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Multifocal contact lenses (MFCL) may reduce visual acuity (VA), contrast sensitivity, and subjective quality of vision in young adults compared with single vision contact lenses, according to research published in Contact Lens and Anterior Eye.
Researchers conducted a double-masked, repeated measures study of 26 participants with myopia (age range 19-25 years, spherical equivalent (SE) range, -0.50 to -5.75 D). They randomly assigned patients to 1 of 4 contact lens groups: single vision, concentric dual focus multifocal, distance center aspheric multifocal, or aspheric multifocal. Each participant wore all 4 types of lenses across 2 visits. Investigators evaluated the patients for distance visual acuity, near visual acuity, contrast sensitivity, and subjective perceptions of visual quality. The subjective analysis involved participants rating clarity, effect of ghosting, and stability of vision on a 5-point Likert scale (1=worst performance to 5=best performance).
The researchers found that single vision contact lenses provided the best distance VA followed by the concentric design, aspheric lenses, and distance center aspheric design (P =.04, P =.001, and P =.001, respectively). The distance center aspheric multifocals provided the biggest reduction in visual impact with a mean 0.19±0.14 logMAR reduction, and a log contrast sensitivity reduction of 0.22±0.15. Near acuity reduction was worst for the aspheric design (0.05±0.07 logMAR) compared with single vision contact lenses (P =.007).
Subjective analysis revealed the poorest clarity of vision with the distance center aspheric design (3.0±1.1), highest degree of ghosting with the concentric multifocals (3.5±1.1), and worst stability of vision with aspheric lenses (3.3±1.2) for distance acuity, while the concentric design scored poorest in each category (3.6±1.0, 3.1±1.2, and 3.5±1.1, respectively, P =.001 for all) for near vision.
The study “speaks to the multifactorial relationship between MFCL optical design and the dynamic visual system of non-presbyopic wearers. Whilst achieving optimized acuity is no doubt important for young wearers, there is a question of whether altering distance refraction to maximize vision could reduce myopic defocus in the peripheral retina and impact myopia control efficacy.”
Study limitations include a small sample size, the use of only 4 types of contact lenses, and fixed add powers for all participants.
Disclosure: One study author declared affiliations with the biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Reference
Schmid K, Gifford KL, Atchison DA. The effect of concentric and aspheric multifocal soft contact lenses on binocular vision in young adult myopes. Cont Lens Anterior Eye. Published online March 15, 2022. doi:10.1016/j.clae.2022.101588
