Comparative Efficacy of Two Defocus Soft Contact Lenses on Axial Length and Choroid in High Myopic Adolescents

ABSTRACT Background To compare the 1‐year myopia control efficacy of two defocus soft contact lenses (SCLs) versus single‐vision spectacles in high myopic adolescents (spherical equivalent refraction [SER] of 6.00 diopters or more). Methods 237 participants were randomised into three groups: peripheral gradual defocus SCLs (Group A), multipoint defocus SCLs (Group B) and single‐vision spectacles (Group C), with 12‐month follow‐up. Outcomes included axial length change (ΔAL), SER change (ΔSER), choroidal thickness (CT) and choroidal vascular density (VDCC). Results 217 subjects completed follow‐up. From Month 3, Group B had the smallest ΔAL: 12‐month ΔAL was (0.12 ± 0.08) mm, significantly lower than Groups A (0.25 ± 0.10 mm) and C (0.48 ± 0.12 mm), all p < 0.001. Group B's ΔSER (−0.13 ± 0.09 D) was also smaller than Groups A (−0.24 ± 0.11 D) and C (−0.45 ± 0.13 D) (all p value less than 0.05). Group B showed increased VDCC/CT (notably 3‐mm foveal area), Group C decreased and Group A stabilised. Multiple regression indicated Group B intervention (β = −0.32, p = 0.002) and 3‐mm CT change (β = −0.28, p = 0.006) independently correlated with smaller ΔAL (model R 2 = 0.35, p value less than 0.001). Conclusion Multipoint defocus SCLs outperform other methods in controlling high myopia and improving choroidal parameters.