Multifocal Soft Contact Research Articles

IMI 2023 Digest.

Myopia is a dynamic and rapidly moving field, with ongoing research providing a better understanding of the etiology leading to novel myopia control strategies. In 2019, the International Myopia Institute (IMI) assembled and published a series of white papers across relevant topics and updated the evidence with a digest in 2021. Here, we summarize findings across key topics from the previous 2 years. Studies in animal models have continued to explore how wavelength and intensity of light influence eye growth and have examined new pharmacologic agents and scleral cross-linking as potential strategies for slowing myopia. In children, the term premyopia is gaining interest with increased attention to early implementation of myopia control. Most studies use the IMI definitions of ≤-0.5 diopters (D) for myopia and ≤-6.0 D for high myopia, although categorization and definitions for structural consequences of high myopia remain an issue. Clinical trials have demonstrated that newer spectacle lens designs incorporating multiple segments, lenslets, or diffusion optics exhibit good efficacy. Clinical considerations and factors influencing efficacy for soft multifocal contact lenses and orthokeratology are discussed. Topical atropine remains the only widely accessible pharmacologic treatment. Rebound observed with higher concentration of atropine is not evident with lower concentrations or optical interventions. Overall, myopia control treatments show little adverse effect on visual function and appear generally safe, with longer wear times and combination therapies maximizing outcomes. An emerging category of light-based therapies for children requires comprehensive safety data to enable risk versus benefit analysis. Given the success of myopia control strategies, the ethics of including a control arm in clinical trials is heavily debated. IMI recommendations for clinical trial protocols are discussed.

Multifocal versus modified monovision corrections: A non-dispensing comparison of visual assessment in presbyopic neophytes.

To compare the visual performance of two simultaneous-vision soft multifocal contact lenses and to compare multifocal contact lens and its modified monovision counterpart in presbyopic neophytes. A double-masked, prospective, comparative study was conducted on 19 participants fitted with soft PureVision2 multifocal (PVMF) and clariti multifocal (CMF) lenses in random order. High- and low-contrast distance visual acuity, near visual acuity, stereopsis, contrast sensitivity, and glare acuity were measured. The measurements were conducted using multifocal and modified monovision design with one brand and then repeated with another brand of lens. High-contrast distance visual acuity showed a significant difference between CMF (0.00 [-0.10-0.04]) and PureVision2 modified monovision (PVMMV; -0.10 [-0.14-0.00]) correction (P = 0.003) and also between CMF and clariti modified monovision (CMMV; -0.10 [-0.20-0.00]) correction (P = 0.002). Both modified monovision lenses outperformed CMF. The current study did not show any statistically significant difference between contact lens corrections for low-contrast visual acuity, near visual acuity, and contrast sensitivity (P > 0.01). Stereopsis at near distance was significantly lower with both modified monovision (PVMMV: 70 [50-85]; P = 0.007, CMMV: 70 [70-100]; P = 0.006) and with CMF (50 [40-70]; P = 0.005) when compared to spectacles (50 [30-70]). Glare acuity was significantly lower with multifocal (PVMF: 0.46 [0.40-0.50]; P = 0.001, CMF: 0.40 [0.40-0.46]; P = 0.007) compared with spectacles (0.40 [0.30-0.40]), but no significant difference was noted between the multifocal contact lenses (P = 0.033). Modified monovision provided superior high-contrast vision compared to multifocal correction. Multifocal corrections performed better for stereopsis when compared to modified monovision. In parameters like low-contrast visual acuity, near acuity, and contrast sensitivity, both the corrections performed similarly. Both multifocal designs showed comparable visual performances.

Comparison of visual performance between peripheral gradient high-addition multifocal soft contact lenses and orthokeratology.

