Scientific Presentations

2021

Chamberlain,P., Arumugam,B., Jones,D., Logan N., Peixoto-de-Matos S., Young G. Myopia progression in children on cessation of dual-focus contact lens wear: MiSight 1 day 7-year findings American Academy of Optometry, Boston, 2021

Guthrie S, Luensmann D, Woods J, Vega J, Orsborn G. Relationships between success factors in daily disposable multifocal lenses American Academy of Optometry, Boston, 2021 [ Show Abstract ]

PURPOSE:
To evaluate relationships between subjective responses to two daily disposable multifocal contact lenses (MFCLs), stenfilcon A (stenA-MF) and delefilcon A (delA-MF).

METHODS:
Habitual MFCL wearers participated in a prospective, randomized, subject-masked, bilateral crossover study at five optometry offices. Subjects wore each study contact lens (SCL) for 2 weeks and answered lens handling (0-10), satisfaction (1-fell short of needs; 2-met needs; 3-exceeded needs) and agreement (4-strongly agree; 3-slightly agree; 2-slightly disagree; 1-strongly disagree) questions. Responses were analyzed using Wilcoxon Matched-Pairs testing for differences between lens types. Spearman correlations were done for each lens type separately.

RESULTS:
Fifty-eight subjects (50F:8M; mean 54.4 ± 7.3 years) were included in the analysis; mean spherical-equivalent refraction OD: -1.10 ± 2.7D [-6.50D to +3.75D], add +2.00 ± 0.4D [+1.00D to +2.50D]. Subjects had greater agreement for stenA-MF compared to delA-MF for “SCL met my needs for vision” (stenA-MF: 3.3; delA-MF: 2.9; p=0.02) and for “I would like to wear SCL in the future” (stenA-MF: 2.9; delA-MF: 2.6; p=0.03). For each SCL there was a significant correlation between responses to these two questions (stenA-MF: rs=0.81; delA-MF: rs=0.84; p<0.05). For stenA-MF, “SCL met my needs for vision” was significantly correlated (p<0.05) with Day 13 (D13) end-of-day (EOD) satisfaction with comfort (rs=0.36) and dryness (rs=0.39). There were no significant correlations for delA-MF (comfort: rs=-0.06; dryness: rs=0.11; both p>0.05). Similarly, for stenA-MF, “I would like to wear SCL in the future” was significantly correlated (p<0.05) with D13 EOD satisfaction with comfort (rs=0.46) and dryness (rs=0.41). Again, there were no significant correlations for delA-MF (comfort: rs=0.03; dryness: rs=0.10; both p>0.05). There were no statistically significant differences between stenA-MF and delA-MF for D13 EOD satisfaction with comfort (stenA-MF: 2.0; delA-MF: 2.0; p=0.72) or dryness (stenA-MF: 1.9; delA-MF: 1.9; p=0.88). For both SCLs, EOD satisfaction with comfort was significantly correlated (all p<0.05) with EOD satisfaction with dryness (stenA-MF: rs=0.71; delA-MF: rs=0.67), ease of handling for removal (stenA-MF: rs=0.35; delA-MF: rs=0.51) and comfortable wear time (CWT) (stenA-MF: rs=0.30; delA-MF: rs=0.37). CWT was similar for both SCLs (stenA-MF: 11.6 hours; delA-MF: 11.0; p=0.08), but stenA-MF was rated significantly better for ease of handling for removal (stenA-MF: 8.4 vs delA-MF: 7.6, p=0.02).

CONCLUSIONS:
While end-of-day comfort and dryness are important factors in contact lens success, these results suggest that satisfaction with vision for these multifocal lens wearers was a better indicator (both rs>0.80) of their desire to continue wearing the multifocal lenses in the future.

