Abstract
Objective. To evaluate the degree of axial elongation with soft radial refractive gradient (SRRG) contact lenses, orthokeratology (OK), and single vision (SV) spectacle lenses (control) during a period of 1 year before treatment and 2 years after treatment. Methods. This was a prospective, longitudinal, nonrandomized study. The study groups consisted of 30, 29, and 41 children, respectively. The axial length (AL) was measured during 2 years after recruitment and lens fitting. Results. The baseline refractive sphere was correlated significantly (Spearman's Rho (ρ) correlation = 0.542; P < 0.0001) with the amount of myopia progression before baseline. After 2 years, the mean myopia progression values for the SRRG, OK, and SV groups were −0.56 ± 0.51, −0.32 ± 0.53, and −0.98 ± 0.58 diopter, respectively. The results represent reductions in myopic progression of 43% and 67% for the SRRG and OK groups, respectively, compared to the SV group. The AL increased 27% and 38% less in the SRRG and OK groups, respectively compared with the SV group at the 2-year visit (P < 0.05). Axial elongation was not significantly different between SRRG and OK (P = 0.430). Conclusion. The SRRG lens significantly decreased AL elongation compared to the SV control group. The SRRG lens was similarly effective to OK in preventing myopia progression in myopic children and adolescent.
Highlights
Myopia is associated with ocular complications that can lead to permanent vision loss [1]
A small but significant correlation was found between the baseline sphere and the amount of M relative peripheral refractive error (RPRE) for the temporal and nasal retina (ρ = −0.279; P = 0.02; and ρ = −0.223; P = 0.05, resp.) with higher degrees of myopia having higher degrees of relative peripheral hyperopia
The eccentricity remained almost unchanged during the study in all groups. Both the soft radial refractive gradient (SRRG) and OK groups slowed progression of the refractive error by about 43% and 67%, respectively, and they slowed the ocular growth by about 27% and 38%, respectively
Summary
Myopia is associated with ocular complications that can lead to permanent vision loss [1]. This is especially true in relation to the amount of refractive error that is related to an increased risk of retinal detachment, glaucoma, cataract, and chorioretinal degeneration as the leading causes of permanent visual impairment [2]. Recent studies have shown that inducing a multifocal image on the eye and moving the image forward at the peripheral retina, leaving it myopically defocused, generates a visual stimulus to slow ocular growth [5, 6]. Progressive addition lenses have a significant but clinically small effect [8, 9] that is potentially related to changes in defocus of superior retinal images [10]. Rigid gas permeable contact lenses have a small effect that can be confounded by the keratometric changes [13]
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