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목 적 : 누진가입도렌즈(Progressive Addition Lens; PAL)의 근시억제효과를 평가하기 위하여 한국 근시아동을 대상으로 단초점렌즈(Single Vision Lens; SVL)와 누진가입도렌즈(Progressive Addition Lens;PAL) 착용 후 임상적 효과를 비교하였다. 방 법 : 근시아동(-0.50~-4.50D, 6~12세) 106명을 모집하여 무작위 이중맹검법(randomized double-masked)으로 나누어 SVL와 PAL 안경을 착용하도록 하였으며 PAL 안경의 가입도는 +1.00D와 +1.50D를사용하였다. 안경 착용 전에 조절마비(1% tropicamide) 자동굴절검사를 시행하고 IOL master를 이용하여안축장을 측정한 후, 대상자에게 처방한 안경을 활동하는 동안 착용하도록 하고 12개월 전·후에 다시 조절마비자동굴절검사와 안축장을 측정한 후 비교하였다. 결 과 : 107명의 대상자 중 100명의 대상자(94%)가 12개월 동안 성공적으로 참여하였으며 PAL 착용군70명(+1.00D 가입도 34명, +1.50D 가입도 36명)과 SVL 착용군 30명으로 구성되었다. 12개월 동안 굴절력의 변화는 PAL 착용군에서는 -0.43±0.39D, SVL 착용군에서는 -0.78±0.32D로 두 그룹의 차이값은0.35D로 유의한 차이가 있었고(p < 0.001), 가입도에 따라서는 차이가 없었다(p=0.94). 안축장의 길이는PAL 착용군에서 0.11±0.02mm 증가하고 SVL 착용군에서 0.24±0.01mm 증가하여 두 그룹의 차이값은0.13mm로 유의하게 차이가 있었고(p < 0.001) 가입도에 따라서는 차이가 없었다(p=0.617). PAL 착용군과SVL 착용군에서굴절력의 변화량은 안축장의변화량과 높은상관을나타내었다(PAL: r=-0.76, p < 0.001,SVL: r = -0.56, p < 0.001). 결 론: 근시가 진행 중인 아동에서 PAL 안경의 사용은 비록 그 양은 작지만, 안축장의 길이증가와 굴절력의 변화를 일정부분 지연시키는 것으로 사료된다.


Purpose : To evaluate the clinical effectiveness of myopia control progressive addition lenses (PALs) compared with single vision lenses (SVLs) on myopia progression in Korean children. Methods : One hundred six children (ages 6-12 years) with myopia between 0.50D and 4.50D spherical equivalent were recruited. They were randomly assigned (randomized double-masked) to receive either PALs with 1.00D or 1.50D addition or conventional SVLs and were followed for 12months. The primary outcome measure was progression of myopia, as determined by cycloplegic (1%tropicamide) autorefraction. The secondary outcome measure was change in axial length of the eyes,as assessed by PCI (IOL master). Result : Of the 107 children, 100 children (9.79±1.50 years, 94%) completed the 12 month visit. They were composed of PALs with a 1.00 addition (n=34) or PALs with a 1.50 addition (n=36) or SVLs (n=30). The 12 months difference in progression were -0.43±0.39D in the PAL group and -0.78±0.32D in the SVL group that the difference between the two groups was statistically significant (p < 0.001) with mean difference of 0.35D, however between the two groups in the addition power was no statistically difference (p = 0.940). Mean spherical equivalent increases in the axial length of eyes in the PAL and SVL groups, respectively, were 0.11±0.02 mm and 0.24±0.01 mm,with a statistically significant 12 month mean difference of 0.13 mm (p < 0.001), however between the two groups in the addition power was no statistically difference (p = 0.617). Mean changes in axial length correlated with those in refractive error (r = -0.76 for PAL and r = -0.56 for SVL). Conclusion : This results suggest that myope children may have an additional benefit of slowed progression of myopia.