Clinical analysis of orthokeratologylens and multifocal soft lens in safety and effect
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摘要:
目的 通过对多焦软镜和角膜塑形镜的研究, 比较两者控制近视的有效性和临床安全性。 方法 采用前瞻性研究方法, 选择在甘肃省妇幼保健院配戴硬性角膜塑形镜和多焦软镜的患者各60例(120眼), 两组均在戴镜前, 戴镜后1, 3, 6, 12个月进行眼表疾病指数(OSDI)问卷调查; 同时检查泪膜破裂时间(BUT)、角膜染色评分(CSF)、睑板腺功能评估, 分析戴镜前后眼表功能, 并对两组患者在戴镜6, 12, 18个月后观察眼轴及屈光度数变化, 以评估近视控制效果。 结果 硬镜组BUT在戴镜后2月开始低于软镜组, 差异有统计学意义(t=4.35, P < 0.05)。硬镜组戴镜后1个月开始, BUT短于戴镜前, 差异有统计学意义(F=305.83, P < 0.05)。软镜组在戴镜6个月后的BUT差异无统计学意义(F=0.38, P>0.05)。CSF和睑板腺功能评估两组在戴镜前后及两组间差异均无统计学意义(F时间值分别为1.55, 1.38, 10.15, 1.50, F组间值分别为2.31, 0.02, P值均>0.05)。硬镜组戴镜后18个月, 球镜度数平均增长-0.53 D, 和戴镜前近视度数差异有统计学意义(F=6.54, P < 0.05)。软镜组戴镜后18个月, 球镜度数平均增长-0.34 D, 和戴镜前近视度数差异有统计学意义(F=2.88, P < 0.05)。硬镜组和软镜组戴镜后18个月, 眼轴的增长差异均有统计学意义(F值分别为2.73, 2.83, P值均 < 0.05)。 结论 角膜塑形镜和多焦软镜均为控制近视安全有效的措施。 Abstract:Objective To compare the effectiveness and clinical safety between the two through the observation of Orthokeratology lens and multifocal soft lens. Methods By using prospective longitudinal design, sixty patients (120 eyes) with orthokeratology lens and multifocal soft lens were selected. After 1, 3, 6 and 12 months, our tests were conducted, including ocular surface disease index (OSDI) questionnaire, tear break-up time(BUT), corneal fluerescein staining (CSF) and meibomian gland function assessment, before and after wearing glasses, ocular axis and refraction in 6, 12 and 18 months after were evaluated to assess the effect of myopia control. Results But in the orthokeratology lens group was lower than the soft lens group after two months. The difference was statistically significant(t=4.35, P < 0.05). After 1 month of wearing glasses, BUT in the orthokeratologylens group was shorter than before(F=305.83, P < 0.05). In the group of soft lens, there was no statistically significance before and after wearing glasses(F=0.38, P>0.05). There was no difference in corneal fluorescence staining (CSF) and meibomian gland function between the two groups before and after wearing glasses.(Ftime=1.55, 1.38, 10.15, 1.50, P>0.05, Fgroup=2.31, 0.02, P>0.05). After 18 months of wearing orthokeratology lens, the average degree of spherical lens increased by -0.53 D, which was different from that before wearing(F=6.54, P < 0.05). After wearing soft lens 18 month, the average degree of spherical lens increase by -0.34 D, which was different from that before wearing(F=2.88, P < 0.05). After 18 months of wearing glasses, there were differences in the growth of ocular axis between the two groups(F=2.73, 2.83, P < 0.05). Conclusion Orthokeratology lens and multifocal soft lens are both safe and effective measures to control myopia. -
Key words:
- Contact lenses /
- Myopia /
- Controlled clinical trial /
- Analysis of variance /
- Child /
- Adolescent
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 硬镜组与软镜组戴镜前后OSDI问卷评分比较(x±s)
Table 1. Comparison of OSDI questionnaire scores before and after wearing in the hard and soft mirror groups(x±s)
组别 人数 戴镜前 戴镜1月 戴镜3月 戴镜6月 硬镜组 60 3.04±0.19 3.43±0.20 3.89±0.23 3.24±0.22 软镜组 60 3.00±0.16 3.02±0.16 3.05±0.17 3.11±0.15 t值 0.36 2.86 7.29 6.85 P值 0.55 0.09 0.01 0.01 
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表 2 硬镜组与软镜组戴镜前后BUT比较(x±s，s)
Table 2. Comparison of BUT changes before and after wearing in the hard and soft mirror groups(x±s, s)
组别 眼数 戴镜前 戴镜1月 戴镜2月 戴镜3月 戴镜6月 硬镜组 120 10.56±1.21 7.47±1.92 7.30±1.16 7.41±1.14 7.40±1.14 软镜组 120 10.45±1.21 10.33±1.17 10.30±1.14 10.30±1.14 10.30±1.14 t值 0.66 0.39 4.35 7.58 7.93 P值 0.42 0.53 0.04 0.01 0.01
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表 3 硬镜组与软镜组戴镜前后SIT与CFS评分比较[M(P25, P75)]
Table 3. Comparison of lipid and corneal staining scores between the before and after wearing the hard and soft mirror groups[M(P25, P75)]
组别 眼数 睑板腺脂质 角膜染色 戴镜前 戴镜1月 戴镜3月 戴镜6月 戴镜12月 戴镜前 戴镜1月 戴镜3月 戴镜6月 戴镜12月 硬镜组 120 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 0) 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 1) 软镜组 120 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 1) 0(0, 1)
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表 4 硬镜组与软镜组患者治疗前后等效球镜度与眼轴长度情况(x±s)
Table 4. The changes of diopter before and after wearing glasses in the two groups(x±s)
组别 眼数 等效球镜度/D 眼轴长度/mm 治疗前 戴镜6月 戴镜12月 戴镜18月 治疗前 戴镜6月 戴镜12月 戴镜18月 硬镜组 120 -2.85±1.04 -2.87±1.04 -3.15±0.98 -3.38±1.20 23.68±0.60 23.71±0.60 23.79±0.61 24.30±0.71 软镜组 120 -6.37±1.35 -6.51±1.27 -6.67±1.29 -6.71±1.41 24.18±0.80 24.21±0.69 24.27±0.71 24.89±0.62
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