Eye School, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Key Laboratory of Sichuan Province Ophthalmopathy Prevention & Cure and Visual Function Protection, Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Ophthalmic Res. 2022;65(4):398-416. doi: 10.1159/000523675. Epub 2022 Feb 28.
In children, myopia has become a widespread and serious global public health problem. Soft multifocal contact lenses (SMCLs) have been widely studied to control myopia progression in children. However, their efficacy in myopia control in children and its adverse effects and which added power SMCLs are more effective and safer remains to be explored.
Evaluate the efficacy and safety of various add power SMCLs to slow myopia progression in children.
Eligible randomized controlled trials were retrieved from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases. The present meta-analysis analyzed the mean differences (MD) in myopic progression, axial length, and odds ratios for adverse effects and dropout rates between SMCLs with different added powers and control groups. Changes in visual performance were also systematically evaluated.
Seven independent studies involving 805 children were included in the present meta-analysis. At 1-year, the weighted MD (WMD) in myopia progression between SMCL and control groups was -0.22 diopters (D) (95% confidence interval [CI]: -0.56 to 0.12 D) for low add power SMCLs, 0.09 D (95% CI: 0-0.19 D) for medium add power SMCLs, and 0.2 D (95% CI: 0.13, 0.27 D) for high add power SMCLs. At 2-years, the WMD for medium add power was 0.12 D (95% CI: -0.03 to 0.27 D), and for high add power was 0.25 D (95% CI: 0.14-0.35 D). No differences were detected for adverse effects (p = 0.2) and acceptability (p = 0.74) between different added powers. Additionally, differences in visual performance changes, produced by different added powers, were not detected.
The present meta-analysis showed that high add power SMCLs are more effective and stable to control myopia progression. Besides, the adverse effects and acceptability were not related to the added power.
在儿童中，近视已成为全球普遍且严重的公共卫生问题。软性多焦点接触镜（SMCL）已被广泛研究用于控制儿童近视进展。然而，其在儿童近视控制中的疗效以及不同附加度数的 SMCL 哪种更有效和更安全的问题仍有待探讨。
评估不同附加度数 SMCL 控制儿童近视进展的疗效和安全性。
从 PubMed、MEDLINE、EMBASE 和 Cochrane 对照试验中心注册数据库中检索到符合条件的随机对照试验。本荟萃分析分析了不同附加度数 SMCL 与对照组之间近视进展、眼轴长度和不良反应及辍学率的优势比的均值差异（MD）。还系统评估了视觉表现的变化。
本荟萃分析纳入了 7 项独立的研究，共涉及 805 名儿童。在 1 年时，低附加度数 SMCL 与对照组相比，近视进展的加权 MD（WMD）为-0.22 屈光度（D）（95%置信区间[CI]：-0.56 至 0.12 D），中附加度数 SMCL 为 0.09 D（95% CI：0 至 0.19 D），高附加度数 SMCL 为 0.20 D（95% CI：0.13，0.27 D）。在 2 年时，中附加度数的 WMD 为 0.12 D（95% CI：-0.03 至 0.27 D），高附加度数的 WMD 为 0.25 D（95% CI：0.14-0.35 D）。不同附加度数之间不良反应（p = 0.2）和可接受性（p = 0.74）无差异。此外，不同附加度数对视觉表现变化的影响也无差异。
本荟萃分析表明，高附加度数 SMCL 对控制近视进展更有效且稳定。此外，不良反应和可接受性与附加度数无关。
