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Visual Performance of Four Simultaneous-Image Multifocal Contact Lenses Under Dim and Glare Conditions

García-Lázaro, Santiago Ph.D.; Ferrer-Blasco, Teresa Ph.D.; Madrid-Costa, David Ph.D.; Albarrán-Diego, César M.Sc.; Montés-Micó, Robert Ph.D.

Eye & Contact Lens: Science & Clinical Practice: January 2015 - Volume 41 - Issue 1 - p 19–24
doi: 10.1097/ICL.0000000000000060

Objective: To assess and compare the effects of four simultaneous-image multifocal contact lenses (SIMCLs), and those with distant-vision–only contact lenses on visual performance in early presbyopes, under dim conditions, including the effects of induced glare.

Methods: In this double-masked crossover study design, 28 presbyopic subjects aged 40 to 46 years were included. All participants were fitted with the four different SIMCLs (Air Optix Aqua Multifocal [AOAM; Alcon], PureVision Multifocal [PM; Bausch & Lomb], Acuvue Oasys for Presbyopia [AOP; Johnson & Johnson Vision], and Biofinity Multifocal [BM; CooperVision]) and with monofocal contact lenses (Air Optix Aqua, Alcon). After 1 month of daily contact lens wearing, each subject's binocular distance visual acuity (BDVA) and binocular distance contrast sensitivity (BDCS) were measured using the Functional Visual Analyzer (Stereo Optical Co., Inc.) under mesopic conditions (3 candela [cd]/m2) both with no glare and under the 2 levels of induced glare: 1.0 lux (glare 1) and 28 lux (glare 2).

Results: Among the SIMCLs, in terms of BDVA, AOAM and PM outperformed BM and AOP. All contact lenses performed better at level without glare, followed by Glare 1, and with the worst results obtained under glare 2. Binocular distance contrast sensitivity revealed statistically significant differences for 12 cycles per degree (cpd). Among the SIMCLs, post hoc multiple comparison testing revealed that AOAM and PM provided the best BDCS at the three luminance levels. In both cases, BDVA and BDCS at 12 cpd, monofocal contact lenses outperformed all SIMCL ones at all lighting conditions.

Conclusions: Air Optix Aqua Multifocal and PM provided better visual performance than BM and AOP for distance vision with low addition and under dim conditions, but they all provide worse performance than monofocal contact lenses.

Optometry Research Group (GIO), Department of Optics, University of Valencia, Valencia, Spain.

Address correspondence to Santiago García-Lázaro, Ph.D., Optometry Research Group, Department of Optics, Faculty of Physics, University of Valencia, C/Dr Moliner, 50, 46100 Burjassot (Valencia), Spain; e-mail:

The authors have no funding or conflicts of interest to disclose.

Accepted May 21, 2014

© 2015 Contact Lens Association of Ophthalmologists, Inc.