Fan Hao-Bo, Li Zhi-Lin, Zhang Xue-Min, Xie Ai-Rui, Wei Qiu-Mei, Song Ting-Ting, Duan Jun-Guo
Eye College of Chengdu University of Traditional Chinese Medicine, Chengdu 610000, Sichuan Province, China.
Department of Optometry and Pediatric Ophthalmology, Ineye Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu 610000, Sichuan Province, China.
Int J Ophthalmol. 2025 Apr 18;18(4):723-734. doi: 10.18240/ijo.2025.04.20. eCollection 2025.
To evaluate the effects of microlens design of peripheral defocus modifying spectacle lenses (PDMSLs) and non-microlens design of PDMSLs on controlling myopia progression in children and adolescents.
A systematic search was carried out in the PubMed, Cochrane Library, Embase, CNKI, and Web of Science databases. The search targeted randomized controlled trials (RCTs) and cohort studies (CTs) that explored the effects of PDMSLs on myopia control among children and adolescents. The Cochrane risk-of-bias tool and the Newcastle-Ottawa Scale were employed to evaluate the risk of bias in the included studies. The published biases of the included studies were evaluated using Egger's test.
Nine studies (7 RCTs, 2 CTs) were included, involving 4332 participants in the PDMSLs group and 7317 participants in the single vision lenses (SVLs) group. Meta-analysis showed that PDMSLs with microlens design had lower change in spherical equivalent refraction (SER) than SVLs at 6, 12, 18, and 24mo after wearing glasses, with reductions of 0.19 D (95%CI: 0.14 to 0.24, <0.00001), 0.36 D (95%CI: 0.25 to 0.46, <0.00001), 0.43 D (95%CI: 0.32 to 0.55, <0.00001), and 0.51 D (95%CI: 0.33 to 0.69, <0.00001), respectively. The changes in axial length (AL) were also lower in PDMSLs compared to SVLs, with reductions of -0.09 mm (95%CI: -0.13 to -0.04, =0.0002), -0.15 mm (95%CI: -0.21 to -0.08, <0.00001), -0.27 mm (95%CI: -0.34 to -0.20, <0.00001), and -0.29 mm (95%CI: -0.38 to -0.20, <0.00001), respectively. There was no significant difference between the non-microlens group and SVLs in controlling the changes of SER and AL in myopia (both >0.05).
The synthesized evidence indicates superior myopia management outcomes with microlens design of PDMSLs compared to both SVLs and non-microlens design of PDMSLs in children and adolescents.
评估周边离焦修饰型眼镜片(PDMSLs)的微透镜设计和非微透镜设计对控制儿童及青少年近视进展的效果。
在PubMed、Cochrane图书馆、Embase、中国知网和Web of Science数据库中进行系统检索。检索目标为探索PDMSLs对儿童及青少年近视控制效果的随机对照试验(RCTs)和队列研究(CTs)。采用Cochrane偏倚风险工具和纽卡斯尔-渥太华量表评估纳入研究的偏倚风险。使用Egger检验评估纳入研究的发表偏倚。
纳入9项研究(7项RCTs,2项CTs),PDMSLs组有4332名参与者,单光镜片(SVLs)组有7317名参与者。荟萃分析显示,佩戴眼镜后6、12、18和24个月时,具有微透镜设计的PDMSLs的等效球镜度(SER)变化低于SVLs,分别降低了0.19 D(95%CI:0.14至0.24,<0.00001)、0.36 D(95%CI:0.25至0.46,<0.00001)、0.43 D(95%CI:0.32至0.55,<0.00001)和0.51 D(95%CI:0.33至0.69,<0.00001)。与SVLs相比,PDMSLs的眼轴长度(AL)变化也更低,分别降低了-0.09 mm(95%CI:-0.13至-0.04,=0.0002)、-0.15 mm(95%CI:-0.21至-0.08,<0.00001)、-0.27 mm(95%CI:-0.34至-0.20,<0.00001)和-0.29 mm(95%CI:-0.38至-0.20,<0.00001)。在控制近视的SER和AL变化方面,非微透镜组与SVLs之间无显著差异(均>0.05)。
综合证据表明,与SVLs以及PDMSLs的非微透镜设计相比,PDMSLs的微透镜设计在儿童和青少年近视管理方面具有更好的效果。