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Chen X, Zuo S, Zhang C, Sun B, Zhang M, Jiang D, Chen Y. Interventional Study on the Effectiveness of Eye Exercises Based on Composite Feedback Model in School-Age Children. Risk Manag Healthc Policy 2024; 17:1787-1801. [PMID: 39007108 PMCID: PMC11244621 DOI: 10.2147/rmhp.s467570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Accepted: 06/28/2024] [Indexed: 07/16/2024] Open
Abstract
Objective This study aims to explore the effects of eye exercises on the accommodative ability of Chinese school-aged children. Methods This study used a convenience cluster sampling and selected 149 students from grades 2-5 in a Wenzhou primary school to participate in the intervention in June 2022. This study involved a one-month intervention teaching eye exercises using a composite feedback model. Assessments were made at 3 and 9 months post-intervention. Data collection occurred thrice, including a baseline and two follow-ups, measuring monocular and binocular accommodative facility, monocular and binocular accommodative amplitude, CISS scale, spherical equivalent refraction, and uncorrected visual acuity. Analysis used chi-square tests and generalized estimating equations to evaluate the exercises' effectiveness, with a significance threshold of P < 0.05. Results 134 students completed the follow-up, including 61 females (45.52%). After teaching intervention, students showed significant improvements in the accuracy of manipulation, rhythm, acupoint location, strength effectiveness and rhythm of acupressure eye exercises (all P < 0.05), with increases of 10.37%, 13.03%, 16.96%, and 25.17%, respectively. Follow-up assessments revealed both monocular and binocular accommodative amplitude at T3 were significantly higher than at T1 and T2. Moreover, the binocular accommodative amplitude in the high-quality eye exercise group remained significantly higher than that in the low-quality group even(B=1.39,1.46, P < 0.01). Eye exercises could improve monocular and binocular accommodative amplitude in the short term(P < 0.05). High-quality eye exercises could alleviate visual fatigue (B=-2.00--3.49, both P < 0.05). However, eye exercises did not demonstrate any advantages in affecting spherical equivalent refraction or uncorrected visual acuity (P > 0.05). Conclusion Eye exercises can alleviate myopia-related symptoms in Chinese children aged 7 to 11 years. However, this study did not find that eye exercises effectively reduce the degree of myopia in children. Trial Registration The original trial (Registration site: https://www.chictr.org.cn/ Registration number: ChiCTR2300070903) was retrospectively registered on 26/04/2023.
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Affiliation(s)
- Xiaojun Chen
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Shushu Zuo
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Chunhua Zhang
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Bing Sun
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Mengyue Zhang
- School of Optometry and Ophthalmology, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Dandan Jiang
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
| | - Yanyan Chen
- National Clinical Research Center for Ocular Diseases, Eye Hospital, Wenzhou Medical University, Wenzhou, Zhejiang, 325027, People's Republic of China
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Jabeen A, Luensmann D, Woods J, Hill JS, Jones L. Evaluation of Lag of Accommodation with Full-Field Diffusion Optics Technology™ (DOT) Contrast Management Spectacle Lenses in Emmetropic Children. Clin Ophthalmol 2024; 18:1181-1190. [PMID: 38711574 PMCID: PMC11073533 DOI: 10.2147/opth.s453790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/24/2024] [Indexed: 05/08/2024] Open
Abstract
Purpose To evaluate the impact on the lag of accommodation (LOA) in emmetropic children after short-term wear of full-field Diffusion Optics TechnologyTM (DOT) spectacle lenses, designed to modulate retinal contrast to control myopia progression. Patients and Methods This was a single-visit, prospective, randomized, subject-masked study of emmetropes (ametropes ±1.00D or less in each meridian) with no history of myopia control treatment. Unaided logMAR visual acuity was measured, and ocular dominance was determined using the sighting method. In a randomized order, participants wore plano full-field contrast management (DOT) spectacles (no clear central aperture) or control spectacles (standard single vision spectacle lenses). Each participant was given 5 minutes for adaptation to the respective lenses before open field autorefraction measurements were taken at 6 meters and 40 cm. Ten measurements were taken for each eye. Data were evaluated from the right eye and the dominant eye separately. Results A total of 30 participants (20 females and 10 males) with a mean age of 10.4 ± 2.8 (7 to 17) years completed the study. There was no significant difference in right eye mean LOA with contrast management spectacles 0.57 ± 0.39D versus control spectacles 0.62 ± 0.34D; Wilcoxon test, p = 0.37. For dominant eyes, LOA values were 0.60 ± 0.40D and 0.68 ± 0.33D with contrast management spectacles and control spectacles, respectively (p = 0.14). Additionally, no significant difference was observed in mean LOA between males and females or between age groups (7-11 years vs 12-17 years) for either right or dominant eyes with contrast management or control spectacles (all p > 0.05). Conclusion Full-field contrast management spectacle lenses had no significant effect on LOA compared to standard single vision spectacle lenses, indicating no differential impact on accommodative response over the short period of lens wear tested.
