Multifocal Soft Contact Research Articles

Two-year Retrospective Case Series Analysis of Myopic Progression between Orthokeratology, Soft Multifocal Contact Lenses and Low Dose Atropine

Purpose: To review the rate of myopic progression associated with various myopia control strategies employed at the Cornea, Contact Lens & Myopia Control Clinic at the University of Waterloo School of Optometry and Vision Science in Waterloo, Ontario, Canada, from 2015 to 2020.

Subjective lens experience when refit with daily disposable multifocal contact lenses

Purpose: Practitioners can be reluctant to switch successful multifocal soft contact lens (MF) wearers to different materials or replacement frequencies, fearing the new MF will be less accepted. Subjective responses are highly valued in MF fitting and this study investigated subjective responses from habitual MF (hab-MF) wearers after a refit into daily disposable MF; stenfilcon A (stenA-MF) and delefilcon A (delA-MF).

The effect of optic zone diameter on choroidal response using bifocal soft multifocal contact lenses

The effect of optic zone diameter on choroidal response using bifocal soft multifocal contact lenses

Efficacy and Safety of Different Add Power Soft Contact Lenses on Myopia Progression in Children: A Systematic Review and Meta-Analysis

Background: In children, myopia has become a widespread and serious global public health problem. Soft multifocal contact lenses (SMCLs) have been widely studied to control myopia progression in children. However, their efficacy in myopia control in children and its adverse effects and which added power SMCLs are more effective and safer remains to be explored. Objectives: Evaluate the efficacy and safety of various add power SMCLs to slow myopia progression in children. Method: Eligible randomized controlled trials were retrieved from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases. The present meta-analysis analyzed the mean differences (MD) in myopic progression, axial length, and odds ratios for adverse effects and dropout rates between SMCLs with different added powers and control groups. Changes in visual performance were also systematically evaluated. Results: Seven independent studies involving 805 children were included in the present meta-analysis. At 1-year, the weighted MD (WMD) in myopia progression between SMCL and control groups was −0.22 diopters (D) (95% confidence interval [CI]: −0.56 to 0.12 D) for low add power SMCLs, 0.09 D (95% CI: 0–0.19 D) for medium add power SMCLs, and 0.2 D (95% CI: 0.13, 0.27 D) for high add power SMCLs. At 2-years, the WMD for medium add power was 0.12 D (95% CI: −0.03 to 0.27 D), and for high add power was 0.25 D (95% CI: 0.14–0.35 D). No differences were detected for adverse effects (p = 0.2) and acceptability (p = 0.74) between different added powers. Additionally, differences in visual performance changes, produced by different added powers, were not detected. Conclusions: The present meta-analysis showed that high add power SMCLs are more effective and stable to control myopia progression. Besides, the adverse effects and acceptability were not related to the added power.

İki Farklı Multifokal Kontakt Lensinin Objektif ve Subjektif Değerlendirilmesi: Randomize Klinik Çalışma

Objective: The aim of this research is to evaluate 2 different soft multifocal contact lenses (MFCL) that were used in daily and monthly presbyopia rehabilitation in terms of visual acuity and patient satisfaction. Material and Methods: Balafilcon A and Etafilcon A were applied to 62 patients. Visual acuity was evaluated in appropriate photopic conditions with logMAR at 6 m for distance and with Jaeger chart at 30 cm for near. Treatment and routine follow-up letter contrast sensitivity (CS) tests were recorded. A questionnaire was filled by patients regarding their contact lens satisfaction separately for near, intermediate and distance vision that includes questions about ghosting, visual clarity, and overall image satisfaction. The average was calculated after scoring of these between 0-10. Results: Visual acuities were obtained: For the participants who used Balafilcon A is 0.053 (±0.02), and in near vision Jaeger chart 1.03 (±0.4); for the participants who used Etafilcon A is 0.053 (±0.01) in distance visual acuity and in near vision Jaeger chart 1.23 (±0.45). While there was no significant difference in near and distance vision between the 2 lenses, the CS increased in both lenses. However, this increase was lesser than the detected increment in glasses. The near, intermediate and distance patient satisfaction were similar in all lenses. Conclusion: A visual rehabilitation that satisfies MFCL applied patients can be achieved by considering the design of the lens according to the need for distance or near vision.