The aim of this study was to evaluate the short-term effects of peripheral gradient high-addition multifocal soft contact lenses (MFSCLs) and orthokeratology (Ortho-K lenses) on visual performance in myopic children. Thirty myopic children participated in this prospective study. Each participant wore different sets of lenses in the following sequence: single-vision spectacles (SVSPs) as a control, MFSCLs and Ortho-K lenses. Ocular aberrations, topography, high-contrast visual acuity (HCVA), low-contrast visual acuity (LCVA) and accommodation of the right eye were measured with each type of correction on a different day. Compared with SVSPs, high-addition MFSCLs and Ortho-K lenses significantly increased all items of aberrations (all p < 0.05) except trefoil (p = 0.17). MFSCLs induced less coma, root mean square of the third-order aberration (RMS3) and higher order aberrations than Ortho-K lenses (all p < 0.05). No significant difference in HCVA was found across the three correction types (F = 1.19, p = 0.39). In terms of LCVA, MFSCLs performed significantly poorer than SVSPs (difference, 0.16 logMAR; p = 0.001) and slightly worse than Ortho-K lenses (difference, 0.08 logMAR; p = 0.35). No significant difference in decentration was found between the two types of contact lenses, and no associations were observed between decentration and visual acuity at both high- and low-contrast levels (all p > 0.05). For MFSCLs, decentration was positively related to coma (r = 0.43, p = 0.02) and RMS3 (r = 0.44, p = 0.02), which was not the case for Ortho-K lenses. Accommodative facility was worse with MFSCLs than Ortho-K lenses (p = 0.001). Multifocal soft contact lenses differed from Ortho-K lenses in aberration profile and LCVA, although decentration was similar. Decentration <1 mm had minimal influence on both HCVA and LCVA for either type of correction, but significantly increased third-order aberrations for MFSCLs, but not Ortho-K lenses.

Effect of peripheral defocus on axial growth and modulation of refractive error in children with anisohyperopia.

To establish whether axial growth and refractive error can be modulated in anisohyperopic children by imposing relative peripheral hyperopic defocus (RPHD) using multifocal soft contact lenses. This study is a prospective, controlled paired-eye study with anisohyperopic children. Axial growth and refractive error were observed without intervention for the first 6 months of the 3-year trial with participants wearing single vision spectacles. Then, participants wore a centre-near, multifocal, soft contact lens (+2.00 D add) in their more hyperopic eye for 2 years, with a single vision contact lens worn in the fellow eye if required. The 'centre-near' portion of the contact lens in the more hyperopic eye corrected distance refractive error while the 'distance' portion imposed hyperopic defocus in the peripheral retina. Participants reverted to single vision spectacles for the final 6 months. Eleven participants, mean age of 10.56 years (SD 1.43; range 8.25-13.42), completed the trial. No increase in axial length (AL) was found during the first 6 months in either eye (p > 0.99). Axial growth across the 2-year intervention period was 0.11 mm (SEM 0.03; p = 0.06) in the test eye versus 0.15 mm (SEM 0.03; p = 0.003) in the control eye. AL was invariant during the final 6 months in both eyes (p > 0.99). Refractive error was stable during the first 6 months in both eyes (p = 0.71). Refractive error change across the 2-year intervention period was -0.23 D (SEM 0.14; p = 0.32) in the test eye versus -0.30 D (SEM 0.14; p = 0.61) in the control eye. Neither eye demonstrated a change in refractive error during the final 6 months (p > 0.99). Imposing RPHD using the centre-near, multifocal, contact lens specified here did not accelerate axial growth nor reduce refractive error in anisohyperopic children.

Visual Quality Indicators with Multifocal and Dual-Focus Soft Contact Lenses for Myopia Control

