Effective Decrease in Myopia Progression With Two Mechanisms of Management

Purpose: To ascertain the effectiveness of 0.01% atropine treatment to inhibit myopia progression and the possible additive potency with peripheral defocus contact lenses over 3 years and the rebound effect 1 year after cessation of treatment. Methods: This prospective study included 127 children aged 8 to 5 years, divided into three treatment groups: 0.01% atropine and single-vision spectacles (At+SV, n = 36), 0.01% atropine and peripheral defocus contact lens (At+PDCL, n = 30), and 0.01% atropine and dual-focus contact lens (At+DF, n = 25). A control group was prescribed single-vision spectacles (n = 36). Cycloplegic spherical equivalence refraction was measured every 6 months during 3 years of treatment and 1 year after cessation. Results: Myopia progression decreased over 3 years of treatment, more during the second and third years than the first year, to a statistically significant degree in the atropine groups ( P < .01): in the first, second, and third years, respectively, −0.42 ± 0.34, −0.19 ± 0.18, −0.22 ± 0.19 diopters (D) in the At+SV group, −0.26 ± 0.21, −0.14 ± 0.37, and −0.15 ± 0.31 D in the At+PDCL group, and −0.22 ± 0.15, −0.15 ± 0.22, and −0.11 ± 0.14 D in the At+DF group. Myopia progressed 1 year after cessation of treatment: −0.29 ± 0.28 D in the At+SV group, −0.13 ± 0.28 D in the At+PDCL group, and −0.09 ± 0.18 D in the At+DF group. After 3 years, there was no statistically significant difference in myopia progression between the At+SV and At+PDCL or At+DF groups ( P < .05). Conclusions: Low-dose atropine has been substantiated in this cohort as an effective treatment to decelerate myopia progression over 3 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 At+DF group exhibited a statistically lower rebound effect than the At+SV group. [ J Pediatr Ophthalmol Strabismus . 2024;61(3):204–210.]