February 18, 2025
By Dwight Akerman, OD, MBA, FAAO, Dipl AAO, FBCLA, FIACLE
Photo Credit: Getty Images
Yum et al. investigated the synergistic effect of dual-focus soft contact lenses (CLs) and 0.05% atropine in managing myopia in children experiencing rapid progression. As myopia becomes increasingly common among children, developing effective treatment strategies is crucial to prevent long-term vision impairment. This study aimed to evaluate whether combining these two interventions could improve myopia control compared to administering atropine alone.
The research involved a retrospective study design and included 142 myopic children aged between 7 and 13 years. Parental consent was obtained for the participants, who were treated based on their rate of myopia progression. For children whose myopia progressed by more than -1.00D per year, a nightly dose of 0.05% atropine was prescribed. After one year of treatment, those who demonstrated a progression greater than 0.75D/year or an axial length increase exceeding 0.25 mm were placed into a combination therapy group receiving both dual-focus contact lenses (MiSight 1 day lenses) and atropine. This combination group accounted for 71 children. The remaining 71 children who exhibited slower progression (less than -0.50D/year and less than 0.20 mm/year in axial elongation) continued treatment with only 0.05% atropine, forming the monotherapy group.
The study aimed to evaluate changes in myopia progression and axial elongation, using statistical analysis to assess the efficacy of the interventions. The findings showed that adding dual-focus contact lenses to the 0.05% atropine significantly reduced both myopia progression and axial elongation in the combination group. The results were notable, with statistical significance reported (p=0.001 for myopia progression and p=0.012 for axial elongation), demonstrating the effectiveness of the combined approach in slowing the rapid progression of myopia.
Interestingly, before the introduction of dual-focus lenses, the combination group exhibited significantly faster myopia progression than the monotherapy group (with both p<0.001). However, post-intervention data showed no significant difference in progression rates between the two groups (p=0.504 and p=0.479), suggesting that the dual-focus lenses effectively leveled out the progression rate after their inclusion in treatment.
Another important finding was the impact of myopia severity on treatment outcomes. The study highlighted that the inhibition of axial elongation was markedly more pronounced in children with low to moderate myopia compared to those categorized as having high myopia, with a significance level of p=0.028. This suggests that children with less severe myopia might see greater benefits from the dual-focus contact lens combination in terms of slowing progression.
In conclusion, the study by Yum et al. provides compelling evidence supporting the combined use of dual-focus soft contact lenses and 0.05% atropine as an effective strategy for controlling myopia in children with rapidly progressing cases. The results indicate that this combination not only reduces myopia progression but does so more effectively in children with low to moderate myopia. As myopia rates continue to rise, these findings are critical for clinical practice, paving the way for enhanced management strategies tailored to individual patients. The authors advocate for further research to explore the long-term effects of such combination therapies in larger cohorts to solidify these findings and enhance treatment protocols for managing pediatric myopia.
Abstract
Synergistic Effect of Dual-Focus Soft Contact Lenses and 0.05% Atropine on Myopia Control in Children With Rapidly Progressing Myopia
Hae Ri Yum , So Young Han, Shin Hae Park, Sun Young Shin
Objectives: The aim of this study was to evaluate the combined effect of dual-focus soft contact lenses (CLs) and 0.05% atropine in the control of myopia.
Methods: A retrospective study was conducted on 142 myopic children aged 7 to 13 years. A single nightly instillation of 0.05% atropine at bedtime was prescribed if the rate of myopia progression exceeded −1.00 D/year. After 1 year of treatment, patients who exhibited myopia progression of more than 0.75 D/year or an increase in axial length of more than 0.25 mm/year were additionally treated with dual-focus soft CLs (MiSight) alongside 0.05% atropine (Combination group, n=71). By contrast, patients who showed myopia progression of less than 0.50 D/year and axial elongation of less than 0.20 mm/year continued treatment with 0.05% atropine only (Monotherapy group, n=71). Subjects in the combination group were further divided into high myopia and low/moderate myopia subgroups, using a cutoff of −6 D.
Results: Myopia progression and axial elongation were significantly slower after the addition of dual-focus soft CLs to 0.05% atropine in the combination group (P=0.001 and P=0.012, respectively). The combination group exhibited statistically significantly faster myopia progression than the monotherapy group before the addition of dual-focus soft CLs (both P<0.001), but no significant difference in myopia progression between the two groups was observed afterward (P=0.504 and P=0.479, respectively). The inhibition of axial elongation was more pronounced in the low/moderate myopia group compared with the high myopia group (P=0.028).
Conclusions: The combination of dual-focus soft CLs and 0.05% atropine is an effective treatment strategy for controlling myopia in children with rapidly progressing myopia. The additive effect was greater in children with low/moderate myopia than in those with high myopia.
Yum, H. R., Han, S. Y., Park, S. H., & Shin, S. Y. (2024). Synergistic Effect of Dual-Focus Soft Contact Lenses and 0.05% Atropine on Myopia Control in Children With Rapidly Progressing Myopia. Eye & Contact Lens, 10-1097.
DOI: 10.1097/ICL.0000000000001154
