周边离焦对远视性屈光参差儿童眼轴增长和屈光不正调节的影响。

Effect of peripheral defocus on axial growth and modulation of refractive error in children with anisohyperopia.

机构信息

School of Optometry, Aston University, Birmingham, UK.

出版信息

Ophthalmic Physiol Opt. 2023 Jul;43(4):805-814. doi: 10.1111/opo.13139. Epub 2023 Apr 7.

DOI:10.1111/opo.13139

PMID:37026593

Abstract

PURPOSE

To establish whether axial growth and refractive error can be modulated in anisohyperopic children by imposing relative peripheral hyperopic defocus (RPHD) using multifocal soft contact lenses.

METHODS

This study is a prospective, controlled paired-eye study with anisohyperopic children. Axial growth and refractive error were observed without intervention for the first 6 months of the 3-year trial with participants wearing single vision spectacles. Then, participants wore a centre-near, multifocal, soft contact lens (+2.00 D add) in their more hyperopic eye for 2 years, with a single vision contact lens worn in the fellow eye if required. The 'centre-near' portion of the contact lens in the more hyperopic eye corrected distance refractive error while the 'distance' portion imposed hyperopic defocus in the peripheral retina. Participants reverted to single vision spectacles for the final 6 months.

RESULTS

Eleven participants, mean age of 10.56 years (SD 1.43; range 8.25-13.42), completed the trial. No increase in axial length (AL) was found during the first 6 months in either eye (p > 0.99). Axial growth across the 2-year intervention period was 0.11 mm (SEM 0.03; p = 0.06) in the test eye versus 0.15 mm (SEM 0.03; p = 0.003) in the control eye. AL was invariant during the final 6 months in both eyes (p > 0.99). Refractive error was stable during the first 6 months in both eyes (p = 0.71). Refractive error change across the 2-year intervention period was -0.23 D (SEM 0.14; p = 0.32) in the test eye versus -0.30 D (SEM 0.14; p = 0.61) in the control eye. Neither eye demonstrated a change in refractive error during the final 6 months (p > 0.99).

CONCLUSIONS

Imposing RPHD using the centre-near, multifocal, contact lens specified here did not accelerate axial growth nor reduce refractive error in anisohyperopic children.

摘要

目的

通过使用多焦点软接触镜施加相对周边远视离焦（RPHD），来确定轴向生长和屈光不正是否可以在远视性屈光不正儿童中得到调节。

方法

本研究是一项前瞻性、对照配对眼研究，纳入远视性屈光不正儿童。在 3 年试验的前 6 个月，参与者不接受任何干预，只佩戴单焦远视眼镜。然后，在 2 年内，参与者在远视程度较高的眼睛中佩戴中心-近用、多焦点、软性接触镜（+2.00 D 附加），如果需要，在对侧眼佩戴单焦接触镜。远视程度较高的眼睛中的接触镜的“中心-近用”部分矫正远距屈光不正，而“远距”部分在周边视网膜上施加远视离焦。最后 6 个月，参与者恢复单焦远视眼镜。

结果

11 名参与者，平均年龄 10.56 岁（标准差 1.43 岁；范围 8.25-13.42 岁）完成了试验。在任何一只眼睛中，在前 6 个月都没有发现眼轴（AL）的增加（p>0.99）。在 2 年的干预期间，在试验眼中，眼轴增长 0.11 毫米（SEM 0.03；p=0.06），而在对照眼中，眼轴增长 0.15 毫米（SEM 0.03；p=0.003）。在两只眼睛中，AL 在最后 6 个月期间保持不变（p>0.99）。在前 6 个月，两只眼睛的屈光不正均保持稳定（p=0.71）。在 2 年的干预期间，在试验眼中，屈光不正变化为-0.23 D（SEM 0.14；p=0.32），而在对照眼中，屈光不正变化为-0.30 D（SEM 0.14；p=0.61）。在最后 6 个月期间，两只眼睛均未出现屈光不正的变化（p>0.99）。