Efficacy of Toric Contact Lenses in Fitting and Patient-Reported Outcomes in Contact Lens Wearers

Abstract

TCLs are a good option when trying to improve the vision of patients with low-to-moderate astigmatism given the subjective improvements in outcomes.

A Randomized Trial to Evaluate the Effect of Toric Versus Spherical Contact Lenses on Vision and Eyestrain

“…These improved subjective scores demonstrate that the subjects within this study preferred toric contact lenses to spherical contact lenses at follow-up. 13 Although improvement with toric contact lenses is not reflected in the electromyography recordings at the follow-up visit, this lack of sustained electromyography improvement at follow-up is consistent with the hypothesis that subjects adapted to the reduced image quality caused by uncorrected astigmatism resulting in less eyestrain/squinting when wearing spherical contact lenses despite still noting a difference between lens types. Both subjective refractive quality of life and objective visual acuity favored toric over spherical contact lenses at follow-up, demonstrating that astigmatic patients benefitted from toric contact lenses even if no difference in eyestrain was detected at the follow-up visit.…”

“…These electromyography results should also be considered in context with the high- and low-contrast visual acuity data and subjective questionnaire data that we previously reported. 13 Although the improvements in both high- and low-contrast visual acuities with toric contact lenses versus spherical contact lenses were consistent at both the fitting visit and the follow-up visit, the electromyography root mean squared data only showed significantly reduced eyestrain at the fitting visit. The National Eye Institute Refractive Error Quality of Life questionnaire global score, the clarity of vision subscale score and satisfaction with correction subscale score all showed subjective improvements with toric (74.9±10.5, 75.7±46.0, 79.7±15.5, respectively) versus spherical contact lenses (67.6±14.4, 50.1±31.7, 62.0±28.9, respectively) at the follow-up visit.…”

“…A full description of the sample size calculation can be found in the article outlining these results. 13 The study was closed upon reaching our sample size goal of having 60 subjects complete all study visits, per protocol.…”

Comparing spectacle and toric contact lens prescribing trends for astigmatism

“… 9 One drawback of studies of induced astigmatism is that the described effects are associated with the short-term experience of astigmatism. However, these findings are consistent with the clinical signs and symptoms of uncorrected refractive errors in real patient populations 10 and so the results are likely to be indicative of real experience. Not correcting the astigmatism of patients with real astigmatism has been found to result in poorer visual outcomes.…”

“…Not correcting the astigmatism of patients with real astigmatism has been found to result in poorer visual outcomes. 10 Toric CL correction has been found to result in better visual acuity 11 – 13 than spherical CL correction in people with astigmatism. Further, validated patient-reported outcome measures such as the National Eye Institute Refractive Error Quality of Life Instrument (overall score and clarity of vision) 10 and Convergence Insufficiency Symptoms Survey 10 also show better outcomes for toric over spherical CL correction in people with astigmatism.…”