January 5, 2026
By Dr. Mengjun Zhu
Photo Credit: Getty Images
Both orthokeratology lenses and aspheric multifocal soft contact lenses exhibit favorable myopia control efficacy and have been widely used in myopic children. Chen et al., 20251 investigated whether one modality demonstrated superior efficacy in controlling myopia than the other.
OrthoK lenses and aspheric multifocal soft contact lenses both operate on the principle of peripheral myopic defocus. Although previous studies have compared the myopia control efficacy of the two methods, the authors of this paper adopted a randomized, prospective, contralateral eye cross-over design to minimize the interference of confounding factors such as age, gender, eye laterality and near-work time, enhancing the reliability of the comparison between OrthoK lenses and aspheric multifocal soft contact lenses in children.
The study enrolled a total of 65 participants, aged 8–12 years, with refractive errors ranging from −1.00D to −5.00D. During the first six months, participants were fitted with an OrthoK lens in one randomly assigned eye and an aspheric multifocal soft contact lens in the contralateral eye. Following this, contact lens wear was discontinued in both eyes for one month, after which the two lens-wearing methods were swapped between eyes and continued for another six months. Parameters such as axial length (AL) and spherical equivalent refraction (SER) of the participants were measured at baseline and during follow-up visits at six, seven, 13 and 14 months.
The study found no statistically significant difference between aspheric multifocal soft contact lenses and OrthoK lenses in controlling myopia progression in children, indicating that their short-term myopia control efficacy is similar. However, subtle trends suggested that OrthoK lenses may have a marginal advantage in slowing myopia progression. Future studies are warranted to explore the potential differences in long-term myopia control efficacy between the two strategies.
Abstract
Randomized Contralateral Eye Study of Myopia Control Between Aspheric Multifocal Soft Contact Lens and Orthokeratology in Children
Ruru Chen, Tianhui Chen, Weiwei Lu, Yue Li, Jiawei Li, Tiankun Li, Hengli Lian, Siping Chen, Colm McAlinden, Xiaoying Wang, Jinhai Huang
Background
This study aimed to compare myopia progression in children wearing an aspheric multifocal contact lens and an orthokeratology (OrthoK) lens.
Methods
A total of 65 participants, aged 9.70 ± 1.31 years, were fitted with an OrthoK lens in one randomly assigned eye and a multifocal soft contact lens in the contralateral eye for the first 6 months (period 1). Following this, contact lens wear was discontinued in both eyes for 1 month, after which the two lens-wearing methods were swapped between eyes and continued for another 6 months (period 2). Axial length (AL), spherical equivalent refraction (SER), central corneal thickness (CCT), and central choroidal thickness (CChT) were measured at the 0-, 6-, 7-, 13-, and 14-month visits. AL and SER were the primary outcome measures.
Results
For the OrthoK and multifocal soft lens, AL elongation was 0.14 ± 0.11 mm and 0.23 ± 0.12 mm, respectively, after period 1. AL elongation for the OrthoK and multifocal lens was 0.12 ± 0.19 mm and 0.20 ± 0.13 mm, respectively, after period 2. The SER change for the OrthoK and multifocal lens was -0.20 ± 0.27 D and -0.33 ± 0.30 D after period 1 and -0.26 ± 0.40 D and -0.36 ± 0.46 D after period 2, respectively. No significant differences were observed between the two treatment groups (all P > 0.05).
Conclusions
During the 14-month observation period, no statistically significant differences in myopia progression were found between the aspheric multifocal contact lens and the OrthoK lens. Further longitudinal observation is necessary to characterize the disparities in long-term myopia-control efficacy between the two intervention strategies.
 |
Dr. Mengjun Zhu (MSc (Med)) is a Chief Physician of the Shanghai Eye Disease Prevention and Treatment Center, and a member of the International Academy of Orthokeratology-Asia (IAOA), the Hong Kong Academy of Orthokeratology (HKAOK), and the Hong Kong Cornea and Contact Lens Society (HKCCLS). Research areas: orthokeratology, soft contact lenses, myopia control, epidemiology. |
References
1 Chen R, Chen T, Lu W, Li Y, Li J, Li T, Lian H, Chen S, McAlinden C, Wang X, Huang J. Randomized contralateral eye study of myopia control between aspheric multifocal soft contact lens and orthokeratology in children. Cont Lens Anterior Eye. 2025 Dec;48(6):102508. doi: 10.1016/j.clae.2025.102508. Epub 2025 Sep 16. PMID: 40962628.
