Synergistic Effect of Dual-Focus Soft Contact Lenses and 0.05% Atropine on Myopia Control in Children With Rapidly Progressing Myopia

OBJECTIVES: The aim of this study was to evaluate the combined effect of dual-focus soft contact lenses (CLs) and 0.05% atropine in the control of myopia. METHODS: A retrospective study was conducted on 142 myopic children aged 7 to 13 years. A single nightly instillation of 0.05% atropine at bedtime was prescribed if the rate of myopia progression exceeded -1.00 D/year. After 1 year of treatment, patients who exhibited myopia progression of more than 0.75 D/year or an increase in axial length of more than 0.25 mm/year were additionally treated with dual-focus soft CLs (MiSight) alongside 0.05% atropine (Combination group, n=71). By contrast, patients who showed myopia progression of less than 0.50 D/year and axial elongation of less than 0.20 mm/year continued treatment with 0.05% atropine only (Monotherapy group, n=71). Subjects in the combination group were further divided into high myopia and low/moderate myopia subgroups, using a cutoff of -6 D. RESULTS: Myopia progression and axial elongation were significantly slower after the addition of dual-focus soft CLs to 0.05% atropine in the combination group ( P =0.001 and P =0.012, respectively). The combination group exhibited statistically significantly faster myopia progression than the monotherapy group before the addition of dual-focus soft CLs (both P <0.001), but no significant difference in myopia progression between the two groups was observed afterward ( P =0.504 and P =0.479, respectively). The inhibition of axial elongation was more pronounced in the low/moderate myopia group compared with the high myopia group ( P =0.028). CONCLUSIONS: The combination of dual-focus soft CLs and 0.05% atropine is an effective treatment strategy for controlling myopia in children with rapidly progressing myopia. The additive effect was greater in children with low/moderate myopia than in those with high myopia.