目的：探讨与常规后光学区直径(6mm-BOZD)相比，减小后光学区直径(5mm-BOZD)角膜塑形镜在青少年近视矫治过程中的有效性及安全性。

方法：采用前瞻性随机对照试验。选取2016-04/2019-01就诊的青少年近视患者100例100眼(均取右眼数据)，球镜度为-1.00～-5.00D，随机分为两组：试验组患者配戴5mm-BOZD角膜塑形镜，对照组患者配戴6mm-BOZD角膜塑形镜。比较两组患者治疗1a期间的眼轴长度(AL)、等效球镜度(SE)、相对周边屈光度(RPR)、最佳矫正视力(BCVA)、裸眼近视力(NVA)、应用Efron分级记录眼前节情况、角膜滞后量(CH)、角膜阻力因子(CRF)、角膜补偿眼压(IOPcc)、平均非侵入性泪膜破裂时间(NIKBUTav)及高阶像差(RMS_h)。

结果：治疗1a后，试验组患者的AL增加0.05±0.05mm，对照组增加0.15±0.05mm(t=-8.949，P<0.001)； 试验组患者SE增加-0.18±0.27D，对照组增加-0.42±0.35D(t=3.609，P=0.001)； 两组患者在N30°、N20°、T30°位点RPR的变化均有差异(均P<0.05)。两组患者BCVA、NVA、Efron分级、CH、CRF、IOPcc、NIKBUTav、RMS_h比较均无差异(均P>0.05)。

结论：减小后光学区直径角膜塑形镜在观察期内能安全并更有效地矫治青少年近视。

METHODS: A prospective randomized controlled trial was performed. There were 100 cases with 100 eyes of adolescent myopia(all right eye data were taken)selected from April 2016 to January 2019, the spherical degree was -1.00--5.00D. Then they were randomly divided into the two groups. The experimental group wore 5mm-BOZD orthokeratology, and the control group wore 6mm-BOZD orthokeratology. Their axis length(AL), spherical equivalent(SE), relative peripheral refraction(RPR), best corrected visual acuity(BCVA), uncorrected near visual acuity(NVA), Efron grading was applied to record the anterior segment of the eyes, corneal hysteresis(CH), corneal resistance factor(CRF), corneal-compensated intraocular pressure(IOPcc), average noninvasive Keratograph tear breakup time(NIKBUTav)and higher order aberration(RMS_h) were compared between the two groups during the 1a treatment period.

RESULTS: After 1a of treatment, the AL in experimental group increased 0.05±0.05mm,while it increased 0.15±0.05mm(t=-8.949, P<0.001)in control group. The SE in experimental group increased -0.18±0.27D,while it increased-0.42±0.35D(t=3.609, P=0.001)in control group. There were statistical differences in RPR changes at N30°, N20° and T30°sites between the two groups(P<0.05). There were no statistical differences in BCVA,NVA,Efron grade,CH,CRF,IOPcc,NIKBUTav and RMS_h between the two groups(P>0.05).

CONCLUSION:Reducing back optic zone diameter orthokeratology can correct adolescent myopia safely and more effectively during the observation period.