This study showed that aspheric multifocal soft contact lenses (Biofinity +2.50D and NaturalVue) reduce accommodative response and increase exophoria, while MiSight concentric dual-focus minimally impacts binocular vision function compared to single vision contact lenses. All myopia control contact lenses increased divergence range slightly but did not impact convergence.
The MiSight 1 day clinical trial is the longest in soft lens myopia control, showing efficacy in children and teens in up to 6 years of wear. The first three years showed a 50-60% axial length and refractive efficacy. In the second three years, all control group children were switched to MiSight and showed axial growth similar to children under continued treatment, indicating benefits for commencing wear in children and teens alike.
The long-term safety of contact lens wear in children is a known concern amongst parents and eye care practitioners alike. This six year study demonstrated successful contact lens wear in a group of 8-12 year olds, with no serious contact lens adverse events reported and no change in clinical ocular signs compared to pre-contact lens wear. This demonstrates that children as young as 8 can successfully wear daily disposable contact lenses for multiple consecutive years.
The risk of microbial keratitis (MK) in orthokeratology-wearing children was shown in a 2013 analysis to be around 14 per 10,000 patient wearing years, but new data indicates that it may be lower. Data gathered from a large group of practices in Russia found MK risk of around 5 per 10,000 patient-wearing years, similar to the risk of daily wear soft lenses. This should increase confidence in fitting orthokeratology to children for myopia control.
Considering even emmetropic eyes elongate, what are the limits of myopia control efficacy? This novel analysis explores the absolute axial elongation of treated and untreated myopes in the MiSight 3-year clinical trial in comparison to previously published models of myopic and emmetropic eye growth. The results indicate a potential limit to the short-term percentage efficacy of myopia control treatments.
Total spherical-like higher-order aberrations (HOA) increased by more than double in the distance-centred +2.50 Add compared to +1.50 Add, with total coma-like HOA increasing further. Since orthokeratology studies have reported an association between more change in HOAs and better myopia control efficacy, this could indicate a mechanism of action in multifocal contact lens myopia control.
Young adults fit with CooperVision Proclear multifocal contact lenses showed no loss of peripheral vision detection ability compared to single vision contact lenses. The near add was chosen to generate +0.50 or +1.00 of peripheral blur, confirmed by peripheral refraction measurement. This is a positive indication that fitting MFCLs in young wearers doesn’t impact peripheral visual performance.
After the 3-year MiSight 1 day clinical trial, the control group children were switched to MiSight. A ‘virtual control group’ mathematical model, previously published, was utilized to demonstrate a continued myopia control effect across six years, plus effectiveness of treatment for children who commenced wear at age 11-15 years.
The BLINK study found that +2.50 Add centre-distance multifocal contact lenses (MFCLs) slowed myopia progression but the +1.50 Add didn’t. Further analysis indicates that increased peripheral defocus created by the +2.50 Add only accounted for around 15% of the myopia control effect, indicating other mechanisms are involved.
The purpose of this 2 year study was to determine the effect of MiSight contact lenses used to control myopia on binocular vision and accommodation in children, as compared with children wearing SV spectacles, with the researches finding no significant differences in binocular and accommodative measures between the study groups.