title: Combined Effect of Ocular and Multifocal Contact Lens Induced Aberrations on Visual Performance: Center-Distance Versus Center-Near Design.
abstract: OBJECTIVE
  To evaluate the combined effects of inherent ocular aberrations and induced aberrations with a multifocal soft contact lens (MFCL) after 15 days of lens wear in presbyopic participants and their influence on visual performance at distance and near under high and low contrast conditions.
  
  
  METHODS
  Forty presbyopic participants (mean age, 48.7±3.4) presenting a mean addition of 1.53±0.58 D were fitted with Biofinity Multifocal (CooperVision) and included in the study. Measurements comprised distance and near monocular high (100%) and low contrast (10%) logMAR visual acuity (VA). Ocular aberrations were obtained with Hartmann-Shack aberrometer (IRX3, Imagine Eyes) and analyzed for 2 mm and maximum round natural pupil.
  
  
  RESULTS
  Distance VA was significantly higher in dominant eye, whereas near VA was significantly better in the non-dominant eye (P<0.05 in all conditions). For a 2-mm pupil in the dominant eye fitted with MFCL, spherical-like aberration significantly increased (P=0.027) so as higher-order aberrations (HOA) (P=0.002). A significant increase was also observed in spherical-like aberrations (P=0.001), coma-like aberrations (P=0.006) and HOA (P=0.004) in non-dominant eye. For the maximum round natural pupil size, a significant decrease in vertical coma was observed (P=0.018) in dominant eye, whereas a significant increase in spherical-like (P<0.001) and coma-like aberrations (P=0.007) was observed in non-dominant eye. A negative significant correlation was found between vertical coma and high contrast VA (Rho=-0.405, P=0.011) in dominant eye; whereas in non-dominant eye, a significant correlation was found between induced secondary astigmatism and distance VA under high (Rho=0.556, P<0.001) and low contrast (Rho=0.448, P=0.005).
  
  
  CONCLUSIONS
  On-eye visual performance of MFSCL is dependent on the high-order aberrations induced by dominant and non-dominant design coupled with the wearer's inherent aberrations.
authors.affiliation: Clinical and Experimental Optometry Research Laboratory (CEORLab), Department of Physics (Optometry), School of Sciences, University of Minho, Gualtar, Braga, Portugal.
authors.forename: Daniela
authors.initials: D
authors.lastname: Lopes-Ferreira
authors.forename: Paulo
authors.initials: P
authors.lastname: Fernandes
authors.forename: António
authors.initials: A
authors.lastname: Queirós
authors.forename: José M
authors.initials: JM
authors.lastname: González-Meijome
mesh_terms: D003263:Contact Lenses, Hydrophilic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011305:Presbyopia / Q000503:physiopathology / Q000628:therapy*; D011474:Prosthesis Design; D011680:Pupil; D012029:Refraction, Ocular / Q000502:physiology*; D014792:Visual Acuity