青少年近视眼配戴RGPCL、Ortho-K及框架眼镜一年后调节滞后的差异

Objective To discuss the differences in accommodative lag between pre-adolescent myopes who wore rigid gas permeable contact lenses (RGPCL), orthokeratology (Ortho-K) lenses or spectacles for a year. Methods Seventy pre-adolescent myopes aged 9 to 14 years were enrolled in the study. Every subject was measured for refraction with MPMVA, corneal curvature radius and corneal topography. Twenty-five subjects were selected to wear FIGPCL, 25 subjects were chosen to wear Ortho-K lenses and the other 20 subjects wore spectacles. According to the above measurements and the compliance of children and their parents. Regular after-care visits were made at 3-month intervals. Accommodative response (AR) was measured with an open field infrared autorefractor (WAM-5500) in accommodative stimulus (AS) level of 2~5 D after one year. Accommodative lag and the AR/AS slope were calculated by statistical methods. Results Fifty-seven subjects completed the experiment. The results demonstrate no significant difference in accommodative lag between RGPCL, Ortho-K lens and spectacle wearers for the 2 D AS level (P＞0.05), while for the 3 D, 4 D and 5 D AS levels, there were significant differences in accommodative lag among the three groups(F=4.373, P＜0.05; F=5.833, P＜0.01; F=6.157, P＜0.01), the smallest for Ortho-K, then RGPCL. The AR/AS slope demonstrated the same trend with accommodative lag, but the differences were not significant (P＞0.05). Conclusion Compared to spectacles, there is an obvious decrease in accommodative lag in pre-adolescent myopes one year after wearing RGPCL and Ortho-K lenses, which strongly suggests that RGPCL and Ortho-K lenses can control the development of myopia in pre-adolescents.