Comparative Efficacy of Two Defocus Soft Contact Lenses on Axial Length and Choroid in High Myopic Adolescents.

BACKGROUND

To compare the 1-year myopia control efficacy of two defocus soft contact lenses (SCLs) versus single-vision spectacles in high myopic adolescents (spherical equivalent refraction [SER] of 6.00 diopters or more).

METHODS

237 participants were randomised into three groups: peripheral gradual defocus SCLs (Group A), multipoint defocus SCLs (Group B) and single-vision spectacles (Group C), with 12-month follow-up. Outcomes included axial length change (ΔAL), SER change (ΔSER), choroidal thickness (CT) and choroidal vascular density (VDCC).

RESULTS

217 subjects completed follow-up. From Month 3, Group B had the smallest ΔAL: 12-month ΔAL was (0.12 ± 0.08) mm, significantly lower than Groups A (0.25 ± 0.10 mm) and C (0.48 ± 0.12 mm), all p < 0.001. Group B's ΔSER (-0.13 ± 0.09 D) was also smaller than Groups A (-0.24 ± 0.11 D) and C (-0.45 ± 0.13 D) (all p value less than 0.05). Group B showed increased VDCC/CT (notably 3-mm foveal area), Group C decreased and Group A stabilised. Multiple regression indicated Group B intervention (β = -0.32, p = 0.002) and 3-mm CT change (β = -0.28, p = 0.006) independently correlated with smaller ΔAL (model R 2 = 0.35, p value less than 0.001).

CONCLUSION

Multipoint defocus SCLs outperform other methods in controlling high myopia and improving choroidal parameters.