Abstract
Purpose :
Multifocal contact lenses (MFCL) slow myopia progression by superimposing peripheral myopic defocus to the retina with various efficacies. Their effectiveness may be explained by reduced accommodation responses (AR) during MFCL wear compared with single vision (SV) CLs, which alters MFCL’s treatment effect at near. One episode of auditory biofeedback training during MFCL wear can increase AR in both adult and pediatric myopes one week later. We assessed the time course of the effect of one episode of biofeedback training on AR and whether repeated biofeedback training could increase AR during MFCL wear in young myopes.
Methods :
CL wearers (age 23.64±1.81 y, refractive error OD -3.97±1.84 D, OS -3.83±2.02 D, n = 22) were randomized into 3 groups, (1) Single Training, (2) Regular Repeated Training, and (3) Extended Repeated Training, to complete 4 weekly visits. In all groups, AR through the Biofinity SV and MFCLs at baseline and after training through MFCLs were measured in the right eye for various accommodative stimuli (AS) using eccentric infrared photorefraction (see table for details). The lag of accommodation (LAG, AR – AS) at different time points was analyzed using Repeated Measures ANOVAs.
Results :
While wearing MFCLs significantly increased LAG compared with SV at V1 (p<.005, all subjects pooled), one episode of biofeedback training significantly reduced LAG immediately after the training (greater effect for higher AS), and its effect was still significant at V4 (Group 1, p<.05 for all). Repeated training only further reduced LAG at V2 (post training vs. pre training at V2, p=.03, Groups 2 and 3 pooled). Finally, extended training tended to further reduce LAG, which did not reach significance at either visit (post training, Group 3 vs. Group 2 at V3, p=.058). See figure for details.
Conclusions :
One episode of auditory biofeedback training could maintain reduced LAG up to 4 weeks. On the other hand, weekly repeated training only had limited effects on further reducing LAG, suggesting a ceiling effect. Weekly repeated training with doubled duration did not further reduce LAG possibly due to subject fatigue. Longitudinal studies are needed to both optimize the training patterns and stimuli, and to investigate whether auditory biofeedback training could serve as an adjunct therapy to improve MFCL’s efficacy in reducing myopia progression in children.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.