Reduction of Myopic Progression Using a Multifocal Soft Contact Lens: A Retrospective Cohort Study

Abstract

To evaluate myopia progression over an approximately 6-year follow-up period in children and young adults wearing a commercially available, daily disposable, soft multifocal contact lens with an extended depth of focus (center distance) design. Methods: This retrospective cohort analysis included data from 196 patients of mean (SD) age 12.3 (2.7) years (range, 5-20 years), fit with the NaturalVue Multifocal (NVMF) contact lens at 15 practices in the United States over 6 years. All patients showed at least −0.50D of myopic progression in at least one eye prior to wearing the lens. Data from the right eye were analyzed. One-way ANOVA with Tukeys post-hoc t-tests were used for statistical analysis, with a significance level set at P < 0.05. Results: After wearing these lenses for 6-72 months, the average myopia progression slowed by approximately 0.84 D or 85% compared to baseline, which was statistically significant at all time points (P < 0.0001). Frequency distribution revealed that 91% of wearers showed a decrease in myopia progression compared to baseline, with 79% of wearers showing a ≥70% reduction in myopia progression. The average change in axial length in a subset of the population over 47 months of follow-up was approximately 0.10 mm/year. Compared with changes expected in an age-and ethnicity-matched myopic virtual control group obtained from published meta-analysis data, both myopic refractive error progression and axial elongation were significantly lower in NVMF wearers at 12, 24 and 36 months (P < 0.001). Analysis of the age-and ethnicity-matched virtual control group predicted that the Cumulative Absolute Reduction of axial Elongation (CARE) value over 3 years would be 0.45 mm. Conclusion: Wearers of the soft multifocal contact lens displayed significant reductions in myopia progression throughout a follow-up period of 6 years.

Intraocular Straylight and Multifocal Soft Contact Lens Fit With a Myopia Control Approach

“…Two of the contact lenses feature center-distance optics that have been investigated for the ability to control myopia progression, the Biofinity Multifocal "D" +2.50 add (CooperVision, San Ramon, CA) and the NaturalVue Multifocal (Visioneering Technologies, Alpharetta, GA). 16,21,22,32 The Biofinity Multifocal "D" is a progressive aspheric design with a central spherical power for distance correction surrounded by a progressive zone of increasing plus power. The NaturalVue Multifocal is an extended depth of focus design with a rapid increase in plus power near the center of the lens followed by a return to distance power outside of the plus zone and is indicated for use in presbyopic patients requiring up to a +3.00D add.…”

“…18,19 More recently, other soft contact lens designs have also been used, such as extended depth of focus designs for presbyopia and dual focus contact lenses. 10,[20][21][22][23] Although soft contact lens methods used to slow the progression of myopia have been shown to provide good high-contrast visual acuity, they reduce low-contrast acuity, reduce contrast sensitivity, increase halos, and cause subjective visual disturbances. [24][25][26] One potential contributing factor the observed changes in visual quality may be an increase in intraocular straylight with use of multifocal contact lens optics.…”

“…18,19 More recently, other soft contact lens designs have also been used, such as extended depth of focus designs for presbyopia and dual focus contact lenses. 10,20–23…”