目的：比较多区正向离焦(DIMS)设计镜片和高非球面微透镜(HAL)设计镜片延缓青少年近视进展的效果。

方法：本研究为临床随机对照研究，从我院2021-01-01/2023-06-30验配DIMS镜片患者中随机选取(随机数表法，下同)154例为DIMS组，从验配HAL镜片患者中随机选取147例为HAL组。两组患者均每晚一次联合使用0.01%阿托品滴眼液控制近视，所有患者每天配戴眼镜均在12 h以上。记录快速散瞳后等效球镜度(SE)和眼轴长度(AL)，两组人员均取右眼数据，比较两组配镜后12 mo的结果。

结果：多元线性回归分析发现，基线年龄与SE、AL变化值显著相关(均P<0.01)。DIMS组和HAL组戴镜12 mo SE变化值分别为-0.41±0.18、-0.34±0.13 D(P<0.001)； DIMS组和HAL组AL变化值分别为0.31±0.08、0.27±0.06 mm(P<0.001)。将患者分为7-9岁和10-12岁，7-9岁组配戴DIMS镜片12 mo后SE变化值(t=2.250，P=0.025)和AL变化值(t=3.120，P=0.002)均比配戴HAL镜片大，10-12岁组中同样如此(t=5.931、5.033，均P<0.001)。

结论：在联合使用0.01%阿托品滴眼液情况下，配戴HAL镜片控制青少年近视屈光度和AL效果比DIMS镜片更好。

METHODS: Clinical randomized controlled study. Totally 301 students aged 7-12 who underwent optometry in our hospital from January 2021 to June 2023 were randomly divided into two groups. The first group consisted of 154 patients who were fitted with DIMS lenses(DIMS group). In the second group, 147 cases were fitted with HAL(HAL group). Both groups used 0.01% atropine eye drops to control myopia and all students wore glasses for more than 12 h every day. The spherical equivalent(SE)and axial length(AL)after rapid mydriasis were recorded. The data of the right eyes were taken, and the results after fitting for 12 mo were compared between the two groups.

RESULTS: Multiple linear regression analysis showed that baseline age was significantly correlated with the changes of SE and AL(all P<0.01). After controlling baseline variables, the adjusted changes in SE for 12 mo after wearing glasses in the DIMS group and HAL group were -0.41±0.18 and -0.34±0.13 D, respectively(P<0.001); the changes of AL in the DIMS group and HAL group were 0.31±0.08 and 0.27±0.06 mm, respectively(P<0.001). Patients were divided into younger group(7-9 years old)and older group(10-12 years old). The changes in SE(t=2.250, P=0.025)and AL(t=3.120, P=0.002)of the younger group who wearing DIMS lens were greater than those with HAL after 12 mo, and the same was true in the older group(t=5.931, 5.033, both P<0.001).

CONCLUSION: Under the condition of combined use of 0.01% atropine eye drops, HAL is more effective than DIMS lens in controlling myopia diopter and AL of adolescents.