Adaptability of myopic children to progressive addition lenses with a modified fitting protocol in the Correction of Myopia Evaluation Trial (COMET).
Adaptability of myopic children to progressive addition lenses with a modified fitting protocol in the Correction of Myopia Evaluation Trial (COMET).
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在近视矫正评估试验 (COMET) 中，近视儿童对采用改良验配方案的渐进多焦点镜片的适应性。
DOI：
10.1097/01.opx.0000159360.88324.01
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发表时间：
2005
期刊：
影响因子：
--
通讯作者：
Hyman,Leslie
中科院分区：
文献类型：
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作者：
Kowalski,PatriciaM;Wang,Ying;Owens,RobertE;Bolden,Joanne;Smith,JustinB;Hyman,Leslie
目的。本研究的目的是评估参加近视矫正评估试验 (COMET) 的近视儿童对使用渐进多焦点镜片 (PAL) 的适应性，并采用修改后的配戴方案，将距离配戴十字设置在瞳孔中心上方 4 毫米处。方法.COMET 是一项多中心、随机临床试验，旨在评估 PAL 与单光镜片 (SVL) 是否能减缓 3 年内青少年发病近视儿童的进展速度。在入组的 469 名儿童中，234 名被分配到 SVL，235 名被分配到 PAL（接近加法 + 2.00 D），这些儿童根据标准研究方案进行验配，验配十字位于瞳孔中心上方 4 毫米处。通过比较治疗组之间问题就诊的频率和原因、视力症状、遮盖测试结果以及戴镜依从性，评估儿童对使用 PAL 的适应性。结果。在随访的前 3 年中，佩戴 PAL 的儿童和佩戴 SVL 的儿童在问题就诊的次数或原因方面没有观察到差异。收到学习眼镜一周后，佩戴 PAL 的儿童表现出与适应性相关的三种视觉症状的频率较高：从黑板上往下看，桌子上的物品清晰可见 (p = 0.001)、阅读时模糊 (p = 0.003) 和下楼梯困难 (p = 0.02)。佩戴 PAL 的儿童更有可能在 1 周时报告至少一种适应症状：比值比为 2.76（95% 置信区间 = 1.28–5.95）。到 1 个月时，这些差异消失了，并且所有视觉症状的频率在 3 年多的时间里两个治疗组都保持较低且相似。 5 名儿童（3 名 SVL，2 名 PAL）在遮盖测试中观察到斜视。没有一个孩子必须从 PAL 改为 SVL，而其中两个孩子由于双眼视力问题而从 SVL 改为 PAL。儿童和家长报告称，在整个随访期间，两组佩戴眼镜的依从性均接近 100%。分配到 PAL 的 235 名儿童中，大多数 (98%) 都维持了修改后的验配方案，没有任何问题超过 3 年。结论。这些数据表明，儿童可以安全、舒适地佩戴 PAL 至少 3 年。
Purpose.The purpose of this study was to evaluate the adaptability of myopic children participating in the Correction of Myopia Evaluation Trial (COMET) to the use of progressive addition lenses (PALs) with a modified fitting protocol of setting the distance fitting cross 4 mm above the pupil center.Methods.COMET was a multicenter, randomized clinical trial to evaluate whether PALs vs. single-vision lenses (SVLs) slowed the rate of progression in children with juvenile-onset myopia over 3 years. Of the 469 children enrolled, 234 were assigned to SVLs and 235 were assigned to PALs (+ 2.00 D near addition), which were fit according to a standard study protocol with the fitting cross positioned 4 mm above the pupil center. The children’s adaptability to the use of PALs was evaluated by comparing the frequency and reasons for problem visits, visual symptoms, cover test results, and adherence to wearing glasses between treatment groups.Results.During the first 3 years of follow-up, no differences were observed between children wearing PALs and those wearing SVLs with respect to the number or reasons for problem visits. One week after receipt of the study glasses, children wearing PALs showed a higher frequency of three visual symptoms related to adaptability: looking down from the blackboard and getting items on their desk in focus (p= 0.001), blur when reading (p= 0.003), and difficulty going down steps (p= 0.02). Children wearing PALs were more likely to report at least one adaptation symptom at 1 week: odds ratio of 2.76 (95% confidence interval= 1.28–5.95). By 1 month, these differences disappeared and the frequency of all visual symptoms remained low and similar for both treatment groups over 3 years. Strabismus was observed on cover test in five children (three SVLs, two PALs). None of the children had to be changed from PALs to SVLs, whereas two of the children were changed from SVLs to PALs as a result of binocular vision problems. The children and parents reported adherence to wearing the eyeglasses approached 100% compliance throughout the follow-up period for both groups. Most (98%) of the 235 children assigned to PALs maintained the modified fitting protocol without any problems over 3 years.Conclusion.These data show that children can safely and comfortably wear PALs for at least 3 years.