Visual performance and accommodative function with prototype extended depth-of-focus lenses against single-vision contact lenses

Abstract

Purpose : Our research group has shown contact lenses (CLs) which extend depth of focus by deliberate manipulation of multiple modes of spherical aberration (EDOF) have efficacy for myopia control, have better visual performance (VP) than other CLs used for myopia control but worse VP than single vision CLs. This study assessed the VP and accommodative function of 2 new EDOF CLs against 1-day ACUVUE Moist (1DAM) in myopic non-presbyopes.

Methods : This was a prospective, randomized, double-masked study in which 26 non-presbyopes wore 2 different EDOF designs (EDOF-A, EDOF-B) and 1DAM for 1 week.
Acuity-based VP comprised high and low contrast visual acuity (HCVA/LCVA: logMAR) at 6m, 70cm and 40cm.
Subjective VP comprised a 1-10 numeric rating scale (NRS) for vision clarity, ghosting, vision when driving, vision satisfaction, haloes at night, ease of changing focus and comfort.
Accommodative function assessment comprised phorias at 3m and 33cm, monocular accommodative facility (MAF) at 33cm and accommodative lag at 40cm.
VP and accommodative function variables were compared between lens types using linear mixed model and significance was set at 5%.

Results : Results are reported as mean± 2x standard error.
1DAM and EDOF-A were significantly better than EDOF-B for HCVA at all distances (≤2 letters, p<0.001) while there were no difference between 1DAM and EDOF-A (p=0.611). 1DAM was significantly better than EDOF-A and EDOF-B for LCVA at 6m (0.06±0.02 v 0.11±0.04 & 0.21±0.03, p≤0.035) while EDOF-A was significantly better than EDOF-B (p<0.001). There were no significant differences between CLs for LCVA at 70cm and 40cm (p≥0.205).
1DAM and EDOF-A were significantly better than EDOF-B for vision clarity (8.6±0.4 & 8.4±0.4 v 8.0±0.4, p≤0.001) and vision when driving (8.8±0.5 & 8.5±0.5 v 8.0±0.5, p≤0.012). There were no significant differences between CLs for any other subjective VP (p≥0.083) and there were no significant differences between 1DAM and EDOF-A (p≥0.083) for any subjective VP.
1DAM showed less accommodative lag than both EDOF-A and EDOF-B (0.77±0.14 v 0.98±0.15 & 1.00±0.15, p≤0.020) while there were no differences between CLs for phoria or MAF (p≥0.176).

Conclusions : VP with EDOF-A was no worse than 1DAM. EDOF CLs slightly reduced accommodative effort at near in non-presbyopes. Different EDOF designs offer varying VP.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.