Increasing negative spherical aberration with soft contact lenses improves high and low contrast visual acuity in young adults (original) (raw)
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Ophthalmic and Physiological Optics
We aimed to determine myopia control efficacy with novel contact lenses (CL) that (1) reduced both central and peripheral defocus, and (2) provided extended depth of focus with better global retinal image quality for points on, and anterior to, the retina and degraded for points posterior to the retina. Methods: Children (n = 508, 8-13 years) with cycloplegic spherical equivalent (SE) À0.75 to À3.50D were enrolled in a prospective, double blind trial and randomised to one of five groups: (1) single vision, silicone hydrogel (SH) CL; (2) two groups wearing SH CL that imposed myopic defocus across peripheral and central retina (test CL I and II; +1.00D centrally and +2.50 and +1.50 for CL I and II at 3 mm semi-chord respectively); and (3) two groups wearing extended depth of focus (EDOF) hydrogel CL incorporating higher order aberrations to modulate retinal image quality (test CL III and IV; extended depth of focus of up to +1.75D and +2.50D respectively). Cycloplegic autorefraction and axial length (AL) measurements were conducted at six monthly intervals. Compliance to lens wear was assessed with a diary and collected at each visit. Additionally, subjective responses to various aspects of lens wear were assessed. The trial commenced in February 2014 and was terminated in January 2017 due to site closure. Myopia progression over time between groups was compared using linear mixed models and where needed post hoc analysis with Bonferroni corrections conducted. Results: Myopia progressed with control CL À1.12 AE 0.51D/0.58 AE 0.27 mm for SE/AL at 24 months. In comparison, all test CL had reduced progression with SE/ AL ranging from À0.78D to À0.87D/0.41-0.46 mm at 24 months (AL: p < 0.05 for all test CL; SE p < 0.05 for test CL III and IV) and represented a reduction in axial length elongation of about 22% to 32% and reduction in spherical equivalent of 24% to 32%. With test CL, a greater slowing ranging from 26% to 43% was observed in compliant wearers (≥6 days per week; Control CL: À0.64D/0.30 mm and À1.14D/0.58 mm vs test CL: À0.42D to À0.47D/0.12-0.18 mm and À0.70 to À0.81D/0.19-0.25 mm at 12 and 24 months respectively). Conclusions: Contact lenses that either imposed myopic defocus at the retina or modulated retinal image quality resulted in a slower progression of myopia with greater efficacy seen in compliant wearers. Importantly, there was no difference in the myopia control provided by either of these strategies.
Northern Clinics of Istanbul, 2015
OBJECTIVE: To evaluate the aberration and visual quality differences between myopic and astigmatic eyes before and after contact lens application by using corneal aberrometer and low-contrast sensitivity chart. METHODS: Eighty eyes of 40 patients were included in this study. Patients were divided into two groups as myopic (40 eyes, n=20) and astigmatic groups (40 eyes, n=20). We used aspheric Balafilcon A (Purevision and Purevision Toric Bausch&Lomb, Rochester, USA) lenses for each group. Corneal aberrations and low-contrast sensitivity values were measured and compared for each patient in both groups. RESULTS: There were no statistically significant differences between myopic and astigmatic groups when we compared low-contrast sensitivity values for both on-and off-eyes. Mean total higher-order aberration (HOA) values for off-eye, were 0.29±0.10 μm, and 0.33±0.10 μm for on-eye in the myopic group, while they were 0.42±0.14 μm in off-eye and 0.37±0.23 μm in on-eye in the astigmatic group. Off-eye mean coma, irregular astigmatism and total higher-order aberration RMS (root-mean-square) values were significantly higher in the astigmatic group compared to the myopic group (p=0.006, p=0.001, p=0.001) but mean on-eye RMS values were not. CONCLUSION: Myopic and astigmatic patients differ in terms of high-order aberrations and these differences cannot be equalized after contact lens application, but visual quality can be improved in both patients by using contact lenses.