Purpose. The purpose of this study was to determine and compare visual quality indicators in eyes wearing multifocal center-distance, and dual-focus soft contact lenses that are specifically designed for the purpose of myopia progression management, as well as single-vision soft contact lenses. Material and Methods. Visual quality indicators of 34 eyes of healthy, young myopic adults ages 20 to 35 were determined. Non-cycloplegic measurements were conducted without contact lenses (baseline) and while subjects wore soft multi- focal center-distance soft contact lenses (ArtMost SoftOK SMR and SEED 1-day Pure UP Multistage daily disposable), dual-focus soft contact lenses (CooperVision MiSight 1 Day), and single-vision soft contact lenses (iLens Aqua Bi-weekly). In this study, the lenses were referred to as SoftOK, Pure UP, MiSight, and iLens. The measured and analyzed visual quality indicators included high-contrast distance and near visual acuity, stereopsis, accommodative amplitude, accommo- dative response, spherical aberration, and horizontal coma. Results. High-contrast distance and near visual acuities, accommodative responses, and stereopsis values achieved with the SoftOK, Pure UP, and MiSight contact lenses werecomparable to those achieved with the iLens single-vision soft contact lenses and to baseline values. Accommodative amplitude was slightly reduced with the MiSight contact lens and spherical aberration was significantly higher with the SoftOK lens compared to the other lenses. Both findings had statistical significance (P = 0.047 and P &lt; 0.001, respec- tively). Horizontal coma, most likely resulting from slight lens decentration, was higher and more variable with the SoftOK lens compared to the other lenses, although no statistical significance was determined. Conclusion. Dual-focus and multifocal center-distance soft contact lenses allow for good visual quality, especially clear vision at distance and near. Small differences in accommoda- tive amplitude and spherical aberration were found between lens designs, however the clinical impact requires further investigation. Keywords myopia management, soft multifocal contact lens, visual quality indicators, spherical aberration, accommodative amplitude

Interventions for myopia control in children: a living systematic review and network meta-analysis.

Interventions for myopia control in children: a living systematic review and network meta-analysis.

Efficacy in Myopia Control: Does Race Matter?

Efficacy in Myopia Control: Does Race Matter?

Wearer Experience and Eye Care Professional Acceptance with a 1 Day Multifocal Contact Lens.

A large observational survey was undertaken to determine eye care professional (ECP) and patient experience of stenfilcon A multifocal soft contact lens (MyDay multifocal) when prescribed in a real-world setting. A total of 196 ECPs from eleven countries fit up to ten presbyopes with stenfilcon A multifocal. Data were collected on fit success at the initial visit, patient satisfaction with comfort, vision at distance, intermediate, and near, overall vision, overall satisfaction, and handling at the initial and follow-up visits after 1-2 weeks of wear. ECPs completed questionnaires on multifocal fitting experience and expectations before and after the fitting period. A total of 196 pre-fitting and 141 post-fitting ECP surveys were collected. A total of 1505 initial fits (mean age 53.4, range 38 to 81 years, 73% female, 27% neophytes) and 1440 follow-up visits were completed. The mean distance vision contact lens prescription was -1.32DS (range -12.00DS to +8.00DS) with Add powers: Low 56%, Medium 24%, and High 21%. At the follow-up visit 77% (n=1108) of trials were successful. Mean patient satisfaction ratings (1-10 scale, where 1 is not at all satisfied, and 10 extremely satisfied) at the initial visit were higher than eight out of ten for comfort, vision, and overall satisfaction, and were not significantly different after 1-2 weeks of wear. Stenfilcon A multifocal was preferred by 66% of patients over their habitual correction. In most cases mean satisfaction scores and the proportion of patients highly satisfied were not significantly different between myopes and hyperopes, across Add range, between new and habitual wearers, and wearers of frequently replaced and 1 day contact lenses. ECPs in real-world clinical settings found stenfilcon A multifocal contact lenses easy to fit to a wide range of patients, with a high fit success rate and high levels of patient satisfaction for overall comfort, vision, satisfaction, and handling.

Change of Spherical Aberration in Early Presbyopia Wearing Center-Near Multifocal Soft Contact Lens

Change of Spherical Aberration in Early Presbyopia Wearing Center-Near Multifocal Soft Contact Lens

The Effect of Multifocal Soft Contact Lens Wear on Axial and Peripheral Eye Elongation in the BLINK Study.

