title: Short-term comparison between extended depth-of-focus prototype contact lenses and a commercially-available center-near multifocal.
abstract: OBJECTIVE
  To compare the visual performance of prototype contact lenses which extend depth-of-focus (EDOF) by deliberate manipulation of multiple higher-order spherical aberration terms and a commercially-available center-near lens (AIR OPTIX Aqua Multifocal, AOMF).
  
  
  METHODS
  This was a prospective, cross-over, randomized, single-masked (participant), short-term clinical trial where 52 participants (age 45-70 years) were stratified as low, medium or high presbyopes and wore EDOF and AOMF on different days. Objective measures comprised high and low contrast visual acuity (HCVA/LCVA, logMAR), and contrast sensitivity (log units) at 6m; HCVA at 70cm, 50cm and 40cm and stereopsis (seconds of arc) at 40cm. HCVA at 70cm, 50cm and 40cm were measured as "comfortable acuity" rather than conventional resolution acuity. Subjective measures comprised clarity-of-vision and ghosting at distance, intermediate and near, overall vision satisfaction and ocular comfort (1-10 numeric rating scale) and lens purchase (yes/no response). Statistical analysis included repeated measures ANOVA, paired t-tests and McNemar's test.
  
  
  RESULTS
  Significant differences between lens types were independent of strata (p≥0.119). EDOF was significantly better than AOMF for HCVA at 40cm (0.42±0.18 vs. 0.48±0.22, p=0.024), stereopsis (98±88 vs. 141±114, p<0.001), clarity-of-vision at intermediate (8.5±1.6 vs. 7.7±1.9, p=0.006) and near (7.3±2.5 vs. 6.2±2.5, p=0.005), lack-of-ghosting (p=0.012), overall vision satisfaction (7.5±1.7 vs. 6.4±2.2, p<0.001) and ocular comfort (9.0±1.0 vs. 8.3±1.7, p=0.002). Significantly more participants chose to only-purchase EDOF (33% vs. 6%, p=0.003).). There were no significant differences between lens types for any objective measure at 6m or clarity-of-vision at distance (p≥0.356).
  
  
  CONCLUSIONS
  EDOF provides better intermediate and near vision performance in presbyopes than AOMF with no difference for distance vision during short-term wear.
authors.affiliation: The Brien Holden Vision Institute, Sydney, NSW 2052, Australia; School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Tilia
authors.affiliation: The Brien Holden Vision Institute, Sydney, NSW 2052, Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Munro
authors.affiliation: The Brien Holden Vision Institute, Sydney, NSW 2052, Australia.
authors.forename: Jiyoon
authors.initials: J
authors.lastname: Chung
authors.affiliation: The Brien Holden Vision Institute, Sydney, NSW 2052, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Sha
authors.affiliation: The Brien Holden Vision Institute, Sydney, NSW 2052, Australia.
authors.forename: Shona
authors.initials: S
authors.lastname: Delaney
authors.affiliation: The Brien Holden Vision Institute, Sydney, NSW 2052, Australia.
authors.forename: Danny
authors.initials: D
authors.lastname: Kho
authors.affiliation: The Brien Holden Vision Institute, Sydney, NSW 2052, Australia.
authors.forename: Varghese
authors.initials: V
authors.lastname: Thomas
authors.affiliation: The Brien Holden Vision Institute, Sydney, NSW 2052, Australia; School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Klaus
authors.initials: K
authors.lastname: Ehrmann
authors.affiliation: The Brien Holden Vision Institute, Sydney, NSW 2052, Australia; School of Optometry and Vision Science, The University of New South Wales, Sydney, NSW 2052, Australia. Electronic address: r.bakaraju@brienholdenvision.org.
authors.forename: Ravi Chandra
authors.initials: RC
authors.lastname: Bakaraju
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D003263:Contact Lenses, Hydrophilic; D015350:Contrast Sensitivity / Q000502:physiology; D018592:Cross-Over Studies; D003867:Depth Perception / Q000502:physiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011305:Presbyopia / Q000534:rehabilitation*; D011446:Prospective Studies; D011474:Prosthesis Design; D012029:Refraction, Ocular / Q000502:physiology; D014792:Visual Acuity / Q000502:physiology
keywords: Aberraciones de alto orden; Desempeño visual; Extended depth of focus contact lenses; Higher order aberrations; Lentes de contacto con profundidad de campo extendida; Lentillas multifocales; Multifocal contact lenses; Presbicia; Presbyopia; Visual performance