目的：比较夜戴型角膜塑形镜与框架眼镜治疗青少年近视效果，为青少年近视治疗方法选择提供参考。

方法：前瞻性研究。选择2020-06/11在我院接受治疗的青少年近视患者106例。根据患者意愿将其分为两组：对照组53例在验光后给予常规框架眼镜治疗，观察组53例则给予夜戴型角膜塑形镜治疗。比较两组患者治疗前后裸眼视力(LogMAR)、验光指标(等效球镜度数、柱镜度数)、眼生物学参数(眼轴长度、中央角膜厚度、前房深度、晶状体厚度)。

结果：治疗1a后观察组裸眼视力(LogMAR)优于对照组(0.51±0.12 vs 0.73±0.15)，等效球镜度数(-0.23±0.05 vs -5.32±1.35D)及柱镜度数均小于对照组(-1.53±0.22 vs -1.97±0.35DC)(P<0.001)。治疗1a后两组眼轴长度较治疗前增长且治疗后对照组眼轴更长(25.53±0.84 vs 25.95±0.83mm)； 治疗后观察组晶状体厚度较治疗前增加(3.39±0.19 vs 3.31±0.15mm)(P<0.05)。治疗1a后观察组调节幅度(14.29±1.37 vs 12.90±1.07D)、调节灵敏度(11.05±2.09 vs 7.59±1.82cpm)、总角膜上皮点染率(15.1% vs 1.9%)均较对照组更高，调节滞后量较对照组更低(0.55±0.11 vs 0.97±0.30D)(P<0.05)。治疗前后两组患者角膜内皮细胞密度(3197.23±249.66 vs 3207.41±258.14cells/mm²)、角膜内皮细胞面积(309.27±28.04 vs 312.62±24.95mm²)、并发症发生率(5.7% vs 9.4%)，差异均无统计学意义(P>0.05)。

结论：夜戴型角膜塑形镜可改善青少年近视患者裸眼视力，降低等效球镜度数及柱镜度数，并可改善调节相关参数且对角膜功能无明显影响。

METHODS: A prospective study was conducted on 106 adolescent myopia patients who received treatment in our hospital from June to November 2020. According to the wishes of patients, they were divided into two groups with 53 cases in each group. The control group was given regular frame glasses after optometry, while the observation group was given night-wearing orthokeratology lenses. The uncorrected visual acuity(LogMAR), refractive index(spherical equivalent and cylindrical lens power), and ocular biological parameters(axial length, central corneal thickness, anterior chamber depth and lens thickness)were compared between the two groups.

RESULTS: The uncorrected visual acuity(LogMAR)of the observation group was lower than that of the control group at 1a after treatment(0.51±0.12 vs. 0.73±0.15), and the spherical equivalent(-0.23±0.05 vs. -5.32±1.35D)and cylindrical lens power(-1.53±0.22 vs. -1.97±0.35DC)were smaller than those of the control group(P<0.001). The axial length of the eyes in the two groups increased at 1a after treatment and the axial length in the control group was longer(25.53±0.84 vs. 25.95±0.83 mm); the lens thickness of the observation group was increased compared with that before treatment(3.39±0.19 vs. 3.31±0.15 mm; P<0.05). After 1a treatment, the accommodative amplitude(14.29±1.37 vs. 12.90±1.07D), accommodative facility(11.05±2.09 vs. 7.59±1.82cpm), and total staining rate of corneal epithelium in the observation group were higher than those in the control group(15.1% vs. 1.9%), and the accommodative lag was lower than that in the control group(0.55±0.11 vs. 0.97±0.30D; P<0.05). There were no significant differences in corneal cell density(3197.23±249.66 vs. 3207.41±258.14 cells/mm²), corneal endothelial cell area(309.27±28.04 vs. 312.62±24.95mm²)and the incidence of complications between the two groups before and after treatment(5.7% vs. 9.4%; P>0.05).

CONCLUSION: Night-wearing orthokeratology lenses can improve uncorrected visual acuity in adolescent patients with myopia, reduce the spherical equivalent and cylindrical lens power, and improve the accommodation-related parameters, but has no significant effect on the corneal function.