PurposeThe purpose of this study was to compare axial and peripheral eye elongation during myopia therapy with multifocal soft contact lenses.MethodsParticipants were 294 children (177 [60.2%] girls) age 7 to 11 years old with between −0.75 diopters (D) and −5.00 D of myopia (spherical component) and less than 1.00 D astigmatism at baseline. Children were randomly assigned to Biofinity soft contact lenses for 3 years: D-designs with a +2.50 D addition, +1.50 D addition, or single vision. Five measurements of eye length were averaged at the fovea, ±20°, and ±30° in the horizontal and vertical meridians of the right eye using the Haag-Streit Lenstar LS 900.ResultsAxial elongation over 3 years with single vision contact lenses was greater than peripheral elongation in the superior and temporal retinal qeuadrants by 0.07 mm (95% confidence interval [CI] = 0.05 to 0.09 mm) and 0.06 mm (95% CI = 0.03 to 0.09 mm) and similar in the inferior and nasal quadrants. Axial elongation with +2.50 D addition multifocal contact lenses was similar to peripheral elongation in the superior retinal quadrant and less than peripheral elongation in the inferior and nasal quadrants by −0.04 mm (95% CI = −0.06 to −0.01 mm) and −0.06 mm (95% CI = −0.09 to −0.02 mm).ConclusionsWearing +2.50 D addition multifocal contact lenses neutralized or reversed the increase in retinal steepness with single vision lenses. The mismatch between greater inhibition of elongation at the fovea than peripherally despite greater peripheral myopic defocus suggests that optical myopia therapy may operate through extensive spatial integration or mechanisms other than local defocus.

Updates on Optical Strategies of Myopia Control

Myopia has become a pandemic disease in the past few years and its sight-threatening consequences associated with high myopia have been a challenging issue for most public health societies. Controlling myopia progression has also become a global concern for many people particularly, parents of myopic children. Accordingly, a large body of work has been devoted to considering different optical and non-optical methods to prevent or retard myopia progression. Different optical strategies such as sunder correction, monofocal spectacles or contact lenses, bifocal or progressive spectacle lenses, multifocal contact lenses, gas-permeable (GP) contact lenses, and orthokeratology (ortho-K) have been proposed to slow down the myopia progression. Although the effectiveness of these treatment strategies has been vastly studied, there are some debates concerning the most efficient method in controlling myopia progression. The present study reviewed the current optical therapies to control the progression of myopia. A literature review revealed that optical strategies, such as myopic under correction, monofocal spectacles or contact lenses, GP contact lenses, and bifocal and multifocal spectacle lenses did not provide a clinically significant reduction in myopia progression. In contrast, ortho-K and newly introduced multifocal soft contact lenses may significantly slow myopia progression.

Fusion NEW Multifocal lenses are a novelty on the Russian market of contact vision correction. Lens fitting guide

Presbyopia is becoming a global problem worldwide, leading to reduced quality of life due to lack of correction or hypocorrection in 94% of people over 45. Multifocal soft contact lenses (MFCLs) are one of the fastest growing methods of contact correction for presbyopia. According to a report by our international colleagues, MFCLs represent 14% of all types of MCLs worldwide in 2021, an increase of 2% from 2020.In this article we will look at the OKVision® Fusion NEW Multifocal fitting algorithm to help professionals simplify and speed up the fitting process and help patients get the vision quality they want at the right distances.

Reduction of Myopic Progression Using a Multifocal Soft Contact Lens: A Retrospective Cohort Study

