| Objectives:To observe the changes of ocular biological parameters in children and adolescents with myopia before and after wearing orthokeratology,analyze their myopia control effects,and explore the relationship between myopia control effects and changes in visual function.Methods:In a cohort study,60 children and adolescents with myopia diagnosed in outpatient clinics from August 2021 to February 2023 were selected and divided into31 cases in the Ortho-k group,who were fitted with orthokeratology(Ortho-k),29 cases in the SVSLs group,who were fitted with single vision spectacle(SVSLs).All children with myopia had their eye position,spherical equivalent(SE),intraocular pressure(IOP),axial length(AL),anterior chamber depth(ACD),distance corrected visual acuity(DCVA),near corrected visual acuity(NCVA),distance and near stereoscopic function,amplitude of accommodation(AMP),Positive and negative relative accommodation(PRA、NRA),accommodative accuracy obtained before lens fitting.Additional corneal topography,corneal endothelioscopy,and corneal epithelial fluorescein staining were performed for Ortho-k group.These parameters were retested in 6th and 12 th months.The data were analyzed by SPSS 25.0,and statistical differences exist at P<0.05.Results:1.General information: 8 cases were lost in the Ortho-k group,23 cases in the complete data;9 cases were lost in the SVSLs group,20 cases in the complete data.In the Ortho-k group,the SE progression decreased significantly in the 6th and 12 th months compared with the SVSLs group,the difference was statistically significant(P<0.05),the axial growth was slower than the SVSLs group in the 6th and 12 th months,the difference was statistically significant(P<0.05);wearing Ortho-k had no significant effect on IOP,ACD,and corneal endothelial cell density in 6th and 12 th months,the difference was not statistically significant compared with baseline(P>0.05),but had a significant effect on corneal curvature,the difference was statistically significant compared with baseline(P<0.05),and it stabilized after 6th months,the difference between 6th with 12 th was not statistically significant(P>0.05),the values of baseline corneal curvature and axial elongation in the Ortho-k group were negatively correlated(P<0.05).2.DCVA 、 NCVA: The trend of DCVA over time varied depending on the correction method,in which the DCVA in the Ortho-k group increased in 6th and 12 th months after wearing the lenses compared with the baseline value,but decreased in12 th months compared with 6th months,the differences were statistically significant(P<0.05);while the DCVA in the SVSLs group gradually decreased in 6th and 12 th months compared with the baseline value,and the differences were statistically significant(P<0.05).In addition,the NCVA of both groups was within the normal range before and after wearing the lenses,and the difference was not statistically significant(P>0.05).3.Stereopsis function: The near stereo acuity values in both groups showed an decreasing trend with correction time,with a statistically significant decrease in the first 6 months(P<0.05)and no statistically significant decrease in the second 6months(P>0.05);the effect of wearing different glasses on this trend was not statistically different(P>0.05).No significant strabismus was found during the follow-up of the review in both groups,and the range of binocular fusion and distance stereopsis was within the normal value before and after wearing glasses,the difference was not statistically significant(P>0.05).4.Accommodative function(AF):Wearing Ortho-k significantly decreased accommodative lag(Lag),and there was a statistically significant difference compared with wearing SVSLs(P<0.05),except for Lag,the difference between the remaining AF was not significant(P>0.05);NRA and Lag in the SVSLs group did not change significantly before and after wearing the lenses(P>0.05),the rest of AF were significantly changed with correction time(P<0.05),and the increase in the first 6months(PRA,Lag show decrease)was statistically significant(P<0.05),the increase in the second 6 months(PRA,Lag show decrease)was not statistically significant(P>0.05);the trend over time for AF other than AMP varies depending on the correction method(P<0.05).Conclusions:1.Children and adolescents with myopia wearing Ortho-k had flattened corneal physiological curvature and corrected myopia,SE and AL increase slower than the SVSLs group,with high safety,greater baseline corneal curvature is associated with better myopia prevention and control.2.Wearing Ortho-k improved myopic children and adolescents’ distance corrected visual acuity,near stereopsis function,and accommodative function,with the improvement of distance corrected visual acuity and accommodative lag being better than those wearing SVSLs. |
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