Pearce Matthew G
Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI, USA.
Clin Exp Optom. 2014 May;97(3):225-33. doi: 10.1111/cxo.12126. Epub 2014 Jan 8.
Uncorrected refractive error is the leading cause of global visual impairment. Given resource constraints in developing countries, the gold standard method of refractive error correction, custom-made spectacles, is unlikely to be available for some time. Therefore, ready-made and recycled spectacles are in wide use in the developing world. To ensure that refractive error interventions are successful, it is important that only appropriate modes of refractive error correction are used. As a basis for policy development, a systematic literature review was conducted of interventional studies analysing visual function, patient satisfaction and continued use outcomes of ready-made and recycled spectacles dispensed to individuals in developing countries with refractive errors or presbyopia. PubMed and CINAHL were searched by MESH terms and keywords related to ready-made and recycled spectacle interventions, yielding 185 non-duplicated papers. After applying exclusion criteria, eight papers describing seven studies of clinical outcomes of dispensing ready-made spectacles were retained for analysis. The two randomised controlled trials and five non-experimental studies suggest that ready-made spectacles can provide sufficient visual function for a large portion of the world's population with refractive error, including those with astigmatism and/or anisometropia. The follow-up period for many of the studies was too short to confidently comment on patient satisfaction and continued-use outcomes. No studies were found that met inclusion criteria and discussed recycled spectacles. The literature also notes concerns about quality and cost effectiveness of recycled spectacles, as well as their tendency to increase developing countries' reliance on outside sources of help. In light of the findings, the dispensing of ready-made spectacles should be favoured over the dispensing of recycled spectacles in developing countries.
未矫正的屈光不正为全球视力损害的主要原因。鉴于发展中国家资源有限，屈光不正矫正的金标准方法——定制眼镜，在一段时间内不太可能普及。因此，成品眼镜和回收眼镜在发展中世界广泛使用。为确保屈光不正干预措施取得成功，重要的是仅使用适当的屈光不正矫正方式。作为政策制定的基础，我们对干预性研究进行了系统的文献综述，分析了分发给发展中国家患有屈光不正或老花眼的个人的成品眼镜和回收眼镜的视觉功能、患者满意度及持续使用效果。通过与成品眼镜和回收眼镜干预相关的医学主题词和关键词在PubMed和CINAHL中进行检索，得到185篇无重复的论文。在应用排除标准后，保留了八篇描述七项成品眼镜配镜临床结果研究的论文进行分析。两项随机对照试验和五项非实验性研究表明，成品眼镜可为世界上很大一部分屈光不正人群，包括散光和/或屈光参差患者，提供足够的视觉功能。许多研究的随访期过短，无法对患者满意度和持续使用效果进行可靠评价。未发现符合纳入标准且讨论回收眼镜的研究。文献还指出了对回收眼镜质量和成本效益的担忧，以及它们可能增加发展中国家对外部援助依赖的倾向。鉴于这些研究结果，在发展中国家，应优先分发成品眼镜而非回收眼镜。
