Short-term comparison between extended depth-of-focus prototype contact lenses and a commercially-available center-near multifocal

Abstract

PurposeTo compare the visual performance of prototype contact lenses which extend depth-of-focus (EDOF) by deliberate manipulation of multiple higher-order spherical aberration terms and a commercially-available center-near lens (AIR OPTIX Aqua Multifocal, AOMF).MethodsThis was a prospective, cross-over, randomized, single-masked (participant), short-term clinical trial where 52 participants (age 45–70 years) were stratified as low, medium or high presbyopes and wore EDOF and AOMF on different days. Objective measures comprised high and low contrast visual acuity (HCVA/LCVA, log MAR), and contrast sensitivity (log units) at 6 m; HCVA at 70 cm, 50 cm and 40 cm and stereopsis (seconds of arc) at 40 cm. HCVA at 70 cm, 50 cm and 40 cm were measured as “comfortable acuity” rather than conventional resolution acuity. Subjective measures comprised clarity-of-vision and ghosting at distance, intermediate and near, overall vision satisfaction and ocular comfort (1–10 numeric rating scale) and lens purchase (yes/no response). Statistical analysis included repeated measures ANOVA, paired t-tests and McNemar's test.ResultsSignificant differences between lens types were independent of strata (p ≥ 0.119). EDOF was significantly better than AOMF for HCVA at 40 cm (0.42 ± 0.18 vs. 0.48 ± 0.22, p = 0.024), stereopsis (98 ± 88 vs. 141 ± 114, p < 0.001), clarity-of-vision at intermediate (8.5 ± 1.6 vs. 7.7 ± 1.9, p = 0.006) and near (7.3 ± 2.5 vs. 6.2 ± 2.5, p = 0.005), lack-of-ghosting (p = 0.012), overall vision satisfaction (7.5 ± 1.7 vs. 6.4 ± 2.2, p < 0.001) and ocular comfort (9.0 ± 1.0 vs. 8.3 ± 1.7, p = 0.002). Significantly more participants chose to only-purchase EDOF (33% vs. 6%, p = 0.003).). There were no significant differences between lens types for any objective measure at 6 m or clarity-of-vision at distance (p ≥ 0.356).ConclusionsEDOF provides better intermediate and near vision performance in presbyopes than AOMF with no difference for distance vision during short-term wear.

Extended depth of focus contact lenses vs. two commercial multifocals: Part 2. Visual performance after 1 week of lens wear

“…Most of these observations were in-line with the outcomes from our previous short-term (1-h) evaluations. 19 , 20 The insignificant interaction between ‘lens-type’ and ‘add-group’ suggests that the improvements in performance seen with prototypes were not driven by a particular participant pool.…”

“…Although the observed visual acuity with the prototype lenses was better than with the control lenses at intermediate and near test distances, the differences were not clinically relevant as they were within 2 letters. Unlike our previous short-term studies, 19 , 20 the current trial used a conventional ‘resolution-based’ acuity test instead of a ‘comfort-based’ reading assessment to measure intermediate and near visual performance. As a result, the average near visual acuity measures with both prototype and control lenses were on average 0.2–0.3 logMAR better than our previous observations with similar lenses.…”

“…Previously, we assessed the visual performance of prototype lenses against two commercial lenses in presbyopes after 1 h of lens wear, and found prototype lenses offered good vision at intermediate and near, without compromising distance vision. 19 , 20 Although, such initial on-eye results of prototype lenses are encouraging and supportive towards the theory of extension in the depth of focus achieved through manipulation of higher order spherical aberration, several authors have shown that the subjective visual performance of multifocal contact lenses differs from initial fitting and after several days of wear. 21 , 22 , 23 The aim of the current study was therefore to assess the acuities, contrast sensitivity, stereopsis and subjective visual performance of the test and control lenses after one week of wear and to compare clinical findings with theoretical measures obtained through ray-tracing.…”

“…Similar questionnaires were used in our previous short-term assessments of contact lenses. 19 , 20 Unlike these short-term studies, the current study required participants to experience contact lenses under ‘real-world’ conditions, and so vision performance was separated under day and night-time conditions and additional questions were asked for vision when driving and night-time halos. Briefly, the questions comprised clarity of vision (1 = blurred, 10 = clear) and ghosting (1 = none, 10 = severe) for distance, intermediate and near and vision when driving (1 = blurred, 10 = clear) specifically under day and night-time conditions.…”

Bifocal and Multifocal Contact Lenses for Presbyopia and Myopia Control

“…Results from Fernandes et al [97] were within ±1 line of their reported VA for all the experimental conditions except for Monovision under near low contrast visual acuity (LCNVA), which performed better than Multifocal lens in their study. Recently, several clinical studies also evaluated visual performance with different contact lenses [103][104][105]107]. Bakaraju et al [103] measured the high contrast visual acuity (HCVA) and the low contrast visual acuity (LCVA) for the Airoptix Aqua, the Acuvue Oasys and extended depth of focus (EDOF) contact lens.…”