Common Factors in Multifocal Contact Lens Dissatisfaction

Background: This research project aims to better understand factors contributing to the
dissatisfaction of soft multifocal contact lens wearers, leading to better patient outcomes
for future lens selection. Methods: Patients were recruited based on a negative response
to the question “Is/was your contact lens use meeting your expectations for success?”. A
documented comprehensive eye exam within the last two years and previous fitting/use
of a soft multifocal lens were also used as inclusion/exclusion criteria. Twelve study
participants were analyzed for their wearing and lens care habits/time, style/design of
lens, high and low contrast visual acuity, occupation, visual tasks while wearing their
lenses, refractive and ocular measurements, allergies, systemic and ocular medications,
personality traits, expectations, age, quality of life, previous lens wear and number of
lenses necessary to be fit successfully. The collected data was then compared to values
from a partner study of successful multifocal contact lens wearers. Results: No significant
differences in distance acuity, habitual working distance, activities of daily living, or
personality were found between the satisfied and dissatisfied study groups. Significant
differences were found for objective and subjective measurements of near and
intermediate vision between the two groups. The average coma for unsuccessful patients
not wearing multifocal lenses
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was higher compared to successful patients while not wearing multifocal lenses (0.63
versus. 0.50). Although it was not statistically significant, it was very close (p = 0.53).
Average pupil size differences were found also to be significantly larger (by an average of
0.5 mm) in unsuccessful patients. Conclusions: Complete fitting of candidates for
multifocal contact lens correction should include average pupil testing to increase lens
satisfaction. Further testing for induced aberrations should be conducted to determine
significance in multifocal lens satisfaction. Future multifocal lens design could be further
refined if pupil size and induced aberrations were considered.