Controlled induction of spherical aberration with custom soft contact lenses
Clinical and Experimental Optometry, 2009
Background: This study investigated the non-invasive induction of spherical aberration (SA) levels consistent with complication-free wavefront-guided (WFG) refractive surgery using custom WFG soft contact lenses and quantified the resulting impact on visual performance.Methods: Twelve healthy individuals of typical military age (mean of 26.08 ± 1.92 years) meeting the inclusion criteria of emmetropia (less than ± 0.50 DS and less than ± 0.50 DC) as measured by subjective refraction served as subjects. Five plano lenses were manufactured to induce a range of SA typical of those encountered after refractive surgery. The measured SA values over a 6 mm artificial pupil in these five lenses were -0.224 µm, 0.074 µm, 0.214 µm, 0.495 µm and 0.621 µm. For each subject, the level of total ocular aberrations through 10 Zernike radial orders over a 6 mm pupil was measured with a custom Shack-Hartmann wavefront sensor, while wearing each lens. Visual performance was evaluated using high contrast visual acuity (HCVA) measured through a 6 mm artificial pupil.Results: Custom WFG soft contact lenses can be manufactured to include the range of SA that occurs with complication-free refractive surgery (-0.20 µm to +0.60 µm) and produces a change in SA within a similar range when worn on the eye. High contrast visual performance with these lenses varied, depending on the amount of SA in each lens. Visual performance worsened with greater amounts of positive or negative SA and a quadratic fit to the data peaked at +0.209 µm.Conclusions: Defined levels of SA can be manufactured and induced (non-invasively) with WFG soft contact lenses and their effect on logMAR high contrast visual performance can be measured. Results show that subjects' best logMAR HCVA occurs with the presence of positive residual SA. When designing the actual test lens, the targeted change in aberrations for each subject will likely be better achieved by first measuring the aberrations of a template lens on the eye and then compensating for unique subject dependent eye-lens interactions.
Visual performance of myopia control soft contact lenses in non-presbyopic myopes
Clinical optometry, 2018
To compare the visual performance of soft contact lenses reported to reduce myopia progression. In a double-blind, randomized, crossover trial, 30 non-presbyopic myopes wore MiSight™, center-distance Proclear Multifocal (+2.00 D add), and two prototype lenses for 1 week each. High- and low-contrast visual acuities at 6 m, and 70 and 40 cm; stereopsis at 40 cm; accommodative facility at 33 cm; and horizontal phoria at 3 m and 33 cm were measured after 1 week. Subjective performance was assessed on a numeric rating scale for vision clarity, lack of ghosting, vision stability, haloes, overall vision satisfaction, and ocular comfort. Frequency of eye-strain symptoms and willingness to purchase lenses were also reported with categorical responses. Participants reported wearing times (total and visually acceptable). Linear mixed models and chi-square tests were employed in analysis with level of significance set at 5%. Theoretical optical performance of all lenses was assessed with schema...
Contact Lens and Anterior Eye, 2019
To assess the visual performance of multifocal contact lenses (MFCLs) with high addition powers designed for myopia control. Methods: Twenty-four non-presbyopic adults (mean age 24 years, range 18-36 years) were fitted with soft MFCLs with add powers of +2.0 D (Add2) and +4.0 D (Add4) (RELAX, SwissLens) and single vision lenses (SVCL; Add0) in a counterbalanced order. In this double-masked study, half of the participants were randomly fitted with 3 mm-distance central zone MFCLs while the other half received 4.5 mm-distance central zone MFCLs. Visual acuity was measured at distance (3.0 m) and at near (0.4 m). Central and peripheral contrast sensitivity was evaluated at distance using the Gabor patch test. The area under the logarithmic contrast sensitivity function curve (ALCSF) was calculated and compared between the groups (i.e. different additions powers used). Results: Near and distance visual acuities were not affected by the lenses, neither Add2 nor Add4, when compared to Add0, however, CZ3 significantly reduced distance visual acuity with Add4 when compared to CZ4.5 (−0.08 logMAR vs. for CZ3 and-0.18 logMAR for CZ4.5, p = 0.013). MFCLs impaired central ALCSF only when Add2 was used (15.99 logCS for Add2 and 16.36 logCS for SVCLs, p = 0.021). Peripheral ALCSF was statistically lower for both addition powers of the MFCLs when compared to SVCLs (12.70 for Add2 and Add4, 13.73 for SVCLs, p = 0.009). The above effects were the same for both central zones used. Conclusions: MFCLs with CZ3 diameter and high add power (Add4) slightly reduced distance visual acuity when compared to CZ4.5 but no reduction in this parameter was found with medium add power (Add2). Central contrast sensitivity was impaired only by MFCLs with the lower add power (Add2). Both add powers in the MFCLs reduced peripheral contrast sensitivity to a similar extent.
