Findings from a report by the American Academy of Ophthalmology (AAO) Ophthalmic Technology Assessment (OTA) Committee evaluated the efficacy of multifocal soft contact lenses (CLs) in slowing myopia progression and axial length (AL) elongation in children.
What is an Ophthalmic Technology Assessment?
AAO’s OTAs evaluate new and existing procedures, drugs, and diagnostic and screening tests for clinical efficacy and safety.
- The results are reviewed for currency by its panel every 5 years, and the panel decides whether to maintain, revise, or retire the OTA.
Bring in myopia.
As one of the most common ocular disorders worldwide, there are various pharmacologic and optical interventions for managing myopia—though studies have demonstrated variability in the effectiveness of these approaches.
Managing myopia with multifocal soft CLs is a popular treatment approach for myopic children. This involves specific zones designed to provide optimal myopic correction centrally and limit peripheral hyperopic defocus.
Now, talk about the study.
Investigators performed a literature review of the PubMed database for studies on myopia control with multifocal soft CLs.
After selecting 12 studies, researchers used these to compare the efficacy of multifocal soft CLs with single-vision spectacles and CLs.
Findings?
All studies showed less myopic progression in the multifocal soft CL group compared to single-vision spectacles or CLs during at least 1 year, with changes in spherical equivalent (SE) ranging from:
- Multifocal soft CL group: 0.22-0.81 diopters (D)
- Control groups: 0.50-1.45 D
Further: AL elongation was reduced in the multifocal soft CL group compared with controls:
- Multifocal soft CL group: 0.05-0.39 mm
- Control groups: 0.17-0.67 mm
Anything else?
Of note, the difference in SE and AL change between the groups was clinically modest and statistically significant in 11 and 12 studies, respectively.
No serious adverse events were reported with CL use in any of the included studies.
Limitations?
The study authors noted that “differences in patient inclusion criteria and study methodology limited a direct comparison of the results between studies.”
Meaning: The optimal treatment duration for multifocal soft CLs as well as the type of multifocal design and magnitude of add power most effective for myopia control both remain unclear.
Take home.
These findings suggest that multifocal soft CL use in children resulted in slower myopia progression and AL elongation compared to single-vision spectacles or CLs over at least 1 year.
However, further research is warranted to identify:
- Optimal treatment duration for multifocal soft CLs
- The rate of myopia progression over longer periods of time
- Myopia progression after discontinuation of multifocal CLs