Myopiekontrolle: aktuelle Strategien

Purpose. The prevalence of myopia is increasing worldwide and its long-term effects can have major impacts on eye health. Paediatric onset of myopia leads to a higher risk for developing high levels of myopia in adulthood. Slowing down or stopping myopia progression is an important task for the future. Material and Methods. Based on a literature review, the latest developments in the field of myopia control for children were summarized. The current study situation for orthokeratology, soft contact lenses, atropine therapy and spectacle lenses for the management of myopia is discussed in detail. Results. Results on the safety and effectiveness of orthokeratology and modified soft contact lenses are exceedingly consistent. Soft multifocal contact lenses, as well as newer spectacle lenses, recently received regulatory approval for myopia control. Studies on the administration of atropine recommend a dosage of 0.01 - 0.05 %. All methods slow down myopia progression and decrease axial length growth of the eye. Side effects, adverse events or discontinuation of treatment only occur in the rarest of cases. Orthokeratology and atropine continue to deliver the best results. Conclusion. From today’s perspective, carrying out myopia control can be recommended with great certainty. The choice of method depends on the individual requirements of each patient, with all methods offering success in reducing myopia progression. In the future, even more advanced contact lens geometries, more precise atropine dosages or improved optics of spectacle lenses will further increase the success of the treatment. Keywords. Progressive myopia, myopia control, children, contact lenses, atropine, spectacle lenses

MICROBIAL BIOBURDEN OF ORTHOKERATOLOGY AND HYDROGEL CONTACT LENSES AND STORAGE CASES USING A HYDROGEN-PEROXIDE DISINFECTING SYSTEM

Background and objective: The fitting of orthokeratology (ortho-k) and multifocal soft contact lenses (SCL) is becoming increasingly popular worldwide for reducing the rate of myopia progression. However, overnight wear use of lenses and microbial contamination of contact lenses and storage vials has been shown to increase the risk of corneal inflammatory and infiltrative events (CIEs). Therefore, we conducted a pilot study to compare the rate, level, and type of microbial contamination of contact lenses and storage vialswhen participants wear ortho-k and SCL in combination with a hydrogen-peroxide disinfecting system.
 Material and Methods: A prospective, single-centre, randomized, crossover study was conducted to evalu-ate the rate and level of contact lens and storage vials contamination during the use of ortho-k and SCL along with a hydrogen-peroxide disinfecting solution over two 10 day wearing periods. Ocular signs and symptoms were assessed during lens wear at baseline and after each wearing period. In addition, contact lens and storage vials were collected, and the type and amount of microbial contamination were evaluated using viable culture and standard identification methods.Results: Twenty-five adults were enrolled, and 21 completed the study. One (5%) ortho-k lens, five (24%) ortho-k storage vials, one (5%) SCL and one (5%) SCL storage vial were contaminated (P > 0.05), predominantly with Gram-positive bacteria. None of the participants had contamination with both ortho-k and SCL. No significant differences were found between the ocular signs, including conjunctival redness and roughness, or conjunctival or corneal staining (all P > 0.05), irrespective of using ortho-k or SCL.
 Conclusion: This study provides the first data that directly compares microbial contamination of ortho-K versus SCL in patients using a hydrogen-peroxide disinfection system. However, the overall microbial contamination rate of contact lens storage vials was much lower (30%) than the previously reported study with ortho-k lens wear. The results support conducting a larger clinical trial designed to understand differences in microbial contamination with different lens materials and modalities.

Myopia control with soft multifocal contact lenses: 18-month follow-up.

PURPOSE:The study aimed to establish the outcome of multifocal contact lenses (MFCL) (Multistage + 1.50D and Proclear + 3.00D) on myopia progression and axial length elongation over an 18-month period.METHODS:Thirty myopic schoolchildren (5 males and 25 females) aged between 13 and 15 years were randomly assigned to wear either single vision contact lens (SVCL), Multistage MFCL + 1.50D, or Proclear +3.00D MFCL for 1½ years using a double-masked design. Cycloplegic refraction, corneal curvature, and axial length were measured.RESULTS:Myopia progression was controlled by 38.6% and 66.6% in children wearing Multistage + 1.50D and Proclear +3.00D MFCL, respectively, in comparison to children wearing SVCL over an 18-month period. In terms of axial elongation, this study found a 31.1% and 63.2% control in axial elongation over 18 months of treatment in comparison to the SVCL group. No statistical significant difference in corneal curvature was found between initial and last visits for all the three groups (SVCL, P = 0.90; Multistage + 1.50 MFCL, P = 0.78, and Proclear + 3.00 MFCL, P = 0.05).CONCLUSION:Proclear +3.00D MFCL was revealed to cause slow development of myopia and axial elongation among myopic schoolchildren. MFCL with higher add powers could be more effective on myopia progression in comparison with moderate add powers.