Central and peripheral visual performance in myopes: Contact lenses versus spectacles
Contact Lens and Anterior Eye, 2011
Myopia is known to degrade visual performance with both optical and retinal changes implicated. Whether contact lenses or spectacles provide better visual performance for myopes is still under debate. The purpose of this study was to examine central and peripheral visual function in myopic subjects corrected with contact lenses versus spectacles. Methods: Size thresholds were measured at 13 locations for 20 myopic subjects (mean spherical equivalent refractive error (SE): −6.43 ± 1.22 D and cylinder power: −0.23 ± 0.22 D) corrected with contact lenses (new etafilcon A contact lens, fitted 15 min prior to measurements) versus spectacles. Measurements were taken at both low (ıl/l = 14%) and high (ıl/l = 100%) contrast levels. The data were analysed using one way repeated-measures ANOVA. Results: Size thresholds increased with eccentricity in a similar manner for both forms of optical correction. Repeated-measures ANOVA showed no statistically significant difference in central and peripheral visual performance between the two forms of correction for both low and high contrast tasks. The outcome remained the same following correction for spectacle magnification. Conclusion: Eye care practitioners can be confident that modern soft contact lenses do not impair visual performance compared to spectacle lenses for the majority of myopes.
Eye and Vision
Objectives To investigate the short- and long-term effects of myopia control spectacle lenses with highly aspherical lenslets (HAL) and slightly aspherical lenslets (SAL) on visual function and visual quality using data obtained from a randomized controlled clinical trial. Methods This was a prospective, randomized, controlled, and double-blinded study; 170 myopic children aged 8–13 years were randomly assigned to the HAL, SAL, or single-vision spectacle lenses (SVL) groups. Distance and near visual acuity (VA) at high (100%) and low (10%) contrast in photopic and scotopic conditions, near phoria, stereoacuity, and accommodative lag, microfluctuations (AMFs), amplitude (AA) were measured after wearing lenses for 10 min, 6 months, and 12 months. Results In total, 161 subjects completed all follow-up in 12 months and were included in the analysis. After 10 min of wearing, the HAL and SAL groups had lower scotopic and low-contrast VA than the SVL group (decreased 0.03–0.08 logMAR and 0...
Visual Performance of Subjects Wearing Presbyopic Contact Lenses
Optometry and Vision Science, 2006
Purpose. The purpose of this study is to assess the visual performance of subjects wearing gas-permeable (GP) multifocal contact lenses, soft bifocal contact lenses, GP monovision lenses and spectacles. Methods. The study included 32 subjects between the ages of 42 and 65 years wearing GP monovision, the Acuvue Bifocal (Vistakon), the Essentials GP Multifocal (Blanchard), and progressive addition lenses (PAL; spectacles group). There were eight subjects in each of these groups who were already wearing these modalities. Binocular low (18%) and high (95%) contrast acuities were recorded using the Bailey-Lovie chart; binocular contrast sensitivity from 1.5 to 18 cycles per degree (cpd) measured with the Vistech VCTS 6500 system, and monocular glare sensitivity at three luminance settings (400, 100, and 12 foot lamberts) was measured using the brightness acuity tester (BAT). Binocular near visual task performance (a modified version of letter counting method used in previous presbyopic studies) was also assessed. Results. For the contact lens-wearing groups, subjects wearing GP multifocals provided the best binocular high and low contrast acuity followed by soft bifocal wearers. There was relative parity between the binocular high and low contrast acuity with PAL and GP multifocal wearers. Monovision acuity, measured binocularly, was determined to be lower than the other three groups with this difference being most significant with high contrast acuity. Among contact lens-wearing groups, it was observed that GP multifocal lens wearers experienced the lowest amount of monocular disability glare followed by soft bifocal wearers and monovision wearers. Subjects wearing soft bifocal lenses and monovision demonstrated slightly reduced binocular contrast sensitivity at all spatial frequencies. In the contact lens groups, GP multifocal lens wearers had the highest binocular contrast sensitivity at all spatial frequencies, on parity with PAL wearers, except at the highest spatial frequency (18 cpd) at which PAL wearers had better vision. Error scores for the binocular near visual task performance between the four groups revealed subjects with GP multifocal lenses and PAL wearers to have the least errors, followed by monovision users and then soft bifocal wearers with the most errors. Conclusion. Subjects wearing GP multifocals, soft bifocals, monovision, and PAL spectacles have good binocular contrast sensitivity, satisfactory binocular low and high contrast acuity, and increased sensitivity to glare. Presbyopic subjects requiring the use of contact lenses under dim light levels could benefit from GP multifocal lenses. Contrast and glare sensitivity evaluations provide significant information regarding the visual performance of the presbyopic contact lenses and should be included in regular presbyopic contact lens fitting. (Optom Vis Sci 2006;83:611-615)
