Bifocal soft contact lenses as a possible myopia control treatment: A case report involving identical twins

San Bruno, California 94066, USA.
Clinical and Experimental Optometry (Impact Factor: 1.34). 08/2008; 91(4):394-9. DOI: 10.1111/j.1444-0938.2007.00230.x
Source: PubMed

ABSTRACT Several studies have suggested that bifocal and progressive spectacles can reduce progression of myopia in esophoric children. This study compared myopic progression with bifocal (BSCL) and single vision soft contact lenses (SVSCL) in identical twins with near point esophoria.
Two 12-year-old myopic girls were randomly assigned to wear either BSCL or SVSCL for one year using a double-masked design. Both twins then wore BSCLs for another year. Ocular measurements included cycloplegic and manifest refractions, corneal curvature and axial length. Distance and near phorias were measured through distance corrections and near associated phorias, with both types of contact lenses.
Through their SVSCLs, both children exhibited near associated esophorias, which were neutralised by the BSCLs. The child wearing SVSCLs over the first year showed significant myopic progression, increasing -1.19 D (binocular average), while the child wearing BSCLs showed no progression (+0.13 D). The latter child showed limited progression (-0.28 D) over the second year, while switching from SVSCLs to BSCLs arrested progression in the other child (+0.44 D after one year). Axial length data were consistent with the refractive findings; the child exhibiting more myopia at the end of the first 12 months of the study had longer eyes (by 0.64 mm) than her sister, although their corneas also had steepened more (by 0.44 D compared to 0.18 D). The children showed minimal changes [corrected] in eye size over the second year when both wore BSCLs (binocular averages: -0.05, -0.09 [corrected] mm, respectively).
The apparent inhibitory effect of BSCLs on myopic progression reported in this twin study argues for further study of their efficacy as a control treatment for myopes with near esophoria.

