AIM:To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses(PDMSLs)and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.METHODS:A system...AIM:To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses(PDMSLs)and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.METHODS:A systematic search was carried out in the PubMed,Cochrane Library,Embase,CNKI,and Web of Science databases.The search targeted randomized controlled trials(RCTs)and cohort studies(CTs)that explored the effects of PDMSLs on myopia control among children and adolescents.The Cochrane risk-of-bias tool and the Newcastle-Ottawa Scale were employed to evaluate the risk of bias in the included studies.The published biases of the included studies were evaluated using Egger’s test.RESULTS:Nine studies(7 RCTs,2 CTs)were included,involving 4332 participants in the PDMSLs group and 7317 participants in the single vision lenses(SVLs)group.Metaanalysis showed that PDMSLs with microlens design had lower change in spherical equivalent refraction(SER)than SVLs at 6,12,18,and 24mo after wearing glasses,with reductions of 0.19 D(95%CI:0.14 to 0.24,P<0.00001),0.36 D(95%CI:0.25 to 0.46,P<0.00001),0.43 D(95%CI:0.32 to 0.55,P<0.00001),and 0.51 D(95%CI:0.33 to 0.69,P<0.00001),respectively.The changes in axial length(AL)were also lower in PDMSLs compared to SVLs,with reductions of-0.09 mm(95%CI:-0.13 to-0.04,P=0.0002),-0.15 mm(95%CI:-0.21 to-0.08,P<0.00001),-0.27 mm(95%CI:-0.34 to-0.20,P<0.00001),and-0.29 mm(95%CI:-0.38 to-0.20,P<0.00001),respectively.There was no significant difference between the non-microlens group and SVLs in controlling the changes of SER and AL in myopia(both P>0.05).CONCLUSION:The synthesized evidence indicates superior myopia management outcomes with microlens design of PDMSLs compared to both SVLs and nonmicrolens design of PDMSLs in children and adolescents.展开更多
AIM: To evaluate the effectiveness of peripheral defocus spectacle lenses(PDLs) in myopia control. METHODS: Literature retrieval on Pub Med, Cochrane Library, Embase, and Web of Science databases, and the search time ...AIM: To evaluate the effectiveness of peripheral defocus spectacle lenses(PDLs) in myopia control. METHODS: Literature retrieval on Pub Med, Cochrane Library, Embase, and Web of Science databases, and the search time limit was from the establishment of each database to December 29, 2021 were conducted. Change of spherical equivalent refraction(SER) and axial change(AL) were extracted from the literatures that met the inclusion criteria, and Rev Man5.3 software was used for Meta-analysis. RESULTS: A total of 4 randomized controlled trials(RCTs) were included in this Meta-analysis, involving 770 myopic children. The results showed that PDLs could delay the progression of myopia in children with myopia compared with single vision spectacle lenses(SVLs;WMD=0.21 D, 95%CI: 0.01, 0.41, P=0.04). However, there was no significant difference in controlling the growth of axial length(AL) in myopic children(WMD=-0.10 mm, 95%CI:-0.21, 0.01, P=0.07). The results of the effectiveness of myopia control between the two spectacle lenses showed that PDLs were more effective in controlling the progression of myopia(OR=5.73, 95%CI: 2.58, 12.70, P<0.001) and delaying the growth of AL(OR=44.25, 95%CI: 8.84, 221.58, P<0.001) than SVLs, and the differences were statistically significant. CONCLUSION: PDLs can control the progression of myopia compared with SVLs, but cannot delay the growth of AL, and the effectiveness of PDLs in myopia control better than SVLs.展开更多
AIM:To investigate efficacy and ocular surface safety of 3 kinds of different correction methods for correction of high myopia in adolescents.METHODS:A prospective,randomized,controlled clinical trial was conducted.Fr...AIM:To investigate efficacy and ocular surface safety of 3 kinds of different correction methods for correction of high myopia in adolescents.METHODS:A prospective,randomized,controlled clinical trial was conducted.From January 2022 to December 2022,62 adolescents with high myopia(124 eyes)were recruited,with spherical refractive errors ranging from-6.00 to-7.50 diopters(D)and refractive astigmatism≤1.50 D.All participants were randomly assigned to three groups:the orthokeratology combined with single-vision spectacle lenses(OK+SVLs)group(20 cases,40 eyes),the peripheral