Comparing EDOF (SEED 1dayPURE EDOF) soft contact lens designs for myopia control

Paper title: Effect of Variation in Extended Depth-Of-Focus Design on Myopia Control and Visual Function in Japanese Children

Authors: Ninomiya S (1), Koh S, Ueshima S, Nishida K

1. Itami Central Eye Clinic (S.N., S.U.), Hyogo, Japan; Department of Innovative Visual Science (S.K.), The University of Osaka Graduate School of Medicine, Osaka, Japan; and Department of Ophthalmology (S.K., K.N.), The University of Osaka Graduate School of Medicine, Osaka, Japan.

Date: Published online June 25, 2026

Reference: Ninomiya S, Koh S, Ueshima S, Nishida K. Effect of Variation in Extended Depth-Of-Focus Design on Myopia Control and Visual Function in Japanese Children. Eye Contact Lens. 2026 Jun 25.

Link to open access paper

While animal studies suggest a dose-dependent relationship between peripheral add power and myopia control,^1,2  the clinical evidence in humans is more complex. EDOF soft contact lenses slow myopia progression through retinal defocus, but treatment efficacy varies between optical designs and add powers.³  A higher add power may offer stronger myopia control, but this potential benefit must be balanced against concerns with reduced contrast sensitivity and visual clarity. 

This multicentre, double-masked, randomized controlled trial evaluated EDOF soft contact lenses (SEED 1dayPure EDOF) for myopia control and compared a +1.50 D Mid-EDOF design with a +0.75 D Low-EDOF design and single-vision (SV) soft contact lenses. Japanese children (n = 60) aged 6–12 years were allocated to Mid-EDOF (n = 21), Low-EDOF (n = 22) or to SV soft contact lenses (n = 17). The groups were comparable at baseline for age, spherical equivalent refraction and axial length. Axial length and cycloplegic spherical equivalent were assessed at 6 and 12 months, alongside contrast sensitivity, higher-order aberrations and subjective visual quality. Mean daily lens wear across the groups was 12.9 hours.

Key findings were as follows.

• Myopia control effect: At 12 months, axial elongation was 0.19 mm with +1.50 D Mid-EDOF vs 0.36 mm with single-vision lenses, a difference of 0.17 mm (49% less axial elongation). Myopia progression was −0.34 D vs −0.82 D, a difference of 0.48 D (59% less progression). The +0.75 D Low-EDOF lens showed little difference from control (0.33 vs 0.36 mm; −0.79 vs −0.82 D). 
• Visual function: Mid-EDOF increased higher-order aberrations and reduced contrast sensitivity, while Low-EDOF also reduced contrast sensitivity but did not increase higher-order aberrations compared with control. Subjective visual quality remained comparable across all groups, despite these objective changes. 
• Safety: No serious adverse events occurred, and corneal endothelial cell density remained stable across all groups over the 12-month study period. 

These findings suggest that add power may be an important consideration when selecting an EDOF soft contact lens for myopia management. Low-EDOF did not significantly slow myopia progression compared with the single-vision control, while Mid-EDOF slowed axial elongation by 49% and myopia progression by 59% over 12 months. This suggests there may be a threshold add power required to achieve a meaningful myopia control effect with the SEED 1dayPure EDOF soft contact lens: Mid-EDOF should ideally be chosen for myopia management over Low-EDOF.

The greater efficacy of the Mid-EDOF lens did not appear to come at the expense of children's perceived visual quality. Although objective testing showed increased higher-order aberrations and reduced photopic contrast sensitivity compared with spectacles and single-vision contact lenses, subjective visual quality did not differ significantly between groups over 12 months. This suggests that children can tolerate and adapt well to the Mid-EDOF design, which can provide useful reassurance when discussing expected vision with children and their parents.

Average lens wear was high at 12.9 hours per day, although some children wore their lenses for as little as 8.7 hours per day. Earlier lens removal in some participants was associated with evening dryness, potentially related to the hydrogel lens material. Asking specifically about end-of-day comfort and addressing ocular surface symptoms may therefore help support consistent daily wear and treatment adherence.

The results also highlight the value of axial length for monitoring early treatment response. Significant slowing of axial elongation was evident by six months, whereas a statistically significant difference in spherical equivalent refraction was not observed until 12 months. Clinicians may need to be cautious about judging treatment efficacy from refractive change alone at six months, with assessment over at least 12 months also helping to account for seasonal variation in myopia progression. It also appears that axial length provides an earlier indication of treatment response. 

Several limitations should be considered when interpreting the findings. The 12-month follow-up period was relatively short, which prevents the evaluation of the long-term durability of the lenses' treatment effects. It also means that potential rebound effects following discontinuation of lens wear were not evaluated. 

Furthermore, with 60 participants enrolled, the study lacked the statistical power to explore how individual baseline characteristics (such as initial refractive error or axial length) influenced treatment response. This small cohort also prevented the researchers from performing a dose-response analysis to see how daily wear hours directly correlated with myopia-control efficacy. 

There were also limitations in the assessment of visual quality. Subjective visual quality was evaluated using a simple five-point scale, which may not have been sensitive enough to identify more subtle differences in visual experience between the lens designs.

Objectives: To evaluate the efficacy of extended depth-of-focus (EDOF) soft contact lenses with different optical profiles in controlling myopia progression and their effect on visual function in Japanese children.

Methods: In this 12-month multicenter, double-masked, randomized controlled trial, 60 Japanese children aged 6 to 12 years were assigned to wear two types of EDOF soft contact lenses with different depths of focus (Mid-EDOF [+1.50 D] or Low-EDOF [+0.75 D]) or single-vision daily disposable contact lenses (control). Axial length and cycloplegic spherical equivalent (SE) were measured at 6 and 12 months. Visual function, including contrast sensitivity, higher-order aberrations (HOAs), and subjective visual quality, was assessed at baseline and follow-up.

Results: Mid-EDOF lenses significantly suppressed axial elongation and SE progression by 49% and 59%, respectively, compared with single-vision lenses (P<0.01). Low-EDOF lenses exerted no significant effect on axial elongation or SE progression. Visual function assessments revealed reduced contrast sensitivity and increased HOAs in the Mid-EDOF group; subjective visual quality remained comparable across groups. No serious adverse events were reported.

Conclusion: Mid-EDOF lenses significantly suppress myopia progression, with tolerable visual function changes, potentially providing effective myopia control. Low-EDOF lenses showed no significant benefit over single-vision lenses. EDOF lenses' optical profile critically affects treatment efficacy.