Myopia control with soft multifocal contact lenses

Raffa, Lina; Allinjawi, Kareem; Sharanjeet-Kaur,; Akhir, Saadah M; Mutalib, Haliza Abdul

doi:10.4103/1319-4534.347305

Saudi Journal of Ophthalmology

2021

DOI: 10.4103/1319-4534.347305

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Myopia control with soft multifocal contact lenses

Lina Raffa

Kareem Allinjawi

Sharanjeet-Kaur Sharanjeet-Kaur

et al.

Abstract: PURPOSE: The study aimed to establish the outcome of multifocal contact lenses (MFCL) (Multistage + 1.50D and Proclear + 3.00D) on myopia progression and axial length elongation over an 18-month period. METHODS: Thirty myopic schoolchildren (5 males and 25 females) aged between 13 and 15 years were randomly assigned to wear either single vision contact lens (SVCL), Multistage MFCL + 1.50D, or Proclear +3.00D MFCL for 1½ years using a double-masked desig… Show more

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Cited by 6 publications

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Myopia Control: Are We Ready for an Evidence Based Approach?

Eppenberger,

Grzybowski,

Schmetterer

et al. 2024

Ophthalmol Ther

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Introduction Myopia and its vision-threatening complications present a significant public health problem. This review aims to provide an updated overview of the multitude of known and emerging interventions to control myopia, including their potential effect, safety, and costs. Methods A systematic literature search of three databases was conducted. Interventions were grouped into four categories: environmental/behavioral (outdoor time, near work), pharmacological (e.g., atropine), optical interventions (spectacles and contact lenses), and novel approaches such as red-light (RLRL) therapies. Review articles and original articles on randomized controlled trials (RCT) were selected. Results From the initial 3224 retrieved records, 18 reviews and 41 original articles reporting results from RCTs were included. While there is more evidence supporting the efficacy of low-dose atropine and certain myopia-controlling contact lenses in slowing myopia progression, the evidence about the efficacy of the newer interventions, such as spectacle lenses (e.g., defocus incorporated multiple segments and highly aspheric lenslets) is more limited. Behavioral interventions, i.e., increased outdoor time, seem effective for preventing the onset of myopia if implemented successfully in schools and homes. While environmental interventions and spectacles are regarded as generally safe, pharmacological interventions, contact lenses, and RLRL may be associated with adverse effects. All interventions, except for behavioral change, are tied to moderate to high expenditures. Conclusion Our review suggests that myopia control interventions are recommended and prescribed on the basis of accessibility and clinical practice patterns, which vary widely around the world. Clinical trials indicate short- to medium-term efficacy in reducing myopia progression for various interventions, but none have demonstrated long-term effectiveness in preventing high myopia and potential complications in adulthood. There is an unmet need for a unified consensus for strategies that balance risk and effectiveness for these methods for personalized myopia management. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-024-00951-w.

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Myopia Control: Are We Ready for an Evidence Based Approach?

Eppenberger,

Grzybowski,

Schmetterer

et al. 2024

Ophthalmol Ther

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Advances in myopia control strategies for children

Zhang,

Zaabaar,

French

et al. 2024

Br J Ophthalmol

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Myopia has long been a global threat to public health. Timely interventions are likely to reduce the risk of vision-threatening complications. There are both established and rapidly evolving therapeutic approaches to slow myopia progression and/or delay its onset. The effective methods for slowing myopia progression include atropine eye-drops, defocus incorporated multiple segments (DIMS) spectacle lenses, spectacle lenses with highly aspherical lenslets target (HALT), diffusion optics technology (DOT) spectacle lenses, red light therapy (RLT), multifocal soft contact lenses and orthokeratology. Among these, 0.05% atropine, HALT lenses, RLT and +3.00 peripheral addition soft contact lenses yield over 60% reduction in myopia progression, whereas DIMS, DOT and MiSight contact lenses demonstrate at least 50% myopia control efficacy. 0.05% atropine demonstrates a more optimal balance of efficacy and safety than 0.01%. The efficacy of 0.01% atropine has not been consistent and requires further validation across diverse ethnicities. Combining atropine 0.01% with orthokeratology or DIMS spectacles yields better outcomes than using these interventions as monotherapies. Increased outdoor time is an effective public health strategy for myopia prevention while recent studies suggest that 0.05% low-concentration atropine and RLT therapy have promising potential as clinical myopia prevention interventions for high-risk groups. Myopia control spectacle lenses, being the least invasive, are safe for long-term use. However, when considering other approaches, it is essential to ensure proper instruction and regular follow-ups to maintain safety and monitor any potential complications. Ultimately, significant advances have been made in myopia control strategies, many of which have shown meaningful clinical outcomes. However, regular use and adequate safety monitoring over extended durations are imperative to foster confidence that can only come from extensive clinical experience.

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IMI 2023 Digest

Sankaridurg

Berntsen

Bullimore

et al. 2023

Invest. Ophthalmol. Vis. Sci.

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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.

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Myopia control with soft multifocal contact lenses

Cited by 6 publications

References 23 publications

Myopia Control: Are We Ready for an Evidence Based Approach?

Myopia Control: Are We Ready for an Evidence Based Approach?

Advances in myopia control strategies for children

IMI 2023 Digest

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