Guthrie S, Luensmann D, Woods J, Vega J, Orsborn G. Comfort and vision correlations in daily disposable multifocal lenses BCLA Virtual Clinical Conference & Exhibition, 2021 [ Show Abstract ][ PDF ]

Purpose: To evaluate the subjective responses to two daily disposable multifocal contact lenses (MFCLs), stenfilcon A (stenA-MF) and delefilcon A (delA-MF), and to see if there is a correlation between preferences based on vision and comfort.
Method: Habitual MFCL wearers participated in a prospective, randomized, subject-masked, bilateral crossover study at five sites. Subjects wore the study MFCLs for 2-weeks each and then responded to preference questions comparing the study lenses for comfort and vision for near, intermediate, distance, digital device use and overall at all distances. A 5-point Likert scale (Strong/slight preference for each lens or no preference) was used.
Results: For the 58 eligible subjects (50F:8M; mean 54.4±7.3 years), preferences were as follows (#stenA-MF:#delA-MF, p-value): subjects favoured stenA-MF for overall comfort (26:9, p=0.03), intermediate vision (25:8, p=0.03), overall vision (34:10, p=0.04) and vision for digital device use (27:10, p=0.03). Preferences were equivocal for near vision (29:14, p=0.06) and distance vision (13:19, p=0.51). Correlation analysis found that the lens preference based on overall comfort was significantly correlated (all p<0.05) with lens preference based on vision at near (rs=0.61), intermediate (rs=0.48), overall (rs=0.65) and for digital device use (rs=0.66). Lens preference based on overall vision was also correlated with lens preference based on vision at near (rs=0.85), intermediate (rs=0.71), and for digital device use (rs=0.87). Lens preference based on vision with digital device use correlated with lens preference based on vision at near (rs=0.85), and intermediate distance (rs=0.69).
Conclusions: Subjects preferred stenA-MF for a range of comfort and distance measures. Preferences for overall comfort and overall vision were both significantly correlated to the same three preferences of near, intermediate and digital device vision, illustrating how comfort and vision are intricately related when evaluating MFCLs and supporting how poor vision could potentially impact comfort.

Jones DA, Luensmann D, Alton K, Werner L. The prevalence of refractive error in children in a Canadian rural, First Nation Community
American Academy of Optometry, Boston, 2021 [ PDF ]

Luensmann D, Schulze M, Woods J, Lazon de la Jara P, Vega J, Orsborn G. Fitting success with stenfilcon A daily disposable multifocal lenses
BCLA Virtual Clinical Conference & Exhibition, 2021 [ Show Abstract ][ PDF ]

Purpose: Multifocal contact lens (MFCL) fitting sometimes raises concerns about the number of fitting attempts required to determine the optimal lens prescription. This study compared the fit process and success rates of stenfilcon A (stenA) MFCL with delefilcon A (delA) MFCL when fitted to existing MFCL wearers in a randomized order.

Method: Successful MFCL wearers with <1.00DC of astigmatism were recruited at five clinical sites in the US. The first trial lenses were determined from current subjective refraction and the respective fitting guides. Prescription changes were reviewed at this first fit visit and also when participants returned for an optimization visit after wearing the lenses for 3-7 days. Multiple lens powers could be trialed at each visit, all were recorded.

Results: Fifty-eight subjects (50F:8M), mean age 54.4±7.3 years [42 to 70 years] were included in the analysis. The spherical-equivalent refraction was OD -1.10±2.7D [-6.50D to +3.75D] with near add +2.00±0.4D [+1.00D to +2.50D]. StenA-MFCL was successfully fit with the first pair of trial lenses in 83% (48) participants, while 10% (6) needed one additional lens and 7% (4) needed an extra two lenses to reach their final power. Regarding count of eyes, 12% (14) needed power optimizations. DelA-MFCL was successfully fit with the first pair of trial lenses in 66% (38) participants, while 17% (10) needed one additional lens, 10% (6) needed two extra lenses and 7% (4) needed three extra lenses to reach their final lens power. Regarding count of eyes, 25% (30) needed power optimizations.

Conclusions: Habitual MFCL wearers were successfully fitted with both MF lens types when following the respective fitting guides. There was a higher success rate with the first lens pair for stenA-MFCL (>8/10 patients) compared to delA-MFCL (<7/10 patients), and no more than one additional fitting lens (per eye) was needed when fitting stenA-MFCL.

