角膜塑形镜和低浓度阿托品在儿童近视控制中的作用

高守铭　　马姝婷　　李丽霞　　毛延焰

[摘要] 目的 探討角膜塑形镜和低浓度阿托品在儿童近视控制中的作用。 方法 选取2018年1月至2019年5月我院就诊的140例近视儿童为研究对象，采用随机数字表法将其分为试验组和对照组，每组各70例。对照组给予角膜塑形镜配戴干预，试验组给予角膜塑形镜配戴和低浓度阿托品干预，比较两组治疗前后屈光度及眼轴长度的变化情况，比较两组LLT、OSI、BUT指标情况及不良反应总发生率，比较两组角膜内皮计数、IOP。 结果 治疗后试验组眼轴长度变化差值为（0.12±0.02）mm、屈光度变化差值为（0.04±0.01）D，明显低于对照组的（0.67±0.12）mm、（1.06±0.13）D，差异有统计学意义（P<0.05）;治疗后试验组的LLT为（62.11±4.72）mm、BUT为（6.15±2.05）s，明显长于对照组的（56.84±5.35）mm、（5.31±1.25）s，OSI为（1.27±0.33）低于对照组的（1.94±0.31），差异有统计学意义（P<0.05）;治疗后试验组与对照组不良反应总发生率比较（18.6% vs. 20.0%），差异无统计学意义（P>0.05）;治疗后试验组与对照组角膜内皮计数、IOP比较，差异无统计学意义（P>0.05）。 结论 角膜塑形镜联合低浓度阿托品治疗效果较为理想，值得临床应用。

[关键词] 角膜塑形镜;低浓度阿托品;儿童;近视

[中图分类号] R778.11          [文献标识码] B          [文章编号] 1673-9701（2021）12-0087-04

The role of orthokeratology and low-concentration atropine in the control of myopia in children

GAO Shouming   MA Shuting   LI Lixia   MAO Yanyan

Department of Ophthalmology， Fuzhou Children′s Hospital of Fujian Medical University， Fuzhou Children′s Hospital of Fujian Province， Fuzhou 350001， China

[Abstract] Objective To explore the effect of orthokeratology and low-concentration atropine in the control of myopia in children. Methods A total of 140 myopic children who were treated in our hospital from January 2018 to May 2019 were selected as the research objects. They were divided into the experimental group and the control group by a random number table，with 70 cases in each group. The control group was given the intervention of orthokeratology lens wearing，and the experimental group was given the intervention of orthokeratology lens wearing and low-concentration atropine. The changes in refractive power and axial length of the two groups before and after treatment were compared. The LLT， OSI， BUT， the total incidence of adverse reactions， and the corneal endothelium count and IOP bwtween the two groups were compared. Results After treatment，the difference in axial length change （0.12±0.02） mm and the difference in refractive power （0.04±0.01） D in the experimental group were lower than those of （[0.67±0.12] mm， [1.06±0.13] D） in the control group，with significant difference（P<0.05）. After treatment， the LLT was（62.11±4.72） mm and BUT was（6.15±2.05） s in the experimental group，which were longer than those of （[56.84±5.35] mm， [5.31±1.25]s） in the control group. OSI was （1.27±0.33） in the experimental group was lower than that of （1.94±0.31） in the control group， with significant difference （P<0.05）. After treatment， there was no significant difference in the adverse reaction rate between the experimental group （18.6%） and the control group （20.0%）（P>0.05）. After treatment， there was no significant difference in the corneal endothelium count and IOP between the experimental group and the control group（P>0.05）. Conclusion Orthokeratology combined with low-concentration atropine has a better therapeutic effect and is worthy of clinical application.

[Key words] Orthokeratology; Low-concentration atropine; Children; Myopia

近视的发生是由于眼轴过长，当处于调节放松状态时，平行光线进入眼球的屈光系统后在视网膜前聚焦，导致所看到的物像模糊不清[1]。目前我国青少年的近视发生率首居世界第一，临床中尚无治疗儿童近视的确切方法，因此如何有效控制近视的发展成为临床关注的热点。常规的框架眼镜是常用矫正近视的方法，但其不具有控制近视发展的作用[2]。角膜塑形镜是一种特殊设计的硬性透气性隐形眼镜，目前认为能有效控制眼轴的增长，进而起到控制近视发展的作用。低浓度阿托品对近视具有……