Randomized trial of effect of bifocal and prismatic bifocal spectacles on myopic progression

Cheng, Desmond, Schmid, Katrina L., Woo, Geore, & Drobe, Bjorn (2010) Randomized trial of effect of bifocal and prismatic bifocal spectacles on myopic progression. Archives of Ophthalmology, 128(1), pp. 12-19.

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Abstract

Objective: To determine whether bifocal and prismatic bifocal spectacles could control myopia in children with high rates of myopic progression. ----------

Methods: This was a randomized controlled clinical trial. One hundred thirty-five (73 girls and 62 boys) myopic Chinese Canadian children (myopia of 1.00 diopters [D]) with myopic progression of at least 0.50 D in the preceding year were randomly assigned to 1 of 3 treatments: (1) single-vision lenses (n = 41), (2) +1.50-D executive bifocals (n = 48), or (3) +1.50-D executive bifocals with a 3–prism diopters base-in prism in the near segment of each lens (n = 46). ----------

Main Outcome Measures: Myopic progression measured by an automated refractor under cycloplegia and increase in axial length (secondary) measured by ultrasonography at 6-month intervals for 24 months. Only the data of the right eye were used. ----------

Results: Of the 135 children (mean age, 10.29 years [SE, 0.15 years]; mean visual acuity, –3.08 D [SE, 0.10 D]), 131 (97%) completed the trial after 24 months. Myopic progression averaged –1.55 D (SE, 0.12 D) for those who wore single-vision lenses, –0.96 D (SE, 0.09 D) for those who wore bifocals, and –0.70 D (SE, 0.10 D) for those who wore prismatic bifocals. Axial length increased an average of 0.62 mm (SE, 0.04 mm), 0.41 mm (SE, 0.04 mm), and 0.41 mm (SE, 0.05 mm), respectively. The treatment effect of bifocals (0.59 D) and prismatic bifocals (0.85 D) was significant (P < .001) and both bifocal groups had less axial elongation (0.21 mm) than the single-vision lens group (P < .001). ----------

Conclusions: Bifocal lenses can moderately slow myopic progression in children with high rates of progression after 24 months.

Impact and interest:

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ID Code: 37666
Item Type: Journal Article
Refereed: Yes
Keywords: Bifocal, Prismatic Bifocal Spectacles, Myopic Progression
DOI: 10.1001/archophthalmol.2009.332
ISSN: 0003-9950
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > OPTOMETRY AND OPHTHALMOLOGY (111300)
Divisions: Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Optometry & Vision Science
Copyright Owner: Copyright 2010 American Medical Association
Deposited On: 30 Sep 2010 22:38
Last Modified: 29 Feb 2012 14:14

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