Luensmann D, Schulze M, Woods J, Vega J, Orsborn G. Intermediate vision with multifocal contact lenses American Academy of Optometry, Boston, 2021 [ Show Abstract ]

Purpose:
Fitting multifocal contact lenses (MFCL) typically focusses on optimizing distance and near vision, however many presbyopes require good intermediate vision to focus on targets such as desktop screens. This study determined the performance of habitual MFCL (hab-MFCL), stenfilcon A MFCL (stenA-MFCL) and delefilcon A MFCL (delA-MFCL) for intermediate distance vision in existing MFCL wearers.

Methods:
Five clinical sites in the US recruited habitual MFCL wearers with <1.00DC of astigmatism. Habitual MFCL were power optimized and both study lens types were fit following the respective fitting guides. After two weeks of hab-MFCL wear, study MFCL were worn in a masked/randomized order for the same period of time. Intermediate visual acuity (VA) at 0.75m was determined and subjective responses (fell short of needs; met needs; exceeded needs) were collected along with preference ratings (strongly prefer, slightly prefer, no preference). Subjective responses and logMAR VA were analyzed using Wilcoxon Matched-Pairs testing for differences and binomial testing was conducted on preference ratings.

Results:
Fifty-eight subjects (50F:8M), mean age 54.4±7.3 years [42 to 70 years] were included in the analysis. The mean spherical-equivalent refraction was OD -1.10±2.7D [-6.50D to +3.75D]. The average near spectacle Rx add was +2.00±0.4D [+1.00D to +2.50D] and included 18 participants (31%) who required an add of up to +1.75D and 40 (69%) with an add of at least +2.00D. After two weeks of wear, intermediate logMAR VA with stenA-MFCL (0.08±0.10 logMAR) was statistically significantly better compared to hab-MFCL (0.12±0.11 logMAR, p=0.002) and compared to delA-MFCL (0.12±0.12 logMAR, p<0.001). Vision clarity at intermediate distance was rated similarly for hab-MFCL and stenA-MFCL (p=1.00), while both were rated better than delA-MFCL (p=0.01 for both). Preference ratings for intermediate vision clarity showed no significant preferences for stenA-MFCL over hab-MFCL (p=0.36), however both were preferred over delA-MFCL (p=0.03 for both). Vision clarity with digital device use and overall vision clarity were preferred with stenA-MFCL compared to delA-MFCL (p≤0.03 for both), while no preference was found between stenA-MFCL and hab-MFCL for those questions (p>0.05 for both).

Conclusion:
All MFCL were worn successfully for two weeks, however differences in the intermediate vision clarity were noted between lens types, in favour of stenA-MFCL compared to delA-MFCL. Digital devices are frequently used at work and during leisure time today and form part of the need for optimal intermediate vision. While it may often be overshadowed by distance and near vision assessments, good performance at the intermediate distance can be just as critical to ensure success in MFCL wearers.

Ng AY, Yumori J. Rethinking Eye Cosmetics and Cosmetic Procedures: What Should We be Telling Our Patients? Best of Boston Academy (Virtual), 2021 [ Show Abstract ]

Cosmetics are used widely to enhance our appearance, clean, and maintain the condition of our skin. With face mask-wearing on the rise many cosmetic users are choosing to accentuate their eyes further with eye cosmetics. However, patients might not have considered the effects that some eye cosmetic products and procedures may have on their eyes. This session will explore the complications that can arise from some common products and procedures, and highlight points of discussion where we should be engaging with our patients.

Schulze M, Luensmann D, Woods J, Vega J, Orsborn G.. Comfort and vision with two daily disposable multifocal lenses when worn by habitual multifocal contact lens wearers BCLA Virtual Clinical Conference & Exhibition, 2021 [ Show Abstract ][ PDF ]

Purpose: Practitioners can be reluctant to switch successful multifocal soft contact lens (MF) wearers to different materials or replacement frequencies, fearing the new MF will be less accepted. Subjective responses are highly valued in MF fitting and this study investigated subjective responses from habitual MF (hab-MF) wearers after a refit into daily disposable MF; stenfilcon A (stenA-MF) and delefilcon A (delA-MF).

