Six-Month Changes in Accommodation and Vergence in Juvenile Myopes Wearing Multifocal Soft Contact Lenses

PURPOSE: To investigate 6-month changes in accommodation and vergence in juvenile myopes wearing multifocal soft contact lenses (MFSCLs) versus single-vision spectacles (SVLs). METHODS: A prospective, matched cohort study was conducted involving 49 myopic children aged 8 to 14 years. Participants were divided into two groups: those fitted with MFSCLs (n=26) and those with SVLs (n=23). Measurements of accommodation (e.g., lag, microfluctuations, facility, relative accommodation) and vergence (e.g., phoria, vergence range, accommodative convergence/accommodation [AC/A] ratio) were taken at baseline, 1, and 6 month. RESULTS: Multifocal soft contact lenses significantly reduced accommodative lag (F=13.75) and increased microfluctuations (F=30.93; both P<0.001) compared with SVLs throughout the study. Initial exophoric shift and decreased AC/A ratio at baseline (both P<0.001) were transient and not sustained at 1- or 6-month follow-ups. Over 6 months, the MFSCLs showed significant changes in accommodative lag, amplitude, facility, phoria, and AC/A ratio (all P<0.05). Notably, accommodative lag, phoria, and AC/A ratio changed from baseline to 1 month, then stabilized with continued wear. CONCLUSIONS: These findings demonstrate rapid binocular adaptation to MFSCL in juvenile myopes, with key parameters stabilizing within the first month despite sustained effects on accommodative lag and microfluctuations over 6 months. TRIAL REGISTRATION: Chinese Clinical Trial Registry: ChiCTR-OOC-17012103. Registered July 23, 2017, http://www.chictr.org.cn/showproj.aspx?proj=20622.