defocus rigid gas permeable contact lenses(Defocus RGPCL)group(22 cases,44 eyes),and the singlevision spectacle lenses(SVLs)group(20 cases,40 eyes).All of them were followed up for 1.5y.The observation indicators included refractive error,axial length(AL),tear break-up time(BUT),percentage of hexagonal corneal endothelial cells(CEC),CEC density,and ocular surface adverse reactions.RESULTS:The three groups had mean age of 14.84±1.87y,14.57±1.91y,and 14.80±1.52y,respectively.No statistically significant differences were found in age,gender,corneal curvature,AL,and spherical equivalent among the groups(all P>0.05).At the 6mo,1,and 1.5y follow-ups after spectacle lens wear,the improvements in refractive error in the OK+SVLs and Defocus RGPCL groups were significantly superior to those in the SVLs group(F=4.221,P=0.017;F=7.226,P=0.001;F=16.140,P<0.001),while no significant difference was observed between the OK+SVLs and Defocus RGPCL groups(all P>0.05).Intergroup comparisons of AL changes revealed statistically significant differences at all follow-up time points(F=3.493,P=0.034;F=9.930,P<0.001;F=20.570,P<0.001),with no notable difference between the OK+SVLs and Defocus RGPCL groups(all P>0.05).After 1.5y of lens wear,the intergroup comparison of BUT showed a statistically significant difference(F=5.783,P=0.004),whereas no significant differences were found in the percentage of hexagonal CEC and CEC density among the three groups(all P>0.05).No severe complications were observed in the two contact lens groups;only 5 eyes presented with grade 1 or 2 bulbar conjunctival hyperemia and corneal epithelial staining.All adverse reactions were well controlled by temporary lens discontinuation or medication,and resumed lens wear subsequently,with no statistically significant difference in the incidence of adverse reactions between the two contact lens groups(P>0.05).CONCLUSION:Orthokeratology lenses and peripheral defocus RGPCL yield better visual acuity correction and superior image quality,which can minimize retinal image aberrations induced by high refractive errors.Both interventions achieve satisfactory corrective vision and effective myopia control effects in adolescents with high myopia,with no significant adverse reactions observed during the follow-up period,indicating a high level of wearing safety for clinical application.展开更多
基金Supported by Sichuan Province Science and Technology Plan(No.2023YFS0506)Medical Research Project of Jinniu District,Chengdu,Sichuan Province(No.JNKY2024-94)Xinglin Scholar Program at Chengdu University of Traditional Chinese Medicine(No.ZYTS2023028).
文摘AIM:To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses(PDMSLs)and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.METHODS:A systematic search was carried out in the PubMed,Cochrane Library,Embase,CNKI,and Web of Science databases.The search targeted randomized controlled trials(RCTs)and cohort studies(CTs)that explored the effects of PDMSLs on myopia control among children and adolescents.The Cochrane risk-of-bias tool and the Newcastle-Ottawa Scale were employed to evaluate the risk of bias in the included studies.The published biases of the included studies were evaluated using Egger’s test.RESULTS:Nine studies(7 RCTs,2 CTs)were included,involving 4332 participants in the PDMSLs group and 7317 participants in the single vision lenses(SVLs)group.Metaanalysis showed that PDMSLs with microlens design had lower change in spherical equivalent refraction(SER)than SVLs at 6,12,18,and 24mo after wearing glasses,with reductions of 0.19 D(95%CI:0.14 to 0.24,P<0.00001),0.36 D(95%CI:0.25 to 0.46,P<0.00001),0.43 D(95%CI:0.32 to 0.55,P<0.00001),and 0.51 D(95%CI:0.33 to 0.69,P<0.00001),respectively.The changes in axial length(AL)were also lower in PDMSLs compared to SVLs,with reductions of-0.09 mm(95%CI:-0.13 to-0.04,P=0.0002),-0.15 mm(95%CI:-0.21 to-0.08,P<0.00001),-0.27 mm(95%CI:-0.34 to-0.20,P<0.00001),and-0.29 mm(95%CI:-0.38 to-0.20,P<0.00001),respectively.There was no significant difference between the non-microlens group and SVLs in controlling the changes of SER and AL in myopia(both P>0.05).CONCLUSION:The synthesized evidence indicates superior myopia management outcomes with microlens design of PDMSLs compared to both SVLs and nonmicrolens design of PDMSLs in children and adolescents.
