Investigating the utility of clinical assessments to predict success with presbyopic contact lens correction

Ahmed Sivardeen, Deborah Laughton, James S. Wolffsohn

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Abstract

Purpose - To determine the utility of a range of clinical and non-clinical indicators to aid the initial selection of the optimum presbyopic contact lens. In addition, to assess whether lens preference was influenced by the visual performance compared to the other designs trialled (intra-subject) or compared to participants who preferred other designs (inter-subject).

Methods - A double-masked randomised crossover trial of Air Optix Aqua multifocal, PureVision 2 for Presbyopia, Acuvue OASYS for Presbyopia, Biofinity multifocal and monovision was conducted on 35 presbyopes (54.3 ± 6.2 years). Participant lifestyle, personality, pupil characteristics and aberrometry were assessed prior to lens fitting. After 4 weeks of wear, high and low contrast visual acuity (VA) under photopic and mesopic conditions, reading speed, Near Activity Visual Questionnaire (NAVQ) rating, subjective quality-of-vision scoring, defocus curves, stereopsis, halometry, aberrometry and ocular physiology were quantified.

Results - After trialling all the lenses, preference was mixed (n = 12 Biofinity, n = 10 monovision, n = 7 Purevision, n = 4 Air Optix Aqua, n = 2 Oasys). Lens preference was not dependent on personality (F = 1.182, p = 0.323) or the hours spent working at near (p = 0.535) or intermediate (p = 0.759) distances. No intersubject or strong intrasubject relationships emerged between lens preference and reading speed, NAVQ rating, halo size, aberrometry or ocular physiology (p > 0.05).

Conclusions - Participant lifestyle and personality, ocular optics, contact lens visual performance and ocular physiology provided poor indicators of the preferred lens type after 4 weeks of wear. This is confounded by the wide range of task visual demands of presbyopes and the limited optical differences between current multifocal contact lens designs.
Original languageEnglish
Pages (from-to)322-330
JournalContact Lens and Anterior Eye
Volume39
Issue number5
Early online date26 May 2016
DOIs
Publication statusPublished - 1 Oct 2016
Externally publishedYes

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