目的：对比观察不同程度屈光参差单眼近视儿童配戴角膜塑形镜1a的双眼近视进展情况。

方法：回顾性病例对照研究。收集2018-06/2019-06于西安市第一医院就诊并验配角膜塑形镜的8～12岁的单眼近视屈光参差患者60例，双眼等效球镜(SE)差值≥2.5D为高度屈光参差组30例，1.0D≤双眼SE差值<2.5D为低度屈光参差组30例。比较两组患者戴镜6mo，1a的双眼眼轴长度(AL)和非戴镜眼SE变化情况。

结果：随访6mo，1a时，高度屈光参差组戴镜眼眼轴增长均少于低度屈光参差组(P<0.001)，非戴镜眼眼轴增长量和SE增长均大于低度屈光参差组(均P<0.001)，且高度屈光参差组双眼眼轴差缩短幅度均大于低度屈光参差组(P<0.05)。相关性分析显示戴镜前屈光参差度和双眼眼轴差缩短量具有相关性(F=0.293、0.458，均P<0.001)。

结论：单眼近视屈光参差儿童在配戴角膜塑形镜后，高度屈光参差者较低度屈光参差者戴镜眼眼轴增长更慢，而非戴镜眼眼轴和等效球镜度进展更快。配戴角膜塑形镜可有效缩小屈光参差，且戴镜前屈光参差程度越大，双眼轴差缩小越多。

METHODS:Retrospective case-control study. The data of 60 unilateral myopic anisometropia children, 8-12-year-old patients who fitted with orthokeratology lens in Xi'an No.1 Hospital from June 2018 to June 2019 were collected. The binocular spherical equivalent(SE)difference ≥2.5D was found in 30 cases in the high anisometropia group, and 1.0D≤ binocular SE difference <2.5D was found in 30 cases of the low anisometropia group. The patients in the two groups were observed and compared after wearing lens for 6mo and 1a of the changes of binocular axial length(AL)and SE without-lens eyes.

RESULTS: At the follow-up at 6mo and 1a, the growth of AL in the high anisometropia group with orthokeratology lens was less than that in the low anisometropia group(P<0.001). The amount of growth of AL without-lens eyes and the growth of SE were greater than that in the low anisometropia group(all P<0.001), and the shortening range of the binocular AL in the high anisometropia group was greater than that in the low-degree anisometropia group(P<0.05). The correlation analysis showed that the anisometropia and the shortening of axial difference were correlated(F=0.293, 0.458, all P<0.001).

CONCLUSION: In anisometropia children with unilateral myopia, after wearing the orthokeratology lens, the progression in high anisometropia group was slower than low anisometropia after wearing the orthokeratology lens, but the progression of AL without-lens eyes and SE was faster than low anisometropia. Wearing orthokeratology lens can effectively reduce anisometropia, and the greater degree of the anisometropia the more binocular axial difference was narrowed, the more binocular axial difference was narrowed.