Efficacy of a progressive multifocal soft contact lens in myopia management in Caucasian children: A two-year follow-up

Abstract

Purpose

To evaluate myopia progression as assessed by changes in axial length (AL) and spherical equivalent (SE) from baseline in Caucasian children wearing multifocal soft contact lenses (MCL) compared to single-vision distance spectacles. Methods: Forty progressing (at least -0.75D increase in previous 12 months) myopic children (7–12 years old) with SE ranging from -0.75 to -4.50 D were recruited in a longitudinal prospective non-randomized study. 20 were fitted with MCL (+2.50D add), whereas 20 wore single-vision distance spectacles. Cycloplegic refraction was measured with an auto-refractometer (Topcon TRK-2P, Japan) and AL with IOLMaster 700 (Carl Zeiss, Germany). Subjective responses related to vision and comfort of MCL wear were determined with a questionnaire scaled from 0 (very poor) to 10 (excellent). Results: After 2 years, mean change in SE/AL in the MCL group was - 0.82±0.25D/0.51±0.02 mm and -1.12±0.14D/0.66±0.03 mm in the spectacles group (all p < 0.001). Cumulative Absolute Reduction in Axial Elongation (CARE) was 0.15 mm. Difference in SE change was 0.30D. 97.5 % of children in the spectacles group showed an AL increase of between 0.61 and 0.70, and 70 % of eyes showed an SE increase of −1.00 D. In the MCL group, there was no case with an elongation >0.60 mm, with 67.5 % of eyes being between 0.51 and 0.60 mm. In contrast, over half of the MCL group exhibited lower SE progression, from 0.50 to 0.75 D. Conclusion: A slower myopia progression rate was achieved with a centre distance MCL with +2.50D addition after two years of wear compared with the spectacles group.