Visual performance and high-order aberrations with different contact lens prototypes with potential for myopia control

Abstract

Purpose: Contact lenses (CLs) used for myopia control incorporate variable power distribution across the optic zone potentially creating degradation of the high-order aberrations. The present study aims to evaluate the retinal image quality and visual performance in three prototypes of CLs intended to control axial elongation of the eye before they are considered for clinical trials. Methods: This is a non-dispensing cross-over, double-blind study where 30 right eyes of myopic subjects worn 3 multifocal test lenses and 1 monofocal control lens in random order. Lens 1 was a radial refractive gradient design (center distance) and Lens 2 and 3 center-near with an additional annular ring for near. Nominal add power was 2.00D, 1.50D, and 2.00D, respectively. Subjects had an age 21.96 +/- 2.23 years [18-30] and mean spherical equivalent refraction M = -2.23 +/- 1.50D [-0.75 to -5.50] with refractive astigmatism below -0.75D. Higher-order aberrations (HOA), glare formation (halo), high- and low-contrast LogMAR visual acuity (VA), and contrast sensitivity function (CSF) was measured under monocular conditions. Results: All individual terms of HOA and total root mean square from 3rd to 8th order increased significantly with the 3 test lenses compared to control. Between test lenses, Lens 1 increased significantly the higher HOA compared with Lens 2 and Lens 3. Halo size was significantly larger with test lenses compared with control, with Lens 1 showing the largest. VA under high-contrast conditions was similar for all lenses. Under low-contrast conditions, Lens 1 and Lens 2 performed significantly worse than control (Bonferroni post hoc correction, p < 0.001). CSF was below normal limits with Lens 1 for 3 and 6 cpd spatial frequency but was not significantly different between test lenses and control. Conclusions: Lenses with larger stabilized areas for distance vision interfere less with VA and induce lower values of HOA and image degradation.