MiSight 1 day contact lenses: what the clinical trial evidence shows

MiSight 1 day (CooperVision) is a daily disposable soft contact lens designed to slow myopia in children. It has one of the longest randomised evidence bases of any myopia control product. This review sets out what the trials show.

How MiSight works

MiSight is a dual-focus lens. Concentric zones alternate between the child's distance correction and zones with added plus power. The eye receives a clear distance image and, at the same time, an image focused in front of the retina, which is thought to signal the eye to slow its growth.

What the evidence shows

Three years. In a double-masked randomised trial at four sites in four countries, 144 children aged 8 to 12 were enrolled and 109 completed three years. Myopia progressed by 0.51 D in the MiSight group against 1.24 D in the single-vision contact lens group, a difference of 0.73 D (59%). Axial length grew 0.30 mm against 0.62 mm, a difference of 0.32 mm (52%). There were no serious ocular adverse events (Chamberlain et al., 2019).

Six years. In the extension, all children wore MiSight for a further three years. The slowing seen in the original treatment group was sustained. Children switched from the control lens slowed too, with within-eye comparisons showing a 71% slowing of axial growth. About 10% of eyes did not respond to treatment (Chamberlain et al., 2022).

An honest read of the evidence

• The studies were led by the manufacturer's own researchers. The design was double-masked and multi-site, with academic investigators at each site, which is a strength.
• About a quarter of enrolled children did not complete three years, and the six-year phase had no untreated control group.
• Around one eye in ten did not respond. No trial yet tells us how to identify those children in advance.
• Contact lens wear in children needs good hygiene and regular review. The trial's safety record was good under trial conditions.

Myopia device research at NZERC

The open questions are comparisons between contact lens designs, combination with atropine, and predicting who will respond. The New Zealand Eye Research Centre (NZERC) has clinician investigators who fit myopia control and specialty contact lenses, and measures axial length and choroidal thickness and vascularity. Lens manufacturers and sponsors are invited to read our information for sponsors and CROs. Families can register their interest in myopia studies. For assessment and fitting, contact our affiliated clinical practice, Rose Optometry.

References

• Chamberlain P, Peixoto-de-Matos SC, Logan NS, Ngo C, Jones D, Young G. A 3-year randomized clinical trial of MiSight lenses for myopia control. Optom Vis Sci 2019;96(8):556-567. doi:10.1097/OPX.0000000000001410
• Chamberlain P, Bradley A, Arumugam B, et al. Long-term effect of dual-focus contact lenses on myopia progression in children: a 6-year multicenter clinical trial. Optom Vis Sci 2022;99(3):204-212. doi:10.1097/OPX.0000000000001873