Progressive-addition lenses versus single-vision lenses for slowing progression of myopia in children with high accommodative lag and near esophoria.
Gwiazda J, Chandler DL, Cotter SA, Everett DF, Hyman L, Kaminski BM, Kulp MT, Lyon DW, Manny RE, Marsh-Tootle WL, Matta NS, Melia BM, Norton TT, Scheiman MM, Silbert DI, Weissberg EM, Marsh-Tootle WL, Anderson ML, Frazier M, Hopkins KT, Weise KK, Baldwin C, Hill M, Manny RE, Anderson HA, Kim SA, Fern KD, Solis G, Ketcham A, Weissberg EM, Harb EN, Bittinger S, Owens R, Silbert DI, Blackburn DD, Hosey TJ, Singman EL, Matta NS, Dastgheib KA, Pavlica MR, Lyon DW, Eric K, Dunlap K, Long S, Wilhite J, Warren DF, Scheiman MM, Pollack K, Scombordi BJ, Kulp MT, Bullimore MA, Walline JJ, Stevens N, Pierce GE, Dallas F, Cotter SA, Barnhardt CN, Huang K, Nguyen MM, Heyman C, Parker SM, Rouse MW, Kraker T, Beck RW, Chandler DL, Diamond ER, Donahue Q, Gillespie H, Kaminski BM, Lee SV, Melia BM, Moke PS, Everett DF, Gwiazda JE, Chandler DL, Cotter SA, Everett DF, Holmes JM, Hyman L, Kulp MT, Lyon DW, Manny RE, Marsh-Tootle WL, Matta NS, Melia BM, Norton TT, Repka MX, Scheiman MM, Silbert DI, Weissberg EM, Holmes JM, Bacal DA, Beck RW, Birch EE, Christiansen SP, Cotter SA, Donahue S, Everett DF, Hoover DL, Huston PA, Kraker RT, Lee KA, Matta NS, Morrison DG, Repka MX, Rutstein RP, Sala NA, Scheiman MM, Wallace DK, Diener-West M, Baker JD, Barlow W, Buckley EG, Davis B, Dobson V, Everett DF, Phelps DL, Poff S, Saunders RA, Tychsen L.
Abstract
PURPOSE:
To determine whether progressive-addition lenses (PALs) relative to single-vision lenses (SVLs) slow the progression of low myopia in children with high accommodative lag and near esophoria.
METHODS:
One hundred eighteen children 8 to <12 years of age with spherical equivalent refraction (SER) from -0.75 to -2.50 D and near esophoria ≥2 PD were enrolled in this double-masked multicenter randomized trial. A key additional eligibility criterion was high accommodative lag, initially defined as at least 0.50 D (accommodative response less than 2.50 D for a 3.00-D demand) and later restricted further to at least 1.00 D. One hundred four subjects had accommodative lag of at least 1.00 D, and 14 had lag between 0.50 and 0.99 D. The children were randomized to receive either PALs with a +2.00-D addition or standard SVLs. The clinicians performing the outcome testing, as well as the children and their families, were masked to treatment group. Follow-up visits occurred every 6 months for 3 years. At annual visits, refractive error was assessed in each eye by using cycloplegic autorefraction. The main outcome measure was change from baseline to 3 years in SER by cycloplegic autorefraction.
RESULTS:
The mean change in SER between baseline and the 3-year primary outcome visit was -0.87 D in the PAL group and -1.15 D in the SVL group, for a difference of 0.28 D (95% confidence interval [CI], 0.01-0.55D).
CONCLUSIONS:
The PALs used in this study were found to have a statistically but not clinically significant effect of slowing myopia progression in children with high accommodative lag and near esophoria. (ClinicalTrials.gov number, NCT00320593.).
- PMID:
- 21282579
- [PubMed - indexed for MEDLINE]
- PMCID:
- PMC3088561
Free PMC ArticleFigure 2.
Mean change in spherical equivalent refractive error during follow-up. The mean difference between treatment groups (SVL − PAL) in the change in spherical equivalent refractive error from baseline to 1 year was 0.14 D (95% CI, −0.005–0.30 D), from baseline to 2 years was 0.23 D (95% CI, 0.02–0.45), and from baseline to the 3 years was 0.28 D (95% CI, 0.01–0.55).
Invest Ophthalmol Vis Sci. 2011 April;52(5):2749-2757.
Figure 1.
Flowchart of subjects throughout the study.
Invest Ophthalmol Vis Sci. 2011 April;52(5):2749-2757.
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