角膜塑形镜配戴不同时长对青少年近视影响的Meta分析
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Meta-analysis of the effects of different lengths of orthokeratology on myopia in adolescents
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    摘要:

    目的:系统评价角膜塑形镜配戴不同时长对青少年近视患者的角膜曲率、屈光度、裸眼视力及眼轴的影响。增加青少年近视患者对配戴角膜塑形镜的认识及对配戴时长的合理把握,为广大青少年近视患者提供相应的戴镜指导。

    方法:计算机检索 PubMed、CBM、WanFang Data、VIP和 CNKI等数据库,检索角膜塑形镜对控制青少年近视进展的相关文献,检索时限均为建库至2019-04。经过两名本课题参与的研究人员独立进行文献的筛选和相关数据资料的提取及方法学质量评价之后,使用RevMan软件(Ver5.3)进行Meta分析。

    结果:最后本课题共纳入了8个相关的研究,包含了1 136例患有近视的青少年。Meta分析结果显示:在戴镜后1wk角膜曲率变化无统计学意义\〖1wk:MD=0.91,95%CI(-0.01~1.83),P=0.05\〗。但戴镜后1、3、6、12mo时,角膜曲率有一定程度降低\〖1mo:MD=0.82,95%CI(0.12~1.53),P=0.02; 3mo:MD=1.31,95%CI(0.63~2.00),P<0.05; 6mo:MD=1.35,95%CI(0.62~2.09),P<0.05; 12mo: MD=1.41,95%CI(0.68~2.14),P<0.05\〗。戴镜后12mo,屈光度增长得到有效控制\〖12mo:MD=2.61,95%CI(1.52~3.71),P<0.05\〗。裸眼视力也得到了提高\〖12mo:MD=-0.81,95% CI(-0.84~-0.79),P<0.05\〗。在戴镜12mo后,眼轴增长无统计学意义\〖12mo: MD=-0.06,95% CI(-0.21~0.09),P=0.44\〗。

    结论:角膜塑形镜不仅能够降低角膜的曲率,还可以控制眼轴的增长,然而,这些结果都是长期才会发生。

    Abstract:

    AIM: To systematically evaluate changes in dioptre, keratometry results, uncorrected visual acuity, and ocular axis in teenage patients with myopia using orthokeratology lens for different durations. To understand and determine the duration for using orthokeratology lens more accurately in these patients and to provide correct and reliable treatment guidance for these patients.

    METHODS: Computerised search was conducted to retrieve studies from PubMed, CBM, WanFang Data, VIP, and CNKI databases, from the establishment of the databases to April 2019. The search yieldedrelevant studies on the use of orthokeratology to control the development of myopia in teenage patients. After two researchers independently conducted literature screening, data extraction, and methodological quality evaluation, a Meta-analysis was performed using RevMan 5.3 software.

    RESULTS: Finally, 8 relevant studies were selected, which included 1 136 teenage patients with myopia. The Meta-analysis revealed that after wearing orthokeratology lens for 1wk, keratometry results changed without statistical significance \〖1wk: MD=0.91, 95% CI(-0.01-1.83), P=0.05\〗. However, after using orthokeratology lens for 1, 3, 6, and 12mo, keratometry results decreased \〖1mo: MD=0.82, 95% CI(0.12-1.53), P=0.02; 3mo: MD=1.31, 95% CI(0.63-2.00), P<0.05; 6mo: MD=1.35, 95% CI(0.62-2.09), P<0.05; 12mo: MD=1.41, 95% CI(0.68-2.41), P<0.05\〗. Further, after 12mo of using orthokeratology lens, the increase in dioptre was effectively controlled \〖12mo: MD=2.61, 95% CI(1.52-3.71), P<0.05\〗, and the uncorrected visual acuity improved \〖12mo: MD=-0.81, 95% CI(-0.84--0.79), P<0.05). The ocular axis did not show a statistically significant increase \〖12mo: MD=-0.06, 95% CI(-0.21-0.09), P=0.44\〗.

    CONCLUSION: The use of orthokeratology lens cannot only reducekeratometry values, but also control the growth of the ocular axis. However, these results can be achieved only after long-term wear.

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刘莎,董竟,王彬.角膜塑形镜配戴不同时长对青少年近视影响的Meta分析.国际眼科杂志, 2019,19(11):1901-1907.

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  • 收稿日期:2019-05-29
  • 最后修改日期:2019-09-27
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  • 在线发布日期: 2019-10-23
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