欧洲儿童和青少年使用离焦多区域（DIMS）镜片和高非球面微透镜（HAL）镜片控制近视效果的比较。

Comparison of the performance of myopia control in European children and adolescents with defocus incorporated multiple segments (DIMS) and highly aspherical lenslets (HAL) spectacles.

作者信息

Lembo Andrea, Schiavetti Irene, Serafino Massimiliano, Caputo Roberto, Nucci Paolo

机构信息

Ophthalmology, University of Milan Faculty of Medicine and Surgery, Milano, Italy

Department of Health Sciences, University of Genoa, Genova, Italy.

出版信息

BMJ Paediatr Open. 2024 Dec 31;8(1):e003187. doi: 10.1136/bmjpo-2024-003187.

DOI:10.1136/bmjpo-2024-003187

PMID:39741002

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11749801/

Abstract

PURPOSE

A performance comparison of two myopia control spectacle lens designs, defocus incorporated multiple segments (DIMS) and highly aspherical lenslets (HAL), at slowing myopia progression in a European child/adolescent population. Previous research directly comparing these designs has been limited to Chinese participants and 1-year follow-up. The prevalence of myopia in European child/adolescent has been estimated at 22.60%.

METHODS

Retrospective cohort study of individuals (6-17 years) with myopia progression. Participants wore DIMS (Hoya MiyoSmart) or HAL (Essilor Stellest) spectacles for a minimum of 2 years. Axial length (AL) and cycloplegic autorefraction (spherical equivalent refraction (SER)) were measured at baseline and 1 and 2 years.

RESULTS

Mean 1-year SER changes for DIMS were -0.34D (±0.46 SD) and HAL -0.30D (±0.30); 2-year changes for DIMS were -0.50D (±0.64 SD) and HAL -0.63D (±0.56). Mean 1-year AL increases for DIMS were 0.19 mm (±0.56) and HAL 0.15 mm (±0.47); 2-year increases for DIMS were 0.29 mm (±0.63) and HAL 0.32 mm (±0.72). For equivalence margins of 0.25D and 0.50D for SER at 1 and 2 years, respectively, and similarly 0.20 mm and 0.30 mm margins for AL, DIMS and HAL lenses were equivalent apart from AL at 1 year where the 0.21 mm 95% CI upper limit just exceeded 0.20 mm. At both 1 and 2 years, none of the differences in mean SERs or ALs between DIMS and HAL were clinically or statistically significant (p≥0.05 Mann-Whitney U test). Using linear mixed model analysis, the interaction between lens type and time did not significantly affect SER or AL at 1- or 2-year follow-up (p≥0.05). 38.4% of children/adolescents with DIMS had no SER progression at 2 years, compared with 21.9% with HAL (p=0.047).

CONCLUSION

In a European population, DIMS and HAL lenses are essentially equivalent in their ability to reduce myopia progression and AL elongation over a 2-year follow-up period.

摘要

目的

比较两种近视控制眼镜镜片设计——离焦整合多焦点（DIMS）镜片和高非球面微透镜（HAL）镜片，在减缓欧洲儿童/青少年近视进展方面的性能。此前直接比较这两种设计的研究仅限于中国参与者且随访期为1年。据估计，欧洲儿童/青少年的近视患病率为22.60%。

方法

对有近视进展的6至17岁个体进行回顾性队列研究。参与者佩戴DIMS（豪雅MiyoSmart）或HAL（依视路Stellest）眼镜至少2年。在基线、1年和2年时测量眼轴长度（AL）和睫状肌麻痹验光（球镜等效屈光度（SER））。

结果

DIMS镜片1年的SER平均变化为-0.34D（±0.46标准差），HAL镜片为-0.30D（±0.30）；DIMS镜片2年的变化为-0.50D（±0.64标准差），HAL镜片为-0.63D（±0.56）。DIMS镜片1年的AL平均增加0.19毫米（±0.56），HAL镜片为0.15毫米（±0.47）；DIMS镜片2年的增加为0.29毫米（±0.63），HAL镜片为0.32毫米（±0.72）。对于1年和2年时SER的等效界值分别为0.25D和0.50D，以及类似地对于AL的界值为0.20毫米和0.30毫米，DIMS镜片和HAL镜片是等效的，但在1年时AL除外，其0.21毫米的95%置信区间上限刚刚超过0.20毫米。在1年和2年时，DIMS镜片和HAL镜片之间的平均SER或AL差异在临床或统计学上均无显著意义（曼-惠特尼U检验，p≥0.05）。使用线性混合模型分析，在1年或2年随访时，镜片类型和时间之间的交互作用对SER或AL没有显著影响（p≥0.05）。佩戴DIMS镜片的儿童/青少年中，38.4%在2年时SER无进展，而佩戴HAL镜片的这一比例为21.9%（p=0.047）。