Purpose

To evaluate the efficacy of multifocal soft contact lenses to reduce asthenopic symptoms in myopes with accommodative lag.

Methods

Twenty-four myopic participants, aged 18–35 years, with mean spherical equivalent (MSE) of ≤ -0.75D, were recruited in a randomised, double-blind crossover study. All participants were existing contact lens wearer with near orthophoria or esophoria, presenting with subjective asthenopic symptoms at baseline [Convergence Insufficiency Symptom Survey (CISS) score ≥ 21] and a lag of accommodation ≥ +0.75 D. All participants were initially fitted with single vision contact lenses for a one month period. Participants were then randomly assigned 1:1 to wear low add or high add multifocal soft contact lenses for a further month. After this period, the groups were reversed. Data were collected at baseline and following one month’s wear of each lens. Change in CISS score was evaluated as the primary outcome measure, while secondary outcome measures were changes in accommodative lag and heterophoria status.

Results

Baseline CISS score was (mean ± SD) 25.04 ± 4.58. Post-intervention scores were as follows: single vision: 24.46 ± 4.59, low add: 12.17 ± 6.89, high add: 13.71 ± 7.23. Both low add and high add multifocal soft contact lens wear was associated with an improvement in CISS score compared to baseline CISS and single vision (all p < 0.01). No significant difference was found between the CISS score for the baseline CISS and single vision (p = 1.00). No significant difference was found in lag of accommodation between lens conditions (all p > 0.05), however, there was an exophoric shift in near heterophoria between single vision and both multifocal contact lenses (low add: (mean difference 1.33 Δ, p = 0.02; high add: mean difference 1.23 Δ, p = 0.02) but not between habitual spectacle or any other modality (all p > 0.05).

Conclusions

The use of multifocal soft contact lenses for a one-month period was associated with reduced severity of asthenopic symptoms in pre-presbyopic myopes with accommodative lag. Whilst improvement of symptoms does not appear to be mediated by a significant reduction in accommodative lag, changes in heterophoria may play a role in reducing asthenopic symptoms.

中文翻译：

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多焦点软性隐形眼镜缓解调节滞后性近视眼疲劳症状的疗效

目的

评估多焦点软性隐形眼镜在减轻调节滞后性近视患者的虚弱症状方面的疗效。

方法

在一项随机、双盲交叉研究中招募了 24 名年龄在 18-35 岁、平均球面当量 (MSE) ≤ -0.75D 的近视参与者。所有参与者都是现有的隐形眼镜佩戴者，有近正斜视或内视斜视，在基线时出现主观虚弱症状 [会聚不足症状调查 (CISS) 评分 ≥ 21] 和调节滞后 ≥ +0.75 D。所有参与者最初都配备单视隐形眼镜一个月。然后，参与者以 1:1 的比例随机分配，在一个月内佩戴低添加或高添加多焦点软性隐形眼镜。在这段时间之后，这些组被颠倒了。在基线和每个镜片佩戴一个月后收集数据。CISS评分的变化被评估为主要结果测量，

结果

基线 CISS 评分为（平均值 ± SD）25.04 ± 4.58。干预后得分如下：单视：24.46±4.59，低附加：12.17±6.89，高附加：13.71±7.23。与基线 CISS 和单视相比，低添加和高添加多焦点软性隐形眼镜佩戴与 CISS 评分的改善相关（均p  < 0.01）。基线 CISS 和单视的 CISS 评分之间没有显着差异（p  = 1.00）。镜片条件之间的调节滞后没有显着差异（所有p  > 0.05），但是，单视和两种多焦点隐形眼镜之间的近隐斜视存在外隐变化（低附加：（平均差异 1.33 Δ，p  = 0.02 ; 高加：均差 1.23 Δ，p  = 0.02) 但不在习惯性奇观或任何其他形式之间 (所有p > 0.05)。

结论

使用多焦点软性隐形眼镜 1 个月与具有调节滞后的前老花眼近视患者的虚弱症状严重程度降低有关。虽然症状的改善似乎不是由调节滞后的显着减少所介导的，但隐斜视的变化可能在减轻乏力症状方面发挥作用。