Efficacy and Safety of Different Add Power Soft Contact Lenses on Myopia Progression in Children: A Systematic Review and Meta-Analysis

Abstract

Background: In children, myopia has become a widespread and serious global public health problem. Soft multifocal contact lenses (SMCLs) have been widely studied to control myopia progression in children. However, their efficacy in myopia control in children and its adverse effects and which added power SMCLs are more effective and safer remains to be explored. Objectives: Evaluate the efficacy and safety of various add power SMCLs to slow myopia progression in children. Method: Eligible randomized controlled trials were retrieved from PubMed, MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials databases. The present meta-analysis analyzed the mean differences (MD) in myopic progression, axial length, and odds ratios for adverse effects and dropout rates between SMCLs with different added powers and control groups. Changes in visual performance were also systematically evaluated. Results: Seven independent studies involving 805 children were included in the present meta-analysis. At 1-year, the weighted MD (WMD) in myopia progression between SMCL and control groups was -0.22 diopters (D) (95% confidence interval [CI]: -0.56 to 0.12 D) for low add power SMCLs, 0.09 D (95% CI: 0-0.19 D) for medium add power SMCLs, and 0.2 D (95% CI: 0.13, 0.27 D) for high add power SMCLs. At 2-years, the WMD for medium add power was 0.12 D (95% CI: -0.03 to 0.27 D), and for high add power was 0.25 D (95% CI: 0.14-0.35 D). No differences were detected for adverse effects (p = 0.2) and acceptability (p = 0.74) between different added powers. Additionally, differences in visual performance changes, produced by different added powers, were not detected. Conclusions: The present meta-analysis showed that high add power SMCLs are more effective and stable to control myopia progression. Besides, the adverse effects and acceptability were not related to the added power.