PurposeTo evaluate myopia progression over an approximately 6-year follow-up period in children and young adults wearing a commercially available, daily disposable, soft multifocal contact lens with an extended depth of focus (center distance) design.MethodsThis retrospective cohort analysis included data from 196 patients of mean (SD) age 12.3 (2.7) years (range, 5–20 years), fit with the NaturalVue Multifocal (NVMF) contact lens at 15 practices in the United States over 6 years. All patients showed at least −0.50D of myopic progression in at least one eye prior to wearing the lens. Data from the right eye were analyzed. One-way ANOVA with Tukeys post-hoc t-tests were used for statistical analysis, with a significance level set at P < 0.05.ResultsAfter wearing these lenses for 6–72 months, the average myopia progression slowed by approximately 0.84 D or 85% compared to baseline, which was statistically significant at all time points (P < 0.0001). Frequency distribution revealed that 91% of wearers showed a decrease in myopia progression compared to baseline, with 79% of wearers showing a ≥70% reduction in myopia progression. The average change in axial length in a subset of the population over 47 months of follow-up was approximately 0.10 mm/year. Compared with changes expected in an age- and ethnicity-matched myopic virtual control group obtained from published meta-analysis data, both myopic refractive error progression and axial elongation were significantly lower in NVMF wearers at 12, 24 and 36 months (P < 0.001). Analysis of the age- and ethnicity-matched virtual control group predicted that the Cumulative Absolute Reduction of axial Elongation (CARE) value over 3 years would be 0.45 mm.ConclusionWearers of the soft multifocal contact lens displayed significant reductions in myopia progression throughout a follow-up period of 6 years.

Retardation of Myopia by Multifocal Soft Contact Lens and Orthokeratology: A 1-Year Randomized Clinical Trial.

This randomized, single-blind, clinical trial compared the effectiveness of multifocal soft contact lenses (MFSCLs), orthokeratology contact lenses (Ortho-kCLs), and single vision spectacles (SVSs) for myopia control. Sixty-six eligible Chinese subjects, aged 7 to 15 years old with cycloplegic refraction measurements between -1.00 and -8.00 diopters (D), astigmatism not more than 1.00 D, and no history of myopia control treatment, were randomly assigned to wear MFSCLs, Ortho-kCLs, or SVSs for 1 year. For all three groups, baseline measurements of cycloplegic refraction, axial length (AL), and corneal endothelial cell density (CECD) were made. At the 6- and 12-month follow-up visits, changes in cycloplegic refraction, AL, and CECD were measured in the MFSCL and SVS groups. For the Ortho-kCL group, only changes in the AL were measured at 6 and 12 months, and CECD was measured at the 12-month follow-up visit. After 1 year of lens wear, myopia progression of the SVS group, -0.938±0.117 D, was greater than that of the MFSCLs group, -0.591±0.106 D (P=0.032). Thus, MFSCLs reduced the rate of myopia progression by 37.0% compared with the SVSs. The AL elongations after 1 year were 0.30±0.03 mm for MFSCLs (P=0.027 vs SVSs), 0.31±0.04 mm for Ortho-kCLs (P=0.049 vs SVSs), and 0.41±0.04 mm for SVSs. Compared with the SVS group, the reduction in AL elongation was 26.8% and 24.4% in the MFSCL and Ortho-kCL groups, respectively. There were no significant differences in CECD among the three groups (P>0.05). Compared with SVSs, wearing MFSCLs and Ortho-kCLs significantly delayed myopia progression. MFSCLs and Ortho-kCLs are safe and promising methods of myopia control (chictr.org number, ChiCTR2100048452).

Trends in myopia management attitudes and strategies in clinical practice: Survey of eye care practitioners in Africa

PurposeThere remains a lack of information on the perception and adoption of myopia control strategies among African eye care practitioners (ECPs). This study provides an African perspective to similar previous studies conducted in other parts of the world. MethodsA self-administered survey in English and French was distributed to ECPs across Africa. The items on the questionnaire assessed their level of concern about the increasing prevalence of paediatric myopia, perceived efficacy, opinions on, and adoption of various myopia management modalities. ResultsResponses were obtained from 330 ECPs working in 23 African countries. Respondents were highly concerned about the increasing prevalence of paediatric myopia in their clinic (median 8/10) and perceived approved myopia control soft contact lenses as the most effective at slowing myopia progression (mean perceived reduction in myopia progression ± SD; 53.9 ± 27.1%), followed by single vision spectacles (53.1 ± 30.9%), and orthokeratology (52.8 ± 28.0%). Multifocal soft contact lenses (40.4 ± 25.8%) and pharmaceutical agents such as topical atropine drops (39.5 ± 27.1%) were perceived as least effective in slowing myopia progression. Although ECPs reported being aware of various myopia control strategies, they still mainly prescribed single vision spectacles to a large proportion (64.3 ± 29.9%) of young progressing myopes. Nearly one-third (27%) of ECPs who prescribed single vision lenses stated they were concerned about the cost implications to patients. Other reported concerns included safety of, and inadequate information about myopia control options. ConclusionsAfrican ECPs continue to prescribe single vision lenses for progressing myopes despite being aware of the various myopia control options. Practitioners’ perceptions of the efficacy of several modalities to slow myopia progression do not align with the current best evidence. Clear practice guidelines and continuing education on myopia control are warranted to inform and guide the management of myopic patients in Africa.

