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使用改良型光学离焦软性接触镜控制学龄儿童近视——一项为期12个月的随机双盲对照试验。

Myopia control using a modified optical defocus soft contact lens in schoolchildren-A 12-month randomised double masked control trial.

作者信息

Zhang Hanyu, Leung Ka Yan, Leung Myra, Tang Wing Chun, Wong Chun Ki, Liu Ka King, Tse Dennis Yan Yin, Lee Paul H, Lam Carly Siu Yin

机构信息

School of Medicine, Nankai University, Tianjin, China.

Centre for Eye and Vision Research, Hong Kong, China.

出版信息

Ophthalmic Physiol Opt. 2025 Jun;45(4):969-981. doi: 10.1111/opo.13501. Epub 2025 Apr 1.

Abstract

PURPOSE

Defocus Incorporated Soft Contact (DISC) lenses with +2.50 D myopic defocus reduced myopia progression by 25% in a previous randomised clinical trial (RCT). The current study aimed to evaluate if a stronger myopic defocus, +3.50 D with variable myopic defocus (DISC3.5plus), could slow myopia progression compared with single vision (SV) soft contact lenses in a 12-month RCT.

METHODS

Conducted from December 2018 to January 2021, the current RCT randomly assigned myopic children to wear DISC3.5plus (n = 87) or SV (n = 80) lenses. Myopia progression and axial elongation were compared between the two groups. Analyses were performed for both enrolled and completed participants.

RESULTS

For all enrolled participants, the DISC3.5plus group had significantly less myopia progression (mean difference: -0.15 ± 0.07 D, p = 0.02) and axial elongation (mean difference: 0.04 ± 0.02 D, p = 0.04) than the SV group at 6 months but not at 12 months (myopia progression: p = 0.11; axial elongation: p = 0.13). For completed participants, the DISC3.5plus group (n = 33) had reduced myopia progression at both 6 months (0.25 ± 0.07 D, p = 0.001) and 12 months (0.19 ± 0.09 D, p = 0.049) compared with the SV group (n = 40), but not in axial elongation (6 months: p = 0.16; 12 months: p = 0.32). In January 2020, the coronavirus pandemic disturbed contact lens-wearing patterns.

CONCLUSION

DISC3.5plus lenses significantly slowed myopia progression and axial elongation compared with SV lenses for all enrolled participants over 6 months. The pandemic hindered longer term efficacy follow-up and sample size; thus, further investigation with more participants is needed to confirm sustained treatment effects.

摘要

目的

在之前的一项随机临床试验(RCT)中,具有+2.50 D近视离焦的离焦整合型软性接触镜(DISC)使近视进展减缓了25%。本研究旨在评估在一项为期12个月的RCT中,更强的近视离焦(+3.50 D可变近视离焦,即DISC3.5plus)与单焦点(SV)软性接触镜相比,是否能减缓近视进展。

方法

本RCT于2018年12月至2021年1月进行,将近视儿童随机分配佩戴DISC3.5plus(n = 87)或SV(n = 80)镜片。比较两组之间的近视进展和眼轴伸长情况。对已入组和完成试验的参与者均进行了分析。

结果

对于所有入组参与者,在6个月时,DISC3.5plus组的近视进展(平均差值:-0.15±0.07 D,p = 0.02)和眼轴伸长(平均差值:0.04±0.02 D,p = 0.04)均显著低于SV组,但在12个月时并非如此(近视进展:p = 0.11;眼轴伸长:p = 0.13)。对于完成试验的参与者,与SV组(n = 40)相比,DISC3.5plus组(n = 33)在6个月(0.25±0.07 D,p = 0.001)和12个月(0.19±0.09 D, p = 0.049)时的近视进展均有所减缓,但眼轴伸长方面未减缓(6个月:p = 0.16;12个月:p = 0.32)。2020年1月,新冠疫情扰乱了隐形眼镜的佩戴模式。

结论

对于所有入组参与者,在6个月的时间里,与SV镜片相比,DISC3.5plus镜片显著减缓了近视进展和眼轴伸长。疫情阻碍了长期疗效随访和样本量;因此,需要更多参与者进行进一步研究以确认持续的治疗效果。

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