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Affiliation(s)
- Asiya Jabeen
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Doerte Luensmann
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - Jill Woods
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
| | | | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, ON, Canada
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Chen H, Wang W, Liao Y, Zhou W, Li Q, Wang J, Tang J, Pei Y, Wang X. Low-intensity red-light therapy in slowing myopic progression and the rebound effect after its cessation in Chinese children: a randomized controlled trial. Graefes Arch Clin Exp Ophthalmol 2023; 261:575-584. [PMID: 35976467 DOI: 10.1007/s00417-022-05794-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 01/17/2023] Open
Abstract
PURPOSE To investigate the effect of low-intensity red-light (LRL) therapy on myopic control and the response after its cessation. METHODS A prospective clinical trial. One hundred two children aged 6 to 13 with myopia were included in the LRL group (n = 51) and the single-focus spectacles (SFS) group (n = 51). In LRL group, subjects wore SFS and received LRL therapy provided by a laser device that emitted red-light of 635 nm and power of 0.35 ± 0.02 mW. One year after the control trial, LRL therapy was stopped for 3 months. The outcomes mainly included axial length (AL), spherical equivalent refraction (SER), subfoveal choroidal thickness (SFCT), and accommodative function. RESULTS After 12 months of therapy, 46 children in the LRL group and 40 children in the SFS group completed the trial. AL elongation and myopic progression were 0.01 mm (95%CI: - 0.05 to 0.07 mm) and 0.05 D (95%CI: - 0 .08 to 0.19 D) in the LRL group, which were less than 0.39 mm (95%CI: 0.33 to 0.45 mm) and - 0.64 D (95%CI: - 0.78 to - 0.51 D) in the SFS group (p < 0.05). The change of SFCT in the LRL group was greater than that in the SFS group (p < 0.05). Accommodative response and positive relative accommodation in the LRL group were more negative than those in the SFS group (p < 0.05). Forty-two subjects completed the observation of LRL cessation, AL and SER increased by 0.16 mm (95%CI: 0.11 to 0.22 mm) and - 0.20 D (95%CI: - 0.26 to - 0.14 D) during the cessation (p < 0.05), and SFCT returned to baseline (p > 0.05). CONCLUSIONS LRL is an effective measure for preventing and controlling myopia, and it may also have the ability to improve the accommodative function. There may be a slight myopic rebound after its cessation. The effect of long-term LRL therapy needs to be further explored. TRIAL REGISTRATION Chinese Clinical Trial Registry: Chinese Clinical Trails registry: ChiCTR2100045250. Registered 9 April 2021; retrospectively registered. http://www.chictr.org.cn/showproj.aspx?proj=124250.
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Affiliation(s)
- Hongyan Chen
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.,Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wei Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ya Liao
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.,Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wen Zhou
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China.,Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Qin Li
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jingjing Wang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Jie Tang
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Yifei Pei
- Department of Community and Health Education, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Xiaojuan Wang
- Department of Ophthalmology, The First People's Hospital of Xuzhou, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China. .,Xuzhou Medical University, Xuzhou, Jiangsu, China.
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Vedhakrishnan S, de Castro A, Vinas M, Aissati S, Marcos S. Accommodation through simulated multifocal optics. BIOMEDICAL OPTICS EXPRESS 2022; 13:6695-6710. [PMID: 36589586 PMCID: PMC9774842 DOI: 10.1364/boe.473595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 05/02/2023]
Abstract
We evaluated the interaction of multifocal patterns with eye's accommodation. Seven patterns were mapped on the spatial light modulator and the deformable mirror of an adaptive optics visual simulator, and projected onto the subjects' eyes, representing different contact lens designs: NoLens, Bifocal Center Distance (+2.50D), Bifocal Center Near (+2.50D) and Multifocal Center Near-MediumAdd (+1.75D) and Center Near HighAdd (+2.50D), positive and negative spherical aberration (±1µm). The change in spherical aberration and the accommodative response to accommodative demands were obtained from Hartmann-Shack measurements. Positive spherical aberration and Center Distance designs are consistent with a higher accommodative response (p=0.001 & p=0.003): steeper shift of SA towards negative values and lower accommodative lag.