Vision tests on spectacle lenses and contact lenses for optical myopia correction: a pilot study

ObjectiveVisual performance and short-term tolerability of different designs of myopia correcting options, including therapeutically relevant bifocal contact lenses (CL) and spectacle lenses with ‘defocus incorporated multiple segments (DIMS)’ technology were...

Comprehensive design method of a soft multifocal contact lens with NURBS.

This study presents a comprehensive method for designing a multifocal contact lens (MCL) with Snell's law and non-uniform rational B-spline (NURBS) curves. Instead of using thin lens approximation, general mathematical formulas have been developed to achieve the accurate coordinates of points on the anterior lens surface profile of the MCL to meet various given optical power distributions. Then the NURBS curve is adjusted to fit these data points to obtain the smooth front lens surface profile. This method not only improves the accuracy of the optical power profiles of MCLs but also reduces the spherical aberration in near/distance optical zones. The experimental results show that the power profiles of soft MCLs agree with those of the simulation results and original design requirements. The proposed method has been proven for the MCL design, and it can be feasibly applied in complex optical lens designs.

The effect of concentric and aspheric multifocal soft contact lenses on binocular vision in young adult myopes

PurposeMultifocal soft contact lenses (MFCLs) are prescribed to inhibit myopia progression; these include aspheric and concentric designs. The effects of MFCLs on visual quality, accommodation and vergence in young-adult myopes were evaluated. MethodsParticipants were twenty-six myopes (19–25 years, spherical equivalent −0.50 to −5.75D), with normal binocular vision and no past myopia control. Pupil sizes were 4.4 ± 0.9 mm during distance viewing and 3.7 ± 0.8 mm at near. In random order, participants wore four MFCLs: Proclear single vision distance, MiSight concentric dual focus (+2.00D), distance center aspheric (Biofinity, +2.50D) (CooperVision lenses), and NaturalVue aspheric (Visioneering Technologies). Testing included visual acuity, contrast sensitivity (Pelli-Robson), stereoacuity, accommodation response, negative and positive relative accommodation, horizontal phorias, horizontal fusional vergence and AC/A ratio, and a visual quality questionnaire. ResultsThe four lenses differed in distance (p = 0.001) and near visual acuity (p = 0.011), and contrast sensitivity (p = 0.001). Compared with the single vision lens, the Biofinity aspheric had the greatest visual impact: 0.19 ± 0.14 logMAR distance acuity reduction, 0.22 ± 0.15 log contrast sensitivity reduction. Near acuity was affected less than distance acuity; the reduction was greatest with the NaturalVue (0.05 ± 0.07 logMAR reduction). The MFCLs altered the autorefraction measure at distance and near (p = 0.001); the accommodation response was less with aspheric lenses. Negative relative accommodation reduced with the aspheric lenses (p = 0.001): by 0.9 ± 0.5D with Biofinity and 0.5 ± 0.7D with NaturalVue. Exophoric shifts were greater with aspheric lenses (1.8 ± 2.4Δ Biofinity, 1.7 ± 1.7Δ NaturalVue) than with the concentric MiSight (0.5 ± 1.3Δ). ConclusionsMFCLs alter visual performance, refraction and vergence; two aspheric lenses had greater effect than a concentric lens.

