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专门设计用于控制近视的眼镜镜片的疗效:系统评价和荟萃分析。

Efficacy of spectacle lenses specifically designed for myopia control: systematic review and meta-analysis.

作者信息

Perea-Romero Julia, Signes-Soler Isabel, Badenes-Ribera Laura, Tauste Ana

机构信息

Department of Optics and Optometry and Vision Sciences, Universitat de València, Burjassot, Valencia, Spain.

Department of Optometry and Vision Science, Masinde Muliro University of Science and Technology, P.O. Box, 190-50100, Kakamega, Kenya.

出版信息

Graefes Arch Clin Exp Ophthalmol. 2025 Apr;263(4):909-924. doi: 10.1007/s00417-024-06706-4. Epub 2024 Dec 9.

Abstract

PURPOSE

To investigate the efficacy of spectacle lenses designed to control myopia progression in individuals under 18 years old, focusing on changes in spherical equivalent refraction (SER), axial length (AL) and relative peripheral refraction (RPR).

METHODS

A systematic review was conducted according to Prisma guidelines. Databases searched included PubMed, Embase, and Scopus, covering studies from the last six years without language restrictions. Studies were included based on specific criteria, and data were extracted and analysed using the metafor package in R. Separate meta-analyses were conducted for SER and AL at 12- and 24-month follow-ups, using random-effects models. RPR information was synthesized without meta-analysis.

RESULTS

Out of the 796 studies screened, 21 were included in the review, with 17 selected for the meta-analysis, comprising a total of 6,175 patients. At 12 months, the intervention group showed a significant reduction in SER (d+ = -0.281, p < .0001) and AL (d+ = -0.155, p < .0001) compared to the control group, where d + is the pooled mean effect size estimate. However, at 24 months, no significant differences were observed in SER (d+ = -0.385, p = .067) or AL (d+ = -0.272, p = .137) between groups. Sensitivity analyses confirmed these findings, and publication bias was minimal. Regarding RPR, the results are limited and differ among model lenses.

CONCLUSION

Spectacle lenses designed to control myopia progression show short-term benefits, significantly reducing SER and AL at 12 months. However, their long-term efficacy remains uncertain, with no significant differences observed at 24 months. Further research is needed to understand treatment response factors and evaluate the long-term efficacy and safety of these lenses in myopia management.

摘要

目的

研究旨在控制18岁以下个体近视进展的眼镜镜片的疗效,重点关注等效球镜度(SER)、眼轴长度(AL)和相对周边屈光度(RPR)的变化。

方法

根据Prisma指南进行系统评价。检索的数据库包括PubMed、Embase和Scopus,涵盖过去六年的研究,无语言限制。根据特定标准纳入研究,并使用R语言中的metafor包提取和分析数据。在12个月和24个月随访时,对SER和AL进行单独的meta分析,采用随机效应模型。RPR信息未进行meta分析,而是进行了综合分析。

结果

在筛选的796项研究中,21项被纳入综述,17项被选入meta分析,共涉及6175例患者。在12个月时,与对照组相比,干预组的SER(合并效应量估计值d+ = -0.281,p <.0001)和AL(d+ = -0.155,p <.0001)显著降低。然而,在24个月时,两组之间在SER(d+ = -0.385,p = 0.067)或AL(d+ = -0.272,p = 0.137)方面未观察到显著差异。敏感性分析证实了这些结果,发表偏倚最小。关于RPR,结果有限,且不同型号镜片之间存在差异。

结论

旨在控制近视进展的眼镜镜片显示出短期益处,在12个月时显著降低了SER和AL。然而,其长期疗效仍不确定,在24个月时未观察到显著差异。需要进一步研究以了解治疗反应因素,并评估这些镜片在近视管理中的长期疗效和安全性。

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