中文摘要：

目的探讨硬性透气性角膜接触镜（RGPCL）控制青少年近视合并高度散光的远期效果。设计回顾性病例系列。研究对象戴用RGPCL随诊5年的近视合并高度散光（≥-2.50 D）患者48例（69眼）,平均年龄（15.2±1.5）岁;戴用框架眼镜随诊5年的近视合并高度散光（≥-2.50 D）患者51例（102眼）,平均年龄（15.3±1.6）岁。方法两组患者配镜前后均经复方托呲卡胺散瞳验光。检查二种矫正方法组患者的矫正视力,电脑验光仪检测角膜水平曲率半径、垂直曲率半径和平均曲率半径。两组患者连续5年观察上述数据变化,并对初诊时及第5年随诊的结果进行统计分析。主要指标球镜度、柱镜度、戴镜视力、角膜水平曲率半径值、角膜垂直曲率半径值、角膜平均曲率半径值。结果第5年时,RGPCL组和框架组最佳矫正视力分别为（0.99±0.41）和（0.74±0.13）。第5年与初诊时比较,RGPCL组和框架组球镜度分别增加（0.623±1.067）D、（2.018±1.461）D,两组比较差异有统计学意义（P=0.000）;RGPCL组柱镜度减少（0.696±0.694）D,框架组柱镜度增加（0.417±0.574）D,两组比较差异有统计学意义（P=0.000）。RGPCL组戴镜5年后角膜水平曲率半径、角膜垂直曲率半径、角膜平均曲率半径平均增加量分别为（0.046±0.106）mm、（0.189±0.184）mm、（0.119±0.131）mm。结论 5年的随访结果显示,硬性透气性角膜接触镜对青少年近视合并高度散光患者的近视、散光发展有一定的控制作用。

英文摘要：

Objective To investigate the long term clinical effects of rigid gas permeable contact lens（RGPCL） control on adolescent myopia combined with high astigmatism. Design Retrospective case series. Participants 48 patients（69 eyes）, with a mean age of（15.2±1.5） years with myopia combined with high astigmatism（ ≥-2.50 D） were fitted with RGPCL and followed up for 5 years. 51 patients（102 eyes）, with a mean age of（15.3±1.6） years with myopia combined with high astigmatism（ ≥-2.50 D） were fitted with spectacles and followed up for 5 years. Methods For RGPCL group, after using tropicamide phenylephrine eye drops, the ocular refraction, corrected visual acuity and the radius of corneal curvature changes were observed for 5 years. For spectacles group, after usingtropicamide phenylephrine eye drops, the ocular refraction, corrected visual acuity were observed for 5 years. The differences of the average sphere diopter, cylinder diopter, and corrected visual acuity were compared between RGPCL group and spectacle group. Main Outcome Measures The average sphere diopter, cylinder diopter, corrected visual acuity, average horizontal radius, average vertical radius, average radius of corneal curvature. Results Corrected visual acuity was（0.99±0.41） after wearing RGPCL for 5 years. Corrected visual acuity was（0.74±0.13） after wearing spectacles for 5 years. During the 5-year follow up, the average sphere diopter increased significantly less in RGPCL group than in spectacle group（0.623±1.067 D vs. 2.018±1.461 D）（P〈0.0001）. More strikingly, the cylinder diopter decreased 0.696±0.694 D in RGPCL group, which is significantly different from spectacle group（increased 0.417±0.574 D）（P〈0.0001）. The average horizontal radius, average vertical radius, average radius of corneal curvature increased（0.046 ±0.106）mm,（0.189±0.184）mm,（0.119±0.131）mm after wearing RGPCL for 5 years. Conclusion Myopia and astigmatism progression can be controlled by wearing RGPCL.