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Research Update

Welcome to our monthly Research Update, available exclusively to IACLE and BCLA members to support your teaching and practice.

Issue 31 – July 2019

Myopia control continues to be an important topic and rightly keeps drawing the attention of the scientific world. In this issue, we include a paper that reviews evidence on efficacy and safety of myopia control interventions. A randomised clinical trial evaluates the efficacy of novel contact lenses. And another paper challenges the scientific basis of common beliefs about myopia.

We report on a study that attempts to better understand eye care practitioners’ perceptions about the benefits of daily disposable silicone hydrogel lenses. US researchers assess the effect of offering contact lenses as an aid to select spectacle frames. We include a paper that investigates orthokeratology compression factor on ocular higher order aberrations. And finally, a review article discusses scleral lens issues and complications related to a non-optimal fitting relationship between the lens and ocular surface.

Happy reading!

The IACLE Education Team
Journals reviewed in this issue:
BMC Ophthalmology                               19:106
Ophthalmic & Physiological Optics          39:4
Eye & Contact Lens                                 45:4, 45:3
Contact Lens & Anterior Eye                   42:4
Clinical and Experimental Optometry      Early view

Myopia control interventions in children: are they safe and effective?

As the long-term safety and efficacy of interventions to control myopia remain unresolved, Prousali et al conducted an overview of systematic reviews and meta-analyses (18 eligible reviews involving 6,400 children). Atropine followed by orthokeratology and novel multifocal soft contact lenses were effective in controlling myopic progression. 1% atropine induced blurred near vision and hypersensitivity reactions. Existing evidence has failed to convince practitioners to uniformly embrace treatments for myopic control, possibly due to existence of some heterogeneity, reporting of side-effects and lack of long-term follow-up.

BMC Ophthalmology 2019;19:106. https://doi.org/10.1186/s12886-019-1112-3. Read the full text

Myopia control with EDOF soft contact lenses

Sankaridurg et al conducted this prospective, randomized, double-blind trial to determine myopia control efficacy with novel contact lenses that reduce both central and peripheral defocus, and provide extended depth of focus. Myopic children (n=508) were divided into three groups: 1) single vision, silicone hydrogel (SH) CLs; 2) SH CLs that impose myopic defocus across peripheral and central retina; and 3) Extended depth of focus (EDOF) soft CLs incorporating higher order aberrations. Contact lenses that impose myopic defocus at the retina or modulated retinal image quality resulted in slower myopic progression.

Ophthalmic Physiol Opt 2019;39:4 294-307. Read the full text

Debunking commonly held beliefs about myopia  

To subject commonly held beliefs to scientific scrutiny, Brennan & Cheng examined statements about myopia with reference to the literature. Among statements that lack robust evidence are: low-dose (0.01%) atropine slows myopia progression; relative peripheral hyperopia leads to myopia development and progression in children; under-correction slows myopia progression; hand-held digital devices contribute to the myopia epidemic; more time outdoors slows myopia progression; the impact of outdoor activity on myopia incidence is due to daylight. Caution should be exercised until robust evidence is provided, they say.

Eye & Contact Lens 2019;45:4 215-225. Read the full text


ECP perceptions of silicone hydrogel DD lenses

To understand eye care professionals’ (ECPs) perceptions regarding the benefits of silicone hydrogel (SiH) daily disposable contact lenses (DDCL), Orsborn & Dumbleton administered a survey to 300 ECPs in the US, UK and Japan. Categories of statements included health, comfort, patient experience, and standard of care. ECPs perceived that SiH DDCLs offered long-term eye health and comfort, and would prescribe them to most of their patients. Perceived higher cost of these lenses continues to be the main barrier.

Cont Lens Anterior Eye 2019;42:4 373-379. Read the full text


Frame selection with EASE: the US experience

Mayers et al recruited five optometry practices in the US to assess the impact of offering complimentary contact lenses to spectacle-only wearing patients during frame selection (the EASE approach). Of 410 recruited patients, 205 were offered CLs to wear while selecting new spectacle frames. Patients wearing CLs spent more on their eyewear purchase, were more likely to have received or scheduled a CL fit, and were more likely to consider a CL fitting in the future. Offering CLs to spectacle-only patients positively influences eyewear selection and purchase, and can grow the overall CL business.

Cont Lens Anterior Eye 2019;42:4 406-410. Read the full text 


Compression factor and higher order aberrations

Lau et al conducted this double-blind, contralateral, self-controlled study to investigate the influence of compression factor (extra correcting factor to counteract refractive regression) on changes in ocular higher order aberrations (HOAs) in young myopic children undergoing orthokeratology treatment. Subjects (n=28) were randomly assigned to wear orthoK lenses of different compression factors in each eye (one eye 0.75D and the fellow eye 1.75D). HOAs were measured weekly over one month of lens wear. Increasing the compression factor by 1.00D significantly altered some HOAs, particularly spherical aberration. 

Clin Exp Optom 2019; https://doi.org/10.1111/cxo.12933. Read the abstract


Scleral lens issues and complications

Reviewing 47 publications, Fadel examines issues and complications related to a non-optimal fitting relationship between lens and ocular surface that scleral contact lens (ScCL) fitters may encounter. Issues with ScCLs include excessive central clearance, bearing, corneal staining, air bubbles, midday fogging, conjunctival issues, lens adhesion and decentration. Complications such as epithelial bullae, microcysts, corneal edema and neovascularization are discussed. Understanding etiology and management will allow practitioners to gain more confidence in fitting ScCLs, and prescribe them more often.

Eye & Contact Lens 2019;45:3 152-163. Read the full text

© International Association of Contact Lens Educators 2019

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