Schulle Krystal L, Berntsen David A, Sinnott Loraine T, Bickle Katherine M, Gostovic Anita T, Pierce Gilbert E, Jones-Jordan Lisa A, Mutti Donald O, Walline Jeffrey J
University of Houston College of Optometry, Houston, Texas.
The Ohio State University College of Optometry, Columbus, Ohio *
Optom Vis Sci. 2018 Apr;95(4):292-298. doi: 10.1097/OPX.0000000000001207.
Practitioners fitting contact lenses for myopia control frequently question whether a myopic child can achieve good vision with a high-add multifocal. We demonstrate that visual acuity is not different than spectacles with a commercially available, center-distance soft multifocal contact lens (MFCL) (Biofinity Multifocal "D"; +2.50 D add).
To determine the spherical over-refraction (SOR) necessary to obtain best-corrected visual acuity (BCVA) when fitting myopic children with a center-distance soft MFCL.
Children (n = 294) aged 7 to 11 years with myopia (spherical component) of -0.75 to -5.00 diopters (D) (inclusive) and 1.00 D cylinder or less (corneal plane) were fitted bilaterally with +2.50 D add Biofinity "D" MFCLs. The initial MFCL power was the spherical equivalent of a standardized subjective refraction, rounded to the nearest 0.25 D step (corneal plane). An SOR was performed monocularly (each eye) to achieve BCVA. Binocular, high-contrast logMAR acuity was measured with manifest spectacle correction and MFCLs with over-refraction. Photopic pupil size was measured with a pupilometer.
The mean (±SD) age was 10.3 ± 1.2 years, and the mean (±SD) SOR needed to achieve BCVA was OD: -0.61 ± 0.24 D/OS: -0.58 ± 0.27 D. There was no difference in binocular high-contrast visual acuity (logMAR) between spectacles (-0.01 ± 0.06) and best-corrected MFCLs (-0.01 ± 0.07) (P = .59). The mean (±SD) photopic pupil size (5.4 ± 0.7 mm) was not correlated with best MFCL correction or the over-refraction magnitude (both P ≥ .09).
Children achieved BCVA with +2.50 D add MFCLs that was not different than with spectacles. Children typically required an over-refraction of -0.50 to -0.75 D to achieve BCVA. With a careful over-refraction, these +2.50 D add MFCLs provide good distance acuity, making them viable candidates for myopia control.
为控制近视而验配隐形眼镜的从业者常常会问，近视儿童佩戴高附加度数的多焦点隐形眼镜能否获得良好视力。我们证明，使用市售的中心距软性多焦点隐形眼镜（MFCL）（Biofinity Multifocal “D”；附加度数为+2.50 D）时，视力与佩戴框架眼镜并无差异。
确定为近视儿童验配中心距软性MFCL时，获得最佳矫正视力（BCVA）所需的球镜过矫量（SOR）。
对年龄在7至11岁、近视（球镜成分）度数为-0.75至-5.00屈光度（D）（含）且柱镜度数为1.00 D或更低（角膜平面）的294名儿童双眼验配附加度数为+2.50 D的Biofinity “D” MFCL。初始MFCL度数为标准化主观验光的球镜等效度数，四舍五入至最接近的0.25 D步长（角膜平面）。单眼（每只眼睛）进行SOR以达到BCVA。使用明显的框架眼镜矫正和带有过矫的MFCL测量双眼高对比度的对数视力表视力。使用瞳孔计测量明视瞳孔大小。
平均（±标准差）年龄为10.3±1.2岁，达到BCVA所需的平均（±标准差）SOR为右眼：-0.61±0.24 D/左眼：-0.58±0.27 D。框架眼镜（-0.01±0.06）和最佳矫正MFCL（-0.01±0.07）之间的双眼高对比度视力（对数视力表）无差异（P = .59）。平均（±标准差）明视瞳孔大小（5.4±0.7 mm）与最佳MFCL矫正或过矫量均无相关性（P均≥.09）。
儿童佩戴附加度数为+2.50 D的MFCL获得的BCVA与佩戴框架眼镜时无异。儿童通常需要-0.50至-0.75 D的过矫量才能达到BCVA。通过仔细的过矫，这些附加度数为+2.50 D的MFCL可提供良好的远视力，使其成为控制近视的可行选择。
