Cathleen Fedtke, Klaus Ehrmann, Varghese Thomas, Ravi C Bakaraju

Multifocal soft contact lenses (MFCLs) have been proposed and used for controlling the rate of myopia progression; however, little is known on the performance and adaptation with MFCLs in non-presbyopes. This study aims to evaluate the visual performance of four commercially available MFCLs in non-presbyopic myopic eyes during an adaptation period. Fifty-two experienced myopic contact lens wearers (67% female; mean age 21.4±2.0 years) were enrolled in this trial and 40 completed the trial. Twenty-six participants (Group 1) wore Lotrafilcon B single vision (SV, control), Omafilcon A MFCL center-distance (D) and center-near (N) and the other 26 participants (Group 2) wore Lotrafilcon B SV, Lotrafilcon B MFCL N, and Balafilcon A MFCL N. Lens order was randomized. Participants wore each allocated lens for a minimum of 8 days over four scheduled visits (dispensing and three follow-up visits) with a 1-week washout period between the lens types. At each visit, high-contrast visual acuity (HCVA) (in logarithm of the minimum angle of resolution [logMAR]) and seven subjective performance variables (via questionnaire) were obtained. Power profiles of each lens type, pupil size, and contact lens centration, with lens placed on the eye, were measured. The SV control outperformed the MFCLs in all variables (P<0.05). There were no significant differences in HCVA over time, with the exception of monocular HCVA with Omafilcon A MFCL N, which at the end of the adaptation period had significantly (P<0.05) improved by 0.10 logMAR. No differences were found between visits for any subjective variables. Subjectively, Lotrafilcon B MFCL N performed best and was the only lens that did not decenter significantly compared to the SV control. Conversely, Omafilcon A MFCL N was the worst performing and most decentered lens (P<0.05, y=-0.39 mm), with the greatest plus area under the power profile. MFCLs with greatest power variation across the optic zone, a greater plus area under the distance labeled power profile, and/or lenses that were significantly decentered resulted in the lowest subjective ratings. Over time, quality of vision with MFCLs did not change in non-presbyopic myopic participants, with the exception of Omafilcon A MFCL N, which showed some adaptation effects.