The efficacy of multifocal soft contact lenses for the alleviation of asthenopic symptoms in myopes with accommodative lag

PurposeTo evaluate the efficacy of multifocal soft contact lenses to reduce asthenopic symptoms in myopes with accommodative lag. MethodsTwenty-four myopic participants, aged 18–35 years, with mean spherical equivalent (MSE) of ≤ -0.75D, were recruited in a randomised, double-blind crossover study. All participants were existing contact lens wearer with near orthophoria or esophoria, presenting with subjective asthenopic symptoms at baseline [Convergence Insufficiency Symptom Survey (CISS) score ≥ 21] and a lag of accommodation ≥ +0.75 D. All participants were initially fitted with single vision contact lenses for a one month period. Participants were then randomly assigned 1:1 to wear low add or high add multifocal soft contact lenses for a further month. After this period, the groups were reversed. Data were collected at baseline and following one month’s wear of each lens. Change in CISS score was evaluated as the primary outcome measure, while secondary outcome measures were changes in accommodative lag and heterophoria status. ResultsBaseline CISS score was (mean ± SD) 25.04 ± 4.58. Post-intervention scores were as follows: single vision: 24.46 ± 4.59, low add: 12.17 ± 6.89, high add: 13.71 ± 7.23. Both low add and high add multifocal soft contact lens wear was associated with an improvement in CISS score compared to baseline CISS and single vision (all p < 0.01). No significant difference was found between the CISS score for the baseline CISS and single vision (p = 1.00). No significant difference was found in lag of accommodation between lens conditions (all p > 0.05), however, there was an exophoric shift in near heterophoria between single vision and both multifocal contact lenses (low add: (mean difference 1.33 Δ, p = 0.02; high add: mean difference 1.23 Δ, p = 0.02) but not between habitual spectacle or any other modality (all p > 0.05). ConclusionsThe use of multifocal soft contact lenses for a one-month period was associated with reduced severity of asthenopic symptoms in pre-presbyopic myopes with accommodative lag. Whilst improvement of symptoms does not appear to be mediated by a significant reduction in accommodative lag, changes in heterophoria may play a role in reducing asthenopic symptoms.

The Montreal Experience: A Retrospective Study Part I—Basic Principles and Treatment Algorithm

CONTEXT: Authors have refined myopia control strategies (MCS) from their experience treating more than 800 children who were followed at the Montreal School of Optometry Clinic (CUV). They developed a treatment algorithm known as the Montreal Experience (ME). Contrary to many other MCS, treatment modalities are selected after careful evaluation of a patient’s parameters (rate of progression, age of myopia onset, corneal parameters, pupil area), the risk factors for ocular pathology (growth charts), and taking into account the patient’s lifestyle and potential compliance. This represents a customized approach for each patient. PURPOSE: To evaluate the efficacy of MCS used following ME algorithm; the primary outcome relates to axial length progression over 24 months. METHODS: This is a retrospective study, conducted after approval of University IRB. Data were extracted from the file of each patient who: (1) consulted CUV between January 2017 and December 2018 and (2) were kept under the same MCS (same design/concentration). Clinical population is composed of 298 patients (35% Caucasian; 45% Asian; 20% others), with a median age of 11 (range 5–18). The treatment options were orthokeratology (OK-4 designs; N = 140), multifocal soft contact lenses (SMCL; 5 designs; N = 128), and low-dose atropine (LDA 0.01% to 0.25%; N = 42). RESULTS: Results are analyzed through sophisticated statistical models, designed for this purpose. At the end of a stepwise selection process that sequentially removed model terms that were not statistically significant, nine model terms remained: month, modality, the interaction of month and modality, refraction (SEQ), the interaction of SEQ and modality, gender, age, the interaction of age and month, and the interaction of age and modality. A total of 298 files were kept for analysis. Participant age varied from 9.7 to 12.5 years old. Baseline AL varied from 24.9 to 25.3 mm and SE refraction was −3.7 + 1.7 D on average. This study population was divided between Caucasian (34%), Asian (44%), and other ethnic origins (22%). Overall results indicate that results vary according to modality and months only. There is no statistical difference based on age, gender, and SEQ. All methods used were effective to slow the natural AL growth. Evolution was the lowest when using smaller treatment zones OK lenses (0.249 mm) and the highest (0.376 mm) for those treated with LDA. This OK advantage was statistically significant versus other modalities at 1 and 2 years. CONCLUSION: The Montreal Experience reveals that personalized MCS may be effective to manage myopia efficiently. It shows AL evolution comparable to the documented natural evolution of emmetropes, especially when using customized or smaller treatment zone OK lens design. Future work on other populations will confirm this tendency.

