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Objective and Subjective Visual Performance of Soft Multifocal Contact Lenses of Various Add Powers and Center Optic Zone Sizes

Boroff, Jacob Andrew
http://rave.ohiolink.edu/etdc/view?acc_num=osu1523557549549266

Abstract Details

2018, Master of Science, Ohio State University, Vision Science.
Myopia control is currently a topic of interest due to the increasing prevalence of myopia in the pediatric population of the United States and other areas of the world. Those who suffer from highly myopic refractive errors are predisposed to ocular complications due to exaggerated ocular axial elongation. Both orthokeratology and center-distance soft multifocal contact lenses have been proven through randomized clinical trials to be effective at slowing down axial elongation and minimizing myopic refractive error. There is supporting evidence that myopia control can be maximized by increasing the power and the area of the add within the optical design of a soft multifocal contact lens. This study aims to determine the maximum of these multifocal parameters in a center-distance and center-near soft multifocal contact lens design without causing a clinically meaningful reduction in objective and subjective visual performance. In this study, non-presbyopic subjects wore a total of thirteen different contact lenses; a single vision spherical control, six center-distance multifocals, and six center- near multifocals. For each multifocal design, there were two different add powers (+1.50 D and +2.50 D) and three different center optic zone sizes (1.5 mm, 2.0 mm, and 2.5 mm) assessed. Statistically significant differences in distance high-contrast visual acuity was seen as center optic zone size varied for the +1.50 D add center-distance multifocal (p = 0.01). Both distance high-contrast (p = 0.004) and low-contrast (p = < 0.0001) visual acuity showed statically significant differences as center optic zone size varied for the +2.50 D center-distance multifocal. Distance low-contrast (p = 0.001) and near high- contrast (p = 0.01) visual acuities for the 1.5 mm center optic zone center-distance multifocal were statically different as add power varied. Distance vision, computer vision, near vision, glare/starbursts, ghosting, eye-strain, changes/fluctuations, and overall vision were the statistically significant subjective measures in which the +2.50 D add ranked worse than the +1.50 D add power for the 2.5 mm center optic zone center- distance multifocal (all p-values were less than 0.01). Of these, none differed by more than five letters visual acuity or by two units on the subjective scale. Therefore, all were considered to be clinically meaningful differences between the multifocals. Statistically significant differences in distance high-contrast (p = 0.01) and low- contrast (p=0.001) visual acuities were seen as center optic zone size varied for the +1.50 D add center-near multifocal. Distance low-contrast was the only statistically significant outcome measure for the +2.50 D center-near multifocal (p = 0.001). Add power variation of the 2.5 mm center-near multifocal resulted in a statistically significant difference in distance low-contrast visual acuity (p = 0.02). Computer vision, near vision, glare/starbursts, changes/fluctuations, and overall vision were the statically significant subjective measures in which the 2.5 mm ranked worse relative than the 1.5 mm center optic zone for the +2.50 D center-near multifocal (all p values were less than 0.01). Computer vision, near vision, and comfort were the subjective measures in which the +2.50 D add ranked worse relative to the +1.50 D add power for the 2.5 mm center optic zone size center-near multifocal (all p values were less than 0.01). None of the differences in subjective visual quality measures were more than two units. Of the lenses assessed in this study, the hypothetical multifocal lens for maximizing myopia control would be a +2.50 D add center-distance multifocal with a 1.5 mm center optic zone size or a +2.50 D add center-near multifocal with a 2.5 mm center optic zone size. The findings from this study suggest that these may not be the best option primarily due to reductions in objective visual performance; specifically distance low- contrast visual acuity. However, the medium optic zone size with the highest add power provides adequate subjective and objective vision to warrant use of those lenses for myopia control.
Jeffrey Walline, OD, PhD,FAAO (Advisor)
Heidi Wagner, OD, MPH, FAAO (Committee Member)
Dean VanNasdale, OD, PhD, FAAO (Committee Member)
112 p.
Optics
Myopia control; soft multifocal contact lenses; center-distance; center-near; visual acuity

Recommended Citations

Citations

  • Boroff, J. A. (2018). Objective and Subjective Visual Performance of Soft Multifocal Contact Lenses of Various Add Powers and Center Optic Zone Sizes [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1523557549549266

    APA Style (7th edition)

  • Boroff, Jacob. Objective and Subjective Visual Performance of Soft Multifocal Contact Lenses of Various Add Powers and Center Optic Zone Sizes. 2018. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1523557549549266.

    MLA Style (8th edition)

  • Boroff, Jacob. "Objective and Subjective Visual Performance of Soft Multifocal Contact Lenses of Various Add Powers and Center Optic Zone Sizes." Master's thesis, Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1523557549549266

    Chicago Manual of Style (17th edition)

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This open access ETD is published by The Ohio State University and OhioLINK.