MiSight Provides Modest Advantage Over Ortho-K, Study Finds

Recent study demonstrated modestly lower axial elongation with MiSight Dual-focus soft contact lenses after adjustment for baseline differences, particularly in older children, compared to ortho-K lenses. Photo: Robert Ensley, OD, and Heidi Miller, OD; CooperVision. Click image to enlarge. Orthokeratology (ortho-K) and MiSight dual-focus soft contact lenses are two treatments to control myopia, but the modalities differ substantially in fitting and usage patterns. A recent retrospective study conducted in South Korea analyzed 239 eyes from 123 kids aged eight to 18 years to evaluate the age-specific efficacy of MiSight vs. ortho-K over 18 months. The findings were reported in Eye & Contact Lens.The MiSight group was older and had more significant baseline myopia (longer AL) and more myopic spherical equivalent refraction) compared to the ortho-K group, likely due to practitioner selection bias. After adjusting for baseline AL and cylinder power, MiSight showed modestly lower overall annualized AL elongation (0.20mm/year) compared to ortho-K (0.24mm/year).MiSight was associated with lower AL progression in older children (older than 10 years; 0.18mm/year vs. 0.2mm/year), particularly during the six-to-12-month period (0.07mm/six months vs. 0.11mm/six months). In children aged 10 and younger, adjusted AL elongation rates were comparable (0.44mm/year vs. 0.36mm/year). “These baseline imbalances indicate that patients with more severe myopia, higher astigmatism and older age were more likely to select MiSight lenses, potentially affecting subsequent myopia control efficacy comparisons,” the authors wrote in their paper.Although myopia progression is typically faster in younger children, older MiSight patients showed modestly lower absolute AL elongation than younger ones (0.15mm/year vs. 0.31mm/year unadjusted). “This pattern is consistent with practitioner selection bias (older, more myopic children preferentially fitted with MiSight) and with sustained efficacy of dual-focus lenses across age groups, as demonstrated in the three-year MiSight randomized controlled trial and subsequent analyses,” the authors wrote.These absolute rates align with effective control reported in prior trials (MiSight 0.10mm to 0.20mm/year; ortho-K 0.15mm to 0.25mm/year), confirming both modalities provide meaningful suppression relative to untreated benchmarks. Refractive parameters in MiSight remained stable, with negligible changes in keratometry or cyl, consistent with its peripheral defocus mechanism without corneal remodeling. “By contrast, ortho-K produced initial SE improvement (+1.55D at six months) but persistent cyl worsening, reflecting known risks of corneal reshaping,” the authors explained in their paper. “This variability aligns with reports of induced astigmatism in altered corneal biomechanics in ortho-K users.”In conclusion, these findings highlight potential age-dependent responses to the two modalities and underscore the value of individualized lens selection in pediatric myopia management.Click here for the journal source. Hong HJ, Kim DW, Kim HJ, et al. Age-specific efficacy of MiSight Dual-focus soft contact lenses and orthokeratology lenses for myopia control in pediatric patients: a retrospective comparative study. Eye & Contact Lens. June 4, 2026. [Epub ahead of print.] This article was developed by the editorial staff in conjunction with experts in the field. In the process, AI may have been among the editorial tools used to meet the goals of human editors, who approved all content.