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Affiliation(s)
- Shrilekha Vedhakrishnan
- Instituto de Optica ”Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Alberto de Castro
- Instituto de Optica ”Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Maria Vinas
- Wellman Center for Photomedicine and Harvard Medical school, Massachusetts General Hospital, 50 Blossom St, Boston, MA, USA
| | - Sara Aissati
- Center for Visual Science; The Institute of Optics; Flaum Eye Institute, University of Rochester, Rochester, New York, USA
| | - Susana Marcos
- Instituto de Optica ”Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
- Center for Visual Science; The Institute of Optics; Flaum Eye Institute, University of Rochester, Rochester, New York, USA
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Shi Y. Effect of Atropine Eye Drops Combined with VR-Based Binocular Visual Function Balance Training for Prevention and Control of Juvenile Myopia. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2022; 2022:4159996. [PMID: 36147642 PMCID: PMC9489366 DOI: 10.1155/2022/4159996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/26/2022] [Accepted: 08/08/2022] [Indexed: 11/20/2022]
Abstract
Purpose This study mainly analyzes the efficacy of 0.01% atropine eye drops (low-dose atropine (LDA)) combined with virtual reality (VR)-based binocular visual function (BVF) balance training in the prevention and control of juvenile myopia. Methods One hundred and thirty-six juvenile myopia patients admitted between November 2018 to November 2021 were selected, including 76 cases (research group) receiving LDA + VR-based BVF balance training and 60 cases (control group) treated by LDA intervention alone. Visual acuity (VA; naked vision), ocular parameters (pupil diameter (PD), axial length (AXL), and diopter), intraocular pressure (IOP), accommodation facility, clinical efficacy, and incidence of adverse reactions were observed, compared, and analyzed in both groups. Results After analysis, it was found that the research group showed significantly higher naked vision and PD while statistically lower D after intervention than the corresponding preinterventional parameters than the control group. While AXL showed no statistical difference between the groups and within groups. The IOP also differed insignificantly between groups, but the post-treatment accommodation facility was better in the research group compared with the baseline (before treatment) and control group. In terms of curative effects, an obviously higher total effective rate was determined in the research group. In addition, the two groups showed no significant difference in the incidence of adverse reactions. Conclusions LDA + VR-based BVF balance training deserves clinical popularization, as it can prevent and control myopia among teenagers, with better adjusting effects on eye function and certain safety.
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Affiliation(s)
- Yuping Shi
- Chengdu Aier Eye Hospital, Chengdu 610041, Sichuan, China
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Zhu MJ, Ding L, Du LL, Chen J, He XG, Li SS, Zou HD. Photopic pupil size change in myopic orthokeratology and its influence on axial length elongation. Int J Ophthalmol 2022; 15:1322-1330. [PMID: 36017053 DOI: 10.18240/ijo.2022.08.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 02/25/2022] [Indexed: 11/23/2022] Open
Abstract
AIM To explore the photopic pupil size behavior in myopic children undergoing overnight orthokeratology (ortho-k) over 1-year period and its effects on the axial elongation. METHODS A total of 202 Chinese myopic children were enrolled in this prospective clinical trial. Ninety-five subjects in ortho-k group and eighty-eight subjects in spectacle group completed the 1-year study. Axial length (AL) was measured before enrollment and every 6mo after the start of ortho-k. The photopic pupil diameter (PPD) was determined using the Pentacam AXL and measured in an examination room with lighting of 300-310 Lx. Stepwise multiple linear regression analysis was used to identify variables contribution to axial elongation. RESULTS Compared with spectacle group, the average 1-year axial elongation was significantly slower in the ortho-k group (0.25±0.27 vs 0.44±0.23 mm, P<0.0001). In ortho-k group, PPDs significantly decreased from 4.21±0.62 mm to 3.94±0.53 mm after 1mo of lens wear (P=0.001, Bonferroni correction) and the change lasts for 3-month visit. No significantly change during the other follow-up visits was found (P>0.05, Bonferroni correction). The 4.81 mm PPD may be a possible cutoff point in the ortho-k group. Subjects with PPD below or equal to 4.81 mm tended to have smaller axial elongation compared to subjects with PPD above 4.81 mm after 1-year period (t=-3.09, P=0.003). In ortho-k group, univariate analyses indicated that those with older age, greater degree of myopia, longer AL, smaller baseline PPD (PPDbaseline) experienced a smaller change in AL. In multivariate analyses, older age, greater AL and smaller PPDbaseline were associated with smaller increases in AL. In spectacle group, PPD tended to be stable (P>0.05, Bonferroni correction) and did not affect axial growth. CONCLUSION PPDs experience significantly decreases at 1-month and 3-month ortho-k treatment. Children with smaller PPD tend to experience slower axial elongation and may benefit more from ortho-k.