Effect of Undercorrection Using Spectacle Lens and Multifocal Soft Contact Lens on Binocular Visual Function

Purpose : To investigate the effect of undercorrection using multifocal soft contact lens and +1.00 D spectacle lens on binocular visual function compared to no correction. Methods : Seventeen individuals (mean age of 23.58±2.12 years) were recruited to participate in this study. Seventeen participants have less than sphere refractive error of ±1.00 D and with less than –0.75 D of astigmatism. Repeated measurements were performed using three different correction options; no correction (NC), correction using multifocal contact lenses (CM) with a plano power for distance and addition up to +1.00 D and undercorrection using +1.00 D spectacle lens (UL). The battery of binocular visual function measures includes amplitude of accommodation, accommodative response, accommodative facility, amplitude of divergence, convergence facility and near/distance phoria. Results : Types of vision correction had no significant effect on amplitude of accommodation, amplitude of divergence and distant phoria. Accommodative response with no correction was statistically significantly bigger than other two correction options, and CM induced statistically significant accommodative response compared to UL. Also, accommodative facility with no correction and CM were statistically significantly better than accommodative facility of UL. Convergence facility with UL and CM were statistically significantly better than NC. Also, near phoria measured Howell chart with UL and CM were statistically significant than NC whereas near phoria measured with Maddox rod with UL was statistically different from NC. Conclusion : Multifocal contact lens do not alter important changes in accommodative system yet provide better accommodative stimulus-response and vergence response. The subjects with multifocal contact lens exhibited decreased accommodative response and improved convergence facility. Thus, simultaneous image multifocal contact lenses may be useful for children and young adults who presented accommodative problems or vergence disorder.

The Spatial Distribution of Relative Corneal Refractive Power Shift and Axial Growth in Myopic Children: Orthokeratology Versus Multifocal Contact Lens

PurposeTo determine if the spatial distribution of the relative corneal refractive power shift (RCRPS) explains the retardation of axial length (AL) elongation after treatment by either orthokeratology (OK) or multifocal soft contact lenses (MFCLs).MethodsChildren (8–14 years) were enrolled in the OK (n = 35) or MFCL (n = 36) groups. RCRPS maps were derived by computing the difference between baseline and 12-month corneal topography maps and then subtracting the apex values. Values at the same radius were averaged to obtain the RCRPS profile, from which four parameters were extracted: (1) Half_x and (2) Half_y, i.e., the x- and y-coordinates where each profile first reached the half peak; (3) Sum4 and (4) Sum7, i.e., the summation of powers within a corneal area of 4- and 7-mm diameters. Correlations between AL elongation and these parameters were analyzed by multiple linear regression.ResultsAL elongation in the OK group was significantly smaller than that in the MFCL group (p = 0.040). Half_x and Half_y were also smaller in the OK group than the MFCL group (p < 0.001 each). Half_x was correlated with AL elongation in the OK group (p = 0.005), but not in the MFCL group (p = 0.600). In an analysis that combined eyes of both groups, Half_x was correlated with AL elongation (β = 0.161, p < 0.001).ConclusionsThe OK-induced AL elongation and associated RCRPS Half_x were smaller than for the MFCL. Contact lenses that induce RCRPS closer to the corneal center may exert better myopia control.

Greater higher order aberrations induced by toric orthokeratology versus soft toric multifocal contact lens wear.

