Accommodation in Children after 4.7 Years of Multifocal Contact Lens Wear in the BLINK Study Randomized Clinical Trial

Abstract

Significance: When worn for myopia control in children, soft multifocal contact lenses with a +2.50 D add reduced the accommodative response over a 3-year period, but wearing them for more than 4 years did not affect accommodative amplitudes, lag, or facility.

Purpose: This study aimed to compare the accommodative response to a 3D stimulus between single-vision, +1.50-D add, and +2.50-D add multifocal contact lens wearers during 3 years of contact lens wear and then to compare accommodative amplitude, lag, and facility between the three groups after an average of 4.7 years of wear.

Methods: Bifocal Lenses In Nearsighted Kids study participants aged 7 to 11 years old were randomly assigned to wear single-vision, +1.50-D add, or +2.50-D add soft contact lenses (CooperVision, Pleasanton, CA). The accommodative response to a 3D stimulus was measured at baseline and annually for 3 years. After 4.7 years, we measured objective accommodative amplitudes, lead/lag, and binocular facility with ±2.00-D flippers. We compared the three accommodative measures using multivariate analysis of variance (MANOVA), adjusting for clinic site, sex, and age group (7 to 9 or 10 to 11 years).

Results: The +2.50-D add contact lens wearers exhibited lower accommodative response than the single-vision contact lens wearers for 3 years, but the +1.50-D add contact lens wearers exhibited only lower accommodative response than did the single-vision contact lens wearers for 2 years. After adjustment for clinic site, sex, and age group, there were no statistically significant or clinically meaningful differences between the three treatment groups for accommodative amplitude (MANOVA, P = .49), accommodative lag (MANOVA, P = .41), or accommodative facility (MANOVA, P = .87) after an average of 4.7 years of contact lens wear.

Conclusions: Almost 5 years of multifocal contact lens wear did not affect the accommodative amplitude, lag, or facility of children.

Trial registration: ClinicalTrials.gov NCT02255474 NCT04080128.

Figure 1.

Retention of BLINK Study participants randomly assigned to wear single vision, +1.50 D add, or +2.50 D add contact lenses who had their accommodation measured when they enrolled in the BLINK2 Study. The gray box indicates time of participation in the BLINK Study; outside of the gray box indicates enrollment in the BLINK2 Study.

Figure 2.

Mean ± 95% confidence interval of the accommodative response to a 3 D stimulus for each treatment group after wearing the assigned contact lenses for two weeks, 1 year, 2 years, and 3 years.