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The Efficacy of Defocus Incorporated Multiple Segments Lenses in Slowing Myopia Progression

屈光度 医学 眼科 回顾性队列研究 混淆 倾向得分匹配 随机对照试验 折射误差 眼病 验光服务 视力 外科 内科学
作者
Jiaxin Liu,Yiqiu Lu,Dan Huang,Jiwen Yang,Chunlei Fan,Chunmei Chen,Jianhua Li,Qinqin Wang,Shan Li,Jiang Baolin,Hongyan Jiang,Xiaoning Li,Zhikuan Yang,Weizhong Lan
出处
期刊:Ophthalmology [Elsevier]
卷期号:130 (5): 542-550 被引量:18
标识
DOI:10.1016/j.ophtha.2023.01.007
摘要

Purpose

Defocus incorporated multiple segments (DIMS) spectacle lenses were reported to slow myopia progression significantly in a randomized controlled trial (RCT). The study evaluated their effectiveness in clinical settings.

Design

Retrospective study.

Participants

Patient records involving use of DIMS and single-vision (SV) spectacle lenses were collected from subsidiary hospitals of Aier Eye Hospital Group.

Methods

The spherical equivalent (SE), determined by subjective refraction, was adopted to assess the myopia progression. The strategy of propensity score matching (PSM) was applied to match the confounding baseline characteristics between the 2 groups. The effectiveness was calculated based on the difference of myopia progression of these 2 approaches.

Main Outcome Measures

Change in SE.

Results

Three thousand six hundred thirty-nine patients with DIMS and 6838 patients with SV spectacles were included. The age of the patients was 6 to 16 years (mean ± standard deviation: 11.02 ± 2.53 years). The baseline SE was between 0.00 and –10.00 diopters (D) (mean ± standard deviation: –2.78 ± 1.74 D). After the PSM, data on 2240 pairs with 1-year follow-up and on 735 pairs with 2-year follow-up were obtained. Significantly slower progression was seen in the DIMS group at both the 1-year (DIMS, –0.50 ± 0.43 D; SV, –0.77 ± 0.58 D; P < 0.001) and 2-year (DIMS, –0.88 ± 0.62 D; SV, –1.23 ± 0.76 D; P < 0.001) subdataset. In the 1-year subdataset, 40% and 19% showed myopia progression of no more than 0.25 D for the DIMS and SV groups, respectively (chi-square, 223.43; P < 0.001), whereas 9% and 22% showed myopia progression of more than 1.00 D for the DIMS and SV groups, respectively (chi-square, 163.38; P < 0.001). In the 2-year subdataset, 33% and 20% showed myopia progression of no more than 0.50 D for the DIMS and SV groups, respectively (chi-square, 31.15; P < 0.001), whereas 12% and 29% showed myopia progression of more than 1.50 D for the DIMS and SV groups (chi-square, 65.60; P < 0.001).

Conclusions

Although the magnitude was lower than that reported in the previous RCT, this large-scale study with diversity of the data sources confirmed the effectiveness of DIMS spectacles to slow myopia progression in clinical practice.

Financial Disclosure(s)

Proprietary or commercial disclosure may be found after the references.
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