Abstract： Objective: To investigate the distribution of corneal refractive power before and after using multifocal contact lenses and to assess the relationship between corneal refractive power and axial elongation. Methods: A retrospective study was conducted on 40 eyes of 20 children from December 2018 to April 2019. The 8- to 14-year-old children were fitted with multifocal contact lenses in the Hangzhou Branch of Zhejiang Eye Hospital Affiliated to Wenzhou Medical University Corneal topography was measured by Medmont before and 30 minutes after using multifocal contact lenses. The corneal apical refractive power and corneal tangential power of multiple spots along the nasal, temporal, superior and inferior axes were manually collected. The range included 1 mm to 3.5 mm away from the apex in 0.5 mm steps and were recorded as N/T/S/I (1/1.5/2/2.5/3/3.5). At the same time, the corneal maximum refractive power and apical refractive power were manually collected after wearing the lenses. Corneal and apical refractive power were also collected at the same spots before wearing lenses and were recorded as N/T/S/I max. The difference between any corneal tangential power and corneal apical refractive power was defined as relative peripheral refractive power. The difference between any corneal maximum refractive power and apical refractive power was defined as relative maximum refractive power. The axial length was measured by IOLMaster before and 1 year after wearing the multifocal contact lens. Linear regression was used to analyze the relationship between the relative maximum refractive power and axial elongation. Results: The corneal peripheral refractive power was weaker than the corneal apical refractive power. After multifocal contact lens treatment, the relative peripheral refractive power was significantly increased at the horizontal axes, except at the N2.5, N3 and N3.5 spots. The relative peripheral refractive power was significantly increased at the vertical axes, except at the S3, S3.5 and I3.5 spots. Mean axial elongation at 1 year was 0.28±0.21 mm. The corneal relative maximum refractive power significantly increased after wearing the lens. The initial age and spherical equivalent refractive error (OR=0.393, F=3.447, P=0.042), inferior corneal relative maximum refractive power changes (OR=0.157, F=7.057, P=0.011) and the relative maximum refractive power after wearing the lens (OR=0.108, F=4.583, P=0.039) had significant effects on axial elongation during the 1-year period. Conclusions: The corneal relative peripheral negative refractive power changes to positive refractive power after wearing multifocal contact lens. Besides the initial age and spherical equivalent refractive error, after multifocal lens treatment, the relative maximum refractive maximum refractive power and the changes have significant effects on axial elongation. It was expected to be correlated with a significant reduction in the relative peripheral hyperopia defocus after wearing the lens.
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