多区正向光学离焦镜片控制青少年近视效果及戴镜后散光的变化OA

Objective To investigate the myopia control efficacy and changes in astigmatism following one-year wearing of defocus incorporated multiple segments(DIMS)lenses in adolescents with myopia.Methods Adolescent my-opic patients fitted with DIMS lenses in Lixiang Eye Hospital of Soochow University from January 2023 to January 2024 were randomly selected in this study.According to whether the subjects had astigmatism that needed to be corrected,they were divided into two groups:non-astigmatism group(33 patients,33 eyes),with astigmatism>-0.50 D;astigmatism group(34 patients,34 eyes),with astigmatism ranging from-2.50 D to-0.50 D.The axial length(AL),spherical equivalent refrac-tion(SER),astigmatism,flat keratometry(Kf),steep keratometry(Ks),and mean keratometry(Km)of the aforemen-tioned myopic adolescents were measured and compared before wearing glasses(baseline)and at 3 months,6 months,and 1 year after wearing glasses.Repeated measures ANOVA was used to evaluate the intra-group differences in each parameter over time,and the Bonferroni method was further used for post hoc pairwise comparison if there was statistical signifi-cance.In addition,the Bland-Altman method was used to evaluate the consistency of the above parameters with the baseline data(before wearing glasses)at 1 year follow-up.Results The Km and Ks at baseline in the astigmatism group were greater than those in the non-astigmatism group(both P<0.05).Except astigmatism,Km and Ks,there was no significant difference in the other parameters between the two groups at 3 months,6 months,and 1 year after wearing glasses(all P>0.05).At 1 year after wearing glasses,patients in the astigmatism group had smaller astigmatism but larger Km and Ks than the non-astigmatism group(all P<0.05).Pairwise comparison using the Bonferroni method revealed that there were statis-tically significant differences in AL and SER in both groups,as well as astigmatism in the non-astigmatism group,between before and after one year of wearing glasses(all P<0.008).Compared with the baseline data,the proportion of AL change≤0.2 mm at 1 year after wearing glasses was 32.54％overall,39.39％in the non-astigmatism group,and 26.74％in the astigmatism group;the proportion of AL change≤0.3 mm was 55.22％overall,60.61％in the non-astigmatism group,and 50.00％in the astigmatism group;the proportion of SER change≥-0.50 D was53.73％overall,57.58％in the non-astig-matism group,and 50.00％in the astigmatism group;the proportion of astigmatism change≥-0.50 D was95.52％overall,96.88％in the non-astigmatism group,and 97.06％in the astigmatism group.Conclusion Wearing DIMS lenses can effectively control the growth of AL and SER in myopic adolescents.The astigmatism changes after wearing DIMS lenses are statistically significant but have no clinical significance.