Objective To compare axial length growth and myopia progression among myopic Chinese children wearing single-vision spectacle lenses (SVs), orthokeratology lenses, rigid gas-permeable contact lenses (RGPCLs) or progressive-addition spectacle lenses (PALs) and to evaluate their efficacy in the control of myopia. Methods This was a prospective, non-randomized and case-controlled clinical study. One hundred and four myopic children aged 9 to 15 years were enrolled in this study. Subjects′ refractive conditions ranged from -0.50 to -4.50 DS with astigmatism less than 2.00 DC. Each subject was allocated to one of four correction groups (SV, orthokeratology lens, RGPCL, or PAL), and followed for 24 months. Twenty-one children were fitted with SVs, 24 with orthokeratology lenses, 30 with RGPCLs, and 29 with PALs. Cycloplegic refraction, axial length and topography measurements were performed. Data were analyzed using ANOVA, repeated measured ANOVA and a chi-square test. Results At baseline, the four groups were comparable in terms of age, k-reading, and axial length, exception for spherical equivalent refractive error (F=6.920, P<0.01). The RGPCL group (-3.04±0.79 D) was more myopic than the SV (-2.35±0.80 D), orthokeratology lens (-2.33±1.02 D) and PAL (-2.15±0.60 D) groups at baseline. Axial length increased significantly over 2 years (F=315.912, P<0.01) for the SV group (0.57±0.23 mm), orthokeratology lens group (0.31±0.20 mm), RGPCL group (0.51±0.30 mm) and PAL group (0.61±0.27 mm), with a significant interaction between time and groups (F=4.175, P<0.01) and significant differences among the four correction methods (F=6.599, P<0.01). Axial elongation was slower in the orthokeratology lens group compared to the others, but there were no differences among the SV, RGPCL and PAL groups. Myopia progressed significantly over 2 years (F=121.840, P<0.01) for the SV group (-1.23±0.64 D), RGPCL group (-0.82±0.69 D) and PAL group (-1.12±0.53 D), with insignificant interaction between time and group (F=1.300, P>0.05) and no significant differences among those three correction methods (F=2.987, P>0.05). Conclusion For the efficacy of myopia control, the orthokeratology lens is most remarkable. Rigid gas permeable contact lenses and progressive-addition lenses are not more effective for myopia control than single-vision spectacle lenses.
姜珺,陈云云,吴戈,保金华,毛欣杰,吕帆. 不同矫正方式对儿童近视控制的效果[J]. 中华眼视光学与视觉科学杂志, 2014, 16(2): 73-77.
Jiang Jun,Chen Yunyun,Wu Ge,Bao Jinhua,Mao Xinjie,Lyu Fan. Effect of four types of refractive correction on myopia progression in Chinese children. Chinese Journal of Optometry Ophthalmology and Visual Science, 2014, 16(2): 73-77. DOI: 10.3760/cma.j.issn.1674-845X.2014.02.003
Sperduto RD, Seigel D, Robeas J, et al. Prevalence of myopia in the United States[J]. Arch Ophthalmol,1983,101:405-407.
[2]
Fan DS, Lam DS, Lam RF, et al. Prevalence, incidence, and progression of myopia of school children in Hong Kong[J]. Invest Ophthalmol Vis Sci,2004,45:1071-1075.
[3]
Brodstein RS, Bordstein DE, Olson RJ, et al. The treatment of myopia with atropine and bifocals. A long-term prospective study[J]. Ophthalmology,1984,91:1373-1379.
[4]
Siatkowski RM, Cotter SA, Crockett RS et al. Two-year muhicenter, randomized, double-masked, placebo-controlled, parallel safety and eficacy study of 2% pirenzepine ophthalmic gel in children with myopia[J]. J AAPOS,2008,12:332-339.
[5]
Cho P, Cheung SW. Retardation of myopia in Orthokeratology (ROMIO) study: a 2-year randomized clinical trial[J]. Invest Ophthalmol Vis Sci,2012,53:7077-7085.
[6]
Walline JJ, Jones LA, Sinnott LT, et al. Corneal reshaping and myopia progression[J]. Br J Ophthalmol,2009,93:1181-1185.
[7]
Kakita T, Hiraoka T, Oshika T, et al. Influence of overnight orthokeratology on axial length elongation in childhood myopia[J]. Invest Ophthalmol Vis Sci,2011,52:2170-2174.
[8]
Kang P, Swarbrick H. Peripheral refraction in myopic children wearing orthokeratology and gas-permeable lenses[J]. Optom Vis Sci,2011,88:476-482.
[9]
Wallman J, Winawer J. Homeostasis of eye growth and the question of myopia[J]. Neuron,2004,43:447-468.
[10]
Sankaridurg P, Holden B, Smith E 3rd, et al. Decrease in rate of myopia progression with a contact lens designed to reduce relative peripheral hyperopia: one-year results[J]. Invest Ophthalmol Vis Sci,2011,52:9362-9367.
[11]
Katz J, Schein OD, Levy B, et al. A randomized trial of rigid gas permeable contact lenses to reduce progression of children′s myopia[J]. Am J Ophthalmol,2003,136:82-90.
[12]
Walline JJ, Jones LA, Mutti DO, et al. A randomized trial of the effects of rigid contact lenses on myopia progression[J]. Arch Ophthalmol,2004,122:1760-1766.
[13]
Edwards MH, Li RW, Lam CS, et al. The Hong Kong progressive lens myopia control study: study design and main findings[J]. Invest Ophthalmol Vis Sci,2002,43:2852-2858.
[14]
Gwiazda J, Hyman L, Hussein M, et al. A randomized clinical trial of progressive addition lenses versus single vision lenses on the progression of myopia in children[J]. Invest Ophthalmol Vis Sci,2003,44:1492-1500.
[15]
Gwiazda JE, Hyman L, Norton TT, et al. Accommodation and related risk factors associated with myopia progression and their interaction with treatment in COMET children[J]. Invest Ophthalmol Vis Sci,2004,45:2143-2151.
[16]
Correction of myopia evaluation trial 2 study group for the pediatric eye disease investigator group. Progressive-addition lenses versus single-vision lenses for slowing progression of myopia in children with high accommodative lag and near esophoria[J]. Invest Ophthalmol Vis Sci,2011,52:2749-2757.
[17]
Berntsen DA, Sinnott LT, Mutti DO, et al. A randomized trial using progressive addition lenses to evaluate theories of myopia progression in children with a high lag of accommodation[J].Invest Ophthalmol Vis Sci,2012,53:640-649.