Li Shi-Ming, Kang Meng-Tian, Wu Shan-Shan, Meng Bo, Sun Yun-Yun, Wei Shi-Fei, Liu Luoru, Peng Xiaoxia, Chen Zhuo, Zhang Fengju, Wang Ningli
Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology & Visual Science Key Lab, Beijing Institute of Ophthalmology, Capital Medical University, Beijing, China.
National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Ophthalmic Physiol Opt. 2017 Jan;37(1):51-59. doi: 10.1111/opo.12332. Epub 2016 Nov 23.
To evaluate the effect of soft contact lens with concentric ring bifocal and peripheral add multifocal designs on controlling myopia progression in school-aged children.
We systematically searched MEDLINE, EMBASE, Cochrane Library and reference lists of included trials. Methodological quality of included trials was assessed using Jadad Scale and Newcastle-Ottawa Quality Assessment Scale items.
We identified five randomised controlled trials (RCTs) and three cohort studies with a total of 587 myopic children. Compared with the control group, concentric ring bifocal soft contact lenses showed less myopia progression with a weighted mean difference (WMD) of 0.31 D (95% CI, 0.050.57 D, p = 0.02) and less axial elongation with a WMD of -0.12 mm (95% CI, approximately -0.18 to -0.07 mm, p < 0.0001) at 12 months. Relative to the control group, peripheral add multifocal soft contact lenses showed less myopia progression with a WMD of 0.22 D (95% CI 0.140.31 D, p < 0.0001) and less axial elongation of -0.10 mm (95% CI -0.130.07 mm, p < 0.0001) at 12 months, respectively. The soft contact lenses with concentric ring bifocal and peripheral add multifocal designs produced additional myopia control rates of 3038% for slowing myopia progression and 31~51% for lessening axial elongation within 24 months.
Both concentric ring bifocal and peripheral add multifocal soft contact lenses are clinically effective for controlling myopia in school-aged children, with an overall myopia control rates of 30~50% over 2 years. Concentric ring bifocal soft contact lenses seem to have greater effect than peripheral add multifocal soft contact lenses.
评估采用同心环双焦点和周边附加多焦点设计的软性接触镜对控制学龄儿童近视进展的效果。
我们系统检索了MEDLINE、EMBASE、Cochrane图书馆以及纳入试验的参考文献列表。采用Jadad量表和纽卡斯尔-渥太华质量评估量表项目评估纳入试验的方法学质量。
我们确定了5项随机对照试验(RCT)和3项队列研究,共有587名近视儿童。与对照组相比,同心环双焦点软性接触镜在12个月时近视进展较少,加权平均差(WMD)为0.31 D(95%CI,0.050.57 D,p = 0.02),眼轴伸长较少,WMD为-0.12 mm(95%CI,约-0.18至-0.07 mm,p < 0.0001)。相对于对照组,周边附加多焦点软性接触镜在12个月时近视进展较少,WMD为0.22 D(95%CI 0.140.31 D,p < 0.0001),眼轴伸长较少,为-0.10 mm(95%CI -0.130.07 mm,p < 0.0001)。采用同心环双焦点和周边附加多焦点设计的软性接触镜在24个月内减缓近视进展的额外近视控制率为3038%,减少眼轴伸长的额外近视控制率为31~51%。
同心环双焦点和周边附加多焦点软性接触镜在临床上对控制学龄儿童近视均有效,2年内总体近视控制率为30~50%。同心环双焦点软性接触镜似乎比周边附加多焦点软性接触镜效果更好。