Cylindrical Annular Refractive Element Lenses Reduce Axial Elongation in Children

Treatment with cylindrical annular refractive element (CARE) spectacle lenses can more significantly reduce the rate of axial elongation compared with single vision spectacle lenses in children with myopia, according to a study published in Acta Ophthalmologica. The lenses may also reduce spherical equivalent refraction (SER) progression, but these values failed to attain statistical significance in the investigation. 

Researchers enrolled 118 children with myopia in a randomized, controlled study and included 96 participants in the final analysis (50% girls, mean age, 10.4 years). The team randomly assigned participants to treatment with CARE (n=61) or single-vision (n=57) spectacle lenses. Participants underwent cycloplegic autorefraction and axial length measurement at baseline and 6-month intervals during the 1-year study duration and had mean SER and axial length values of -2.67 diopters (D) and 24.75 mm, respectively at baseline. Adaptation and compliance questionnaires were administered at all visits.

The adjusted 1-year myopia progression was -0.56 D among patients treated with CARE vs -0.71 D for participants undergoing single vision spectacle lens treatment (0.14 D difference; 95% CI, -0.04-0.32; P =.10), the report shows. Participants treated with CARE lenses also experienced significantly less axial elongation compared with children treated with single vision lenses (0.27 mm vs 0.35 mm; 0.09 mm difference; 95% CI, -0.15 to -0.02; P =.009). No adverse events, complaints, or discomfort was reported in either group.

“The results of our study show that CARE lenses designed to induce higher order aberrations can indeed slow axial elongation compared with single-vision spectacle lenses,” according to the researchers. “This seems to prove the intervention of higher order aberrations in myopia progression in turn.”

Study limitations include potential reporting bias, and the failure to consider the effects of near work hours on myopia progression.