Brien Holden Vision Institute, Sydney, New South Wales, Australia.
Brien Holden Vision Institute, Sydney, New South Wales, Australia; School of Optometry and Vision Science, University of New South Wales, Sydney, New South Wales, Australia.
Cont Lens Anterior Eye. 2021 Feb;44(1):94-101. doi: 10.1016/j.clae.2020.11.015. Epub 2020 Dec 4.
To determine factors associated with non-adherence to contact lens wear schedule involving single vision and myopia control contact lenses in children.
Data from 379 children enrolled in a prospective, double masked, randomized clinical trial, aged 8-13 years, cycloplegic spherical equivalent of -0.75 to -3.50D and wearing either: single vision silicone hydrogel (SiH) CL (control lens); two anti-myopia SiH CL that incorporated relative plus in the central and periphery in a stepped manner (test lens I and II); and two extended depth of focus hydrogel CL (test lens III and IV) was considered. A questionnaire was administered to the participants at every scheduled visit and gathered information on days of wear/week and subjective assessments of ocular comfort and visual quality on an analog scale of 1-10.Participants were categorized as "Adherent" when lens wear was ≥ 6 days/week or "Non-adherent" when lens wear ≤ 5 days/week. Categorized adherence data was summarized as a percentage across visits for each CL type. Differences between the two groups were analyzed using linear mixed model.
For the control lens, 79.6 % participants were adherent as compared to 63.7%-74.6% with test lenses (p=0.026). Non-adherence was greater in those that discontinued (p<0.001). Subjective ratings of visual quality for static and dynamic tasks were lower with non-adherent wearers and more variable between visits. Ocular comfort was also poorer in non-adherent wearers irrespective of lens material or lens design. Male gender, lower baseline myopia, lower high contrast visual acuity and esophoria were associated with a higher risk of non-adherence.
The study identified a wide range of factors associated with non-adherence to lens wear schedule. Paying specific attention to these factors when evaluating patients for CL wear and taking steps to ensure satisfaction in lens wear may promote longer term continuation of wear.
确定与儿童单焦点和近视控制隐形眼镜佩戴时间表不依从相关的因素。
对 379 名 8-13 岁、散瞳等效球镜近视度为-0.75 至-3.50D 的儿童进行前瞻性、双盲、随机临床试验的数据进行了评估。他们均佩戴以下类型的隐形眼镜：单焦点硅水凝胶（SiH）隐形眼镜（对照镜）；两种通过中央和周边逐步增加相对正度数来控制近视的 SiH 隐形眼镜（测试镜 I 和 II）；两种扩展景深的水凝胶隐形眼镜（测试镜 III 和 IV）。在每次预定的就诊时，都会向参与者发放一份问卷，收集他们的佩戴天数/周以及对眼部舒适度和视觉质量的主观评估，评估采用 1-10 的模拟量表。当每周佩戴镜片≥6 天时，将参与者归为“依从”；当每周佩戴镜片≤5 天时，将参与者归为“不依从”。根据隐形眼镜类型，将分类依从数据在每次就诊时汇总为百分比。使用线性混合模型分析两组之间的差异。
与对照镜相比，有 79.6%的参与者佩戴测试镜时依从性较好，而佩戴测试镜的参与者依从性为 63.7%-74.6%（p=0.026）。那些停止佩戴的人不依从的比例更高（p<0.001）。在不依从佩戴者中，静态和动态任务的视觉质量主观评价较低，且在就诊之间的变化更大。无论隐形眼镜材料或设计如何，不依从佩戴者的眼部舒适度也较差。男性、较低的基线近视度数、较低的高对比度视力和内斜视与不依从佩戴的风险更高相关。
本研究确定了与佩戴隐形眼镜时间表不依从相关的一系列因素。在评估患者的隐形眼镜佩戴情况时，特别注意这些因素，并采取措施确保对隐形眼镜佩戴的满意度，可能有助于促进长期佩戴。
