An impressive 84% of optometrists and optical dispensers in Australia and New Zealand have said they would choose Hoya’s MiyoSmart spectacle lenses over other myopia treatment options, having been introduced to the “milestone” technology at a live webinar.
The new lens, which has a simultaneous defocus treatment zone, has been shown to slow myopia progression by around 60%*1. The technology, its mechanism of action, efficacy and translation to clinical practice was described at the webinar by myopia experts Drs Kate and Paul Gifford of Myopia Profile Pty Ltd, and high profile New Zealand optometrist Jagrut Lallu.
MiyoSmart takes advantage of Defocus Incorporated Multiple Segments (D.I.M.S.) technology, developed by Hoya Corporation and The Hong Kong Polytechnic University. The innovative technology won the Grand Prize, Grand Award and Gold Medal at the 46th International Exhibition of Inventions of Geneva in April 2018.
Dr Kate Gifford explained that the lens works by delivering “conflicting signals to create simultaneous retinal defocus – some visual information falls on the retina for clear vision, and some falls in front of the retina to create myopic defocus”.
It does this with a 9.4mm diameter central zone which provides the distance refraction, surrounded by a 33mm diameter annulus of multiple defocus segments – 1mm lenslets which give +3.5D of myopic defocus – with the spaces in between them providing more distance correction.
When the wearer looks through this ‘treatment zone’, the 50:50 ratio of clear vision to defocus makes it possible to simultaneously slow the growth of the eyeball and provide clear vision, independent of pupil size and gaze direction.
Frame fit is most important to ensure the greatest treatment effect and wearer comfort, Dr Gifford said. When the frame is correctly fitted, acuity of vision through the central zone as well as the lenslet-covered treatment zone is clear, with only a slightly reduced contrast compared to single vision when looking through the treatment zone.
High Level of Efficacy
Studies demonstrate that the efficacy of MiyoSmart lenses for controlling axial elongation in myopia can be considered equivalent to MiSight contact lenses, orthokeratology and 0.05% atropine, based on current data. Indeed, a study of children in Hong Kong, aged eight to 14, found MiyoSmart curbed axial myopia progression by over 60%* and halted myopia progression in 21.5% of children over the two year study period.
Tough for Kids
MiyoSmart lenses are made from tough, impact resistant polycarbonate1.59. The lenses have UV protection, a special anti-reflection coating, are water repellent and easy to clean – practical properties that make them most suitable for long lasting wear by children. They are available in plano through to -10D, offering a wide range of myopia interventions.
Dr Kate Gifford said it is impressive to note that Hoya Lens is offering prescription warranty if a child’s refraction progresses more than 0.50D (over six months?), indicating a level of confidence in the efficacy of MiyoSmart to slow myopia progression.
Suitable for Simple and Complex Cases
Speaking from New Zealand, Mr Lallu presented two myopia case studies demonstrating the treatment efficacy of MiyoSmart for both simple and more complex clinical cases. While acknowledging the safety profile of contact lenses, Mr Lallu noted that there are practitioners, patients and parents who continue to harbour concerns and or fears about the safety of contact lens wear in children. He said MiyoSmart will be a particularly useful treatment option in these cases.
Feedback from webinar attendees was that one of the main barriers to myopia control strategies is convincing parents of the need to take action. Hoya Lens has developed a range of resources to help optometrists and optical dispensers describe myopia and the need for treatment. Additionally, Drs Kate and Paul Gifford have developed Mykidsvision.org, a patient friendly myopia information website. Myopiaprofile.org is another site established by Drs Gifford, which provides free resources and education for practitioners.
Ulli Hentschel, National Training & Development Manager at Hoya Lens Australia said that in partnership with Myopia Profile Pty Ltd, accreditation courses have been set up for optometrists, optical dispensers and practice staff. . Mr Hentschel explained that practitioners and practice staff are required to complete the short course prior to prescribing MiyoSmart lenses because unlike other lenses, MiyoSmart is a clinical treatment product. This makes it important for practitioners to understand how it works, its efficacy and how it should be prescribed, and for the practice team to support this communication outside of the consulting room Additionally, practitioners need to be able to accurately communicate the treatment option to parents and children.
“We hope this is the catalyst for more myopia management in your practice,” said Mr Hentschel. “By prescribing MiyoSmart, we can help protect children’s vision for the future.”
* Myopia progression (SER) by 59% and axial elongation (AL) decreased by 60% compared with those wearing SV lenses.
1. Lam CSY, Tang WC, Tse DY, Lee RPK, Chun RKM, Hasegawa K, Qi H, Hatanaka T, To CH. Defocus Incorporated Multiple Segments (DIMS) spectacle lenses slow myopia progression: a 2-year randomised clinical trial. British Journal of Ophthalmology. Published Online First: 29 May 2019. doi: 10.1136/bjophthalmol-2018-313739.
Photos by Philip Cheng