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Early symptomatic presbyopes - what correction modality works best?

Woods, Jill, Woods, Craig A. and Fonn, Desmond 2009, Early symptomatic presbyopes - what correction modality works best?, Eye and contact lens, vol. 35, no. 5, pp. 221-226, doi: 10.1097/ICL.0b013e3181b5003b.

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Title Early symptomatic presbyopes - what correction modality works best?
Author(s) Woods, Jill
Woods, Craig A.
Fonn, Desmond
Journal name Eye and contact lens
Volume number 35
Issue number 5
Start page 221
End page 226
Total pages 6
Publisher Lippincott Williams & Wilkins
Place of publication Philadelphia, Pa.
Publication date 2009-09
ISSN 1542-233X
1542-2321
Keyword(s) presbyopia
multifocal
monovision
soft contact lens
performance
subjective ratings
Summary Purpose: To compare the performance of a low-addition silicone hydrogel multifocal soft lens with other soft lens correction options in a group of habitual soft lens wearers of distance correction who are symptomatic of early presbyopia.

Method: This clinical study was designed as a prospective, double-masked, randomized, crossover, dispensing trial consisting of four 1-week phases, one for each of the correction modalities: a low-addition silicone hydrogel multifocal soft lens, monovision, habitual correction, and optimized distance visual correction. The prescriptions of all modalities were finalized at a single fitting visit, and the lenses were worn according to a randomized schedule. All lenses were made from lotrafilcon B material. A series of objective vision tests were conducted: high- and low-contrast LogMAR under high- and low-room lighting conditions, stereopsis, and critical print size. A number of other data collection methods used were novel: some data were collected under controlled laboratory-based conditions and others under real-world conditions, some of which were completed on a BlackBerry hand-held communication device.

Results: All participants were able to be fit with all four correction modalities. Objective vision tests showed no statistical difference between the lens modalities except in the case of low-contrast near LogMAR acuity under low-lighting levels where monovision (+0.29 ± 0.10) performed better than the multifocal (+0.33 ± 0.11, P=0.027) and the habitual (+0.37 ± 0.12, P<0.001) modalities. Subjective ratings indicated a statistically better performance provided by the multifocal correction compared with monovision, particularly for the vision associated with driving tasks such as driving during the daytime (93.3 ± 8.8 vs. 84.2 ± 23.7, P=0.05), at nighttime (88.8 ± 11.7 vs. 74.9 ± 23.6, P=0.001), any associated haloes or glare (92.0 ± 10.6 vs. 78.0 ± 22.8, P=0.003), and observing road signs (90.1 ± 11.8 vs. 79.4 ± 20.2, P=0.027). Preference for the multifocal compared with monovision was also reported when watching television (95.0 ± 6.4 vs. 82.6 ± 20.1, P=0.001) and when changing focus from distance to near (87.0 ± 13.4 vs. 66.1 ± 32.2, P<0.001).

Conclusions: For this group of early presbyopes, the AIR OPTIX AQUA MULTIFOCAL-Low Add provided a successful option for visual correction, which was supported by the results of subjective ratings, many of which were made during or immediately after performing such activities as reading, using a computer, watching television, and driving. These results suggest that making a prediction of success or not based on consulting room acuity tests alone is probably unwise.
Language eng
DOI 10.1097/ICL.0b013e3181b5003b
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2009, Lippincott Williams & Wilkins
Persistent URL http://hdl.handle.net/10536/DRO/DU:30047474

Document type: Journal Article
Collection: School of Medicine
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