Spherical orthokeratology and soft multifocal contact lenses are commonly used for myopia control and correction, but have been shown to increase spherical aberration, coma and total higher order root mean square (HORMS) aberrations. There are limited myopia control contact lens options for patients with moderate to high astigmatism. The purpose of this study was to quantify changes in higher order aberrations (HOA) in myopic astigmatic eyes fitted with toric orthokeratology (TOK) and soft toric multifocal (STM) contact lenses. Ocular wavefront aberrations were measured in both eyes of 30 adult subjects and are reported through the 6th radial order over a 5mm, dilated pupil. All eyes met refractive criteria of myopia (-5.00 D to plano) and cylinder (-3.50 to -1.25 D). Three measurements were taken at baseline and after 10±2days of lens wear (TOK, STM). Sixteen subjects achieved logMAR high contrast visual acuity of 0.30 or better in both eyes and were included in this analysis. Repeated measures analysis of variance and post-hoc paired t-tests were used, as appropriate, with Benjamini-Hochberg correction. Higher order root mean square, spherical aberration (C12), and coma RMS (C7, C8) increased with TOK (0.641 [0.222], 0.409 [0.157], 0.426 [0.187] µm, respectively) and STM (0.481 [0.107], 0.223 [0.139], 0.320 [0.130] µm, respectively) from baseline (all p<0.001). TOK was elevated compared to STM for HORMS (p=0.03), spherical aberration (p=0.001) and coma RMS (p=0.04). Toric orthokeratology induced more HORMS, spherical aberration and coma RMS than STM in myopic astigmats; however, both lens types showed an increase in HOA compared to baseline, which placed patients outside the age and pupil size matched normative ranges. While the optical changes that accompany these modalities are helpful for myopia management, the induction of HOAs may have unintended consequences on visual performance.

Clinical study on the effect of multifocal contact lenses on myopia progression in myopia school children

BackgroundThe efficacy of peripheral low add multifocal soft contact lenses (SCLs) for suppressing the progression of myopia is controversial. The aim of the on-going present clinical study is to investigate whether or not multifocal SCLs with + 0.50 diopters (D) addition suppress the progression of myopia in myopic elementary school children.DesignProspective randomized controlled trial.Subjects and methodsThe study plans to include a total of 100 myopic school children. Target subjects are primary school male and female students with mild to moderate myopia. Children who have eye-related diseases other than myopia are excluded from the study, because they may affect the evaluation of the outcome. Subjects will be randomly assigned to wear daily disposable multifocal contact lenses with + 0.50D addition or daily disposable SCLs. Subjects will wear contact lenses on both eyes and will be observed for 2 years under a double-masked examination. Primary outcome is a change in the axial length over the 2-year period.ObjectivesThe purpose of this study is to identify whether or not multifocal SCLs with + 0.5D addition suppress the progression of myopia in myopic elementary school children as compared with standard SCLs.Trial registration1. UMIN (University Hospital Medical Information Network) UMIN000027940. Registered on July 21, 20172. JRCT (Japan Registry of Clinical Trials) jRCTs052180172. Registered on March 26, 2019

BCLA CLEAR - Effect of contact lens materials and designs on the anatomy and physiology of the eye

This paper outlines changes to the ocular surface caused by contact lenses and their degree of clinical significance. Substantial research and development to improve oxygen permeability of rigid and soft contact lenses has meant that in many countries the issues caused by hypoxia to the ocular surface have largely been negated. The ability of contact lenses to change the axial growth characteristics of the globe is being utilised to help reduce the myopia pandemic and several studies and meta-analyses have shown that wearing orthokeratology lenses or soft multifocal contact lenses can reduce axial length growth (and hence myopia).However, effects on blinking, ptosis, the function of Meibomian glands, fluorescein and lissamine green staining of the conjunctiva and cornea, production of lid-parallel conjunctival folds and lid wiper epitheliopathy have received less research attention. Contact lens wear produces a subclinical inflammatory response manifested by increases in the number of dendritiform cells in the conjunctiva, cornea and limbus. Papillary conjunctivitis is also a complication of all types of contact lenses. Changes to wear schedule (daily disposable from overnight wear) or lens materials (hydrogel from SiHy) can reduce papillary conjunctivitis, but the effect of such changes on dendritic cell migration needs further study. These changes may be associated with decreased comfort but confirmatory studies are needed. Contact lenses can affect the sensitivity of the ocular surface to mechanical stimulation, but whether these changes affect comfort requires further investigation.In conclusion, there have been changes to lens materials, design and wear schedules over the past 20+ years that have improved their safety and seen the development of lenses that can reduce the myopia development. However, several changes to the ocular surface still occur and warrant further research effort in order to optimise the lens wearing experience.

