Changes in the Axial Length of the Eye and Refraction in Children with Progressive Myopia while Wearing Defocused Contact Lenses

Progressive myopia remains one of the urgent problems in modern ophthalmology. Optical methods for controlling progressive myopia suggest the formation of peripheral myopic defocus, which has a stabilizing effect on the axial length of the eye and, as a result, the degree of myopia. One option for optical control of myopia is defocus soft contact lenses.

Purpose: to evaluate the growth of axial length and changes in the spherical equivalent of clinical refraction in users of defocus (bifocal) contact lenses and monofocal glasses expressed in diopters, against the background of the correction of progressive myopia with defocus (bifocal) contact lenses and monofocal glasses.

Materials and methods. The study involved 256 patients with bilateral mild to moderate and high myopia in the range from (–)0.5 to (–)  7.75  D in spherical equivalent and an annual progression gradient from 0.65 to 1.5 D in the age categories 7–10, 11–14, 15–18 years old. Depending on the degree of myopia and the method of correction, the patients were divided into main and control groups. For correction in the main groups, defocused (with an addition of +4.0 D) soft contact lenses (SCLs) were used. In the control groups monofocal glasses were used. All patients underwent a standard ophthalmological examination. Clinical refraction data and axial length of the eye were used as criteria for evaluating the results. The follow-up period was 3, 6, 12 months.

Results. After 12 months of wearing bifocal soft contact lenses, there was a statistically significant slowdown in the growth of the axial length and the spherical equivalent of refraction Higher rates of progression of myopia were in young children (7–10 years). Myopia at the age of 15–18 years is characterized by a decrease in the rate of progression with any type of optical correction and in most cases does not require the appointment of correction with the formation of peripheral myopic defocus.

Conclusion. The results obtained indicate the effectiveness of the use of bifocal SCLs in the control of progressive mild, moderate and high myopia. The main stabilization factor is the formation of peripheral myopic defocus on the retina, followed by a slowdown in the growth of the axial length of the eye and the degree of myopia (spherical equivalent of clinical refraction).

1. Sun J., Zhou J., Zhao P.N. et al. High prevalence of myopia and high myopia in 5060 Chinese university students in Shanghai. Invest Ophthalmol Vis Sci. 2012 Nov 1;53(12):7504–7509. doi: 10.1167/iovs.11-8343.

2. Tarutta E.P., Iomdina E.N., Kvaratskhelia N.G., Milash S.V., Kruzhkova G.V. Peripheral refraction and refractogenesis: cause or effect? Bulletin of ophthalmology. 2017;133(1):70–74. (In Russ.)

3. Avetisov E.S. Myopia. Moscow: Medicine, 2002. (In Russ.)

4. Milash S.V., Tarutta E.P., Epishina M.V., Markosyan G.A., Ramazanova K.A. Evaluation of the thickness of the choroid and other anatomical and optical parameters of the eye in the early stages after orthokeratological correction of myopia. Russian ophthalmological journal. 2019;12(1):26–33. (In Russ.)

5. Smith E.L. Prentice award lecture 2010: A case for peripheral optical treatment strategies for myopia. Optom Vis Sci. 2011;88(9):1029–1044. https://doi.org/10.1097/opx.0b013e3182279cfa

6. Chakraborty R., Read S.A., Collins M.J. Monocular myopic defocus and daily changes in axial length and choroidal thickness of human eyes. Exp Eye Res. 2012;103:47–54.

7. Aller T.A., Liu M., Wildsoet C.F. Myopia control with bifocal contact lenses: A randomized clinical trial. Optom Vis Sci. 2016;93(4):344–352. https://doi.org/10.1097/opx.0000000000000808

8. Patent for the invention “Method for the treatment of progressive myopia and a lens for the treatment of progressive myopia” No. 2657854 dated 13.01.17. (In Russ.)

9. Lopes-Ferreira D., Ribeiro C., Maia R. et al. Peripheral myopization using a dominant design multifocal contact lens. J Optom. 2011;4(1):14–21. https://doi.org/10.1016/S1888-4296(11)70035-8

10. Ticak A., Walline J.J. Peripheral optics with bifocal soft and corneal reshaping contact lenses. Optom Vis Sci.2013;90(1):3–8. https://doi.org/10.1097/opx.0b013e3182781868

11. Zaraiskaya M.M., Bodrova S.G., Pashtaev N.P. Influence of various methods of correction of myopia on the dynamics of its progression in children. Bulletin of the Tambov University. Series: Natural and technical sciences. 2014;19(4):1124–1127. (In Russ.) https://doi.org/10.1016/j.exer.2012.08.002

12. Cho P., Cheung S.-W. Retardation of myopia in orthokeratology (ROMIO) study: A 2-year randomized clinical trial. IOVS. 2012;53(11):7077–7085. doi: 10.1167/iovs.12-10565.

13. Santodomingo-Rubido J., Villa-Collar C., Gilmartin B., Gutié rrez-Ortega R., Sugimoto K. Long-term efficacy of orthokeratology contact lens wear in controlling the progression of childhood myopia. Curr Eye Res. 2017 May;42(5):713–720. doi: 10.1080/02713683.2016.1221979.

14. Swarbrick H.A., Alharbi A., Watt K., Lum E., Kang P. Myopia control during orthokeratology lens wear in children using a novel study design. Ophthalmology. 2015 Mar;122(3):620–30. doi: 10.1016/j.ophtha.2014.09.028

15. Chamberlain P., Peixoto-de-Matos S.C., Logan N.S., Ngo C., Jones D., Young G. A 3-year randomized clinical trial of MiSight lenses for myopia control. Optom Vis Sci. 2019 Aug;96(8):556–567. doi: 10.1097/OPX.0000000000001410.

16. Avetisov S.E., Myagkov A.V., Egorova A.V., Poskrebysheva Z.N., Zhabina O.A. Results of a two-year clinical study of myopia control with bifocal defocus-inducing soft contact lenses. Bulletin of ophthalmology. 2021;137(3):5–12. (In Russ.) https://doi.org/10.17116/oftalma20211370315