Accommodation in young adults wearing aspheric multifocal soft contact lenses

Abstract

The aim of the present project was to investigate accommodative behavior in young adults and adolescents fitted with an aspheric multifocal (center distance) contact lens with focus on evaluating whether these lenses can be an alternative treatment for subjects in which a reduced level of blur and thereby accommodation in near vision is aimed at. Twenty normal subjects aged between 21 and 35 years participated in the study. Aberrometry was perfomed using a Zywave TM aberrometer, first on the uncorrected eyes of all subjects, and again while the subjects wore a multifocal contact lens with a þ1.00 add. A Shin-Nippon N Vision-K 5001 Autoref-Keratometer was used to measure accommodative response with two different refractive corrections: (1) habitual spectacle correction only, and (2) habitual correction and a aspheric multifocal (center distance) contact lens. Four hours of adaptation to the lens was allowed. The lag when wearing only the habitual spectacles was compared with the lag while wearing both the habitual spectacles and the aspheric multifocal contact lens. The mean lag of accommodation for the subject group was 0.85 D (AE0.57 SD) and 0.75 D (AE0.52 SD) without and with the multifocal lens, respectively. Statistical analyses showed no difference in lag (t ¼ 0.8479, p ¼ 0.407) with and without the lens. In conclusion, young normal subjects do not relax accommodation when fitted with aspheric multifocal center distance lenses when the addition is þ1.00. It is therefore unlikely that subjects with accommodative ability, in whom the treatment purpose is to reduce blur and thereby accommodation, can be effectively treated with such lenses.

The efficacy of multifocal soft contact lenses for the alleviation of asthenopic symptoms in myopes with accommodative lag

“…However, the present study's cohort, selected to have manifest accommodative lag and symptoms of asthenopia, failed to exhibit any significant change in lag for any contact lens condition, despite a marked improvement in CISS score with multifocal contact lens wear. This finding is, however, consistent with several other studies which have used centre-near [38,39,[55][56][57] or centredistance multifocal lenses [35] and have detected no significant change in accommodative lag compared to single vision distance contact lenses. Conversely, some studies have reported an increase in lag [34,35,58], while one study investigating bifocal contact lenses found that lag decreased [20].…”

“…Although multifocal soft contact lenses were originally designed to incorporate a near addition prescription in the contact lens to provide clearer vision for presbyopes, studies have suggested that multifocal soft contact lenses could also be used as a possible correcting option to reduce accommodation and binocular dysfunction of pre-presbyopes [34][35][36][37][38][39]. However, the ability of multifocal soft contact lenses as a successful treatment option for ocular asthenopia varies, and is not entirely understood [40,41].…”

Visual performance with multifocal lenses in young adults and presbyopes

“…The extent to which MCLs interact with accommodation has been explored in some studies. Petterson et al [ 19 ] found similar accommodation in pre-presbyopic adults when subjects were wearing bifocal center-distance corrections as compared to their lag with single vision lenses, suggesting that young subjects do not relax their accommodation with multifocal aspheric contact lenses. However, this is in contrast with the results of a study on accommodation dynamics with induced spherical aberration (using adaptive optics), which showed that accommodative lag is modulated differently by the presence of positive spherical aberration (equivalent to center- distance add) or negative spherical aberration (equivalent to center-near add) [ 20 ].…”

Accommodative response in various design soft contact lens wearers

“…This process ensures that a patient is able to see clearly both at distance and near (Benjamin 2006). However, 8% of children and young adults have accommodation dysfunctions, which is regarded as one aspect of myopization process in children (Pettersson et al 2011). Accommodation errors which occur in the event of the accommodative lag place the focus behind the fixation point, leading thus to accommodative insufficiency.…”