The Effects of Center-Near and Center-Distance Multifocal Contact Lenses on Peripheral Defocus and Visual Acuity

Purpose: Multifocal soft contact lenses (MFCLs) are being used for myopia control. This project compares four commercially-available MFCLs (one center-near design and three center-distance designs) to determine their effect on high-contrast and low-contrast logMAR visual acuity (HCVA/LCVA) and changes in retinal defocus along the horizontal meridian of myopic eyes. Methods: Two cohorts of twenty-five non-presbyopic myopic adults (-0.50 to -6.00 D spherical equivalent (SE) myopia and < 1.00 D cylinder) were enrolled. Cohort 1 was fitted with Proclear D and Biofinity D MFCL (center-distance, +2.50D add) and cohort 2 with NaturalVue MFCL (center-distance) and Clariti 1-Day MFCL (center-near, high add), in random order. Visual acuity was optimized with spherical over-refraction. HCVA and LCVA were obtained with each lens and with SE spectacle correction. Cycloplegic autorefraction was performed with each lens and without along the line of sight and at nasal and temporal retinal locations. Data were analyzed with repeated-measures ANOVAs and post-hoc t-tests, when indicated. Results: Compared to SE spectacle correction, Clariti 1-Day MFCL reduced HCVA (1.5 lines) and LCVA (2 lines), and NaturalVue MFCL reduced LCVA (1 line; all P < .05) with no other reductions with the other MFCLs tested. Changes in defocus at each retinal location differed between MFCL designs (lens x location; both P < .0001). The Clariti 1-Day MFCL caused hyperopic changes at multiple peripheral locations (all P < .05). The NaturalVue MFCL caused myopic changes centrally and hyperopic changes at 40° nasal and 30° temporal (all P < .05). The Proclear D and Biofinity D MFCLs caused myopic changes at multiple peripheral locations (all P < .05). Conclusion: The center-near Clariti 1-Day MFCL significantly reduced both HCVA and LCVA and caused hyperopic changes in defocus at multiple peripheral locations, limiting its potential use for myopia control. The center-distance MFCLs did not affect HCVA, but some designs reduced LCVA. Both the Biofinity D and Proclear D caused myopic changes in retinal defocus. The NaturalVue MFCL caused myopic defocus changes centrally but hyperopic changes in the far periphery. Whether differences in center-distance defocus profiles influence the ability to slow myopia progression needs further investigation.