Myopia Control with Bifocal Contact Lenses

Abstract

The distance center bifocal contact lenses tested in this study achieved greater control over myopia progression and axial elongation (>70%) compared with most published results with multifocal spectacles. Further studies are warranted to identify the critical factors and mechanisms underlying this myopia control effect.

Binocular Visual Function in Orthokeratology Contact Lens Wear for Myopia

“…(Kwok et al 2012, Moore et al 2017 The scientific interest in creating a SCL for myopia control, to mimic the SA (Cheng et al 2016) and RPR (Sankaridurg et al 2011) changes of OK, will be complicated by the inherent optics of the SCL. (Moore et al 2017) Use of commercially available multifocal SCLs for myopia control, which are designed for presbyopia, is based on the presumed mechanism of RPR change, however they have been shown not to alter RPR as significantly as OK, (Ticak and Walline 2013) and the most impressive results for myopia control using these types of presbyopia-designed lenses occurred where they were employed specifically for their 'add' power to address near esophoria, (Aller et al 2016) indicating again that binocular vision function is key to management of progressive myopia with contact lens correction. Correlations between RPR and accommodation measures were undertaken to explore this possible relationship.…”

“…(Li et al 2017) Using a commercially available concentric bifocal SCL and targeting myopes with near esophoria, a 79% reduction in axial elongation was seen over the 12 month study. (Aller et al 2016) A further novel SCL design with induced positive spherical aberration (SA) designed to neutralise the negative SA apparent during accommodation found a 39% reduction in axial elongation over 12 months. (Cheng et al 2016) OK similarly induces a large shift in positive SA.…”

“…(Phillips 2005) The paediatric subjects in this study accommodated through their distance corrected eye, though, indicating that monovision did not alter accommodative function, and additionally that sustained central and peripheral myopic retinal defocus slows axial elongation. (Guggenheim andTo 2005, Phillips 2005) One SCL myopia control study specifically examined correction of near esophoria, (Aller et al 2016) and found the largest reduction in axial elongation seen in any comparative SCL study. (Li et al 2017) Using a commercially available concentric bifocal SCL and targeting myopes with near esophoria, a 79% reduction in axial elongation was seen over the 12 month study.…”

“…Gwiazda (2003) showed that children in single vision spectacles with esophoria progressed more quickly than those without; Aller et al (2016) undertook a myopia control study with bifocal soft contact lenses selective for esophoria and found a greater than 70% reduction in axial elongation over one year. Cheng et al (2010) specifically selected progressing myopes for their bifocal spectacle lens myopia control study and found no significant effect of treatment in children with baseline esophoria, with bifocal and prismatic bifocal lenses showing a significant myopia control effect compared to single vision lenses for those with baseline orthophoria and exophoria.…”

“…These studies employed either concentric ring bifocal or peripheral add multifocal designs, and found an average 30-50% reduction in axial elongation over two years, with slightly greater efficacy of the former. (Li et al 2017) The concentric ring bifocal SCLs employed novel designs with an addition of +2.00, (Anstice and Phillips 2011) +2.50 (Lam et al 2014) or that chosen specifically to neutralise near esophoria, (Aller et al 2016) alternating with the normal distance correction. The peripheral add multifocal designs included a commercially available distance-centred multifocal SCL, previously indicated for presbyopia; and three novel designs -a +0.50 Add with nasally decentred optics; (Fujikado et al 2014) a 'soft radial refractive gradient' lens purporting a +2.00 Add at the 35 0 retinal eccentricity and up to a +6.00 Add at the edge of the optic zone (8mm diameter); (Paune et al 2015) a lens with +1.00 Add at 4mm diameter increasing to +2.00 at the 9mm optic zone edge.…”