Multifocal spectacles in childhood myopia: Are treatment effects maintained? A systematic review and meta-analysis

  • Dinesh Kaphle
    Correspondence
    Corresponding author: Dinesh Kaphle, MOptom, Institute of Health and Biomedical Innovation, Queensland University of Technology, 60 Musk Ave, Kelvin Grove, QLD 4059, Australia.
    Affiliations
    School of Optometry and Vision Sciences and Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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  • David A. Atchison
    Affiliations
    School of Optometry and Vision Sciences and Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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  • Katrina L. Schmid
    Affiliations
    School of Optometry and Vision Sciences and Institute of Health and Biomedical Innovation, Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia
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      Abstract

      We evaluate the impact of duration on the treatment effect of multifocal spectacle lenses used to inhibit myopia progression in children. A systematic literature search identified randomized controlled trials where multifocal lenses were prescribed as the intervention, with single-vision lenses as the control. Nine randomized control trials involving 1,701 children aged 8–13 years were included in the meta-analysis. Treatment effects, that is, differences in spherical equivalent refraction between intervention and nonintervention groups, were analyzed over both 6- and 12-month intervals. As treatment duration increased, effectiveness reduced. In 6-month intervals, treatment effects were 0.07 D (95 % CI 0.02, 0.13), 0.03 D (95% CI −0.02, 0.08), and 0.02 D (95% CI −0.05, 0.11) for baseline to 6, 6–12, and 12–18 months, respectively. For 12-month intervals, treatment effects were 0.21 D (95% CI 0.12, 0.29), 0.11 D (95% CI 0.03, 0.19), and 0.12 D (95% CI −0.01, 0.25) for baseline to 12, 12–24, and 24–36 months, respectively. Even during the second 6 months of wear, the ability of multifocal spectacle lenses to inhibit myopia progression was reduced. It is not appropriate to extrapolate the treatment effect observed in the first 6 months or 12 months to estimate the likely future benefit of treatment.

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