November 1, 2024
By Samrat Sarkar, PhD Candidate at the University of New South Wales
Photo Credit: Dreamstime Photos
Multifocal soft contact lenses (MFSCLs) are one of the viable options for controlling myopia progression in children. Various factors such as participant’s age, distance, and stimulus used during accommodation measurement, optical design of the MFSCLs and addition power of MFSCLs may impact the accommodation. This study compared the accommodative amplitude, lag, and facility between single-vision soft contact lens (SVSCLs) wearers or center-distance MFSCLs wearers with a +1.50D or +2.50D add for an average of 4.7 years.
Just under 300 myopic children aged 7 to 11 years were randomly assigned to wear SVSCLs, +1.50D add, and +2.50D add center-distance MFSCLs for three years. The accommodative response was measured at baseline and annually for three years using a 3.00D accommodative stimulus at 33 cm attached to an open-field binocular autorefractor. Participants who completed three years of follow-up and continued to wear assigned contact lenses until 4.7 years were further enrolled to measure accommodative amplitude, accommodation lag/lead, and binocular accommodative facility.
This study found that after two years, the accommodative responses were lower with both +1.50D and +2.50D add MFSCLs compared to SVSCLs. However, after three years, the accommodative response was lower only with +2.50D add MFSCLs compared to +1.50D MFSCLs and SVSCLs. After 4.7 years, the accommodative amplitude, accommodation lag/lead, and binocular accommodative facility were not significantly different among the three groups of contact lens wearers. The researchers concluded that eye care practitioners should not be concerned about the impact on accommodation while prescribing MFSCLs for controlling myopia progression in children.
Abstract
Accommodation in Children after 4.7 Years of Multifocal Contact Lens Wear in the BLINK Study Randomized Clinical Trial
Chandler MA, Robich ML, Jordan LA, Mutti DO, Berntsen DA, Fenton R, Day E, Walline JJ; BLINK2 Study Group
Significance: When worn for myopia control in children, soft multifocal contact lenses with a +2.50 D add reduced the accommodative response over a 3-year period, but wearing them for more than 4 years did not affect accommodative amplitudes, lag, or facility.
Purpose: This study aimed to compare the accommodative response to a 3D stimulus between single-vision, +1.50-D add, and +2.50-D add multifocal contact lens wearers during 3 years of contact lens wear and then to compare accommodative amplitude, lag, and facility between the three groups after an average of 4.7 years of wear.
Methods: Bifocal Lenses In Nearsighted Kids study, participants aged 7 to 11 years old were randomly assigned to wear single-vision, +1.50-D add, or +2.50-D add soft contact lenses (CooperVision, Pleasanton, CA). The accommodative response to a 3D stimulus was measured at baseline and annually for 3 years. After 4.7 years, we measured objective accommodative amplitudes, lead/lag, and binocular facility with ±2.00-D flippers. We compared the three accommodative measures using multivariate analysis of variance (MANOVA), adjusting for clinic site, sex, and age group (7 to 9 or 10 to 11 years).
Results: The +2.50 D add contact lens wearers exhibited lower accommodative response than the single-vision contact lens wearers for 3 years, but the +1.50-D add contact lens wearers exhibited only lower accommodative response than did the single-vision contact lens wearers for 2 years. After adjustment for clinic site, sex, and age group, there were no statistically significant or clinically meaningful differences between the three treatment groups for accommodative amplitude (MANOVA, P = .49), accommodative lag (MANOVA, P = .41), or accommodative facility (MANOVA, P = .87) after an average of 4.7 years of contact lens wear.
Conclusions: Almost 5 years of multifocal contact lens wear did not affect the accommodative amplitude, lag, or facility of children.
Chandler, M. A., Robich, M. L., Jordan, L. A., Mutti, D. O., Berntsen, D. A., Fenton, R., … & BLINK2 Study Group. (2023). Accommodation in children after 4.7 years of multifocal contact lens wear in the BLINK study randomized clinical trial. Optometry and Vision Science, 100(7), 425-431.
DOI: 10.1097/OPX.0000000000002040
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Samrat Sarkar is a PhD Candidate at the School of Optometry and Vision Science at the University of New South Wales. He is undertaking a PhD research project on the role of near vision behavior in myopia progression among children. As a qualified optometrist, he has extensive clinical and research experience in the eye health sector. |
