目的：观察不同环境下瞳孔直径与角膜塑形镜近视控制效果的关系。

方法：选取8～13岁低中度近视患者70例70眼，分别进行验光、瞳孔直径和眼轴长度测量等检查，并配戴夜戴型角膜塑形镜。在不同光线环境下，以平均瞳孔直径作为分界进行分组。测量戴镜前、戴镜6、12、24mo的眼轴长度，并分析不同环境下初始瞳孔直径与眼轴增长量的相关性。

结果：暗室环境和自然光线下，瞳孔直径小于平均值组的患者眼轴增长量均比瞳孔直径大于平均值组快，差异均有统计学意义(P<0.01)，且初始瞳孔直径与角膜塑形镜配戴24mo时眼轴增长量均呈显著负相关(r=-0.4267，P<0.05； r=-0.4925，P<0.01)。

结论：不同环境下瞳孔直径越大，角膜塑形镜近视控制效果越好，其原因可能是较大的瞳孔使角膜塑形镜对视网膜周边近视性离焦的干预作用更强。

METHODS: The optometry, pupil diameter and eye axial length were examined in 70 patients aged 8- to 13-year-old with low and moderate myopia, whom then were given night wear lenses, and we measured the length of eye axis and pupil diameter before wearing lenses, 6, 12 and 24mo after wearing. In two different light environment groups, each group took the average pupil diameter as the dividing and divided into two subgroups; the pupil diameter higher than the mean group(19 cases, 17 cases respectively), the pupil diameter lower than the mean group(16 case, 18 cases respectively). The paired t-test, independent sample t-test, repeated measures ANOVA and Pearson correlation analysis were adopted to analyze.

RESULTS: Whether in darkroom or exposed to natural light, the axial length of pupils whose diameter was lower than the mean diameter increased faster than that above the average diameter of pupils(P<0.01). The initial pupil diameter was significantly negatively correlated with the growth of the eye axis at the end of the 24-month follow-up(r=-0.4267,P<0.05; r=-0.4925,P<0.01).

CONCLUSION: The myopia controlling effect of orthokeratology under two different illumination conditions showed that the effect of myopia control in children with larger pupils is better than that in children with smaller pupils, which may be that the larger pupil makes the orthokeratology maintain stronger intervention on peripheral retina myopic defocus.