Myopia Progression in Children Wearing Spectacles vs. Switching to Contact Lenses.
Myopia Progression in Children Wearing Spectacles vs. Switching to Contact Lenses.
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DOI：
10.1097/opx.0b013e3181a6a250
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发表时间：
2009-06
期刊：
影响因子：
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通讯作者：
The COMET Group
中科院分区：
文献类型：
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作者：
Marsh-Tootle WL;Dong LM;Hyman L;Gwiazda J;Weise KK;Dias L;Fernp KD;The COMET Group
研究近视矫正评估试验（COMET）参与者在临床试验结束后改用软性隐形眼镜（CLs）与继续戴眼镜的近视进展情况。469名6-11岁的不同种族的近视儿童被随机分配配戴单视力镜片（SVLs）或渐进添加镜片（PALs）作为COMET的一部分，为期5年。之后，他们可以选择其他类型的镜头，包括CLs。本文的数据来自286名参与者，他们戴原眼镜6年（n =199），或在5至6年的就诊期间大部分或全部戴cl （n =87）。睫状体麻痹后用1% Tropicamide测定屈光不正和轴长（AL）。主要结果是5- 6年间的近视进展情况。研究人员对183名参与者进行了为期两年的近视进展评估，这些参与者都戴了相同类型的镜片，并多戴了一年。采用多元线性回归比较两种晶状体组的近视眼进展和AL。两组参与者在年龄、种族、5岁近视、住宿和远视方面相似，但更多的女孩改用CLs而不是继续戴眼镜（p<0.0001）。一年后，CL组的平均（±SD）近视进展（- 0.28±0.3d）高于眼镜组（- 0.14±0.36D） （p=0.003），两年后，2年组的近视进展（- 0.52±0.46D对- 0.25±0.39D, p<0.0001）。校正相关因素后，结果相似。校正后各组间AL无显著差异。两组的角膜曲率保持不变。从眼镜转到隐形眼镜的COMET儿童在近视进展方面经历了一个小的，统计上显着的，但临床上无关紧要的增加。
To investigate myopia progression in Correction of Myopia Evaluation Trial (COMET) participants who switched to soft contact lenses (CLs) versus remained in spectacles after the clinical trial ended. 469 ethnically diverse, 6–11 year old myopic children were randomly assigned to wear single vision lenses (SVLs) or progressive addition spectacle lenses (PALs) for 5 years as part of COMET. Afterwards they could choose another lens type, including CLs. Data in this paper are from 286 participants who wore their original spectacle lenses for 6 years (n =199) or wore CLs most or all of the time between the 5- and 6-year visits (n =87). Refractive error and axial length (AL) were measured after cycloplegia with 1% Tropicamide. The primary outcome was myopia progression between the 5- and 6-year visits. Two-year myopia progression was evaluated in a subset of 183 participants who wore the same lens type for an additional year. Myopia progression and AL were compared between the two lens groups using multiple linear regression. Participants in the two groups were similar with respect to age, ethnicity, myopia at 5-years, accommodation and phoria, but more girls switched to CLs than remained in spectacles (p<0.0001). Mean (± SD) myopia progression was higher (p=0.003) after one year in the CL group (−0.28 ± 0.33D) than the spectacle group (−0.14 ± 0.36D), and remained higher after two years in the 2-year subset (− 0.52 ± 0.46D versus −0.25 ± 0.39D, p<0.0001). Results were similar after adjustment for related factors. No significant differences in AL were found between groups after adjustment. Corneal curvature remained unchanged in both groups. COMET children switching from glasses to contact lenses experienced a small, statistically significant but clinically inconsequential increase in myopia progression.