Age-Specific Efficacy of MiSight Dual-Focus Soft Contact Lenses and Orthokeratology Lenses for Myopia Control in Pediatric Patients: A Retrospective Comparative Study

초록

Objectives: To assess age-specific effectiveness of dual-focus soft contact lenses (MiSight) and orthokeratology (Ortho-K) in slowing myopia progression over 18 months in pediatric patients, emphasizing axial length (AL) changes. Methods: Retrospective analysis of 239 eyes from 123 myopic pediatric patients (aged 8-18 years) (MiSight: 137 eyes; Ortho-K: 102 eyes), stratified by age (younger: <= 10 vs. older: >10 years). Primary outcome was AL elongation measured by IOL Master. Secondary outcomes included spherical equivalent (SE), keratometry, and cylinder power (CYL) through autorefraction. Orthokeratology measurements were taken during treatment without washout, limiting direct refractive comparisons. Linear mixed models were used for intragroup changes, and general linear model adjustment was applied for baseline imbalances in AL and CYL. Results: Despite significant baseline imbalances (MiSight group had longer AL and more myopic SE), GLM-adjusted analysis showed modestly lower overall annualized AL elongation with MiSight (0.20 mm/year) compared with Ortho-K (0.24 mm/year). In older children (older than 10 years), MiSight was associated with lower AL progression, particularly between 6 to 12 months (0.07 vs. 0.11 mm/6-months, P =0.012). In younger children (10 years and younger), adjusted AL elongation rates were comparable between groups. MiSight maintained relatively stable refractive parameters, while Ortho-K induced corneal flattening but progressive worsening of CYL. Conclusions: This age-stratified retrospective comparison demonstrated modestly lower axial elongation with MiSight after adjustment for baseline differences, particularly in older children (older than 10 years). These findings suggest potential age-dependent differences in treatment response between the two modalities and highlight the importance of individualized myopia management strategies.

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