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Shannon M. Zollinger, Kathryn L. Richdale, Donald O. Mutti; Factors Influencing Multifocal Contact Lens Choice. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6641.
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Multifocal contact lens fitting is often thought to be more time consuming than other methods of presbyopic correction and might be facilitated by information on the relative advantages of different multifocal brands. We evaluated the comfort and acuity at distance and near of two new silicone hydrogel multifocal contact lenses.
Thirty-five presbyopes between the ages of 43 and 65 were fitted with two brands of multifocal contact lenses (Vistakon Acuvue Oasys for Presbyopia (AOP) and CIBA Vision Air Optix Aqua Multifocal (AOAMF)) according to manufacturers’ guidelines, and in a random order. The subjects had no prior multifocal or monovision contact lens experience. Acuity was measured binocularly at 4m and 40cm using Bailey-Lovie high and low contrast charts by a masked examiner. Subjects rated comfort and vision at distance and near on a 10 point rating scale.
At distance, subjects read 2.4 letters (high contrast, p=0.001) and 4.3 letters (low contrast, p<0.0001) more with AOAMF. There was no significant difference between lenses in high or low contrast near acuity (p<0.70). Subjects rated comfort significantly better (9 out of 10) with AOP than with AOAMF (8 out of 10, p=0.001) . A forward selection stepwise discriminant analysis identified the subjective quality of distance vision of the AOAMF and the comfort of AOP as the two most important factors in their lens preference. The subjective quality of near vision with each lens was a secondary but significant factor. The number of letters read at distance or near did not significantly influence lens preference. AOAMF was chosen by 60% (21/35) of subjects and AOP by 40% (14/35, p=0.31).
These two new multifocals had different relative advantages: AOAMF had better distance vision while AOP had better comfort. Patients used these differences in their selection of a preferred lens. Of note, subjects’ qualitative assessment of vision and comfort was more clinically relevant than any measurement of visual acuity. This information might reduce chair time while fitting and increase subject satisfaction while wearing multifocal contact lenses.
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