The magnitude of change in refraction and axial length differed among studies, but results consistently demonstrated that multifocal contact lenses showed smaller magnitudes of change than the control groups after one year, the researchers reported. Photo: Jeffrey J. Walline, OD. Click image to enlarge.

Multifocal soft contact lenses are one of the main options to mitigate progression of myopia in children, with options that include two or more correction zones as well as extended-depth-of-focus designs, though only one product thus far has an FDA indication for this purpose (CooperVision’s MiSight). Since children’s eyes are still developing, soft contact lenses are seen by some as a safer option than topical atropine therapy or orthokeratology. Still, many questions remain.

A recent Ophthalmic Technology Assessment by the American Academy of Ophthalmology investigated the change in children’s myopic progression when treated with multifocal contact lenses. Researchers gathered information from the PubMed database and identified 12 articles that matched their criteria for this study. They analyzed outcomes such as spherical equivalent refraction and axial length elongation with multifocal contact lens wear vs. single-vision spectacles or contact lenses.

“The magnitude of change in the spherical equivalent and axial length differed among studies; however, the results consistently demonstrated that multifocal contact lenses showed smaller magnitudes of change than the control groups for both spherical equivalent and axial length at one year,” stated the researchers in their paper on this study, published in Ophthalmology.

Their meta-analysis showed that mean spherical equivalent change in children treated with multifocal contact lenses for one year ranged from 0.22D to 0.81D. In contrast, the control group’s change ranged from 0.5D to 1.45D. Similarly, axial elongation in multifocal patients was less, at 0.05mm to 0.39mm vs. 0.17mm to 0.67mm for controls. The researchers noted that 11 of the 12 studies showed statistically significant results when analyzing spherical equivalent changes and all 12 studies showed statistically significant results regarding axial length changes.

Although this meta-analysis supports the widespread conviction that multifocal contact lenses are beneficial treatment options for myopia progression in children, the authors acknowledge that some indications for use remain unclear. After reviewing the 12 studies, researchers could not determine an optimal age for when to employ these lenses and the duration of treatment needed to slow progression and retain positive results. Furthermore, there are various multifocal options with differing powers, so the researchers could not make a decision on which contact lens provides the most benefit.

“Future research to determine the usefulness of multifocal contact lenses for prevention of myopia progression in children is necessary to address several gaps in knowledge,” concluded the researchers in their paper on this study.