The Clinical Effect of Compound Multi-point Optical Defocusing Lens on Myopia Progression in Children
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摘要:
目的 观察儿童配戴复合多点光学离焦镜片对延缓近视效果。 方法 选取2022年11月至2023年3月于云南大学附属医院儿童眼科就诊近视患者,其中单焦点镜片配戴者52例为对照组,复合多点光学离焦镜片配戴者78例作为实验组。比较2组在戴镜前及戴镜后的第3、6、9、12个月,期间主要观察等效球镜度、眼轴长度的变化,对不同组间近视控制效果进行比较。 结果 2组戴镜前后等效球镜度均有不同程度的变化,对照组和实验组治疗效果差异有统计学意义(F = 13.80,P < 0.001)。自佩戴6个月起,对照组屈光度显著低于实验组(P < 0.05),且佩戴时间越长,2组之间的效果差距越大。2组戴镜前后眼轴长度也均有不同程度的变化,但对照组和实验组治疗效果差异无统计学意义(F = 0.028,P = 0.876),提示2种镜片对眼轴的影响差异无统计学意义。 结论 与单焦点镜片相比,复合多点光学离焦镜片能有效延缓儿童近视进展。 Abstract:Objective To observe the effect of the delay of myopia in children wearing composite multi-point optical defocusing lens. Methods A total of 52 cases (n = 104) of monocal lens wearers were selected as the control group, and 78 cases (n = 156) of compound multi-point optical distrocal lens wearers were selected as the experimental group. The effect of myopic control between two groups was compared before and after wearing glasses at 3, 6, 9 and 12 months, during which the changes of equivalent spherical lens and eye axis length were mainly observed. Results The equivalent spherical degree of the two groups before and after wearing glasses had different degrees of change and the treatment effect between the control group and the experimental group was statistically significant (F = 13.80, P < 0.001). After 6 months of wearing glasses, the diopter of the control group was significantly lower than that of the experimental group, and the longer the wearing time, the greater the difference between the two groups. The axial length of the eyes of the two groups also changed to different degrees before and after wearing glasses, but there was no statistical significance in the treatment effect between the control group and the experimental group (F = 0.028, P = 0.876), suggesting that there was no statistical significance in the influence of the two lenses on the axial of the eyes. Conclusion Compared with the single-focus lenses, composite multi-point optical defocus lenses can effectively delay the progression of myopia in children. -
Key words:
- Myopia /
- Peripheral defocusing /
- Axis oculi /
- Composite multi-point optical defocusing
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表 1 基线数据($\bar x \pm s $)
Table 1. Baseline data($\bar x \pm s $)
组别 年龄(岁) n(男/女) 基线眼轴(mm) 基线屈光度(D) 对照组 11.36±1.53 52(26/26) 24.22±0.81 −2.01±0.68 实验组 10.70±1.67 78(43/35) 24.33±0.79 −1.90±0.67 χ2/t −3.202 0.646 1.068 1.247 P 0.002* 0.422 0.286 0.214 *P <0.05。 表 2 戴镜前后屈光度的变化($\bar x \pm s $)
Table 2. Change in diopter before and after wearing glasses ($\bar x \pm s $)
组别 戴镜前(D) 戴镜后(3个月) 戴镜后(6个月) 戴镜后(9个月) 戴镜后(12个月) 对照组(n=104) −2.01±0.68 −2.14±0.72 −2.41±0.78 −2.59±0.83 −2.78±0.82 实验组(n=156) −1.90±0.67 −1.96±0.72 −2.07±0.74 −2.13±0.75 −2.18±0.78 t 1.247 1.952 3.582 4.690 5.981 P 0.214 0.052 <0.001* <0.001* <0.001* *P <0.05。 表 3 戴镜前后眼轴的变化($\bar x \pm s $)
Table 3. Changes of eye axis before and after wearing glasses ($\bar x \pm s $)
组别 戴镜前(D) 戴镜后(3个月) 戴镜后(6个月) 戴镜后(9个月) 戴镜后(12个月) 对照组(n=104) 24.22±0.81 24.32±0.80 24.44±0.77 24.52±0.77 24.62±0.78 实验组(n=156) 24.33±0.79 24.37±0.79 24.40±0.78 24.44±0.81 24.51±0.80 t 1.068 0.447 −0.404 −0.856 −1.093 P 0.286 0.655 0.686 0.393 0.275 -
[1] Eyayu G. Causes of blindness and vision impairment in 2020 and trends over 30 years,and prevalence of avoidable blindness in relation to VISION 2020: The right to sight: An analysis for the global burden of disease study[J]. Lancet Glob Health,2021,9(2):e144-e160. doi: 10.1016/S2214-109X(20)30489-7 [2] Holden B A ,Fricke T R ,Wilson D A ,et al. Global prevalence of myopia and high myopia and temporal trends from 2000 through 2050[J]. Ophthalmology,2016,123(5): 1036. [3] Baird P N,Saw S M,Lanca C,et al. Myopia[J]. Nat Rev Dis Primers,2020,6(1):99 doi: 10.1038/s41572-020-00231-4 [4] Zhang H ,Lam C,Tang W ,et al. Changes in relative peripheral refraction in children who switched from