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Affiliation(s)
- Meng-Jun Zhu
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Li Ding
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Lin-Lin Du
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Jun Chen
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Xian-Gui He
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Shan-Shan Li
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China
| | - Hai-Dong Zou
- Shanghai Eye Disease Prevention & Treatment Center/Shanghai Eye Hospital, Shanghai 200040, China.,Shanghai General Hospital, National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Research Center of Precise Diagnosis and Treatment of Eye Diseases, Shanghai 200080, China
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Chen Y, Shen X. Compensatory Changes in the Anterior Segment and Vascular System of the Eye in Myopic Children After Orthokeratology. Front Pediatr 2021; 9:663644. [PMID: 34568237 PMCID: PMC8458806 DOI: 10.3389/fped.2021.663644] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 08/09/2021] [Indexed: 12/05/2022] Open
Abstract
Purpose: To analyze changes in the anterior segment, retinal vessel density, and choroidal thickness (ChT) after orthokeratology (Ortho-K). Methods: Myopic children were enrolled from Ruijin Hospital, Shanghai, China. Ortho-K lenses and single-vision spectacles were fitted for myopia correction. Ocular measurements were taken at baseline and 6 months, including axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), white to white (WTW), ChT, macular vessel density (MVD), and optic disc vessel density (OVD). Results: Seventy-six patients were enrolled in this study, including 40 in the Ortho-K group and 36 in the control group. At baseline, no parameters between the two groups were statistically different. After 6 months, changes in CCT and ACD decreased in the Ortho-K group compared with those in the control group (p < 0.05); LT and ChT in the Ortho-K group were thicker than those in the control group (p < 0.05), while there was no difference in MVD and OVD compared with those in the control group (p > 0.05). There were moderate positive correlations between ChT and LT and between ChT and OVD in the Ortho-K group (p < 0.05). Conclusion: The changes in the anterior and posterior segments of the eye after Ortho-K lens wearing suggest that the human eye has a powerful compensatory effect on the imposed defocus.
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Affiliation(s)
- Yanwei Chen
- Department of Ophthalmology, School of Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University, Shanghai, China
| | - Xi Shen
- Department of Ophthalmology, School of Medicine, Ruijin Hospital Affiliated Shanghai Jiao Tong University, Shanghai, China
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Batres L, Peruzzo S, Serramito M, Carracedo G. Accommodation response and spherical aberration during orthokeratology. Graefes Arch Clin Exp Ophthalmol 2019; 258:117-127. [PMID: 31720836 DOI: 10.1007/s00417-019-04504-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 09/12/2019] [Accepted: 10/03/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE To evaluate the changes in the accommodative response and in the corneal and internal spherical aberration during 3 months of wear of orthokeratology lenses from the baseline. METHODS Fifty children aged 8 to 17 were recruited for a prospective study and were fitted with orthokeratology lenses. Refraction without cycloplegia, high and low uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), accommodation lag, horizontal near phoria without correction, corneal topography, corneal, and total wavefront aberration were performed at baseline, 1 day, 1 week, 1 month, and 3 months. Data were analyzed by Student's t test for related samples, repeated measures ANOVA test, and Pearson correlation test. RESULTS The spherical equivalent (SE) before and after 3 months was - 3.33 ± 1.60 D and - 0.30 ± 0.46 D, respectively. Accommodation lag was 0.53 ± 0.38 D and 0.20 ± 0.33 D at baseline and at 3 months, respectively. A moderate correlation between lag at the baseline and its change between baseline and the 3-month visit was found (P < 0.05; R = 0.748). The spherical aberration (SA) increased for anterior corneal and total measurement, being statistically significant for all visits (P < 0.05). The internal SA decreased: - 0.105 ± 0.006 at baseline and - 0.196 ± 0.203 at 1 week (P < 0.05). No difference between baseline and the follow-up visits in posterior corneal SA was found (P > 0.05) CONCLUSION: The negative SA of the lens increases during OK treatment compensated for the increase of the anterior corneal surface positive SA, in addition to increasing the accommodative response.
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Affiliation(s)
- L Batres
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain
- Ophthalmological Clinic Doctor Lens, Madrid, Spain
| | - S Peruzzo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain
| | - M Serramito
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain
| | - G Carracedo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, C/Arcos del Jalon 118, 28032, Madrid, Spain.
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