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 |
---|