title: Short-Term Adaptation of Accommodative Responses in Myopes Fitted With Multifocal Contact Lenses.
abstract: OBJECTIVE
  To investigate whether adaptation of accommodative responses occurred in non-presbyopic myopes fitted with four multifocal contact lens (MFCL) designs.
  
  
  METHODS
  Prospective, subject-masked clinical investigation comprising 40 experienced myopic lens wearers (18-25 years) fitted bilaterally with single-vision (SV) control lens (Air Optix Aqua [Alcon, Fort Worth, TX]) and randomized to two of four test MFCL (Proclear MFCL [Distance and Near] [CooperVision, Pleasanton, CA], Air Optix Aqua MFCL, Purevision MFCL [Bausch & Lomb, Rochester, NY]). Lenses were dispensed on a daily wear basis and worn for a minimum of 8 (maximum 14) days over three assessment visits, with a 1-week wash out between stages. Paraxial curvature matched spherical equivalent (M) was measured with lenses on eye using the BHVI-EyeMapper with an internal movable fixation target positioned at target vergences of +1.00 diopter (D) (fogging) and -2.00 to -5.00 in 1.00 D steps (accommodative stimuli). Accommodative facility was assessed by several flips of ±2.00 D/min (cycles/min) at 33 cm and horizontal phoria with a Howell phoria card at distance (3 m) and near (33 cm).
  
  
  RESULTS
  For center-distance MFCL (Proclear D), the spherical equivalent (M) at all near vergences became significantly more negative at the follow-up visits compared with the dispensing visit (P<0.029). For all center-near MFCLs and SV lens, M remained invariant during the adaptation period, however (P≥0.267). At distance, M became significantly less minus with Air Optix Aqua MFCL over time (P=0.049). Accommodative facility increased over the three assessment visits for participants wearing Air Optix Aqua SV, Air Optix Aqua MFCL, and PureVision MFCL (P=0.003). Distance and near horizontal phoria remained stable over the three assessment visits for all lens types (P≥0.181).
  
  
  CONCLUSIONS
  Adaptation differences were not consistently found for static accommodative measures gauged by M, as measured with lenses on eye, and phoria but were found in dynamic measures (facility), perhaps indicating some learning effects. Accommodative adaptation seems unlikely to occur with long-term MFCL in non-presbyopes.
authors.affiliation: Brien Holden Vision Institute (J.O., C.F., J.C., V.T., R.C.B.), Sydney, Australia; and School of Optometry and Vision Science (J.O., R.C.B.), University of New South Wales, Sydney, Australia.
authors.forename: Jerome
authors.initials: J
authors.lastname: Ozkan
authors.forename: Cathleen
authors.initials: C
authors.lastname: Fedtke
authors.forename: Jiyoon
authors.initials: J
authors.lastname: Chung
authors.forename: Varghese
authors.initials: V
authors.lastname: Thomas
authors.forename: Ravi Chandra
authors.initials: RC
authors.lastname: Bakaraju
mesh_terms: D000065:Accommodation, Ocular / Q000502:physiology*; D000328:Adult; D003263:Contact Lenses, Hydrophilic; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D008297:Male; D009216:Myopia / Q000503:physiopathology / Q000534:rehabilitation*; D011446:Prospective Studies; D014792:Visual Acuity / Q000502:physiology; D055815:Young Adult