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Jiyoon Chung, Ravi Bakaraju, Cathleen Fedtke, Jerome Ozkan, Klaus Ehrmann, Darrin Falk, Arthur Ho, Brien Holden; Accommodative Lag, Facility and Phoria with Multifocal Contact Lenses. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4251.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the accommodative lag, facility and phoria measurements of myopic participants fitted with various commercial contact lens designs.
Forty myopic, non-presbyopic, subjects were randomized to be fitted bilaterally, with a single vision control lens (Air Optix Aqua) and two of four multifocal (MF) lenses (Proclear Distance and Near MF, Air Optix Aqua MF and PureVision MF) on a daily wear basis. Subjects wore each lens type for a minimum of 8 days over 4 scheduled (baseline and 3 follow-up) visits with a 1-week wash-out between lens types. Static accommodative responses were assessed with the EyeMapper at all visits. Five repeats were performed in a fogged state (+1D) and at four object vergences from -2 to -5D (1D steps). Paraxial curvature matching of the wavefront aberration map yielded the spherical equivalent. Accommodative facility and phoria (at distance and near) were evaluated using ± 2D flippers and Howell card, respectively. To reduce the effect of between-visit variability, the data was averaged over the four visits.
At +1D fogging, all lens types produced a myopic shift. With the control lens, the accommodative response function was relatively linear (slope = 0.82). Three centre-near MFs (Air Optix, PureVision and Proclear Near) all demonstrated accommodative lead at -2D, optimal response at -3D, and lag at -4 and -5D object vergences. Proclear Distance produced lag over all test vergences. All MFs produced lower accommodative facility compared to control lens (19.2 cycles / min, p<0.05). The facility measures for Air Optix, PureVision, Proclear Near and Proclear Distance were 15.8, 15.7, 14.4, and 16.5 cycles / min, respectively. There were no differences for distance phoria between all lens types. Significant differences were observed for near phoria with Proclear Near MF (5.6 exo, p< 0.05).
There were significant differences between measured accommodative lag for different lens types with Proclear Distance producing greater lag than the rest. This observation was more pronounced at -3D, -4D and -5D accommodative states.
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