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转载:高度近视配戴塑形镜部分降低近视结合白天框架镜对近视减缓的研究

本文由梅颖医生著

高度近视配戴塑形镜部分降低近视结合白天框架镜对近视减缓的研究(IOVS新发表)

发表在Optometry & Vision Science 2013年6月的这篇文章很值得一读。

1、近年来塑形镜控制近视文章中少有的单盲随机试验。

2、样本量少,高病例丢失率是该研究的短板,也说明类似研究的共性,操作难。

3、丢失率高也说明夜间配戴Ok镜白天戴框架镜在操作时有很大的困难和不便,要很大的努力、毅力和决心才行。

4、63%的眼轴控制率比较以往的研究也是最高的,验证了近视度数越高塑形镜控制效果越好,和周边屈光在高度数时改变更明显呼应。

5、年限是2年,也有文章表示塑形镜对近视的控制就在开始的2年,以后如何,是否还有效,仍值得研究。

6、夜晚配戴塑形镜,白天配戴其他非单光框架眼镜,如周边屈光控制镜、渐变镜、双光镜又有什么样的结果呢?

7、需要更大样本的研究,如何控制丢失率、如何匹配其他的近视影响因素,谁能够做?值得大家思考!

——温州医科大学附属眼视光医院 毛欣杰

摘要翻译如下:

ABSTRACT摘要:

Purpose. To investigate if the
combination of partial reduction (PR) orthokeratology (ortho-k) and
spectacles for residual refractive errors in the daytime was
effective to slow myopic progression in high myopic
children.

目的:
研究用塑形镜降低部分近视度数结合白天用框架眼镜矫正残余近视的方式是否能有效减慢儿童高度近视的发展。

Methods. High myopic children (aged 8 to
11 years) with spherical equivalent refraction at least
-5.75 diopters (D) and
myopia -5.00 D or more myopic were
recruited and randomly assigned into PR ortho-k and control groups.
Subjects in the PR ortho-k group were fitted with custom made
four-zone ortho-k lenses with target reduction of 4.00 D for both
eyes, and the residual refractive errors were corrected with
single-vision spectacles for clear vision in the daytime. Control
subjects were fully corrected with single-vision spectacles. Axial
length of each eye of all subjects was measured with the IOLMaster
at 6-month intervals by a masked examiner. This study was
registered at www.clinicaltrial.gov with the identifier
NCT00977236.

方法:
8-11岁,等效球镜在-5.75以上,近视度数在-5.00以上被随机分到塑形镜组和对照组。塑形镜组配戴常规的4弧塑形镜,目标降低度数是-4.00,双眼。白天残余的近视用框架眼镜矫正。对照组配戴单光的框架眼镜。用IOLMaster每隔6个月由盲法设计的检查者测量眼轴。

Results. Fifty-two subjects were
recruited and randomized to the PR ortho-k and control groups.
Twelve PR ortho-k and 16 control subjects completed the study.
Compared with the residual refractive errors at the 1-month visit
(after stabilization of ortho-k treatment), the median increase in
noncycloplegic residual myopia at the 24-month visit was 0.13 D. In
the control group, the median increase in myopia was 1.00 D at the
end of the study. The mean T SD increases in axial length
were 0.19 T 0.21 mm in the PR ortho-k group
and 0.51 T 0.32 mm in the control group
(95% confidence interval, 0.55 to 0.12; unpaired
t
test, p =
0.005).

结果:
52人被录用到塑形镜组和对照组,12位塑形镜组和16位对照组完成了研究。比较一个月时(塑形效果稳定时)和24个月时的残留近视在非散瞳验光结果差异是0.13D。对照组前后的度数差异是1.00D.塑形镜组眼轴的增长是0.190.21
mm,而对照组是0.550.32mm。

Conclusions. This single-masked randomized
study showed that PR ortho-k effectively slowed myopic progression
in high myopes. Axial length elongation was 63% slower in PR
ortho-kYtreated children compared with
children wearing spectacles. (Optom Vis Sci
2013;90:530Y539)

结论:
单盲随机试验表明用塑形镜部分降低近视度数的矫正方法能有效减慢高度近视的进展。眼轴增长减慢了63%。

Key
Words: myopia control, orthokeratology, high myope, myopic
progression, partial correction

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