Randomized Trial of Effect of Bifocal and Prismatic Bifocal Spectacles on Myopic Progression

屈光度 睫状肌麻痹 医学 眼科 随机对照试验 折射误差 视力 双眼视觉 验光服务 外科 光学 物理
作者
Desmond Cheng,Katrina L. Schmid,George C. Woo,Björn Drobe
出处
期刊:Archives of Ophthalmology [American Medical Association]
卷期号:128 (1): 12-12 被引量:94
标识
DOI:10.1001/archophthalmol.2009.332
摘要

Objective

To determine whether bifocal and prismatic bifocal spectacles could control myopia in children with high rates of myopic progression.

Methods

This was a randomized controlled clinical trial. One hundred thirty-five (73 girls and 62 boys) myopic Chinese Canadian children (myopia of ≥1.00 diopters [D]) with myopic progression of at least 0.50 D in the preceding year were randomly assigned to 1 of 3 treatments: (1) single-vision lenses (n = 41), (2) +1.50-D executive bifocals (n = 48), or (3) +1.50-D executive bifocals with a 3–prism diopters base-in prism in the near segment of each lens (n = 46).

Main Outcome Measures

Myopic progression measured by an automated refractor under cycloplegia and increase in axial length (secondary) measured by ultrasonography at 6-month intervals for 24 months. Only the data of the right eye were used.

Results

Of the 135 children (mean age, 10.29 years [SE, 0.15 years]; mean visual acuity, −3.08 D [SE, 0.10 D]), 131 (97%) completed the trial after 24 months. Myopic progression averaged −1.55 D (SE, 0.12 D) for those who wore single-vision lenses, −0.96 D (SE, 0.09 D) for those who wore bifocals, and −0.70 D (SE, 0.10 D) for those who wore prismatic bifocals. Axial length increased an average of 0.62 mm (SE, 0.04 mm), 0.41 mm (SE, 0.04 mm), and 0.41 mm (SE, 0.05 mm), respectively. The treatment effect of bifocals (0.59 D) and prismatic bifocals (0.85 D) was significant (P < .001) and both bifocal groups had less axial elongation (0.21 mm) than the single-vision lens group (P < .001).

Conclusions

Bifocal lenses can moderately slow myopic progression in children with high rates of progression after 24 months.

Applications to Clinical Practice

Bifocal spectacles may be considered for slowing myopic progression in children with an annual progression rate of at least 0.50 D.

Trial Registration

clinicaltrials.gov Identifier:NCT00787579
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