No advantage of Atropine addition to soft multifocal contact lens for myopia correction in kids

The Bifocal & Atropine in Myopia (BAM) study investigated whether combining 0.01% atropine and soft multifocal contact lenses (SMCL) with +2.50-D add power leads to greater slowing of myopia progression and axial elongation than SMCL alone.

BAM participants wore SMCL with +2.50-D add power daily and were administered 0.01% atropine eye drops nightly (n = 46). The BAM subjects (Bifocal + Atropine) were age-matched to 46 participants in the Bifocal Lenses In Nearsighted Kids (BLINK) Study who wore SMCL with +2.50-D add (Bifocal) and 46 BLINK participants who wore single vision contact lenses (Single Vision). The primary outcome was the 3-year change in spherical equivalent refractive error determined by cycloplegic autorefraction, and the 3-year change in axial elongation was also evaluated.

Results:

Of the total 138 subjects, the mean age was 10.1 ± 1.2 years and the mean spherical equivalent was -2.28 ± 0.89 D. The 3-year adjusted mean myopia progression was -0.52 D for Bifocal + Atropine, -0.55 D for Bifocal, and -1.09 D for Single Vision. The difference in myopia progression was 0.03 D (95% CI, -0.14 to 0.21) for Bifocal + Atropine vs Bifocal and 0.57 D (95% CI, 0.38-0.77) for Bifocal + Atropine vs Single Vision. The 3-year adjusted axial elongation was 0.31 mm for Bifocal + Atropine, 0.39 mm for Bifocal, and 0.68 mm for Single Vision. The difference in axial elongation was -0.08 mm (95% CI, -0. 16 to 0.002) for Bifocal + Atropine vs Bifocal and -0.37 mm (95% CI, -0.46 to -0.28) for Bifocal + Atropine vs Single Vision.

Thus, adding 0.01% atropine to soft multifocal contact lenses (SMCL) with +2.50-D add power failed to demonstrate better myopia control than soft multifocal contact lenses (SMCL) alone.

Reference:

Effect of Combining 0.01% Atropine with Soft Multifocal Contact Lenses on Myopia Progression in Children by Jones, Jenny Huang et al. published in Optometry and Vision Science.

https://journals.lww.com/optvissci/Abstract/9000/Effect_of_Combining_0_01__Atropine_with_Soft.97816.aspx