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October 15, 2024
By Dwight Akerman, OD, MBA, FAAO, FBCLA, FIACLE
Photo Credit: Getty Images
This study aimed to investigate the impact of first-time correction (FTC) on changes in myopia progression and axial elongation in myopic children wearing spectacle lenses with highly aspherical lenslets (HAL)*, slightly aspherical lenslets (SAL), and single-vision lenses (SVL). The research was conducted by Yee Ling Wong, Yingying Huang, Xue Li, Ee Woon Lim, Adeline Yang, Björn Drobe, Hao Chen, and Jinhua Bao. It was presented at the 2024 ARVO Annual Meeting.
The randomized trial involved 170 myopic children in Wenzhou, China, aged 8-13 years, with a spherical equivalent (SE) of -0.75D to -4.75D. The participants were randomly assigned to wear one of the three types of spectacle lenses — HAL, SAL, or SVL — for a period of two years. The study defined FTC as the wearing of any optical correction for the first time. The research utilized generalized linear models to assess the influence of FTC on the treatment effect, adjusting for covariates such as baseline age, gender, SE, axial length (AL), age of myopia onset, and parental myopia.
Results showed that out of 170 children, 157 completed the two-year trial, with 67 receiving FTC at the beginning. The findings indicated that children with FTC were less myopic, had a later age of myopia onset, and had shorter AL compared to those without FTC. Over the initial six months, mean adjusted SE change with FTC for HAL and SAL was not significantly different from those without FTC, suggesting that wearing HAL and SAL did not significantly impact myopia progression and axial elongation in the short term. However, the SVL group with FTC showed a more myopic shift compared to the SVL group without FTC during the same period.
Over the two-year period, the study found that the myopia progression and axial elongation in the SVL group with FTC were significantly greater compared to the SVL group without FTC. However, this difference was not observed in the HAL and SAL groups, indicating that myopia control spectacle lenses with aspherical lenslets should be prescribed as a child’s first pair of spectacle lenses. The study concluded that FTC is significantly associated with greater myopia progression and axial elongation in the SVL group but not in the HAL and SAL groups for the first six months and up to two years. These results suggest that the type of spectacle lenses worn at the time of first correction could significantly impact myopia progression and axial elongation in children.
In summary, the research provides valuable insights into the impact of first-time correction and the type of spectacle lenses worn on myopia progression and axial elongation in myopic children. The findings emphasize the importance of considering specialized myopia control spectacle lenses with aspherical lenslets as the primary choice for children’s first pair of spectacle lenses to help address the growing concern of myopia progression in young individuals.
Abstract
Influence of First-Time Correction on Myopia Progression and Axial Elongation in Myopic Children Wearing Spectacle Lenses With and Without Aspherical Lenslets
Yee Ling Wong; Yingying Huang; XUE LI; Ee Woon Lim; Adeline Yang; Björn Drobe; Hao Chen; Jinhua Bao
Purpose: To examine the influence of first-time correction (FTC) on changes in cycloplegic spherical equivalent (SER) and axial length (AL) in children wearing spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) compared to that of single-vision lenses (SVL).
Methods: The randomized trial had 170 myopic children in Wenzhou, China, (8-13 years; SE of -0.75 to -4.75D) randomly assigned to wear one of the three spectacle lenses: HAL, SAL, or SVL for two years. FTC was defined as the wearing of any optical correction for the first time. Generalized linear models, adjusting for covariates baseline age, gender, SER, AL, age of myopia onset, and parental myopia, were used to evaluate the influence of FTC on treatment effect.
Results: A total of 157 (54 HAL, 53 SAL, and 50 SVL) children completed the two-year trial, and 67 (20 HAL, 24 SAL, and 23 SVL) received FTC at the beginning. Children with FTC were less myopic (-1.9 vs -2.9D; P<0.001), had a later age of myopia onset (9.9 vs 9.0y; P<0.001), and shorter AL (24.5 vs 24.8mm; P=0.003), compared to those without FTC.
In the first six months, mean adjusted SER change with FTC for HAL and SAL (-0.13 and -0.21D) was not significantly different from those without FTC (-0.10 and -0.12D), but was more myopic in SVL with FTC (-0.46D) compared to SVL without FTC (-0.22D; P<0.001). Similar results for AL change were seen, with mean adjusted AL change with FTC for HAL, SAL, and SVL (0.10, 0.14, and 0.22mm) and without FTC (0.08, 0.12, and 0.18mm).
Over a longer two-year period, mean adjusted SER change with FTC for HAL and SAL (-0.68 and -1.01D) was not significantly different from those without FTC (-0.74 and -1.00D), but was more myopic in SVL with FTC (-1.58D) compared to SVL without FTC (-1.33D; P<0.001). Similar results for AL change were seen, with mean adjusted AL change with FTC for HAL, SAL, and SVL (0.37, 0.47, and 0.73mm) and without FTC (0.36, 0.50, and 0.64mm).
Conclusions: FTC is significantly associated with greater myopia progression and axial elongation in the SVL group, but not in HAL and SAL groups for the first six months and up to two years. Therefore, myopia control spectacle lenses with aspherical lenslets should be prescribed as a child’s first pair of spectacle lenses.
This abstract was presented at the 2024 ARVO Annual Meeting, which was held in Seattle, WA, May 5-9, 2024.
Wong, Y. L., Huang, Y., LI, X., Lim, E. W., Yang, A., Drobe, B., … & Bao, J. (2024). Influence of first-time correction on myopia progression and axial elongation in myopic children wearing spectacle lenses with and without aspherical lenslets. Investigative Ophthalmology & Visual Science, 65(7), 125-125.
* Essilor Stellest lenses are based on the optical design of HAL spectacle lenses.
