延长,可逆性降低CCT,增加晶状体厚度,但对ACD无明显影响,且相对安全。
Objective To evaluate the 1-year clinical outcome of orthokeratology contact lens wear and glasses wear for myopia in children,mainly focusing on the effects on the biological parameters of the eyeballs.Methods A randomized-controlled clinical study analyzed 200 eyes of 200 adolescent,with low and moderate myopia from January 2018 to August 2018 at Chengdu Aier Eye Hospital.The subjects were divided into an orthokeratology group and a spectacles group,100 eyes in each group.The axial lengths(AL),central corneal thickness(CCT),anterior chamber depth(ACD),and crystalline lens thickness were measured and compared between the two groups before and 6 months,12 months after wearing the lenses,and 1 month after stopping lens wear.This study conformed to the tenets of the Declaration of Helsinki.Written informed consent was obtained from each subject prior to entering the study cohort.The study protocol was approved by the Ethics Committee of Chengdu Aier Eye Hospital(No.[2018]01-1).Results The overall difference in AL was statistically significant in the two groups at various time points(Fgroup=4.617,P=0.043;Ftime=10.939,P=0.023).Compared with before wearing lenses,the AL was significantly lengthened in both of the groups at 6 and 12 months after wearing lenses and 1 month after stopping lens wear(all at P<0.05).There was no significant difference in AL between 1 month after stopping lens wear and 12 months after wearing lenses in the orthokeratology group(P>0.05).Twelve months after wearing lenses,the AL increases values of the orthokeratology group were significantly lower than those of the spectacles group([0.13±0.06]mm vs.[0.29±0.08]mm)(t=16.000,P=0.002).The differences in CCT at time points in the two groups were statistically significant(Fgroup=2.297,P=0.013;Ftime=11.219,P<0.01).At 6 and 12 months after wearing the lenses,the CCT in the orthokeratology group was significantly thinner than that before lens wear(all at P<0.05).CCT showed no significant difference between 1 month after stopping lens wear and before wearing lenses in the orthokeratology group(P>0.05).There was no statistically significanant difference in the ACD between the two groups at time points(Fgroup=4.226,P=0.051;Ftime=3.208,P=0.057).The overall differences in crystalline lens thickness at time points before and after wearing lenses in the two groups were statistically significant(Fgroup=13.13,P<0.01;Ftime=0.804,P=0.047).At 6 and 12 months after wearing the lenses and 1 month after stopping lens wear,the crystalline lens thickness in the orthokeratology group was significantly greater than that before lens wear and that in the spectacles group at the same time points(all at P<0.05).There was no significant difference in the crystalline lens thickness between 1 month after stopping lens wear and 12 months after wearing the lenses in the orthokeratology group(P>0.05).Conclusions Compared with wearing spectacles,orthokeratology lenses wear can effectively slow down the prolongation of the AL,decrease CCT reversibly and increase crystalline lens thickness in adolescent myopic subjects,but it has no significant effect on the ACD.
作者
边思林
刘华
林江
Bian Silin;Liu Hua;Lin Jiang(Jinzhou Medical University,Jinzhou 121001,China;Department of Ophthalmology,Third Affiliated Hospital of Jinzhou Medical University,Jinzhou 121001,China;Chengdu Aier Eye Hospital,Chengdu 610041,China)
出处
《中华实验眼科杂志》
CAS
CSCD
北大核心
2020年第2期121-127,共7页
Chinese Journal Of Experimental Ophthalmology
关键词
近视/治疗
接触镜
生物测量
眼球
疗效
儿童
随机对照研究
OK镜配戴
Myopia/therapy
Contact lenses
Biometry
ocular
Treatment outcome
Child
Randomized controlled study
Orthokeratologic procedure
