Visual performance with multifocal lenses in young adults and presbyopes

PLoS One. 2022 Mar 17;17(3):e0263659. doi: 10.1371/journal.pone.0263659. eCollection 2022.

Abstract

A better understanding of visual performance with Multifocal Contact Lenses (MCLs) is essential, both in young eyes, where MCLs may be prescribed to control the progression of myopia wherein the MCLs optics interact with accommodation, and in presbyopes, where MCLs are increasingly used to compensate the lack of accommodation. In this study, we evaluated the through focus visual acuity (TFVA) with center-near MCLs of three additions (low, medium and high) and without an addition (NoLens) in 10 young adults and 5 presbyopes. We studied the effect of accommodation, age and pupil diameter (in cyclopleged subjects) on visual performance. The MCLs produced a small but consistent degradation at far (by 0.925 logMAR, averaged across eyes and conditions) and a consistent benefit at near in young subjects with paralyzed accommodation (by 1.025 logMAR), and in presbyopes with both paralyzed and natural accommodation (by 1.071 logMAR, on average). TFVA in young adults with NoLens and all MCLs showed statistically significant differences (Wilcoxan, p<0.01) between natural and paralyzed accommodation, but not in presbyopes with MCLs. In young adults, VA improved with increasing pupil diameter with the HighAdd MCL (0.08 logMAR shift from 3 to 5-mm pupil size). Visual imbalance (standard deviation of VA across distances) was reduced with MCLs, and decreased significantly with increasing near add. The lowest imbalance occurred in young adults under natural accommodation and was further reduced by 13.33% with MCLs with respect to the NoLens condition. Overall, the visual performance with MCLs in young adults exceeds that in presbyopes at all distances, and was better than 0.00 logMAR over the dioptric range tested. In conclusion, the center-near lenses do not degrade the near high contrast visual acuity significantly but maintains the far vision in young adults, and produce some visual benefit at near in presbyopes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Accommodation, Ocular
  • Eyeglasses
  • Humans
  • Presbyopia* / therapy
  • Pupil
  • Refraction, Ocular*
  • Young Adult

Grants and funding

This research has received funding from the European Union’s Horizon 2020 Research and Innovation Program, MyFun under the Marie Sklodowska-Curie grant agreement SV, and H2020-MSCA-IF-GF-2019-MYOMICRO-893557 to MV, under the Marie Sklodowska-Curie grant agreement; European Research Council ERC-2019 SILK-EYE & Spanish Government: FIS2019-84753-R to SM; NEI P35 and the Unrestricted Funds Research to Prevent Blindness, NY.