A Randomized Trial Using Progressive Addition Lenses to Evaluate Theories of Myopia Progression in Children with a High Lag of Accommodation
A Randomized Trial Using Progressive Addition Lenses to Evaluate Theories of Myopia Progression in Children with a High Lag of Accommodation
复制标题
DOI：
10.1167/iovs.11-7769
复制
发表时间：
2012-02-01
影响因子：
4.4
通讯作者：
Zadnik, Karla
中科院分区：
文献类型：
--
作者：
Berntsen, David A.;Sinnott, Loraine T.;Zadnik, Karla
目的.比较配戴渐进多焦镜（帕尔斯）和单视镜（SVLs）后停用对高度屈光迟滞儿童近视进展的影响，以评价屈光迟滞和机械张力作为近视进展的理论依据。85名等效球镜（SE）睫状肌麻痹自动验光在-0.75 D和-4.50 D之间的儿童（年龄范围，6-11岁）被随机分配佩戴SVLs或帕尔斯1年;所有儿童均佩戴SVLs第二年。当近视度数大于-2.25DSE时，儿童的屈光迟滞和近轴性斜视均较高。每年之后的主要结果是前一年SE. A. TS的变化。当儿童被随机分配到SVL或帕尔斯时，SE的调整后1年变化为-0.52 D（SVL组）和-0.35 D（PAL组;治疗效应= 0.18 D; P = 0.01）。当所有儿童佩戴SVL的第二年，有SVL和前PAL佩戴者之间的近视进展没有差异（0.06 D; P = 0.50）。屈光迟滞与近视进展无关。PAL效应具有统计学显著性，但临床上很小，这表明旨在减少中央凹散焦的治疗在具有高屈光迟滞的近视儿童中可能不如以前认为的有效。在停止佩戴PAL后未发现治疗损失的证据，支持基于远视散焦的理论，如屈光迟滞;然而，未发现屈光迟滞与近视进展之间的相关性，与近距离工作期间中央凹模糊减少导致的PAL效应不一致。（临床Trials.gov编号，NCT 00335049。）（Invest Ophthalmol维斯科学。2012;53：640-649）DOI：10.1167/iovs.11-7769
PURPOSE. To compare the effect of wearing, then ceasing to wear, progressive addition lenses (PALs) versus single vision lenses (SVLs) on myopia progression in children with high accommodative lag to evaluate accommodative lag and mechanical tension as theories of myopia progression.METHODS. Eighty-five children (age range, 6-11 years) with spherical equivalent (SE) cycloplegic autorefraction between -0.75 D and -4.50 D were randomly assigned to wear SVLs or PALs for 1 year; all children wore SVLs a second year. Children had high accommodative lag and also had near esophoria if their myopia was greater than -2.25 D SE. The primary outcome after each year was the previous year's change in SE.RESULTS. When the children were randomly assigned to SVLs or PALs, the adjusted 1-year changes in SE were -0.52 D (SVL group) and -0.35 D (PAL group; treatment effect = 0.18 D; P = 0.01). When all children wore SVLs the second year, there was no difference in myopia progression between SVL and former PAL wearers (0.06 D; P = 0.50). Accommodative lag was not associated with myopia progression.CONCLUSIONS. The statistically significant, but clinically small, PAL effect suggests that treatments aimed at reducing foveal defocus may not be as effective as previously thought in myopic children with high accommodative lag. Finding no evidence of treatment loss after discontinuing PAL wear supports hyperopic defocus-based theories such as accommodative lag; however, not finding an association between accommodative lag and myopia progression is inconsistent with the PAL effect being due to decreased foveal blur during near work. (Clinical Trials.gov number, NCT00335049.) (Invest Ophthalmol Vis Sci. 2012;53:640-649) DOI:10.1167/iovs.11-7769