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L. J. Keay, Y. Zeng, M. He, J. Mai, B. Munoz, C. Brady, D. S. Friedman; Randomized Clinical Trial Evaluating Ready-Made and Custom Spectacles Delivered via a School-Based Screening Program in China. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2567.
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Myopia is prevalent in China and providing ready-made spectacles (RMS) has advantages. Our aim was to compare the visual performance and satisfaction with RMS versus custom spectacles (CS) among Chinese school children.
A randomized, double-blind clinical trial compared RMS to CS in junior high school students with ≥1 diopter (D) of uncorrected spherical equivalent (SE) refractive error in urban Guangzhou, China. Eligible students had <2.00D astigmatism, <2D myopic- and <1D hyperopic-anisometropia and no ocular disease affecting vision. All spectacles were made to order after cycloplegic refraction. Visual acuity, patterns of use, symptoms and perceived value were compared during 1-month of use.
School based screening identified 965/4607 (20.9%) students with reduced distance vision, 212/965 (22.0%) refused and 248/965 (25.7%) were not eligible and the remaining 495/965 (51.3%) participated. 250 were randomized to RMS and 245 to CS. Those with habitual vision better than 20/40 were excluded from the analysis (35 in RMS and 33 in CS). Social, demographic and ocular findings were similar in the two randomization groups. Average SE refractive error was -2.57±1.31. Spectacle vision was worse wearing RMS in the eye with lower SE (LogMAR 0.11±0.09 vs 0.08±0.07, p=0.004) and higher SE (0.14±0.12 vs 0.08±0.08, p<0.001). There were no differences (p>0.05) in rate of use (94.3% vs 92.2%), wearing to the 1-month visit (46.9% vs 51.5%), planned use (93.3% vs 93.7%), value (89.5% vs 91.7% "moderate or high value or most valued possession"), or symptoms.
While visual acuity was better with CS, no difference was found in acceptability in this population of students with predominantly simple myopic refractive error. This study supports the use of RMS, saving costs and improving the logistics of service delivery.
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