Impact on Distance and Near Contrast Sensitivity of Multifocal Contact Lenses: A Systematic Review

Area of Science:

• Ophthalmology
• Optometry
• Vision Science

Background:

• Presbyopia affects near vision, often managed with multifocal contact lenses (MFCLs).
• Contrast sensitivity (CS) is a key visual function that may be influenced by MFCLs.
• Evaluating the impact of MFCLs on CS is crucial for optimizing visual performance in presbyopic patients.

Purpose of the Study:

• To systematically review and analyze published scientific evidence on the effects of MFCLs on distance and near contrast sensitivity in presbyopia correction.
• To assess the quality of existing research regarding MFCLs and contrast sensitivity.

Main Methods:

• Conducted a bibliographic search across PubMed, Web of Sciences, and Scopus for relevant studies published between 2000 and 2024.
• Included controlled clinical trials evaluating distance and/or near CS in presbyopic patients using MFCLs.
• Utilized the Critical Appraisal Skills Programme (CASP) tool to assess the quality of included studies.

Main Results:

• Eight articles were included in the review, with varying findings on contrast sensitivity function (CSF).
• Some studies found no significant changes in CS with specific MFCL designs (center-distance/center-near) or compared to monovision.
• Other studies reported significant differences when comparing MFCLs to spectacles, with some MFCLs showing worse visual performance than pinhole lenses. Study quality varied, with CASP scores ranging from 5/13 to 8/13.

Conclusions:

• The current evidence base regarding the impact of MFCLs on contrast sensitivity is limited and lacks generalizable conclusions.
• Only a few studies indicate a variable impact of MFCLs on CS, with insufficient evidence to support the clinical benefit of using CS for MFCL fitting and optimization.
• Further high-quality research is required to establish definitive conclusions and clinical utility of contrast sensitivity assessment in multifocal contact lens wear for presbyopia.