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Visual performance with multifocal soft contact lenses in non-presbyopic myopic eyes during an adaptation period

Authors Fedtke C, Ehrmann K, Thomas V, Bakaraju RC

Received 19 September 2015

Accepted for publication 1 December 2015

Published 21 April 2016 Volume 2016:8 Pages 37—46


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 3

Editor who approved publication: Mr Simon Berry

Cathleen Fedtke,1 Klaus Ehrmann,1,2 Varghese Thomas,1 Ravi C Bakaraju,1,2

1The Brien Holden Vision Institute, Clinical Trial Research Centre, 2School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW, Australia

Purpose: Multifocal soft contact lenses (MFCLs) have been proposed and used for controlling the rate of myopia progression; however, little is known on the performance and adaptation with MFCLs in non-presbyopes. This study aims to evaluate the visual performance of four commercially available MFCLs in non-presbyopic myopic eyes during an adaptation period.
Methods: Fifty-two experienced myopic contact lens wearers (67% female; mean age 21.4±2.0 years) were enrolled in this trial and 40 completed the trial. Twenty-six participants (Group 1) wore Lotrafilcon B single vision (SV, control), Omafilcon A MFCL center-distance (D) and center-near (N) and the other 26 participants (Group 2) wore Lotrafilcon B SV, Lotrafilcon B MFCL N, and Balafilcon A MFCL N. Lens order was randomized. Participants wore each allocated lens for a minimum of 8 days over four scheduled visits (dispensing and three follow-up visits) with a 1-week washout period between the lens types. At each visit, high-contrast visual acuity (HCVA) (in logarithm of the minimum angle of resolution [logMAR]) and seven subjective performance variables (via questionnaire) were obtained. Power profiles of each lens type, pupil size, and contact lens centration, with lens placed on the eye, were measured.
Results: The SV control outperformed the MFCLs in all variables (P<0.05). There were no significant differences in HCVA over time, with the exception of monocular HCVA with Omafilcon A MFCL N, which at the end of the adaptation period had significantly (P<0.05) improved by 0.10 logMAR. No differences were found between visits for any subjective variables. Subjectively, Lotrafilcon B MFCL N performed best and was the only lens that did not decenter significantly compared to the SV control. Conversely, Omafilcon A MFCL N was the worst performing and most decentered lens (P<0.05, y=−0.39 mm), with the greatest plus area under the power profile.
Conclusion: MFCLs with greatest power variation across the optic zone, a greater plus area under the distance labeled power profile, and/or lenses that were significantly decentered resulted in the lowest subjective ratings. Over time, quality of vision with MFCLs did not change in non-presbyopic myopic participants, with the exception of Omafilcon A MFCL N, which showed some adaptation effects.

multifocal contact lenses, visual performance, contact lens centration, power profiles, non-presbyopes

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