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    • "Such lenses not only include the plethora of commercially available bi-and multifocal contact lenses but also novel lens designs, including the marketed myopia control contact lens MiSight, which features a large central distance zone surrounded by alternating concentric distant and near zones. Various commercial and novel multifocal contact lenses have been assessed for the capacity to retard myopia progression [13] [14] [15] [16] [17], however, few studies have assessed the visual performance of multifocal contact lenses in non-presbyopic myopic eyes [18] [19] [20]. The accumulated evidence from these studies indicates some degradation of visual performance is likely to occur when contact lenses with multiple refractive zones are worn. "
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    ABSTRACT: To assess visual performance of single vision and multifocal soft contact lenses. At baseline, forty-four myopic participants (aged 18-35 years) were fitted bilaterally with a control lens (AirOptix Aqua). At the four follow-up visits, a total of 16 study lenses (5 single vision, 11 multifocal lenses) were fitted contralaterally. After 1h of lens wear, participants rated (scale 1-10) vision clarity (distance, intermediate and near), magnitude of ghosting at distance, comfort during head movement, and overall comfort. Distance high contrast visual acuity (HCVA), central refraction and higher order aberrations, and contact lens centration were measured. For single vision lenses, vision ratings were not significantly different to the control (p>0.005). The control outperformed Acuvue Oasys, Clariti Monthly and Night and Day in HCVA (mean VA: -0.10±0.07 logMAR, p<0.005). Most refraction and higher order aberration measures were not different between lenses. The Night and Day lens showed greatest differences compared to the control, i.e., C[4, 0] was more positive (p<0.005) at distance (Δ=0.019μm) and near (Δ=0.028μm). For multifocal lenses, the majority of vision ratings (84%) were better with the control (p<0.005). HCVA was better with the control (p<0.005). Proclear Multifocal lenses showed greatest differences for M, C[3, -1] and C[4, 0] at distance and near, and were inferiorly de-centered (p<0.005). Design differences between single vision lenses had a small impact on visual performance. Lenses featuring multifocality decreased visual performance, in particular when power variations across the optic zone were large and/or the lens was significantly de-centered. Copyright © 2015. Published by Elsevier Ltd.
    Contact lens & anterior eye: the journal of the British Contact Lens Association 07/2015; DOI:10.1016/j.clae.2015.07.005 · 1.37 Impact Factor
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    • "However, considering the similar change in the peripheral refractive pattern induced by these lenses [17] [18] [19], it has been hypothesized that such designs can be useful to slow myopia progression [20]. Bifocal contact lenses for presbyopia have previously been used to slow myopia progression [21] [22]. Recently, a "
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    ABSTRACT: Purpose: To evaluate the impact of eye and head rotation in the measurement of peripheral refraction with an open-field autorefractometer in myopic eyes wearing two different center-distance designs of multifocal contact lenses (MFCLs). Methods: Nineteen right eyes from 19 myopic patients (average central M ± SD = -2.67 ± 1.66 D) aged 20-27 years (mean ± SD = 23.2 ± 3.3 years) were evaluated using a Grand-Seiko autorefractometer. Patients were fitted with one multifocal aspheric center-distance contact lens (Biofinity Multifocal D(®)) and with one multi-concentric MFCL (Acuvue Oasys for Presbyopia). Axial and peripheral refraction were evaluated by eye rotation and by head rotation under naked eye condition and with each MFCL fitted randomly and in independent sessions. Results: For the naked eye, refractive pattern (M, J0 and J45) across the central 60° of the horizontal visual field values did not show significant changes measured by rotating the eye or rotating the head (p > 0.05). Similar results were obtained wearing the Biofinity D, for both testing methods, no obtaining significant differences to M, J0 and J45 values (p > 0.05). For Acuvue Oasys for presbyopia, also no differences were found when comparing measurements obtained by eye and head rotation (p > 0.05). Multivariate analysis did not showed a significant interaction between testing method and lens type neither with measuring locations (MANOVA, p > 0.05). There were significant differences in M and J0 values between naked eyes and each MFCL. Conclusion: Measurements of peripheral refraction by rotating the eye or rotating the head in myopic patients wearing dominant design or multi-concentric multifocal silicone hydrogel contact lens are comparable.
    Contact Lens & Anterior Eye 12/2014; 38(2). DOI:10.1016/j.clae.2014.11.201 · 1.37 Impact Factor
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    • "Hence, the optics of both systems should have comparable characteristics. Accordingly, these lenses have been proposed as treatment option for myopia control [20] [21]. A similar principle has been proposed for specifically designed spectacle lenses. "
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    ABSTRACT: Purpose: The purpose of this study was to evaluate the change in corneal wavefront aberrations in young adults who have been fit with multifocal soft contact lenses for myopia progression control. Findings have been analyzed for statistical significance and clinical relevance and compared to reportedly successful Orthokeratology outcomes. Methods: The dominant eye of 40 participants (27 women, 13 men; mean age 27.3 ± 3.2 years; range 23 to 39 years) was fit with Proclear Multifocal center distance lenses (Coopervision, Pleasanton, USA) having a variety of distance powers and reading additions. Refractive errors were limited to a range of –6.00 D up to +1.00 D of sphere, and no greater than –1.00 D of cylinder. Corneal wavefront measurements were performed over 6 mm diameters with a Zeiss Atlas 9000 corneal topographer (Zeiss Meditec, Dublin, USA) prior to, and following lens fitting. Data were converted into rectangular Fourier optics terms M, J0, J45 and RMS values for each reading addition were statistically analyzed. Following evaluation of statistical significance and clinical relevance, results were compared to published data from successful Orthokeratology treatments. Results: Statistically significant changes in higher order aberrations were detected for lenses of all reading additions. Lens groups with higher Add-powers demonstrated stronger changes with increased significance. Final RMS values relating to 2nd, 3rd and 4th Zernike Orders reached clinical significance with a wavefront error of 0.10 μm, the equivalent of 0.25D. Moreover, as Add-powers increased, 3rd and 4th order aberrations likewise showed an increase. Pre-fitting astigmatism values accounted for the highest recorded aberrations and remained predominantly unchanged. Conclusion: Proclear Multifocal center-distance contact lenses were found to increase higher order wavefront aberrations in a manner dependent on their Add-power. In comparison to successful Orthokeratology outcomes, the amounts of resulting aberrations are notably different.
    The Open Ophthalmology Journal 08/2012; OJOph(2-3):45-53. DOI:10.4236/ojoph.2012.23011
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