A Clinical Study of the Impact of Soft Contact Lenses on the Progression of Myopia in Young Patients
Clinical Ophthalmology
To assess the impact of soft contact lenses on the progression of myopia in young patients. Patients and Methods: The observational study included 102 patients divided into 3 groups: MFCL (multifocal contact lenses) group: 15 girls and 9 boys, aged 8-20 (� x= 14.12 ± 2.863) with soft multifocal contact lenses with myopia: � x = −3.12 D ± 1.776 D and mean myopia progression −0.23 ± 0.233D after 2 years; SVCL (single vision contact lenses) group: 30 girls and 5 boys, 11-20 years old (� x=15.5 ± 2.24) with myopia � x = −2.88 ± 2.122 D at admission and mean myopia progression −0.54 ± 0.464 D after 2 years; the spectacle (single vision glasses) group: 25 girls and 18 boys, aged 8-18 years (� x = 13.65 ± 2.448) with single vision glasses with myopia: � x = −1.74 ± 1.412 D at admission and mean myopia progression −0.86 ± 0.489D after 2 years. Medical history and physical examination were performed every 6, 12, 18 and 24 months. Refractive error was examined using the autorefractometry after cycloplegia. Results: The analysis of myopia correction after 2 years showed differences between MFCL and spectacle correction. The change in myopia progression after 2 years was statistically significant for MFCL vs SVCL and MFCL vs spectacle correction when the myopia occured before the period of intensive growth. When myopia occurred during the period of intensive growth, difference was noted for MFCL vs spectacle correction and SVCL vs spectacle correction. When myopia occurred after a period of intensive growth, no significant differences between the groups were observed. Conclusion: 1) Multifocal contact lenses and some single vision contact lenses (Biofinity) may be useful in the control of myopia in younger patients, slowing the progression of nearsightedness; therefore, they can be a therapeutic option in inhibiting the progression of myopia. 2) The best effects of using multifocal contact lenses occur if myopia is diagnosed before the period of intensive growth.
Graefes Archive for Clinical and Experimental Ophthalmology, 2011
Background Theoretically, the accommodative and vergence demands are different between single-vision contact lenses and spectacle lenses. The aim of the present study was to determine whether these differences exist when these two correction methods are used in clinical practice. For this, different visual parameters that characterize the accommodative (accommodation amplitude, accommodative facility, and accommodative response) and binocular function (near and distance horizontal and vertical dissociated phorias, near and vertical associated phorias, near and distance negative and positive fusional vergence, vergence facility, near point of convergence, negative and positive relative accommodation, stimulus AC:A ratio and stereoacuity) were evaluated in a student population when their myopia was corrected with either spectacles or soft contact lenses (SCL). Methods All parameters were measured on two separate occasions in 30 myopic habitual contact lens and spectacle wearers of mean age 19 ± 2.4 years. Some parameters such as accommodation amplitude, accommodative response, and stimulus AC:A ratio were measured using two measurement methods which are commonly used in clinical practice. Three measurements were taken for each parameter and averaged. For the comparative statistical analysis, we used the Student’s t-test (p value < 0.05). Results The following statistically significant differences were found with the use of SCL in comparison to spectacles: higher accommodative lags, higher negative relative accommodation, more esophoric near horizontal dissociated phoria, and lower negative fusional vergence in near vision. Conclusions The results found in this study show a definite trend towards poorer accommodative and vergence function with the use of contact lenses in comparison to glasses. This downward trend, though not statistically significant in accommodative function (lower PRA values and less lens amplitude of accommodation) might suggest that temporal insufficiency in the accommodation process could be occurring while contact lenses are used, thereby possibly creating a lag in accommodation to reduce associated overconvergence. This would be manifested in more esophoric values being found in the vergence function. The higher accommodative lags found in this study with SCL could indicate that prolonged use of SCL in near tasks may provoke a continuous hyperopic retinal defocus, a risk factor for the onset and progression of myopia, as indicated in numerous studies.