兒童眼適能鏡片之視覺表現

本研究利用兒童眼視能鏡片(周邊離焦設計)與一般單焦鏡片比較，探討周邊屈光的變化與近視控制的效果。受測者為7~12歲的國小學童，雙眼等效球面屈光度數介於-0.75 D至-6.00 D。最終收案人數36名受試者，28位男性，8位女性。配戴兒童眼適能鏡片組(實驗組)共21位，平均年齡10.3 ± 1.5歲，右眼等價球面度數平均-2.65 ± 1.35 D、左眼等價球面度數平均-2.78 ± 1.42 D；一般單焦組(對照組)共15位，平均年齡9.40 ± 1.24歲，右眼等價球面度數平均-1.73 ± 2.20 D、左眼等價球面度數平均-1.87 ± 2.20 D。進行視力測量、中心與周邊屈光度、非接觸式眼軸測量、角膜弧度測量以及配戴舒適度問卷。測量結果實驗組相對周邊屈光的等價球面度數M（初戴眼鏡時戴鏡和配戴六個月後的戴鏡比較）右眼在M、J0及J45三項在任何角度均無顯著差異；而左眼M在N10平均增加+0.37 ± 0.53 D（p=0.006）。散光J0，左眼則是在N20平均增加-0.26 ± 0.46 D（p=0.021）、CT平均增加-0.29 ± 0.36 D（p=0.002）、T30增加-0.76 ± 1.40 D（p=0.025）。散光J45，左眼CT平均增加+0.20 ± 0.25 D（p=0.002）。在近視度數方面，六個月實驗組右眼近視增加的度數為-0.43 ± 0.50 D；對照組右眼則為-0.90 ± 1.02 D。實驗組左眼增加的度數為-0.29 ± 0.31 D，對照組左眼則為-0.80 ± 0.85 D。若以兩眼六個月的度數增加率相比，實驗組約比對照組減少57.6 %（0.49 D）的近視加深。六個月的研究結果指出，配戴眼適能鏡片雖然並不能改變周邊屈光狀態，但是仍然具有減緩近視的效果，在剩餘的研究期間中，必須持續關注是否能夠效果是否可以維持。

PurposePrevious studies suggested that the refractive status of the peripheral retina can influence the progression of myopia. Our aim was to compare myopia control in the children’s eyes corrected with Eye Fitness Lens (EFLs) (peripheral defocused design) to those wearing single vision lenses (SVLs). We also investigated the effects of peripheral refractive changes in myopia progression by wearing Eye Fitness Lens (EFLs).MethodsThirty-six myopic children (8 female and 28 male) were enrolled, aged 7 to 12 years with spherical equivalent refractions ranged from -0.50 to -6.00 diopters (D). The children were randomized to receive either SVLs (N=15) or EFLs (N=21) lenses. In the EFLs groups, the mean spherical equivalence of right eyes (OD) was -2.65 ± 1.35 D, and -2.78 ± 1.42 D for left eyes (OS). In the SVLs group, OD spherical equivalence was -1.73 ± 2.20 D, OS spherical equivalence was -1.87 ± 2.20 D. Ocular examinations included visual acuity, central and peripheral refraction, non-contact axial length measurements, and wearing comfort questionnaire survey was also conducted.ResultsThe related peripheral refractive error (RPRE-M) of the EFLs group, there were no significant differences in M、J0、J45 for OD, however, it increased +0.37 ± 0.53 D in the N10 (p = 0.006) for OS. For J0, the mean spherical equivalent of OS increased -0.26 ± 0.46 D in the N20 (p = 0.021), increased -0.29 ± 0.36 D in the CT (p = 0.002), increased -0.76 ± 0.14 D in the T30 (p = 0.025). For J45, it increased +0.20 ± 0.25 D in the CT (p = 0.002) for OS. In the EFLs group, the mean spherical equivalent increased -0.43 ± 0.50 D (OD)、-0.29 ± 0.31 D (OS); in the control group, it increased -0.90 ± 1.02 D (OD)、-0.80 ± 0.85 D (OS). The EFLs group showed a reduction of 57.6 % (0.49 D) in myopia progression compared to the controls.ConclusionThe results indicated that the use of Eye Fitting lenses does not change the peripheral refractive state; however, it still shows the effect of slowing down myopia progression. A longer-term investigation is required to study the effect of the EFLs on the changes in peripheral refraction during myopia progression.