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Patrick Simard, Langis Michaud, Rémy Marcotte-Collard, MHAMED OUZZANI; THE MONTREAL EXPERIENCE: A RETROSPECTIVE STUDY PART II- ORTHO-K AND SOFT MULTIFOCAL LENS PERFORMANCES. Invest. Ophthalmol. Vis. Sci. 2021;62(8):2334.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate the efficacy of different designs of orthokeratology (OK) soft multifocal lenses (SMCL) and low-dose atropine (LAD) to control myopia evolution. The primary outcome relates to axial length (AL) progression during 24 months.
This is a retrospective study based on data that are extracted from the file of each patient who: (1) consulted EOUM between Jan 2017 and Dec 2018 and (2) were kept under the same MCS (same design/concentration).Clinical population is composed of 104 SMCL, 140 OK and 42 LDA participants. Elements analyzed include baseline age, gender, ethnicity, spherical equivalent refractive error (SEQ), photopic pupil size, flat and steep K readings. AL was also evaluated at baseline and after 6, 12 and 24 months. To assess whether intervention had a statistically significant effect, a complex statistical model was built. It was developed by first consider all collected parameters. Then, statistically insignificant predictor terms were removed using backward stepwise elimination. In the final model, 5 predictors were retained (month, SEQ, gender, age and age-month interaction).
For OD only, considering SMCL, 4 designs are compared. AL variation at 12/24 months was: 0.14 +/- 0.18 (N=43) and 0.29 +/- 0.29 (N=22) for senofilcon A; 0.07 +/- 0.29 (N=16) and 0.33 +/- 0.66 (N=10) for comfilcon A, 0.18 +/- 0.15 (N=18) and 0.33 +/- 0.25 (N=9) for Omafilcon Toric, 0.13 +/- 0.1 (N=8) and 0.2 +/- 0.06 (N=5) for etafilcon A. About OK lenses, AL results are: 0.18 +/- 0.19 (N=40) and 0.35 +/- 0.27 (N=36) for HDS 5 curves, 0.05 +/- 0.19 (N=44) and 0.17 +/- 0.29 (N=19) for custom 7 curves design; 0.13 +/- 0.17 (N=16) and 0.23 +/- 0.19 (N=11) for custom double-reservoir design, 0.03 +/- 0.18 (N=13) and 0.21 +/- 0.33 (N=15) for a 4 zones VST design. LDA results are 0.21 +/- 0.16 (N=34) and 0.37 +/- 0.25 (N=19). There was no statistical difference between SMCL or OK lenses, within the same category. However, OK leaded to significant better control after 1 year, which was no longer true after 24 months (see part 1)
When correctly selected at baseline, there is no long term difference between contact lens modalities used to control myopia evolution. OK lenses seem to give better results at the beginning but SMCL becomes as efficient with time. Atropine seems to lead to increased evolution at any time point.
This is a 2021 ARVO Annual Meeting abstract.
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