SEARCHRCTophthalmology, dry eye

RCT·ophthalmology, dry eye, contact lenses, presbyopia, clinical trial·PMC10636056

The influence of large-diameter multifocal contact lens on ocular surface, visual quality, and visual function for presbyopic adults with dry eye syndromes

Scientific Reports · 5 authors, 4 centres

AI SUMMARY

FIDELITY 100%

POPULATIONPresbyopic adults aged 40–55 years with dry eye syndromes (OSDI ≥ 13, DEQ-5 > 6 and < 12), refractive error myopia ≤ 8.00 D, astigmatism ≤ 1.75 D, near ADD ≥ 0.75 D

INTERVENTIONWearing large-diameter multifocal contact lenses (Proclear, SMR, or Optimum) for 6–8 hours/day for 2 weeks

COMPARISONBaseline (wearing habitual multifocal spectacles) and between lens groups

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AGENT 01 · STRUCTURED SUMMARY

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TL;DR

This study compared three large-diameter multifocal contact lenses (Proclear, SMR, Optimum) in presbyopic adults with dry eye syndromes over two weeks. While all lenses caused some negative effects on the ocular surface and tear film (e.g., increased corneal staining, reduced tear break-up time), visual quality (MTF) and subjective comfort (OSDI, VBP) improved, especially with distance-center designs (SMR and Optimum). The findings suggest that proper lens selection can benefit visual function despite transient ocular surface changes.

Full summary

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**Background:** Dry eye syndromes (DES) are common in presbyopic adults, and contact lens wear can exacerbate ocular surface issues. Large-diameter multifocal contact lenses (soft and rigid) are used to correct presbyopia, but their impact on the ocular surface, tear film, and visual quality in patients with DES is not well understood. This study aimed to evaluate the effects of three different large-diameter multifocal contact lenses on these parameters in presbyopic adults with DES.

**Methods:** A mixed two-factor design (3 groups × 4 measurements) experimental study was conducted from November 2020 to May 2021 at Chung Shan Medical University, Taiwan. 42 presbyopic adults (mean age 46.24 ± 3.88 years; 12 men, 30 women) with DES (OSDI ≥ 13, DEQ-5 > 6 and < 12) were randomly assigned to three groups: Proclear (soft, near-center design, n=12), SMR (soft, distance-center design, n=12), and Optimum (rigid gas-permeable, distance-center design, n=18). Participants wore lenses 6–8 hours/day for 2 weeks. Measurements were taken at baseline (wearing spectacles), day 1, week 1, and week 2. Ocular surface (corneal fluorescence staining, conjunctival/limbal redness using Efron Grading Scales and Oxford scale), tear quality (non-invasive tear break-up time [NI-TBUT], lipid layer thickness, contact TBUT), visual quality (blink frequency, modulation transfer function [MTF] total area and high-order aberration ratio, OSDI and VBP questionnaires), and visual function (near visual acuity, stereopsis, near point of accommodation) were assessed. Statistical analysis used two-way ANOVA with repeated measures and simple main effects.

**Key Results:** Ocular surface: Corneal fluorescence staining (F=7.235, p=0.001) and limbal redness (F=3.443, p=0.042) worsened over time, especially with Optimum (corneal: F=4.489, p=0.007; limbal: F=3.357, p=0.026), but values remained within normal range. Conjunctival redness showed no significant difference between groups. Tear quality (lens-on): NI-TBUT decreased significantly for all lenses (Proclear: F=6.177, p=0.002; SMR: F=17.132, p<0.001; Optimum: F=4.807, p=0.005). Lipid layer thickness decreased for Proclear (F=7.118, p=0.001) and SMR (F=3.778, p=0.020) but not for Optimum (F=0.291, p=0.832). Tear quality (lens-off): NI-TBUT remained worse for SMR (F=11.786, p<0.001). Lipid layer thickness improved for SMR (F=8.423, p<0.001) and Optimum (F=7.043, p<0.001). Contact TBUT improved for Optimum (F=4.860, p=0.005). Visual quality: Blink frequency (lens-on) showed no significant change (F=1.088, p=0.357); lens-off blink frequency increased for Optimum (F=7.729, p<0.001). MTF total area ratio improved significantly for all lenses (Proclear: F=71.318, p<0.001; SMR: F=13.752, p<0.001; Optimum: F=20.766, p<0.001). MTF high-order aberration ratio worsened for all lenses (Proclear: F=13.440, p<0.001; SMR: F=19.702, p<0.001; Optimum: F=20.211, p<0.001). OSDI scores improved for SMR (F=8.117, p=0.002) and Optimum (F=3.567, p=0.041). VBP scores improved for Optimum (F=3.132, p=0.047). Visual function: Near visual acuity improved for Optimum (F=3.847, p=0.015). Stereopsis showed no significant difference. Near point of accommodation worsened for Proclear (right: F=12.255, p<0.001; left: F=13.436, p<0.001) but not for SMR or Optimum.

