Combination Low-Concentration Atropine and Contact Lenses for Myopia Control

Abstract

Abstract Purpose: To ascertain the effectivity of 0.01% atropine (A0.01%) treatment to inhibit myopia progression and the possible additive potency with peripheral defocus contact lenses over three years and the rebound effect one year after cessation of treatment. Methods: This prospective study included 127 children aged 8–15 years, divided into three treatment groups: A0.01% and single vision (SV) spectacles (At, n=36), A0.01% and peripheral defocus contact lens (At+PDCL, n=30), 0.01%At and dual focus (At+DF, n=25) and a control group prescribed SV spectacles (n=36). Cycloplegic spherical equivalence refraction (SER) was measured every six months during three years of treatment and one year after cessation. Results: Myopia progression decreased over three years of treatment, more during the second and third years than the first, to a statistically significant degree in the A0.01% monotherapy group(P<0.01): In the first, second, and third years respectively in the At group -0.42±0.34D, -0.19±0.18, -0.22±0.19D, in the At+PDCL group -0.26±0.21D, -0.14±0.37D and -0.15±0.31D, in the At+DF group -0.22±0.15D, -0.15±0.22D, and -0.11±0.14D. Myopia progressed one year after cessation of treatment: -0.29±0.28D in the At group, -0.13±0.28D in the At+PDCL group, and -0.09±0.18D in the At+DF group. After three years, there was no statistically significant difference in myopia progression between groups At and At+PDCL or At+DF (P<0.05). Conclusions: Low-dose atropine has been substantiated in this cohort as an effective treatment to decelerate myopia progression over three years, more effective in the second and third years of treatment. The combination treatment did not exhibit a statistically significant advantage over monotherapy in this cohort. The dual-focus lens group exhibited a statistically lower rebound effect than the monotherapy group.