The effects of simultaneous dual focus lenses on refractive development in infant monkeys

Purpose: We investigated the effects of two simultaneously imposed, competing focal planes on refractive development in monkeys.Methods: Starting at 3 weeks of age and continuing until 150 6 4 days of age, rhesus monkeys were reared with binocular dual-focus spectacle lenses. The treatment lenses had central 2-mm zones of zero power and concentric annular zones with alternating powers of +3.0 diopter [D] and plano (pL or 0 D) (n = 7; +3D/pL) or −3.0 D and plano (n = 7; −3D/pL). Retinoscopy, keratometry, and A-scan ultrasonography were performed every 2 weeks throughout the treatment period. For comparison purposes data were obtained from monkeys reared with full field (FF) +3.0 (n = 4) or −3.0 D (n = 5) lenses over both eyes and 33 control animals reared with unrestricted vision.Results: The +3 D/pL lenses slowed eye growth resulting in hyperopic refractive errors that were similar to those produced by FF+3 D lenses (+3 D/pL = +5.25 D, FF +3 D = +4.63 D; P = 0.32), but significantly more hyperopic than those observed in control monkeys (+2.50 D, P = 0.0001). One −3 D/pL monkey developed compensating axial myopia; however, in the other −3 D/pL monkeys refractive development was dominated by the zero-powered portions of the treatment lenses. The refractive errors for the −3 D/pL monkeys were more hyperopic than those in the FF −3 D monkeys (−3 D/pL = +3.13 D, FF −3D = −1.69 D; P = 0.01), but similar to those in control animals (P = 0.15).Conclusions: In the monkeys treated with dual-focus lenses, refractive development was dominated by the more anterior (i.e., relatively myopic) image plane. The results indicate that imposing relative myopic defocus over a large proportion of the retina is an effective means for slowing ocular growth.