Schilling Tim, Ohlendorf Arne, Varnas Saulius R, Wahl Siegfried
Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany.
Institute for Ophthalmic Research, Eberhard Karls University Tuebingen, Tuebingen, Germany 2Carl Zeiss Vision International GmbH, Aalen, Germany.
Invest Ophthalmol Vis Sci. 2017 Jul 1;58(9):3319-3324. doi: 10.1167/iovs.17-21589.
Insufficient accommodative response is assumed to result in myopia progression. We have investigated if the accommodative lag in myopes is different between a single vision lens (SVL) and the progressive addition lens PAL 2, clinically trialled for its ability to reduce progression of myopia, and if there exist differences in accommodative lag between PAL 2 and other PALs with the same addition power (+1.50 D).
The influence of spherical SVL and four different designs of PALs that differ in the near zone width (PAL 1) or that have different signs and magnitude of horizontal gradients of mean power adjacent to their near vision zones (PAL 3 and PAL 4) on the accommodative response was investigated for different near viewing distances (40, 33, and 25 cm) in 31 subjects, aged 18 to 25 years.
The SVL correction resulted in insufficient accommodative response for the near object viewing distances tested. PAL 2 did significantly reduce accommodative lag for all near object distances tested. The PAL design with a more negative horizontal mean power gradient (PAL 4) provided a lower lag of accommodation when compared with PAL 2 at the shortest object distance of 25 cm (P = 0.03) and was able to reduce the lag of accommodation to a level below the depth of focus for the higher near working distances tested.
Designs of PAL with more negative horizontal mean power gradients are the most effective in lowering the lag of accommodation in myopes. This could make them good test candidates for myopia control applications.
调节反应不足被认为会导致近视进展。我们研究了近视患者在单焦点镜片（SVL）和已进行临床测试以评估其减缓近视进展能力的渐进多焦点镜片PAL 2之间的调节滞后是否存在差异，以及PAL 2与其他具有相同附加度数（+1.50 D）的渐进多焦点镜片之间的调节滞后是否存在差异。
研究了球面SVL以及四种不同设计的渐进多焦点镜片（其近用区宽度不同（PAL 1），或者在其近用视觉区相邻处平均屈光力的水平梯度符号和大小不同（PAL 3和PAL 4））对31名年龄在18至25岁的受试者在不同近用观察距离（40、33和25 cm）下的调节反应的影响。
对于所测试的近用物体观察距离，SVL矫正导致调节反应不足。PAL 2确实显著降低了所有测试近用物体距离下的调节滞后。在最短物体距离25 cm时，与PAL 2相比，具有更负水平平均屈光力梯度的PAL设计（PAL 4）提供了更低的调节滞后（P = 0.03），并且能够将调节滞后降低到低于所测试更高近用工作距离的焦深水平。
具有更负水平平均屈光力梯度的渐进多焦点镜片设计在降低近视患者的调节滞后方面最有效。这可能使它们成为近视控制应用的良好测试候选者。