single-vision lenses to defocus incorporated multiple segments lenses[J]. Ophthalmic and Physiological Optics,2022,43(3):319-326. [5] Dong L,Kang Y K,Li Y,et al. Prevalence and time trends of myopia in children and adolescents in China: A systemic review and meta-analysis[J]. Retina,2020,40(3):399-411 doi: 10.1097/IAE.0000000000002590 [6] Haarman A E G,Enthoven C A,Tideman J W L,et al. The complications of myopia: A review and meta-analysis[J]. The Association for Research in Vision and Ophthalmology,2020,61(4):49. [7] Li F F,Zhang Y,Zhang X,et al. Age effect on treatment responses to 0.05%,0.025%,and 0.01% atropine: Low-concentration atropine for myopia progression study[J]. Ophthalmology,2021,128(8):1180-1187. doi: 10.1016/j.ophtha.2020.12.036 [8] Zhang X J,Zhang Y,Yip Bhk,et al. Five-year clinical trial of the low-concentration atropine for myopia progression (LAMP) study: Phase 4 report[J]. Ophthalmology,2024,131(9):1011-1020. doi: 10.1016/j.ophtha.2024.03.013 [9] Huang J,Wen D,Wang Q,et al. Efficacy comparison of 16 interventions for myopia control in children: A network meta-analysis[J]. Ophthalmology,2016,123(4):697-708. doi: 10.1016/j.ophtha.2015.11.010 [10] Olenich M. Use of orthokeratology contact lenses in the treatment of progressive myopia spravočnik vrača obŝej praktiki[J]. Journal of Family Medicine,2020,53(7):18-22. [11] Smith M J,Walline J J. Controlling myopia progression in children and adolescents[J]. Adolesc Health Med Ther,2015,6(1):133-140. [12] Wallman J,Winawer J. Homeostasis of eye growth and the question of myopia[J]. Neuron,2004,43(4):447-468. doi: 10.1016/j.neuron.2004.08.008 [13] Zhang H Y ,Lam C S Y ,Tang W C ,et al. Impact of defocus incorporated multiple segments (DIMS) spectacle lenses on relative peripheral refraction (RPR): A 2-year randomized clinical trial[J]. Investigative Ophthalmology & Visual Science,2019,31(9):60-67. [14] Lam C S Y,Tang W C,Zhang H Y,et al. Long-term myopia control effect and safety in children wearing DIMS spectacle lenses for 6 years[J]. Sci Rep,2023,13(1):5475-5482. doi: 10.1038/s41598-023-32700-7 [15] Qin Z,Peng T,Zhang Z,et al. Myopia progression and stabilization in school-aged children with single-vision lenses[J]. Acta 0phthalmol,2021,100(4):e950-e956. [16] Li N,Lin W,Liang R,et al. Comparison of two different orthokeratology lenses and defocus incorporated soft contact (DISC) lens in controlling myopia progression[J]. Eye Vis (Lond),2023,10(1):43. doi: 10.1186/s40662-023-00358-x [17] Li S M,Kang M T,Wu S S,et al. Efficacy,safety and acceptability of orthokeratology on slowing axial elongation in myopic children by meta-analysis[J]. Curr Eye Res,2015,41(5):600-608. [18] Tu E Y,Joslin C E. Recent outbreaks of atypical contact lens-related keratitis: What have we learned?[J]. AM J 0phthalmol,2010,150(5):602-608. doi: 10.1016/j.ajo.2010.06.045 [19] Lee S, Won Y, Lim D. Major complications of overnight orthokeratology lens for myopic correction ann optom contact lens[J]. Ann Optom Contact Lens, 2022, 21(1): 1-7.Lee S,Won Y,Lim D. Major complications of overnight orthokeratology lens for myopic correction ann optom contact lens[J]. Ann Optom Contact Lens,2022,21(1):1-7. [20] Sankaridurg P,Weng R,Tran H,et al. Spectacle lenses with highly aspherical lenslets for slowing myopia: A randomized,double-blind,cross-over clinical trial: Parts of these data were presented as a poster at the annual research in vision and ophthalmology meeting,2022[J]. AM J Ophthalmol,2022,247(1):18-24. [21] Bao J,Huang Y,Li X,et al. Spectacle lenses with aspherical lenslets for myopia control vs single-vision spectacle lenses: A randomized clinical trial[J]. JAMA Ophthalmol,2022,140(5):472-478. doi: 10.1001/jamaophthalmol.2022.0401 [22] Yang J L,Li D L,Chen J,et al. Effect modification of time spent outdoors on the association between early childhood overweight and myopia: A one-year follow-up study[J]. J Public Health-Uk,2024,46(1):107-115. doi: 10.1093/pubmed/fdae006