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A 3-year study on the effect of RGP contact lenses on myopic children
Insights
Rigid gas-permeable (RGP) contact lenses showed potential in controlling myopia progression in Singaporean children. Regular wear for eight hours daily was effective, though discontinuing lens wear had minimal long-term impact.
Area of Science:
- Ophthalmology
- Pediatric Optometry
Background:
- Myopia progression varies significantly between ethnic groups, with faster progression observed in Asian populations.
- Previous Western studies indicated rigid gas-permeable (RGP) contact lenses could manage myopia in children.
Purpose of the Study:
- To evaluate the efficacy of RGP contact lenses in controlling myopia progression in Singaporean children.
- To investigate the underlying mechanisms of myopia control, including corneal flattening and axial length reduction.
- To assess the permanence of myopia control effects after discontinuing lens wear.
Main Methods:
- A three-year prospective study involving approximately 100 Singaporean children requiring myopia management.
- Participants were fitted with RGP contact lenses, with parental support crucial for compliance.
- Data collection focused on refractive error changes and axial length measurements.
Main Results:
- A notable suppression in myopia progression was observed in children wearing RGP lenses compared to those wearing spectacles.
- Complete arrest of myopia occurred in only ten eyes.
- Consistent wear (approximately 8 hours/day) was necessary for efficacy. Drop-out reasons included lack of motivation and lens intolerance.
- Discontinuation of lens wear for over two months showed minimal effect on refractive status, suggesting limited permanent corneal changes.
Conclusions:
- RGP contact lenses can be a viable option for managing rapidly progressing myopia in children.
- Further research is recommended to validate these findings and explore long-term outcomes.
- The myopia control effect appears primarily related to lens wear duration rather than solely corneal reshaping.
Aim And Background:
Recent studies in the West have shown that rigid gas-permeable (RGP) contact lenses can control the progress of myopia in children. These studies were done on Caucasian children, whose myopias are less rapidly progressive than those which we see in Singaporean children. This three-year study was started in 1993, with the following objectives: 1. To verify whether RGP contact lenses can control the progress of myopia in Singaporean children. 2. If so, to investigate the mechanism by which the lenses control myopia; whether by corneal flattening or by reducing the growth of the axial length. 3. If so, to assess if the effects are permanent, by discontinuing lens wear.
Materials And Methods:
The study was carried out at the Eye Clinic of the School Health Service. Enough school children were referred to the clinic from the various schools to achieve about 100 children wearing contact lenses. Past studies showed that the drop-out rate would be 50%, as there is no cosmetic motivation in 10 year-old children to wear contact lenses. The successful wearers were those who had parental encouragement and support.
Results:
The results show that there was a suppression of the progress of myopia in children wearing the lenses as compared to their counterparts wearing spectacles. However, only in ten eyes was there arrest of the myopia. For the lenses to be effective, they needed to be worn regularly for about eight hours a day. Reasons for the drop-outs included lack of motivation, lens intolerance and simply being too busy with the school curriculum. Discontinuance of lens wear for more than 2 months had minimal effect on the refraction, indicating that the controlling effect was not due purely to corneal change.
Conclusion:
It is recommended that more studies be done to confirm the findings of this study. Children with rapidly progressive myopia can wear rigid gas-permeable contact lenses to reduce the progression.