Effects of Near Addition Lenses and Prisms on Accommodative Microfluctuations in Chinese Children

Purpose. To investigate the effects of different near addition lenses and prisms on accommodative microfluctuations (AMFs) in Chinese early-onset myopic (EOM) and emmetropic (EMM) children. Methods. Twenty-one EMM and 27 EOM children aged between 9 and 14years participated in the study. At near, 23 children were exophoric (exo, <0 Delta), and 25 were esophoric (eso, >= 0 Delta). The AMFs and phoria through multiple addition lenses (-1.00, 0, +1.00, +2.00, and +3.00D on each eye) and prisms (base-in prism power: 3 Delta, 2 Delta, 1 Delta; and base-out prism power: 1 Delta and 2 Delta on each eye) were measured at 25cm under binocular viewing conditions with a Grand Seiko WAM-5500 auto-refractor and a modified Thorington card. Results. Higher AMFs were found in EOM than in EMM (EOM, 0.19 +/- 0.06D; EMM, 0.16 +/- 0.03D; p=0.035). Plus additions from +1.00 to +3.00D reduced the AMFs in both EMM and EOM, except +3.00D for EMM. In both refractive groups, -1.00D additions increased AMFs. Esophores showed greater AMFs compared with exophores (esophores, 0.20 +/- 0.01D; exophores, 0.16 +/- 0.01D; p=0.012). Prisms increased the AMFs in EMM and did not alter the AMFs in EOM. Conclusions. Microfluctuations of accommodation decreased with plus addition lenses and increased with negative addition lenses. Plus addition lenses of +2.00 to +3.00D for EOM and +2.00D for EMM decreased AMFs the least at a 25-cm working distance. Esophores had higher AMFs than exophores, indicating that phoria status influences AMFs.