新型漸進多焦(兒控)鏡片用於近視控制的兩年實驗

視光界最權威的期刊IOVS 2014最新的文章

結果再次證實了兒控鏡片控制近視的效果只有約20%

近用時減少調節的使用對於控制近視效果真的有限，就算加上周邊屈光差也沒有改善。

還不如單獨使用周邊屈光差設計的控制近視鏡片

顯示控制近視還是要從視覺影像著手，眼球的機械性力量(調節、內聚等等)的調整，改善程度有限。


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一種新型的漸進多焦鏡片，兩年、多中心、隨機、對照控制的近視控制實驗。

此種新型漸進多焦鏡片採用新設計的周邊正非球面設計

可以同時減少調節與視網膜周邊的遠視性離焦

197位6~12歲兒童參與實驗，等值球面近視在-1.00D ~ -4.50D
隨機分為三組，單焦組，多焦加入度+1.00D，多焦加入度+1.50D

兩年後的結果
單焦組 增加 -1.39 ± 0.09 D

多焦加入度+1.50D比單焦組減少0.27 ± 0.11 D

也就是控制近視效果約20%，統計上達顯著程度。

多焦加入度+1.00D則不具顯著控制近視效果。


Invest. Ophthalmol. Vis. Sci., 2014

Myopia Control with Positively Aspherised Progressive Addition Lenses: A two-year, Multicenter, Randomized, Controlled Trial.

Hasebe, S; Jun, J; Varnas, SR

PURPOSE: To evaluate the effect of newly-designed positively aspherised progressive addition lenses (PA-PALs), which reduce both lag of accommodation and hyperopic defocus on the peripheral retina, on progression of early-onset myopia.
METHODS: PA-PALs have a near addition and a high positive distance zone aspherisation comparable to the addition power. One hundred and ninety-seven children were enrolled, 6 to 12 years of age, with spherical equivalent refraction from -1.00 to -4.50 D. The children were randomized to receive one of three lenses: single vision lenses (SVLs), PA-PALs with +1.0 D addition, or PA-PALs with +1.5 D addition. Follow-up visits occurred every 6 months for two years. The primary outcome is myopia progression evaluated by cycloplegic autorefraction.
RESULTS: One hundred and sixty-nine (86%) children completed the follow-up. Statistical analysis of adjusted progression rates showed a mean (±SE) progression of -1.39 ± 0.09 D in the control group wearing SVLs at the 24-month visit. Statistically significant (p = 0.017) retardation of SER (0.27 ± 0.11 D over 24 months or reduction ratio of 20%) by +1.5 D add PA-PALs relative to the SVLs was found, which was within the range of the percentage efficacy of myopia retardation by the conventional PALs in earlier trials over the same follow-up period. Nearly all retardation occurred in the first 12 months with no significant efficacy in the second year. PA-PALs with +1.0 D addition showed negligible efficacy.
CONCLUSION: The high positive aspherisation of the distance zone added to PALs apparently does not enhance their therapeutic efficacy in slowing myopia progression.
Copyright © 2014 by Association for Research in Vision and Ophthalmology.

PMID: 25270192
URL  - http://www.ncbi.nlm.nih.gov/pubmed/25270192?dopt=Citation