A Double Masked Randomised Crossover Trial of two Silicone Hydrogel Multifocal Contact Lenses

Prof Doc Thesis


Ashleigh, C (2017). A Double Masked Randomised Crossover Trial of two Silicone Hydrogel Multifocal Contact Lenses. Prof Doc Thesis London South Bank University School of Health and Social Care https://doi.org/10.18744/PUB.001988
AuthorsAshleigh, C
TypeProf Doc Thesis
Abstract

Purpose:
To compare visual performance and acceptance of two different
designs of monthly disposable silicone hydrogel multifocal contact
lenses, the Air Optix Aqua Multifocal and the Biofinity Multifocal.
Methods:
A double masked randomised crossover trial of 62 presbyopic
participants (between 41 and 60 years of age) was conducted.
Participants were randomised first into either the Air Optix Aqua
Multifocal or the Biofinity Multifocal lens to be worn for four weeks
for each modality. There was a washout period of one week before
wearing the second option. Measurements included binocular
photopic distance visual acuity (VA), binocular photopic near VA,
stereoacuity at distance and near and contrast sensitivity in
photopic, mesopic and scotopic lighting conditions. Subjective
participant experience for quality of vision was collected using the
VF-14 visual function questionnaire and a specially designed daily
diary.
Results:
Fifty-seven participants completed both periods of this crossover
study (mean age 52.9, 43 females, 14 males). The difference for
binocular photopic distance and near VAs between the Air Optix
Aqua and Biofinity Multifocal were marginal (distance: p>0.13, near:
p>0.24). Differences for stereoacuity at distance and near between
the Air Optix Aqua and Biofinity Multifocal were not statistically
significant (distance: p=0.33, near: p=0.36) and measurements for
contrast sensitivity in mesopic and scotopic lighting conditions
showed no statistically significant difference between the lens types
(mesopic: p>0.18 and scotopic: p>0.31). Photopic contrast sensitivity showed statistically significant results and was marginally better with
the Air Optix Aqua Multifocal than Biofinity Multifocal (p=0.013 by
paired t-test and p=0.018 Wilcoxon Signed Ranks test). This was
judged unlikely to be of clinical significance and most likely a chance
finding. Marginal but not statistically significant preferences were
found for the data of the VF-14 visual function questionnaire and the
daily diary with participants preferring the Air Optix Aqua Multifocal
for distance vision (distance vision scores: Wilcoxon Signed Ranks
test: 79-76%) and reporting more satisfaction with intermediate and
near vision with the Biofinity Multifocal lens design (intermediate
vision scores: 66-60% and near vision scores: 74-72%). Comfort
scores were equally high for both lens designs (comfort scores: 78-
82%). 43 participants (75%) felt soft multifocal contact lenses were a
good alternative to spectacles and 33 participants (58%) were
continuing to use one of the two designs one year after the trial
ended. Of these, 17 wearers (51%) were wearing the Air Optix Aqua
and 16 (49%) the Biofinity Multifocal lens.
Conclusions:
There were no consistent differences in visual performance between
the Air Optix Aqua Multifocal and the Biofinity Multifocal lens
design. The Air Optix Aqua multifocal was found to be marginally
superior in participants’ subjective scores for binocular distance
vision and the Biofinity Multifocal for binocular intermediate and
near vision. Based on feedback at follow up, presbyopic participants
in this research rated soft silicone hydrogel multifocal contact lenses
a good alternative to spectacle wear. Key Words:
Presbyopia, multifocal, silicone hydrogel, contact lens, double
masked crossover, comparison study, visual function questionnaire,
daily diary

Year2017
PublisherLondon South Bank University
Digital Object Identifier (DOI)https://doi.org/10.18744/PUB.001988
Publication dates
Print01 Nov 2017
Publication process dates
Deposited16 Mar 2018
Publisher's version
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