目的：探讨不同屈光度青少年近视患者配戴角膜塑形镜1 a的控制效果。

方法：采用前瞻性非随机对照研究。收集2022-11/2023-05在我院视光科验配角膜塑形镜的青少年近视患者120例224眼，平均年龄11.00±2.08岁，根据等效球镜度分为3组：其中-0.50--2.00 D组86眼，-2.25--4.00 D 组99眼，-4.25--6.00 D组39眼。随访1 a，观察三组患者戴镜前及戴镜1 a后裸眼视力、眼轴、角膜曲率、角膜中央厚度及角膜内皮细胞密度的变化情况。

结果：共113例212眼完成1 a随访，其中-0.50--2.00 D组82眼，-2.25--4.00 D 组95眼，-4.25--6.00 D组35眼。戴镜1 a后，三组患者角膜中央厚度、角膜内皮细胞密度较戴镜前无差异(均P>0.05)，裸眼视力较戴镜前均显著提高，角膜水平曲率(平K值)及角膜垂直曲率(陡K值)均明显变平坦(均P<0.01)。戴镜1 a后三组患者眼轴增长量分别为0.21±0.26、0.13±0.21和0.09±0.10 mm(P<0.05)，-0.50--2.00 D组与-2.25--4.00 D组、-4.25--6.00 D组比较均有差异(P=0.028、0.010)，-2.25--4.00 D组与-4.25--6.00 D组比较无差异(P=0.344)。

结论：青少年近视患者配戴角膜塑形镜安全有效，能预防眼轴非良性增长、有效延缓近视发展，尤其对-2.0 D以上近视患者的眼轴控制更好，近视控制效果更佳。

METHODS: Prospective non-randomized controlled study. A total of 120 adolescent myopic patients(224 eyes), with an average age of 11.00±2.08 years old, who were fitted with orthokeratology lenses in the optometry department of our hospital from November 2022 to May 2023 were collected. There were 3 groups according to the spherical equivalent, including 86 eyes in the group of -0.50--2.00 D, 99 eyes in the group -2.25--4.00 D, and 39 eyes in group -4.25--6.00 D. Patients were followed up for 1 a to observe the changes of uncorrected visual acuity, axial length, corneal curvature, corneal central thickness and corneal endothelial cells density in the three groups after wearing lens for 1 a.

RESULTS:A total of 113 cases(212 eyes)were followed up for 1 a, including 82 eyes in the group of -0.50--2.00 D, 95 eyes in the group of -2.25--4.00 D, and 35 eyes in the group of -4.25--6.00 D. There was no statistical difference in corneal central thickness and corneal endothelial cell density among the three groups of patients after wearing lens for 1 a(all P>0.05). Uncorrected visual acuity was significantly improved, and flat kerotometry(FK)and steep kerotometry(SK)were significantly flatter(both P<0.01). Furthermore, the growth of axial length in the three groups of patients after wearing lens for 1 a was 0.21±0.26, 0.13±0.21 and 0.09±0.10 mm, respectively(P<0.05). There were differences between the -0.50--2.00 D group and the -2.25--4.00 D group and -4.25--6.00 D group(P=0.028, 0.010), and there were no differences between the -2.25--4.00 D group and the -4.25--6.00 D group(P=0.344).

CONCLUSION:It is safe and effective for young myopia patients to wear orthokeratology lenses, which can prevent the non-benign growth of the axial length and effectively delay the development of myopia, and the myopia control effect is better especially for myopia patients of above -2.0 D.