Abstract
Purpose To evaluate the effect of customized progressive addition lenses (CPALs) versus single vision lenses (SVLs) on the progression of juvenile-onset myopia in children with near esophoria. Methods Ninety-three Chinese children, aged 7–14 years with spherical equivalent refraction (SER) ranging from −0.50 to −4.00 D and near esophoria ≥2Δ, were randomly assigned into a CPALs (n = 46) and an SVLs group (n = 47) for a 2-year, double-masked, randomized trial. The primary outcome measure was the progression of myopia, as determined by cycloplegic autorefraction. A customized near addition, calculated by a regression equation, was prescribed to establish a fixed heterophoria status for each child, which was −3Δ exophoria. Results Eighty-four (90.3%) of the 93 children completed the 2-year follow-up. The mean initial near addition lenses were 1.65 ± 0.07 D (mean ± SE). The adjusted 2-year myopia progression was 0.23 ± 0.08 D slower in the CPALs group than in the SVLs group (p=0.046). Post hoc analysis found significantly larger treatment effects for CPALs in children without myopic parents (0.47 ± 0.15 D; 95% CI: 0.18–0.76), with lower baseline myopia (0.33 ± 0.09 D; 95% CI: 0.14–0.52; p < 0.05), with higher baseline accommodative lag (0.36 ± 0.11 D; 95% CI: 0.12–0.60; p < 0.05), and with higher baseline near esophoria (0.30 ± 0.10 D; 95% CI: 0.12–0.48; p < 0.05). Conclusion CPALs exerted a significant but minimal protective effect against myopia progression in Chinese children with esophoric myopia, as compared with SVLs. Regulating near heterophoria and accommodative lag by near addition lenses may not be an appropriate way to prevent myopia progression.
Highlights
Chinese teenagers are susceptible to myopia leading to high prevalence and incidence in China [1–3]. is places a vast annual economic burden in terms of changing spectacles and other myopia control methods
As we found that the amount of near phoria and accommodative lag could not reach a minimum value with the same power of the near addition, we adjusted the power of the near addition to that of the near phoria considered ideal for the Progressive addition lenses (PALs) in order to arrest myopia progression in children with esophoria in the current study
From July to August 2012, 93 children were enrolled in this study, with in the customized progressive addition lenses (CPALs) group and in the single vision lenses (SVLs) group
Summary
Chinese teenagers are susceptible to myopia leading to high prevalence and incidence in China [1–3]. is places a vast annual economic burden in terms of changing spectacles and other myopia control methods. Is places a vast annual economic burden in terms of changing spectacles and other myopia control methods. Myopes are subject to significant public and occupational health burdens, such as vision loss due to glaucoma, myopic macular hole, and myopic retinal detachment [4]. Numerous studies have claimed that myopia is associated with near work [5–7], which is usually accompanied by accommodative lag [8], a primary potential cause to myopia, for which keep the eye hyperopia defocused. Progressive addition lenses (PALs) may control the progression of myopia by decreasing the accommodative lag during near work in myopes. Leung and Brown [9] observed that when Chinese children with myopia wore PALs, both their refraction and axial lengths increased less than those of agematched children wearing single vision lenses (SVLs). Some well-designed studies failed to show definite benefits of PAL wear on myopia progression. Some well-designed studies failed to show definite benefits of PAL wear on myopia progression. e Correction of Myopia Evaluation Trial (COMET) reported a 0.20 D
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