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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.

Special Issue – January 2020

Welcome 2020, the year that signifies perfect vision! 

We begin this symbolic year with the most burning issue of the new decade: myopia. There is a genuine and pressing need to understand the pathogenesis of myopia and to develop innovative interventions to arrest its progression, and eventually reduce the burden on the individual and the world economy. This month we focus on applications of contact lenses for myopia management and also take stock of how well they are integrated in practice.  

‘The original papers presented in this special issue in Contact Lenses & Anterior Eye provide a current snapshot of the research themes of contact lens and anterior eye that are currently being pursued in this challenging and important area of myopia research,’ says the guest editor of this issue on ‘Myopia control with contact lenses’. 

Here are some excerpts from the issue with links to the full text.

The IACLE Education Team


Journals reviewed in this issue:

Contact Lens & Anterior Eye 43:1


International trends in myopia control lenses

To examine the trends in, and factors associated with, contact lens fitting for myopia control (MC) in children (≤17 years of age), Efron et al analysed 535 MC fits and 23,295 other (non-MC) fits from 31 countries that reported ≥100 contact lens fits to children. MC lenses are currently prescribed for younger children (compared to non-MC lenses) in equal measure in terms of soft (primarily centre-distance multifocal) vs rigid lenses (primarily orthokeratology) and males vs females. The extent of MC fitting is low and varies between nations (0-25%).

Cont Lens Anterior Eye 2020;43:1 4-8. Read the full text

Changing attitudes to myopia management

To provide an update of attitudes towards myopia management in clinical practice, Wolffsohn et al distributed a self-administered, internet-based questionnaire in eight languages, through professional bodies to eye care practitioners globally. Among the 1,336 respondents, concern about childhood myopia was highest in Asia and lowest in Australasia. Orthokeratology was perceived to be the most effective method of myopia control. While practitioner concern and reported levels of activity have increased over the last 4 years, the vast majority of clinicians still prescribe single-vision interventions for young myopes.

Cont Lens Anterior Eye 2020;43:1 9-17.  Read the full text


Childhood and lifetime risk with myopia control

Gifford calculated absolute risk of microbial keratitis (MK) in daily disposable soft, reusable soft and orthokeratology CL wear over a childhood (age 8-18) and lifetime (age 8-65) of wear. This was compared to cumulative risk of vision impairment by age 75 based on increasing myopia and axial length. Comparative lifetime risks of CL wear commenced at age 8 for myopia control are less than the lifetime risks of vision impairment with myopia >6D or axial length >26 mm. When only childhood CL wear is considered, the risk-to-benefit balance is skewed towards the positive impact of CL wear, especially in daily disposable lens wear.

Cont Lens Anterior Eye 2020;43:1 26-32. Read the full text


Estimating axial length from conventional measures

Since few clinicians can measure axial length in their practices, could this be estimated from refractive error or from a combination of refractive error and corneal curvature? Morgan et al constructed a model to evaluate the potential for calculating the reciprocal of axial length from the reciprocal of mean anterior corneal radius of curvature and spherical equivalent refractive error. Results suggest considering corneal curvature readings alongside refractive error measurement offers a good estimate of absolute axial length, and this estimate becomes less accurate if refractive error alone is used as a sole proxy for axial length.

Cont Lens Anterior Eye 2020;43:1 18-20. Read the full text


Peripheral refraction stability in OrthoK

To examine the stability of OK-induced relative peripheral refraction (RPR) changes, Gifford et al conducted a prospective, randomized study among 12 myopic children (8-16 years) and eight myopic adults (18-29 years).  RPR was measured unaided and while wearing single-vision soft CLs. Measurements were repeated after 1, 6 and 12 months of OK wear. Relative to unaided and single-vision soft CL correction, OK shifted RPR in the myopic direction and was stable for 12 months. The RPR shift in OK wear varied with degree of myopia but was not correlated with myopia progression.

Cont Lens Anterior Eye 2020;43:1 44-53. Read the full text

Effects of OrthoK on axial length elongation

Fu et al collected retrospective data from 27 children with unilateral myopia and 25 children with bilateral myopia and anisometropia, to investigate the effect of orthokeratology (OK) lens on axial length elongation. Monocular OK was effective in suppressing axial length growth of the myopic eyes and reducing anisometropia value in unilateral myopic children. In smaller degrees of anisometropia, the binocular OK lens could only control axial length elongation in both eyes at the same rate, but not reduce the anisometropia value.

Cont Lens Anterior Eye 2020;43:1 73-77. Read the full text

Comparison of different OrthoK lenses

To analyze axial length elongation in children over 2 years of OK lens wear with four different lenses, relative to a spectacle-wearing control group, Chen et al reviewed records of 266 subjects (532 eyes) fitted with OK lenses or wearing spectacles. Axial length growth was slower in all OK groups than in the control group. Different OK lenses differed minimally in slowing axial length elongation during 2 years of lens wear and all were effective.

Cont Lens Anterior Eye 2020;43:1 78-83. Read the full text

© International Association of Contact Lens Educators 2020

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