Aberrations and Visual Acuity Differ With Pediatric Myopia Control Treatment

Aberrations and visual acuity may vary with myopia control treatment.

Aberrations and visual acuity may be affected by myopia control treatment, with pediatric patients treated with peripheral gradient high-addition multifocal soft contact lenses (MFSCLs) and orthokeratology (ortho-k) experiencing different outcomes, according to a study published in Ophthalmic and Physiological Optics. Decentration may also affect vision when wearing these lenses, the report suggests.

Researchers enrolled children with myopia (N=30; mean age, 10.2 years; 56.67% girls; mean spherical equivalent refractive error [SER], -2.65 diopters [D]), who were treated at a single center, in the crossover intervention and assigned them to treatment with single vision spectacles, followed by MFSCLs, and ortho-K lenses. The team performed ocular aberration, topography, high- and low-contrast visual acuity, and accommodation assessments in the right eye following each treatment and compared aberrations and visual acuity outcomes.

Treatment with MFSCLs and ortho-k significantly increased all aberrations except for trefoil (P =.17) compared with single vision spectacle lenses. Compared with ortho-k treatment, MFSCL treatment resulted in less coma, root mean square of the third-order aberration (RMS3), and higher order aberrations, according to the report.

The 3 myopia control treatments were not associated with changes in high-contrast visual acuity (F, 1.19; P =.39). Low-contrast visual acuity, however, differed significantly between treatment modalities (F, 7.35; P =.001) and was poorest with MFSCLs (mean, 0.49 logarithm of the minimum angle of resolution [logMAR]), followed by ortho-K treatment (mean, 0.41 logMAR), and single vision lenses (mean, 0.33 logMAR). Compared with single vision lenses, MFSCL treatment was associated with significantly decreased low-contrast visual acuity (mean difference [MD], 0.16 logMAR; P =.001).

Clinicians need to be aware of the potential visual impact of these different optical modalities.

Aberrations and visual acuity were assessed with respect to decentration for MFSCLs and ortho-k treatments, and no associations were noted for high or low contrast levels. However, decentration was positively associated with coma (r, 0.43; P =.02) and RMS3 (r, 0.44; P =.02) in participants treated with MFSCLs. These associations were not noted among individuals treated with ortho-k, the report shows.

Accommodative amplitude (F, 5.67; P <.01) and facility (F, 8.60; P <.001) differed significantly among the 3 treatments, in which ortho-K lens treatment was associated with improvements to both outcomes compared with single vision lenses. No differences in outcomes were noted between MFSCLs and single vision treatment.

Assessing aberrations and visual acuity while considering decentration revealed that decentration correlated with coma (r, 0.42; P =.02) and RMS of the third-order aberrations (r, 0.44; P =.02) with MFSCL treatment, but no correlations were observed with ortho-K treatment.

“The current study helps improve our understanding of the effects of MFSCLs and Ortho-K lenses on visual performance. These two optical modalities provide photopic HCVA comparable with spectacle lenses,” according to the researchers.” Clinicians need to be aware of the potential visual impact of these different optical modalities.”

Aberration and visual acuity assessment may have been limited by the nonrandomized design, which is an acknowledged limitation to the research.

Disclosure: This research was supported by Essilor International. Please see the original reference for a full list of disclosures.


Chen Y, Ding C, Li X, et al. Comparison of visual performance between peripheral gradient high-addition multifocal soft contact lenses and orthokeratology. Ophthalmic Physiol Opt. Published online April 11, 2023. doi:10.1111/opo.13144