Effects of progressive addition lenses versus single vision lenses on slowing myopia progression in school-aged children: a meta-analysis

目的 比较渐进镜和单焦点眼镜在延缓学龄儿童近视进展中的效果.方法 Meta分析.系统检索电子数据库Medline、EMBASE、Cochrane Library、中国生物医学文献数据库和中国临床试验注册中心中关于渐进镜的随机对照研究,手工检索相关书籍期刊,双人独立筛选评估文献和进行数据提取,以屈光度变化量、眼轴长度变化量和玻璃体腔长度变化量为结局变量进行Meta分析.结果 总共有5项符合标准的随机对照研究被纳入Meta分析,总样本量为1077例.对比渐进镜和单焦点眼镜采用固定效应模型分析,二者在延缓学龄儿童近视的屈光度进展量的加权均数差为-0.22 D(95％CI:-0.30～-0.14),差异有统计学意义(P＜0.01)；采用固定效应模型分析二者延缓学龄儿童近视眼轴长度进展量的加权均数差为-0.08 mm(95％CI:-0.11～-0.04)(P＜0.01)；采用固定效应模型分析二者延缓玻璃体腔长度进展量的加权均数差为-0.10 mm(95％CI:-0.15～-0.04)(P=0.0004).结论 和单焦点眼镜相比,渐进镜能够显著延缓学龄儿童近视的屈光度进展,同时可显著延缓眼轴长度和玻璃体腔长度的增长.Objective To compare the effects of progressive addition lenses versus single vision lenses in slowing myopia progression in school-aged children.Methods In this meta-analysis,Medline, EMBASE, Cochrane Library, Chinese Biomedical Database and Chinese Clinical Trial Registry were systematically retrieved combined with hand searches of related journals and books for randomized clinical trial on progressive addition lenses.Two reviewers independently screened and evaluated the literatures, and extracted the data from the retrieved studies.Changes in refraction,axial length and vitreous chamber depth that were reported in randomized clinical trials were used as outcome measured for mata-analysis.Results A total of 5 randomized clinical trials meeting the inclusion criteria were included in this meta-analysis.The total sample size was 1077.Compared to single vision lenses, progressive addition lenses showed a weighted mean difference of -0.22 D (95％CI:-0.30～-0.14) for change in myopia in school-aged children using a fixed effect model.The difference was statistically significant (P＜0.01).There was a weighted mean change of axial length difference of -0.08 mm (95％CI:-0.11～-0.04) between these two methods (P＜0.01) using a fixed effect model,and a weighted mean difference of -0.10 mm (95％CI:-0.15～-0.04)(P=0.0004) using a fixed effect model.Conclusion Compared with single vision lenses, progressive addition lenses can significantly slow the progression of refractive error, axial length and vitreous chamber depth in school-aged children.国家重点基础研究发展计划(973)资助项目; 中国博士后科学基金资助项目; 安阳市1530计划建设资助项目中国科技核心期刊(ISTIC)0295-991