摘要目的:比较近视儿童佩戴离焦框架眼镜和角膜塑形(OK)镜的有效性和安全性。方法:前瞻性队列研究。纳入2023年1月至2023年6月于奉节爱尔眼科医院白内障科就诊的近视儿童186例，基于不同矫正方式分为离焦框架眼镜组80例(160眼)与OK镜组106例(212眼)。随访12个月，对比观察两组眼轴长度(AL)及等效球镜度数(SE)变化情况、中小学生视力相关生存质量问卷评分和不良反应发生情况。结果:两组基线AL、SE及生存质量评分差异无统计学意义(均 P>0.05)。戴镜12个月后，OK镜组AL增长量(0.14±0.07)mm低于离焦框架眼镜组(0.21±0.05)mm( t＝7.598, P<0.001)；SE进展幅度OK镜组(0.18±0.04)D亦低于离焦框架眼镜组(0.33±0.05)D( t＝22.725, P<0.001)。在生存质量问卷评分方面，OK镜组戴镜后各维度评分均更优：生理功能[(10.24±2.52)比(11.45±2.98)分， t＝2.996, P＝0.003]、社会活动能力[(3.63±1.47)比(5.42±1.52)分， t＝8.103, P<0.001]、视功能与身体机能[(6.36±1.57)比(7.47±1.65)分， t＝4.670, P<0.001)、情感功能[(10.64±0.94)比(12.53±1.75)分， t＝9.962, P<0.001]。不良反应发生率OK镜组(5.66%, 6/106)显著低于离焦框架眼镜组(15.00%, 12/80)( χ2＝4.550, P＝0.033)。 结论:佩戴OK镜对近视儿童AL增长及SE的控制效果显著优于离焦框架眼镜，安全性更好。

abstractsObjective:To compare the effectiveness and safety of defocus frame glasses versus orthokeratology (OK) lenses in myopic children.Methods:This was a prospective cohort study. A total of 186 myopic children who visited the Cataract Department of Fengjie Aier Eye Hospital between Jan. and Jun. 2023 were included. Based on different correction methods, they were divided into two groups: the defocus frame glasses group (80 children, 160 eyes) and the OK lens group (106 children, 212 eyes). They were followed up for 12 months to compare changes in axial length (AL) and spherical equivalent (SE), as well as scores from the vision-related quality of life questionnaire for primary and secondary school students, and the occurrence of adverse reactions.Results:There were no statistically significant differences in baseline AL, SE, or quality of life scores between the two groups (all P>0.05). After 12 months of wearing glasses, AL growth in the OK lens group [(0.14±0.07) mm] was significantly lower than that in the defocus frame glasses group [(0.21±0.05) mm] ( t=7.598, P<0.001); SE progression in the OK lens group [(0.18±0.04) D] was also significantly lower than that in the defocus frame glasses group [(0.33±0.05) D] ( t=22.725, P<0.001). In terms of quality of life, the OK lens group showed better scores in all dimensions after wearing the lenses: physical function [(10.24±2.52) vs (11.45±2.98) scores, t=2.996, P=0.003], social activity ability [(3.63±1.47) vs (5.42±1.52) scores, t=8.103, P<0.001], vision and physical function [(6.36±1.57) vs (7.47±1.65) scores, t=4.670, P<0.001], and emotional function [(10.64±0.94) vs (12.53±1.75) scores, t=9.962, P<0.001]. The incidence of adverse reactions in the OK lens group (5.66%, 6/106) was significantly lower than that in the defocus frame glasses group (15.00%, 12/80) ( χ2=4.550, P=0.033). Conclusion:The control effect of the OK lens group is significantly better than that of the defocused frame glasses group on axial growth and equivalent spherical lens degree for myopia children, and the incidence of adverse reactions is lower and the safety is better.