Method: After optimising the lens powers, subjects wore hab-MF and both study-MFs for 2-weeks each. Study-MF brands were masked and randomised. Throughout the study, subjects answered 13 experience questions per lens type, and 6 preference questions (comfort and vision for distance, intermediate, near, digital-device use, overall vision) to compare between hab-MF and each study MF, and also between study MFs.

Results: Fifty-eight subjects (50F:8M), mean age 54.4±7.3 years were included. Mean spherical-equivalent OD refraction: -1.10±2.7D [range -6.50D to +3.75D], mean near add +2.00±0.4D. 44% habitually wore daily disposable MF yet all were naïve to the study-MFs. Hab-MF wear resulted in positive responses for all experience questions (p<0.05); for stenA-MF 12 answers were positive (p<0.05), 1 was equivocal (p=0.90); for delA-MF 6 were positive (p<0.05), 7 were equivocal (p>0.05). Preferences between stenA-MF and hab-MF showed no differences (p>0.05). Subjects preferred hab-MF over delA-MF for intermediate vision (p=0.03) but no other preference (p>0.05). Comparing between study MFs, the preference for stenA-MF was stronger than delA-MF for comfort (p=0.03), intermediate vision (p=0.03), digital-device use (p=0.03) and overall vision (p=0.02) with no difference for distance or near vision (p>0.05).

Conclusions: This study showed that even when habitual MF wearers are already successful, refitting with a new design does not necessarily lead to compromised performance; stenA-MF performed comparably to hab-MF, and for some metrics better than delA-MF. These results should give practitioners confidence to recommend newer materials and different replacement frequencies when managing their existing MF wearers.

Woods J, Luensmann D, Schulze M, Vega J, Orsborn G. Subjective lens experience when refit with daily disposable multifocal contact lenses BCLA Virtual Clinical Conference & Exhibition, 2021 [ Show Abstract ][ PDF ]

Purpose: Practitioners can be reluctant to switch successful multifocal soft contact lens (MF) wearers to different materials or replacement frequencies, fearing the new MF will be less accepted. Subjective responses are highly valued in MF fitting and this study investigated subjective responses from habitual MF (hab-MF) wearers after a refit into daily disposable MF; stenfilcon A (stenA-MF) and delefilcon A (delA-MF).

Method: After optimising the lens powers, subjects wore hab-MF and both study-MFs for 2-weeks each. Study-MF brands were masked and randomised. Throughout the study, subjects answered 13 experience questions per lens type, and 6 preference questions (comfort and vision for distance, intermediate, near, digital-device use, overall vision) to compare between hab-MF and each study MF, and also between study MFs.

Results: Fifty-eight subjects (50F:8M), mean age 54.4±7.3 years were included. Mean spherical-equivalent OD refraction: -1.10±2.7D [range -6.50D to +3.75D], mean near add +2.00±0.4D. 44% habitually wore daily disposable MF yet all were naïve to the study-MFs. Hab-MF wear resulted in positive responses for all experience questions (p<0.05); for stenA-MF 12 answers were positive (p<0.05), 1 was equivocal (p=0.90); for delA-MF 6 were positive (p<0.05), 7 were equivocal (p>0.05). Preferences between stenA-MF and hab-MF showed no differences (p>0.05). Subjects preferred hab-MF over delA-MF for intermediate vision (p=0.03) but no other preference (p>0.05). Comparing between study MFs, the preference for stenA-MF was stronger than delA-MF for comfort (p=0.03), intermediate vision (p=0.03), digital-device use (p=0.03) and overall vision (p=0.02) with no difference for distance or near vision (p>0.05).

Conclusions: This study showed that even when habitual MF wearers are already successful, refitting with a new design does not necessarily lead to compromised performance; stenA-MF performed comparably to hab-MF, and for some metrics better than delA-MF. These results should give practitioners confidence to recommend newer materials and different replacement frequencies when managing their existing MF wearers.