Corneal Wavefront Aberrations in Patients Wearing Multifocal Soft Contact Lenses for Myopia Control

Purpose: The purpose of this study was to evaluate the change in corneal wavefront aberrations in young adults who have been fit with multifocal soft contact lenses for myopia progression control. Findings have been analyzed for statistical significance and clinical relevance and compared to reportedly successful Orthokeratology outcomes. Methods: The dominant eye of 40 participants (27 women, 13 men;mean age 27.3 ± 3.2 years;range 23 to 39 years) was fit with Proclear Multifocal center distance lenses (Coopervision, Pleasanton, USA) having a variety of distance powers and reading additions. Refractive errors were limited to a range of –6.00 D up to +1.00 D of sphere, and no greater than –1.00 D of cylinder. Corneal wavefront measurements were performed over 6 mm diameters with a Zeiss Atlas 9000 corneal topographer (Zeiss Meditec, Dublin, USA) prior to, and following lens fitting. Data were converted into rectangular Fourier optics terms M, J0, J45 and RMS values for each reading addition were statistically analyzed. Following evaluation of statistical significance and clinical relevance, results were compared to published data from successful Orthokeratology treatments. Results: Statistically significant changes in higher order aberrations were detected for lenses of all reading additions. Lens groups with higher Add-powers demonstrated stronger changes with increased significance. Final RMS values relating to 2nd, 3rd and 4th Zernike Orders reached clinical significance with a wavefront error of 0.10 μm, the equivalent of 0.25D. Moreover, as Add-powers increased, 3rd and 4th order aberrations likewise showed an increase. Pre-fitting astigmatism values accounted for the highest recorded aberrations and remained predominantly unchanged. Conclusion: Proclear Multifocal center-distance contact lenses were found to increase higher order wavefront aberrations in a manner dependent on their Add-power. In comparison to successful Orthokeratology outcomes, the amounts of resulting aberrations are notably different.

Is the Use of Empirically Designed Custom Soft Contact Lenses a Good Option for Challenging Patients?

Purpose: Reasons for the lack of success for contact lens patients range from poor fit, to discomfort or to a less than optimum wearing schedule. This project was a preliminary investigation of customized soft toric contact lenses as an alternative for unsuccessful contact lens patients or potential drop-outs. Methods: Fifteen healthy non-compromised, previously unsuccessful contact lens wearing patients (13 women, 2 men) with ages from 21 to 33 years (25.1 ± 2.7 years) were the subjects for this study. They were empirically fitted with 15 astigmatic and 5 spherical customized SpecialEyes soft contact lenses. Visual acuities, comfort, lens movement, and rotation were evaluated. Results: Patients fitted with customized SpecialEyes soft contact lenses had statistically significant better visual acuities than with Phoropter Manifest Refraction. The lenses used in this study centered well and moved no more than 1 mm upon each blink. Lens rotation was less than 10 degrees for all toric lenses. Patients gave very positive vision and comfort ratings. Conclusion: This preliminary study supports the application of a software program to empirically design and manufacture Special Eyes custom soft lenses based upon corneal topographical parameters and subjective manifest refraction for those patients who either have challenging corneal parameters, high sphero-cylindrical prescriptions, or are currently dissatisfied with their contact lenses and are potential drop-outs.

Optical Modeling and Analysis of Peripheral Optics of Contact Lenses

Background: Degraded peripheral vision has been hypothesized to be a stimulus for the development of foveal refractive error. Contact lenses have been widely used to correct central vision, but their impacts on peripheral vision are still unknown. The purpose of this study was to use optical model software to evaluate the peripheral optics of rigid gas permeable (RGP) and soft contact lenses (SCLs) in isolation. This will better assist us in understanding their peripheral optical performances on human eyes. Methods: An optical design software package (Zemax EE) was used to model peripheral optics of Menicon RGP lens and Acuvue 2 SCLs. Profiles of sphero-cylindrical power and major higher-order aberrations were computed in 10osteps out to 40o off-axis eccentricity for –3.0 D central focal power contact lens. The results of optical modeling were analyzed and compared with previously published experimental data. Results: –3.0 D RGP lenses and SCLs had –1.4 D and –2.0 D dioptric power at 40o eccentricity, respectively. The reduced dioptric power in the periphery of the analyzed contact lenses quantitatively matched with the reduced amount of hyperopic field curvature found from experimental data when these contact lenses fitted on human eyes. Cylindrical power increased to 0.3 D ~ 0.4 D at 40o eccentricity for both lens types. In addition, both contact lens types produced higher order aberrations, namely 1.2 μm coma and 0.15 μm spherical aberration at 40o eccentricity. Conclusions: Compared to SCLs, RGP lenses with equal focal power had less dioptric power in the periphery. Both RGP lenses and SCLs produced the same amount of major higher-order aberrations with increasing of the field angle. Some of these results can be used to predict and understand the peripheral optical performance of contact lenses on human eyes.