Cavuoto Kara M, Trivedi Rupal H, Prakalapakorn S Grace, Oatts Julius T, Nallasamy Sudha, Morrison David G, Pineles Stacy L, Chang Melinda Y
Bascom Palmer Eye Institute, Department of Ophthalmology, University of Miami Miller School of Medicine, Miami, Florida.
Storm Eye Institute, Department of Ophthalmology, Medical University of South Carolina, Charleston, South Carolina.
Ophthalmology. 2025 Apr;132(4):495-503. doi: 10.1016/j.ophtha.2024.09.031. Epub 2024 Nov 7.
To review the published literature assessing the efficacy of multifocal soft contact lenses for the treatment of myopia progression in children 18 years of age and younger.
A literature search of the PubMed database was conducted last in March 2024 and was limited to articles published in English without date restrictions. The search yielded 76 articles, which were reviewed by the primary author in abstract form, and 28 articles were selected for full-text review. Twelve articles were deemed to have met the inclusion criteria and were assigned a level of evidence rating by the panel methodologist. Eleven studies were rated level I and 1 study was rated level II.
All studies showed less myopic progression, with changes in spherical equivalent (SE) ranging from 0.22 to 0.81 diopters (D) for multifocal soft contact lenses compared with 0.50 to 1.45 D in control groups who used single-vision spectacles or single-vision contact lenses over the course of at least 1 year. Additionally, axial elongation was less in the multifocal soft contact lens group compared with control groups, with a change in axial length (AL) of 0.05 to 0.39 mm in treatment groups compared with 0.17 to 0.67 mm in control groups with at least 1 year of follow-up. The difference in change between the groups was clinically modest and statistically significant in 11 studies for SE and in all 12 studies for AL. No serious adverse events were reported in any of the studies.
Level 1 evidence supports slower myopia progression and AL elongation in children who used multifocal soft contact lenses compared with spectacles or single-vision contact lenses over at least 1 year of follow-up. However, few data are available on optimal treatment duration, the progression over longer periods, or progression after discontinuation of the multifocal contact lenses.
FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
回顾已发表的文献，评估多焦点软性接触镜对18岁及以下儿童近视进展的治疗效果。
2024年3月最后一次对PubMed数据库进行文献检索，检索仅限于无日期限制的英文发表文章。检索出76篇文章，由第一作者以摘要形式进行审阅，28篇文章被选作全文审阅。12篇文章被认为符合纳入标准，并由小组方法学家指定证据等级。11项研究被评为I级，1项研究被评为II级。
所有研究均显示近视进展减缓，多焦点软性接触镜的等效球镜度（SE）变化范围为0.22至0.81屈光度（D），而在至少1年的时间里使用单焦点眼镜或单焦点接触镜的对照组中，SE变化范围为0.50至1.45 D。此外，多焦点软性接触镜组的眼轴伸长比对照组少，治疗组的眼轴长度（AL）变化为0.05至0.39 mm，而至少随访1年的对照组为0.17至0.67 mm。两组间变化的差异在临床上较小，但在11项关于SE的研究和所有12项关于AL的研究中具有统计学意义。所有研究均未报告严重不良事件。
I级证据支持，与眼镜或单焦点接触镜相比，使用多焦点软性接触镜至少随访1年的儿童近视进展和AL伸长较慢。然而，关于最佳治疗持续时间、更长时间的进展情况或停用多焦点接触镜后的进展情况，可用数据很少。
本文末尾的脚注和披露中可能会发现专有或商业披露信息。
