目的:观察低中度近视儿童戴角膜塑形镜后眼球生物学参数的变化。方法:收集2018年1月至2019年6月在上海交通大学医学院附属瑞金医院眼科就诊的8~12岁低中度近视儿童80例,将其随机均分为2组,分别给予角膜塑形镜（角膜塑形镜组）和框架眼镜（框架眼镜组）矫正近视。分别于矫正前（基线）、矫正6个月时和矫正12个月时采用光学相干生物测量仪测量2组儿童的眼轴长度（axial length, AL）、中央角膜厚度（central corneal thickness, CCT）、前房深度（anterior chamber depth, ACD）和晶状体厚度（lens thickness, LT）,采用独立样本t检验分析2组间各时点眼球生物学参数的差异。本研究同时随访角膜塑形镜组儿童戴角膜塑形镜后的不良反应发生情况。结果:角膜塑形镜组（40例）和框架眼镜组（40例）间基线AL、CCT、ACD、LT差异无统计学意义。与基线相比,角膜塑形镜组和框架眼镜组戴镜6个月时的AL变化量分别为（0.08±0.08） mm和（0.16±0.13） mm （t=-4.859,P<0.001）,12个月时分别为（0.18±0.11） mm 和（0.35±0.14） mm （t=-3.723,P<0.001）。与基线相比,角膜塑形镜组戴镜6个月时,CCT、ACD及LT的变化量分别为-4.65 μm、-0.02 mm及+0.02 mm,与框架眼镜组相比,差异有统计学意义（t=-6.205,P<0.001;t=-3.699,P<0.001;t=3.133,P<0.001）;角膜塑形镜组儿童戴镜12个月时,CCT、ACD及LT的变化量分别为-5.03 μm、-0.01 mm及+0.04 mm,与框架眼镜组相比,差异具有统计学意义（t=-9.456,P<0.001;t=-3.171,P<0.001;t=4.125,P<0.001）。随访显示,角膜塑形镜组中有3例儿童出现轻微角膜上皮点状脱落（荧光素染色阳性）,发生率为7.5%（3/40）。结论:角膜塑形镜可有效减缓低中度近视儿童的AL增长速度,戴镜后患儿的CCT减小,ACD减小,LT增加;戴角膜塑形镜的患儿应注意随访不良反应发生情况。

Objective: To observe the changes of ocular biometric parameters in childrenwith low to moderate myopia after wearing orthokeratology lenses. Methods: A total of 80 children with low to moderate myopia at the Ophthalmology Department of Ruijin Hospital were enrolled. Children were randomly divided into 2 groups: orthokeratology lens group (n=40) and spectacles (n=40) group. Axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), and lens thickness (LT) of children in the 2 groups were measured by Lenstar 900 at baseline, 6 months and 12 months after wearing orthokeratology lenses or spectacles, and differences in data between the 2 groups were analyzed with independent t tests. Results: There were no statistically significant differences in AL, CCT, ACD, and LT between the 2 groups at baseline. The incremental AL in the orthokeratology group was lower than that in the spectacles group at both 6 months [(0.08±0.08) mm vs (0.16±0.13) mm, t=-4.859, P<0.001] and 12 months [(0.18±0.11) mm vs (0.35±0.14) mm, t=-3.723, P<0.001). For children in the orthokeratology group, after six monthsof lens wearing, the CCT and ACD decreased by 4.65 μm and 0.02 mm (t=-6.205, P<0.001; t=-3.699, P<0.001), respectively, while LT increased by 0.02 mm (t=3.133, P<0.001), which were significantly different from those of spectacles group. After twelve months of lens wearing, the CCT and ACD decreased by 5.03 μm and 0.01 mm (t=-9.456, P<0.001; t=-3.171, P<0.001), respectively, and the LT increased by 0.04 mm (t=4.125, P<0.001), which were significantly different from those of spectacles group. During the follow-up, slight punctate exfoliation of corneal epithelium occurred in 3 children in orthokeratology lens group,with an incidence of 7.5%. Conclusions: Orthokeratology wearing could slow down axial elongation in children with low to moderate myopia, decrease CCT and ACD, and increase LT. For children wearing lens, adverse effects of punctate exfoliation of corneal epithelium should be paid attention to.