The edition · Ophthalmology
Lenslet spectacles slowed myopia by 71% over two years in a US trial
A double-masked trial extends spectacle-based myopia control beyond East Asian children, while an AAO assessment finds injected and sponge mitomycin C similar in trabeculectomy and an Indian study compares blocks for small-incision cataract surgery.
The edition in brief
Today's ophthalmology edition opens on glaucoma surgery. An American Academy of Ophthalmology technology assessment of 11 studies found injected and sponge-applied mitomycin C during trabeculectomy gave similar pressure control and complication rates, with some studies reporting more diffuse, less vascular blebs and fewer 5-fluorouracil injections after injection. An Indian study of 122 eyes undergoing small-incision cataract surgery found sub-Tenon's anaesthesia had a faster onset and fewer adverse events than peribulbar block, at the cost of less complete akinesia; numerical results were not given in the abstract. A Chinese randomised trial of 120 children found 15 minutes a day of virtual-reality defocus training slowed axial growth by 0.11 mm over six months, a small effect of uncertain long-term meaning. The pearl covers measuring axial length in children on myopia control. The edition closes on a double-masked randomised trial of 159 US children aged 6 to 12: spectacle lenses with highly aspherical lenslets cut myopia progression by 0.64 D (71%) and axial elongation by 0.24 mm (53%) over 24 months compared with single-vision lenses, with no serious adverse events, adding a non-drug, non-contact-lens option for myopia control outside East Asia.
Mitomycin C in trabeculectomy: injection and sponge give similar results
Injected and sponge mitomycin C gave similar pressure control and safety in trabeculectomy; choose on experience, with injection possibly favouring bleb shape.
Sub-Tenon's versus peribulbar block for small-incision cataract surgery
Sub-Tenon's anaesthesia offered faster onset and fewer adverse events than peribulbar block in SICS, at the cost of less complete akinesia.
Virtual-reality defocus training slowed axial growth slightly over six months
Virtual-reality defocus training showed a small six-month effect on axial growth and is not yet ready for routine use.
Track axial length, not just refraction, in myopia control
Monitor myopia control with axial length on the same device every 6 to 12 months, backed by cycloplegic refraction.
Highly aspherical lenslet spectacles cut myopia progression in US children
Consider myopia-control spectacles with highly aspherical lenslets for children with progressing myopia, monitoring axial length to confirm response.
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