Objective: To identify the baseline factors independently related to 3- year myopia progression and axial elongation in COMET. Methods: A total of 469 children were enrolled, randomly assigned to progressive addition ...Objective: To identify the baseline factors independently related to 3- year myopia progression and axial elongation in COMET. Methods: A total of 469 children were enrolled, randomly assigned to progressive addition lenses with a + 2.00 diopter (D) addition or to single vision lenses and observed for 3 years. Eligible children were 6 to 11 years old, with spherical equivalent myopia of-1.25 to-4.50 D, bilaterally. The primary and secondary outcomes, myopia progression by cycloplegic autorefraction and axial elongation by A-scan ultrasonography, were measured annually. Multiple linear regression was used to adjust for covariates, including treatment. Results: Younger baseline age (6- 7 vs 11 years, 8 vs 11 years, and 9 vs 11 years, P<.001; 10 vs 11 years, P=.04), female sex (P=.01), and each ethnic group compared with African Americans (Asian, P=.02; Hispanic, P=.002; mixed, P=.002; white, P=.001) were independently associated with faster 3- year progression. Children aged 6 to 7 years had the fastest progression of all age groups, progressing by a mean (± SD) of 1.31 D± 0.13 more than children aged 11 years. Females progressed 0.16 D more than the males. Children of mixed, Hispanic, Asian, and white ethnicity progressed more than African American children by 0.49 D± 0.16, 0.33 D± 0.11, 0.32 D± 0.13, 0.27 D ± 0.08, respectively. Age and ethnicity, but not sex, were independently associated with axial elongation. Among these myopic children, a 0.5 mm increase in axial length was associated with 1 D of myopia progression. Conclusions: Younger baseline age was the strongest factor independently associated with faster myopic progression and greater axial elongation at 3 years. African American children had less myopic progression and axial elongation than the other ethnic groups.展开更多
Background: Subepithelial nerve fibre bundles and stromal nerves are damaged during laser epithelial keratomileusis (LASEK). The aim of this study was to investigate the recovery of corneal sensation after LASEK for t...Background: Subepithelial nerve fibre bundles and stromal nerves are damaged during laser epithelial keratomileusis (LASEK). The aim of this study was to investigate the recovery of corneal sensation after LASEK for the correction of myopia. Methods: Corneal sensation was evaluated in 40 eyes of 20 patients using a Cochet-Bonnet aesthesiometer before surgery and 3 days, 14 days, 1,3 and 6 months after LASEK for the correction of mild to moderate myopia (range-2.5 D to-8.0 D). At every examination corneal sensation was tested in the apex of the cornea and in one point each at the 12,3, 6 and 9 o’ clock positions 2mm from the centre of the cornea. Results: Corneal sensation was significantly reduced at 3 days and 14 days after surgery (P< 0.01). The loss of corneal sensation was greatest 3 days after surgery and corneal sensation increased during the first month after LASEK. After 1 month,3 months and 6 months no significant difference was found between preoperative and postoperative sensation. There was no significant difference in sensation between different areas of the cornea after LASEK. Conclusions: Corneal nerves are disrupted during LASEK surgery and the procedure results in a significant reduction in corneal sensation. During the first month after surgery the depressed corneal sensation improved and subsequently went back to preoperative values, staying stable 3 months and 6 months after surgery.展开更多
文摘Objective: To identify the baseline factors independently related to 3- year myopia progression and axial elongation in COMET. Methods: A total of 469 children were enrolled, randomly assigned to progressive addition lenses with a + 2.00 diopter (D) addition or to single vision lenses and observed for 3 years. Eligible children were 6 to 11 years old, with spherical equivalent myopia of-1.25 to-4.50 D, bilaterally. The primary and secondary outcomes, myopia progression by cycloplegic autorefraction and axial elongation by A-scan ultrasonography, were measured annually. Multiple linear regression was used to adjust for covariates, including treatment. Results: Younger baseline age (6- 7 vs 11 years, 8 vs 11 years, and 9 vs 11 years, P<.001; 10 vs 11 years, P=.04), female sex (P=.01), and each ethnic group compared with African Americans (Asian, P=.02; Hispanic, P=.002; mixed, P=.002; white, P=.001) were independently associated with faster 3- year progression. Children aged 6 to 7 years had the fastest progression of all age groups, progressing by a mean (± SD) of 1.31 D± 0.13 more than children aged 11 years. Females progressed 0.16 D more than the males. Children of mixed, Hispanic, Asian, and white ethnicity progressed more than African American children by 0.49 D± 0.16, 0.33 D± 0.11, 0.32 D± 0.13, 0.27 D ± 0.08, respectively. Age and ethnicity, but not sex, were independently associated with axial elongation. Among these myopic children, a 0.5 mm increase in axial length was associated with 1 D of myopia progression. Conclusions: Younger baseline age was the strongest factor independently associated with faster myopic progression and greater axial elongation at 3 years. African American children had less myopic progression and axial elongation than the other ethnic groups.
文摘Background: Subepithelial nerve fibre bundles and stromal nerves are damaged during laser epithelial keratomileusis (LASEK). The aim of this study was to investigate the recovery of corneal sensation after LASEK for the correction of myopia. Methods: Corneal sensation was evaluated in 40 eyes of 20 patients using a Cochet-Bonnet aesthesiometer before surgery and 3 days, 14 days, 1,3 and 6 months after LASEK for the correction of mild to moderate myopia (range-2.5 D to-8.0 D). At every examination corneal sensation was tested in the apex of the cornea and in one point each at the 12,3, 6 and 9 o’ clock positions 2mm from the centre of the cornea. Results: Corneal sensation was significantly reduced at 3 days and 14 days after surgery (P< 0.01). The loss of corneal sensation was greatest 3 days after surgery and corneal sensation increased during the first month after LASEK. After 1 month,3 months and 6 months no significant difference was found between preoperative and postoperative sensation. There was no significant difference in sensation between different areas of the cornea after LASEK. Conclusions: Corneal nerves are disrupted during LASEK surgery and the procedure results in a significant reduction in corneal sensation. During the first month after surgery the depressed corneal sensation improved and subsequently went back to preoperative values, staying stable 3 months and 6 months after surgery.
