Contrast Sensitivity with Center-distance Multifocal Soft Contact Lenses

Abstract

Significance: The contrast sensitivity (CS) function provides a more detailed assessment of vision than visual acuity. It was found that center-distance multifocal contact lens designs that are increasingly being prescribed for myopia control reduce distance photopic and mesopic CS in nonpresbyopic patients across a range of spatial frequencies.

Purpose: This study aimed to determine the effect of center-distance multifocal soft contact lenses (MFCLs) on CS under photopic and mesopic conditions in nonpresbyopic patients.

Methods: Twenty-five myopic, nonpresbyopic adults were fitted binocularly with three lenses: Biofinity single vision contact lens (SVCL), Biofinity Multifocal D +2.50 add, and NaturalVue Multifocal in random order. Contrast sensitivity was measured at distance (4 m) under photopic and mesopic conditions and at near under photopic conditions. Log CS by spatial frequency and area under the log contrast sensitivity function (AULCSF) were analyzed between lenses.

Results: Distance photopic CS at each spatial frequency was higher with the SVCL than the MFCLs (P < .001), but there was no difference between the MFCLs (P = .71). Distance mesopic CS from 1.5 to 12 cycles per degree (cpd) was higher with the SVCL than the MFCLs (all P < .02); however, at 18 cpd, there was no difference in CS between NaturalVue and the SVCL (P = .76), possibly because of spurious resolution. Photopic AULCSF for the SVCL was roughly 10% greater than both MFCLs. Contrast sensitivity at near was generally similar between lenses, only slightly lower with the NaturalVue at 11 and 15.5 cpd, but AULCSF at near was not different between lenses (P > .05).

Conclusions: Multifocal contact lenses reduce distance contrast sensitivity under both photopic and mesopic conditions. There is no clinically significant difference in near CS among all three lenses. These data show that MFCLs have effects on vision that are not captured by standard high-contrast visual acuity testing.

Trial registration: ClinicalTrials.gov NCT03705130.

Conflict of interest statement

Conflict of Interest Disclosure: The authors listed report a financial conflict of interest (DAB, Visioneering Technologies Advisory Board; ERR, Alcon Laboratories Advisory Board) and financial support unrelated to this work (ERR, Research Support from SightGlass Vision; DAB, Contact Lens Solutions from Bausch and Lomb). JSW is the chief scientific officer of the International Myopia Institute, on the executive board of the Tear Film and Ocular Surface Society, and the academic chair of the BCLA. He has received honoraria for consultancy from AtiaVision, Bausch and Lomb, Alcon, CooperVision, Johnson and Johnson Vision, Nevakar, Novartis, and Thea Pharmaceutical. He has also received research funding from Alcon, Allergan, Johnson and Johnson Vision, Novartis, M2C Therapeutics, Rayner, and Thea Pharmaceuticals. He is a founder and shareholder in Aston Vision Sciences, Eyoto, and Wolffsohn Research Ltd. No industry financial, technical, or research support was received for this study.

Copyright © 2022 American Academy of Optometry.

Figures

Figure 1.

Targets for distance (A) and near (B) contrast sensitivity testing. Participants indicate on a tablet whether they see a target or blank screen for distance contrast sensitivity testing. For near testing, participants draw a line to trace the boundary of where they can see the contrast sensitivity grating (B)

Figure 2.

Photopic (A, solid lines) and mesopic (B, dashed lines) distance contrast sensitivity function with different contact lens designs. Contrast sensitivity was lower with the multifocal contact lenses compared to the single vision contact lenses except at 18cpd under mesopic conditions where sensitivity with the NaturalVue Multifocal was the same as the single vision lens. Error bars represent 95% confidence interval.

Figure 3.

Area under the log contrast sensitivity function (AULCSF) at distance under photopic and mesopic lighting for each contact lens type. The AULCSF is reduced with the multifocal contact lenses under both photopic and mesopic conditions, but similar between the multifocal lenses. Error bars represent 95% confidence interval.

Figure 4.

Near photopic contrast sensitivity with different contact lens types. Log contrast sensitivity with the NaturalVue Multifocal was slightly reduced compared to the single vision contact lens at 11 and 15.5 cycles/degree (*, P = .04). Error bars represent 95% confidence interval.

Figure 5.

Area under the log contrast sensitivity function (AULCSF) at near was the same with all contact lens types. Error bars represent 95% confidence interval.