**Clinical Implications:** Large-diameter multifocal contact lenses can be used in presbyopic adults with dry eye syndromes, but clinicians should monitor ocular surface changes, especially with rigid lenses. Distance-center designs (SMR and Optimum) may offer better subjective comfort and visual function, particularly for near vision and accommodation. The improvement in MTF total area ratio suggests enhanced visual quality despite increased high-order aberrations. Proper lens fitting and patient education are essential to minimize negative impacts on the tear film. Longer-term studies are needed to assess sustained effects.

PICO

PPOPULATION

Presbyopic adults aged 40–55 years with dry eye syndromes (OSDI ≥ 13, DEQ-5 > 6 and < 12), refractive error myopia ≤ 8.00 D, astigmatism ≤ 1.75 D, near ADD ≥ 0.75 D

IINTERVENTION

Wearing large-diameter multifocal contact lenses (Proclear, SMR, or Optimum) for 6–8 hours/day for 2 weeks

OOUTCOME

Ocular surface (corneal staining, conjunctival/limbal redness), tear quality (NI-TBUT, lipid layer, contact TBUT), visual quality (blink frequency, MTF, OSDI, VBP), visual function (near VA, stereopsis, near point of accommodation)

STUDY TYPE

RCT

SPECIALTY

ophthalmology

SUMMARISED BY

AI pipeline

FIDELITY CHECK

100% · A

ORIGINAL PAPER

PMC10636056

The influence of large-diameter multifocal contact lens on ocular surface, visual quality, and visual function for presbyopic adults with dry eye syndromes

Scientific Reports

READ THE FULL PAPER

ABSTRACT

This study investigated the influence of large-diameter multifocal contact lenses on the ocular surface, visual quality, and visual function for presbyopic adults with dry eye syndromes. The study enrolled 40–55-year-old adults with presbyopia and dry eye syndromes (DES). The subjects were randomly assigned to three groups wearing different designs of contact lenses (Proclear, SMR, and Optimum) for 6–8 h a day for two weeks. Ocular surface health, tear quality, visual quality, and visual function were measured before and after lens wear. No significant difference was observed across all three groups for the amount of conjunctival redness, blink frequency (lens on), and stereopsis vision before and after wearing. Although there seemed to be a significant declining trend for corneal staining and limbal redness, non-invasive tear break-up time (TBUT), and lipid layer thickness while lens wear, the measured values were all within the normal range. Vice-versa after lens removal, results also showed significant improvement on lipid layer thickness, blink frequency (lens off), and contact TBUT. A significant improvement was observed in the modulation transfer function (MTF) of the total area ratio after wearing contact lenses. In contrast, the MTF of the high-order aberration area ratio resulting from lens wear was lower than that of the baseline measurement. There are also significant improvements observed for SMR and Optimum regarding near visual acuity, near point of accommodation, and the subjective questionnaire (OSDI and VBP) scores. Although it is difficult to avoid a specific negative impact on the ocular surface and tear film, visual function and visual quality can still be positively improved, especially shown on larger diameter and distance-center designed multifocal contact lenses.

CITATION EXPORT

Ching-Jen Hsiao, Hsiao-Ching Tung, Chuen‐Lin Tien et al.. The influence of large-diameter multifocal contact lens on ocular surface, visual quality, and visual function for presbyopic adults with dry eye syndromes. Scientific Reports. (2023). https://doi.org/10.1038/s41598-023-46732-6

AUTHORS

5 · 4 CENTRES

Ching-Jen Hsiao, Hsiao-Ching Tung, Chuen‐Lin Tien, Yu-Wen Chang, Ching-Ying Cheng

1https://ror.org/059ryjv25grid.411641.70000 0004 0532 2041Department of Optometry, Chung Shan Medical University, Taichung, Taiwan
2https://ror.org/01abtsn51grid.411645.30000 0004 0638 9256Department of Ophthalmology, Chung Shan Medical University Hospital, Taichung, Taiwan
3Dr. Don’s Eye Clinic, Taipei, Taiwan
4https://ror.org/05vhczg54grid.411298.70000 0001 2175 4846Department of Electrical Engineering, Feng Chia University, Taichung, Taiwan