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Gregory, Hannah R. BS; Nti, Augustine N. OD; Wolffsohn, James S. PhD, FAAO; Berntsen, David A. OD, PhD, FAAO; Ritchey, Eric R. OD, PhD, FAAO

Visual Performance of Center-distance Multifocal Contact Lenses Fit Using a Myopia Control Paradigm

publication date
December 27, 2020
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With multifocal contact lenses (MFCLs) used for myopia control, questions remain regarding visual performance. Information from nonpresbyopic patients provides insight into how MFCLs affect visual acuity and reading performance.



The purpose of this study was to examine the visual performance of center-distance MFCLs in nonpresbyopic adults under different illumination and contrast conditions compared with a single-vision contact lens (SVCL).



Twenty-five adult subjects were fit with three different lenses (CooperVision Biofinity D MFCL +2.50 add, Visioneering Technologies NaturalVue MFCL, CooperVision Biofinity sphere). Acuity and reading performance were evaluated



A statistically significant difference in high-contrast distance acuity was observed (Biofinity, −0.18 ± 0.06; Biofinity MFCL, −0.14 ± 0.08; NaturalVue MFCL, −0.15 ± 0.03; repeated-measures [RM] ANOVA, P = .02). Under mesopic, high-contrast conditions, MFCLs performed worse than SVCLs (Biofinity, −0.05 ± 0.091; Biofinity MFCL, +0.03 ± 0.09; NaturalVue MFCL, +0.05 ± 0.091; RM-ANOVA, P < .0001). Under low-contrast conditions, MFCLs performed one line worse in photopic lighting and two lines worse under mesopic conditions (RM-ANOVA, P < .0001). Glare reduced acuity by 0.5 logMAR for all lenses (RM-ANOVA, P < .001). A statistically significant difference in near acuity was observed (RM-ANOVA, P = .02), but all lenses achieved acuity better than −0.1 logMAR (Biofinity, −0.16 ± 0.06; Biofinity MFCL, −0.17 ± 0.04; NaturalVue MFCL, −0.13 ± 0.08). Reading performance in words per minute (wpm) was worse with MFCLs (Biofinity MFCL, 144 ± 22 wpm; NaturalVue MFCL, 150 ± 28 wpm) than with SVCLs (156 ± 23 wpm; RM-ANOVA, P = .02) regardless of letter size (RM-ANOVA, P = .13). No difference in acuity between the MFCLs was detected (RM-ANOVA: all, P > .05).



Multifocal contact lenses perform similarly to SVCLs for high-contrast targets and display reduced low-contrast acuity and reading speed. Practitioners should recognize that high-contrast acuity alone does not describe MFCL visual performance.


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