Bayesian Meta-Analysis of Myopia Control with Multifocal Lenses.

The aim of this study is to provide reliable guidelines for the mean percentage efficacy together with the 95% credibility interval in slowing down progression of myopia by a specific intervention over defined time periods, derived from a substantial number of randomised controlled clinical trials (RCTs) with consistent outcomes. Multifocal spectacles and contact lenses represent interventions with the largest number of RCTs carried out. Our meta-analyses considered 10 RCTs involving 1662 children which have tested the efficacy of progressive addition spectacle lenses (PALs). In a separate model for comparison purposes nine RCTs with 982 children trialling soft multifocal contact lenses (MFCLs) were analysed. Bayesian random-effects hierarchical models were fitted. The highest efficacy in retarding progression of the scaled sphere equivalent refraction was achieved after 12 M follow-up with the mean 28% reduction in progression and the 95% credibility interval between 21% and 35%. For comparison, the 95% credibility interval for the mean efficacy of soft MFCLs at 12 M follow up is 21% to 37%. We conclude that both multifocal spectacle and contact lenses moderately slow down progression of myopia, relative to single-vision spectacle lenses (SVLs) in the first 12 months after intervention. The relative efficacy of PALs tends to weaken after the first 12 months.

Validation of the online fitting app OptiExpert for a reusable multifocal soft contact lens

Purpose: The multifocal soft lens calculator within the OptiExpert™ app was developed by CooperVision, Inc. to make multifocal contact lens fitting simpler and more efficient. Comparisons between clinician-dispensed lens prescription and app-recommendation were conducted to validate the software.

Мультифокальные мягкие контактные линзы в контроле прогрессирующей миопии у детей

Мультифокальные мягкие контактные линзы в контроле прогрессирующей миопии у детей

노안에서 멀티포컬 소프트 콘택트렌즈의 임상 결과

노안에서 멀티포컬 소프트 콘택트렌즈의 임상 결과

Effect of High Add Power, Medium Add Power, or Single-Vision Contact Lenses on Myopia Progression in Children

Slowing myopia progression could decrease the risk of sight-threatening complications. To determine whether soft multifocal contact lenses slow myopia progression in children, and whether high add power (+2.50 D) slows myopia progression more than medium (+1.50 D) add power lenses. A double-masked randomized clinical trial that took place at 2 optometry schools located in Columbus, Ohio, and Houston, Texas. A total of 294 consecutive eligible children aged 7 to 11 years with -0.75 D to -5.00 D of spherical component myopia and less than 1.00 D astigmatism were enrolled between September 22, 2014, and June 20, 2016. Follow-up was completed June 24, 2019. Participants were randomly assigned to wear high add power (n = 98), medium add power (n = 98), or single-vision (n = 98) contact lenses. The primary outcome was the 3-year change in cycloplegic spherical equivalent autorefraction, as measured by the mean of 10 autorefraction readings. There were 11 secondary end points, 4 of which were analyzed for this study, including 3-year eye growth. Among 294 randomized participants, 292 (99%) were included in the analyses (mean [SD] age, 10.3 [1.2] years; 177 [60.2%] were female; mean [SD] spherical equivalent refractive error, -2.39 [1.00] D). Adjusted 3-year myopia progression was -0.60 D for high add power, -0.89 D for medium add power, and -1.05 D for single-vision contact lenses. The difference in progression was 0.46 D (95% CI, 0.29-0.63) for high add power vs single vision, 0.30 D (95% CI, 0.13-0.47) for high add vs medium add power, and 0.16 D (95% CI, -0.01 to 0.33) for medium add power vs single vision. Of the 4 secondary end points, there were no statistically significant differences between the groups for 3 of the end points. Adjusted mean eye growth was 0.42 mm for high add power, 0.58 mm for medium add power, and 0.66 mm for single vision. The difference in eye growth was -0.23 mm (95% CI, -0.30 to -0.17) for high add power vs single vision, -0.16 mm (95% CI, -0.23 to -0.09) for high add vs medium add power, and -0.07 mm (95% CI, -0.14 to -0.01) for medium add power vs single vision. Among children with myopia, treatment with high add power multifocal contact lenses significantly reduced the rate of myopia progression over 3 years compared with medium add power multifocal and single-vision contact lenses. However, further research is needed to understand the clinical importance of the observed differences. ClinicalTrials.gov Identifier: NCT02255474.