BLINK2 Study Finds No Rebound Effect for Multifocal Myopia Control Contact Lenses

University of Houston researchers have found that myopia progression normalizes upon cessation of treatment with high-add power multifocal contact lenses as teenagers.

High-add power multifocal contact lenses in myopia might be in it for the long haul, according to a new study published in JAMA Ophthalmology today.

Data from the University of Houston College of Optometry’s BLINK2 study has shown that older teenagers who discontinued the use of multifocal contact lenses for childhood myopia did not see a loss of treatment effect, also known as rebound.

According to the study authors, myopia progression rates returned to age-expected rates instead of accelerating.¹

“There has been concern that the eye might grow faster than normal when myopia control contact lenses are discontinued,” said Dr. David Bernsten, lead study author and chair of Clinical Sciences at the University of Houston College of Optometry.

“Our findings show that when older teenagers stop wearing these myopia control lenses, the eye returns to the age-expected rate of growth.”

Study results

In BLINK2, children from the original BLINK study²—originally randomized to wear either high-add power soft bifocal contact lenses (Biofinity; CooperVision; San Ramon, California, United States) or plain single-vision contacts for three years—all wore high-add multifocal contact lenses for the next two years.

Axial length measurements and refractive error, via cycloplegic refraction, were measured yearly.

Key Findings:

After all participants switched to single-vision lenses, axial elongation increased by 0.03 mm per year (95% CI, 0.01 to 0.05) regardless of original BLINK group (p=0.81).
An increase in myopia progression after switching was observed (−0.17 D/year; 95% CI, −0.22 to −0.12). This was also independent of the original BLINK treatment group (p=0.57).¹

What’s next?

With worldwide myopia rates increasing at alarming rates, options to control runaway axial elongation have grown apace.

The so-called ‘bullseye’ design of the contact lenses used in the study is just one piece of an evolving myopia control landscape that includes specially-designed spectacles, orthokeratology lenses, atropine eyedrops and more.

Some of these options, including atropine and orthokeratology, have, at least preliminarily, been shown to suffer from the rebound effect that the BLINK2 study suggests is absent with high-add power soft contact lenses.³

Further research is being done to understand these rebound effects—including when and why they occur—and the BLINK2 study could prove to be an important step in this direction.

“These follow-on results from the BLINK2 study show that the treatment benefit with myopia control contact lenses have a durable benefit when they are discontinued at an older age,” said Dr. Jeffrey Walline, BLINK2 study chair and associate dean for research at the Ohio State University College of Optometry.

References

Berntsen DA, Tićak A, Orr DJ, et al. Axial Growth and Myopia Progression After Discontinuing Soft Multifocal Contact Lens Wear. JAMA Ophthalmol. 2024;5885 [Epub ahead of print]
Walline JJ, Walker MK, Mutti DO, et al. Effect of High Add Power, Medium Add Power, or Single-Vision Contact Lenses on Myopia Progression in Children: The BLINK Randomized Clinical Trial. JAMA.2020;324(6):571-580.
Myopia Rebound: Back with a Vengeance. Myopia Profile website. Available at: https://www.myopiaprofile.com/articles/myopia-rebound-progressing-after-treatment Accessed on January 17, 2025.