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

Abstract

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.

Keywords:

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

Acknowledgments

This work was carried out at the clinics and laboratories of the Brien Holden Vision Institute, Sydney, Australia. The research was fully funded by the Brien Holden Vision Institute. The authors would like to acknowledge the clinical team (Ms Robertson, Ms Crompton, Ms Chung, and Mr Ozkan) and the database management team (Dr Naduvilath and Ms Laarakkers) for their invaluable support to run the study at the Clinical Trial Research Centre, Brien Holden Vision Institute, Sydney, Australia. Authors would like to extend their thanks to Dr Flanagan for reviewing the manuscript and to Dr Kim for measuring the power profiles of the study lenses.

Disclosure

The Brien Holden Vision Institute receives royalties from the sale of Lotrafilcon B MFCL N. The authors report no other conflicts of interest in this work.