基金Supported by National Natural Science Foundation of China(No.81960177)Jiangxi Provincial Science and Technology Grant(No.20192BAB205049)+2 种基金A research grant from Jiangxi Provincial Health Commission(No.202210723)Postgraduate Innovation Special Fund Project of Jiangxi Province(No.YC2021-S077)。
文摘AIM: To evaluate the effectiveness of peripheral defocus spectacle lenses(PDLs) in myopia control. METHODS: Literature retrieval on Pub Med, Cochrane Library, Embase, and Web of Science databases, and the search time limit was from the establishment of each database to December 29, 2021 were conducted. Change of spherical equivalent refraction(SER) and axial change(AL) were extracted from the literatures that met the inclusion criteria, and Rev Man5.3 software was used for Meta-analysis. RESULTS: A total of 4 randomized controlled trials(RCTs) were included in this Meta-analysis, involving 770 myopic children. The results showed that PDLs could delay the progression of myopia in children with myopia compared with single vision spectacle lenses(SVLs;WMD=0.21 D, 95%CI: 0.01, 0.41, P=0.04). However, there was no significant difference in controlling the growth of axial length(AL) in myopic children(WMD=-0.10 mm, 95%CI:-0.21, 0.01, P=0.07). The results of the effectiveness of myopia control between the two spectacle lenses showed that PDLs were more effective in controlling the progression of myopia(OR=5.73, 95%CI: 2.58, 12.70, P<0.001) and delaying the growth of AL(OR=44.25, 95%CI: 8.84, 221.58, P<0.001) than SVLs, and the differences were statistically significant. CONCLUSION: PDLs can control the progression of myopia compared with SVLs, but cannot delay the growth of AL, and the effectiveness of PDLs in myopia control better than SVLs.
基金Supported by Zhejiang Province Medical and Health Science and Technology Plan(No.2023KY1141).
文摘AIM:To investigate efficacy and ocular surface safety of 3 kinds of different correction methods for correction of high myopia in adolescents.METHODS:A prospective,randomized,controlled clinical trial was conducted.From January 2022 to December 2022,62 adolescents with high myopia(124 eyes)were recruited,with spherical refractive errors ranging from-6.00 to-7.50 diopters(D)and refractive astigmatism≤1.50 D.All participants were randomly assigned to three groups:the orthokeratology combined with single-vision spectacle lenses(OK+SVLs)group(20 cases,40 eyes),the peripheral defocus rigid gas permeable contact lenses(Defocus RGPCL)group(22 cases,44 eyes),and the singlevision spectacle lenses(SVLs)group(20 cases,40 eyes).All of them were followed up for 1.5y.The observation indicators included refractive error,axial length(AL),tear break-up time(BUT),percentage of hexagonal corneal endothelial cells(CEC),CEC density,and ocular surface adverse reactions.RESULTS:The three groups had mean age of 14.84±1.87y,14.57±1.91y,and 14.80±1.52y,respectively.No statistically significant differences were found in age,gender,corneal curvature,AL,and spherical equivalent among the groups(all P>0.05).At the 6mo,1,and 1.5y follow-ups after spectacle lens wear,the improvements in refractive error in the OK+SVLs and Defocus RGPCL groups were significantly superior to those in the SVLs group(F=4.221,P=0.017;F=7.226,P=0.001;F=16.140,P<0.001),while no significant difference was observed between the OK+SVLs and Defocus RGPCL groups(all P>0.05).Intergroup comparisons of AL changes revealed statistically significant differences at all follow-up time points(F=3.493,P=0.034;F=9.930,P<0.001;F=20.570,P<0.001),with no notable difference between the OK+SVLs and Defocus RGPCL groups(all P>0.05).After 1.5y of lens wear,the intergroup comparison of BUT showed a statistically significant difference(F=5.783,P=0.004),whereas no significant differences were found in the percentage of hexagonal CEC and CEC density among the three groups(all P>0.05).No severe complications were observed in the two contact lens groups;only 5 eyes presented with grade 1 or 2 bulbar conjunctival hyperemia and corneal epithelial staining.All adverse reactions were well controlled by temporary lens discontinuation or medication,and resumed lens wear subsequently,with no statistically significant difference in the incidence of adverse reactions between the two contact lens groups(P>0.05).CONCLUSION:Orthokeratology lenses and peripheral defocus RGPCL yield better visual acuity correction and superior image quality,which can minimize retinal image aberrations induced by high refractive errors.Both interventions achieve satisfactory corrective vision and effective myopia control effects in adolescents with high myopia,with no significant adverse reactions observed during the follow-up period,indicating a high level of wearing safety for clinical application.
