Please use this identifier to cite or link to this item: http://hdl.handle.net/10397/20766
Title: Effect of bifocal and prismatic bifocal spectacles on myopia progression in children : three-year results of a randomized clinical trial
Authors: Cheng, D
Woo, GC
Drobe, B
Schmid, KL
Issue Date: 2014
Publisher: American Medical Association
Source: JAMA ophthalmology, 2014, v. 132, no. 3, p. 258-264 How to cite?
Journal: JAMA Ophthalmology 
Abstract: IMPORTANCE: Myopia is a significant public health problem, making it important to determine whether a bifocal spectacle treatment involving near prism slows myopia progression in children. OBJECTIVE: To determine whether bifocal and prismatic bifocal spectacles control myopia in children with high rates of myopia progression and to assess whether the treatment effect is dependent on the lag of accommodation and/or near phoria status. DESIGN, SETTING, AND PARTICIPANTS: This 3-year randomized clinical trial was conducted in a private practice. A total of 135 (73 female and 62 male) Chinese-Canadian children (aged 8-13 years; mean [SE] age, 10.29 [0.15] years; mean [SE] myopia, -3.08 [0.10] D) with myopia progression of at least 0.50 D in the preceding year were randomly assigned to 1 of 3 treatments. A total of 128 (94.8%) completed the trial. INTERVENTIONS: Single-vision lenses (control, n = 41), +1.50-D executive bifocals (n = 48), and +1.50-D executive bifocals with 3-Δ base-in prism in the near segment of each lens (n = 46). MAIN OUTCOMES AND MEASURES: Myopia progression (primary) measured using an automated refractor following cycloplegia and increase in axial length (secondary) measured using ultrasonography at intervals of 6 months for 36 months. RESULTS: Myopia progression over 3 years was an average (SE) of -2.06 (0.13) D for the single-vision lens group, -1.25 (0.10) D for the bifocal group, and -1.01 (0.13) D for the prismatic bifocal group. Axial length increased an average (SE) of 0.82 (0.05) mm, 0.57 (0.07) mm, and 0.54 (0.06) mm, respectively. The treatment effect of bifocals (0.81 D) and prismatic bifocals (1.05 D) was significant (P < .001). Both bifocal groups had less axial elongation (0.25 mm and 0.28 mm, respectively) than the single-vision lens group (P < .001). For children with high lags of accommodation (≥1.01 D), the treatment effect of both bifocals and prismatic bifocals was similar (1.1 D) (P < .001). For children with low lags (<1.01 D), the treatment effect of prismatic bifocals (0.99 D) was greater than of bifocals (0.50 D) (P = .03). The treatment effect of both bifocals and prismatic bifocals was independent of the near phoria status. CONCLUSIONS AND RELEVANCE: Bifocal spectacles can slow myopia progression in children with an annual progression rate of at least 0.50 D after 3 years. These results suggest that prismatic bifocals are more effective for myopic children with low lags of accommodation.
URI: http://hdl.handle.net/10397/20766
ISSN: 2168-6165
DOI: 10.1001/jamaophthalmol.2013.7623
Appears in Collections:Journal/Magazine Article

Access
View full-text via PolyU eLinks SFX Query
Show full item record

SCOPUSTM   
Citations

29
Last Week
0
Last month
5
Citations as of Apr 28, 2017

WEB OF SCIENCETM
Citations

25
Last Week
0
Last month
4
Citations as of Apr 27, 2017

Page view(s)

35
Last Week
5
Last month
Checked on Apr 23, 2017

Google ScholarTM

Check

Altmetric



Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.