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Harrison Feng, David Troilo, Xiaoying Zhu; Change in Accommodation and Phoria in Children Treated with Multifocal Soft Contact Lens for Myopia Control. Invest. Ophthalmol. Vis. Sci. 2020;61(7):2693.
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© ARVO (1962-2015); The Authors (2016-present)
Multifocal soft contact lenses (MFCLs) are used for myopia control with variable efficacies, potentially explained by reduced accommodation during MFCLs wear under experimental testing (Kang 2016; Gong 2017). In this study we present initial findings investigating the accommodative response and binocular posture over time in children treated with MFCLs for myopia control.
Subjects (no history of myopia control) were fit with Biofinity MFCLs with +2.00 D ADD and followed for up to 1 yr. MFCLs were worn for at least 10 hrs/d and 5 d/wk. Accommodative response to 3 stimuli (2, 2.5, and 4 D, monocularly measured with Grand Seiko open-field autorefractor) and phorias at distance and near (Modified Thorington) were measured with a Biofinity single vision (SVCLs) correction as a baseline and while wearing MFCLs at the initial fit and at several time points over one year.
Ten subjects were initially enrolled (5 males, age 10.8 ± 2.3 yo, OD SE -3.16 ± 0.90 D). At initial fit, MFCLs significantly induced more exophoria (1.37 ± 5.74 PD) compared to SVCLs (0.04 ± 6.42 PD) at near (p = 0.03). Compared with SVCLs, MFCLs reduced accommodative gain for all 3 stimuli (MF – SV, 2 D: -0.24 ± 0.12, ns; 2.5 D: -0.22 ± 0.08, p < 0.05; 4 D: -0.17 ± 0.07, p < 0.05). No consistent change in accommodation or phoria was discovered during the 3-month follow-up period although some individuals appear to reduce gain over time in the graph.
MFCLs used on children for myopia management have an impact on the accommodation and phoria. Preliminary results in this study are consistent with previous clinical studies. Initial findings show that accommodative behavior while wearing MFCLs remain consistent in some individuals but shift in others. We speculate that this may help explain why some children respond better to treatment than others. More subjects and longer follow-up time are needed so that data can be correlated with treatment efficacy.
This is a 2020 ARVO Annual Meeting abstract.
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