两种特殊光学设计框架眼镜对近视前期儿童近视控制效果的比较研究OA
Comparing the effectiveness of two types of optical defocus spectacle lens designs in controlling myopia among pre-myopic children:a retrospective study
目的:比较多区正向光学离焦(defocus incorporated multiple segments,DIMS)与非球面微透镜(highly aspherical lenslets,HAL)镜片对近视前期儿童眼轴增长、屈光度进展及近视发生率的控制效果.方法:采用回顾性研究设计,纳入 2021 年 3 月—2025 年 5 月在深圳希玛林顺潮眼科医院佩戴 DIMS 或 HAL镜片至少 12 个月的近视前期儿童(6～14 岁)60 例(60 眼),按镜片类型分为 DIMS 组(n=30)和 HAL 组(n=30).收集并比较两组基线资料、眼轴年变化量、屈光度年变化量及终点近视发生率.组间比较采用 t 检验、秩和检验或 χ2 检验;并采用多元线性回归控制混杂因素,辅以事后效能分析评估结果稳健性.结果:两组基线年龄、性别、眼轴及等效球镜度比较差异均无统计学意义(P>0.05).随访后,HAL 组眼轴年增长量(0.13±0.19)mm/年低于 DIMS 组(0.24±0.14)mm/年,P=0.012;多元回归分析显示,在控制混杂因素后,镜片类型仍是眼轴变化的独立预测因子(B=-0.111,P=0.016).HAL 组近视发生率(43.3%)低于 DIMS 组(70.0%,P=0.037).HAL 组中有 4 例(13.3%)出现眼轴缩短,3 例(10.0%)出现屈光回退,DIMS 组无此现象.两组屈光度年变化量差异有统计学意义(P=0.128).结论:在近视前期儿童中,HAL 镜片较 DIMS 镜片能更有效延缓眼轴增长、降低近视发生率,部分患儿可出现眼轴缩短和屈光回退,提示 HAL 镜片或为近视前期儿童更具前景的光学干预选择.
Objective:To evaluate and compare the effectiveness of Defocus Incorporated Multiple Segments(DIMS)lenses and Highly Aspherical Lenslets(HAL)lenses in controlling axial growth,refractive error progression,and the onset of myopia in pre-myopic children.Methods:This retrospective study included 60 pre-myopic children(60 eyes),aged between 6 and 14 years,who wore either DIMS or HAL lenses for a minimum of 12 months from March 2021 to May 2025.Based on the type of lenses they wore,the participants were split into two groups:the DIMS group(n=30)and the HAL group(n=30).We compared baseline characteristics,annual axial growth,annual change in refractive error,and the incidence of myopia at the end of follow-up period between the two groups.Appropriate statistical analyses were carried out,including independent-sample t-test,Mann-Whitney U test,or chi-square test.Multiple linear regression was used to account for potential confounding factors,and a post-hoc power analysis was performed to assess the reliability of the results.Results:There were no notable differences in baseline age,gender,axial length,or spherical equivalent refraction between the two groups(all P>0.05).After the follow-up,the HAL group showed significantly less annual axial growth(0.13±0.19 mm/year)compared to the DIMS group(0.24±0.14 mm/year,P=0.012).Multiple linear regression analysis revealed that,even after adjusting for confounding factors,the type of lens remained a significant independent predictor influencing annual axial growth(B=-0.111,P=0.016).The incidence of myopia was also markedly lower in the HAL group(43.3%)than in the DIMS group(70.0%,P=0.037).In the HAL group,4 eyes(13.3%)showed axial shortening and 3 eyes(10.0%)exhibited refractive regression,while no such changes were observed in the DIMS group.There was no significant difference in the annual change in refractive error between the two groups(P=0.128).Conclusions:Among pre-myopic children,HAL lenses proved to be more effective than DIMS lenses in slowing axial length growth and reducing the incidence of myopia.Some patients in the HAL group even experienced axial shortening and refractive regression,indicating that HAL lenses hold promise as a more effective optical intervention for pre-myopia.
陈丽珍;孙丽
南方医科大学附属珠江医院,广州 510280||广州希玛林顺潮眼科医院,广州 510060||深圳希玛林顺潮眼科医院,深圳 518000南方医科大学附属珠江医院,广州 510280||广州希玛林顺潮眼科医院,广州 510060
医药卫生
近视前期近视控制多区正向光学离焦非球面微透镜儿童
pre-myopiamyopia controldefocus incorporated multiple segmentshighly aspherical lensletschildren
《眼科学报》 2026 (7)
555-567,13
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