Effect of Combining 0.01% Atropine with Soft Multifocal Contact Lenses on Myopia Progression in Children.

Combining 0.01% atropine with soft multifocal contact lenses (SMCLs) failed to demonstrate better myopia control than SMCLs alone. The Bifocal & Atropine in Myopia (BAM) Study investigated whether combining 0.01% atropine and SMCLs with +2.50-D add power leads to greater slowing of myopia progression and axial elongation than SMCLs alone. Participants of the BAM Study wore SMCLs with +2.50-D add power daily and administered 0.01% atropine eye drops nightly (n = 46). The BAM subjects (bifocal-atropine) were age-matched to 46 participants in the Bifocal Lenses in Nearsighted Kids Study who wore SMCLs with +2.50-D add power (bifocal) and 46 Bifocal Lenses in Nearsighted Kids participants who wore single-vision contact lenses (single vision). The primary outcome was the 3-year change in spherical equivalent refractive error determined by cycloplegic autorefraction, and the 3-year change in axial elongation was also evaluated. Of the total 138 subjects, the mean ± standard deviation age was 10.1 ± 1.2 years, and the mean ± standard deviation spherical equivalent was -2.28 ± 0.89 D. The 3-year adjusted mean myopia progression was -0.52 D for bifocal-atropine, -0.55 D for bifocal, and -1.09 D for single vision. The difference in myopia progression was 0.03 D (95% confidence interval [CI], -0.14 to 0.21 D) for bifocal-atropine versus bifocal and 0.57 D (95% CI, 0.38 to 0.77 D) for bifocal-atropine versus single vision. The 3-year adjusted axial elongation was 0.31 mm for bifocal-atropine, 0.39 mm for bifocal, and 0.68 mm for single vision. The difference in axial elongation was -0.08 mm (95% CI, -0.16 to 0.002 mm) for bifocal-atropine versus bifocal and -0.37 mm (95% CI, -0.46 to -0.28 mm) for bifocal-atropine versus single vision. Adding 0.01% atropine to SMCLs with +2.50-D add power failed to demonstrate better myopia control than SMCLs alone.

Comparison of peripheral refraction and higher-order aberrations between orthokeratology and multifocal soft contact lens designed with highly addition

PurposeTo compare peripheral defocus, higher-order aberrations (HOAs), and contrast visual acuity (CVA) in myopic children wearing orthokeratology (OK) lenses and multifocal soft contact lenses (MSCLs) designed with highly addition.MethodsThis is a prospective, nonrandomized, controlled study. Subjects at 8 to 13 years of age with spherical equivalent refraction from − 1.00 to − 5.00 dioptres (D) were included in the OK group (n = 30) and MSCL group (n = 23). Relative peripheral corneal defocus (RPCD) and relative peripheral refraction (RPR) were measured before and after wearing lenses. HOAs including spherical aberration (SA), coma, trefoil, and total HOAs, and high (100%) and low (10%) CVA were compared between the groups. Axial length (AL) was measured before and after wearing the lenses for 1 year.ResultsAfter wearing the lenses, subjects in the MSCL group had RPCD and RPR values similar to the OK group at the paracentral (within 2 mm of the cornea or 20° of the retina, all p > 0.05) but larger than the OK group at the periphery (all p < 0.05). All HOAs increased after wearing the lenses except the trefoil in the MSCL group (all p < 0.05). HOAs increased more in the OK group (all p < 0.05). The 100% and 10% CVAs were worse in the MSCL group (p = 0.02 and p = 0.004). After 1 year, AL elongation was 0.37 mm (SD = 0.16) in the MSCL group and 0.28 mm (0.16) in the OK group (p = 0.06).ConclusionMSCL produced larger myopic defocus at the periphery, increased less HOAs and had worse CVA than OK lens. The high addition of this MSCL did not result in better myopia control efficacyTrial registrationChinese Clinical Trial Registry: ChiCTR1800018564. Registered 25 September 2018; retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=31376