Toric ortho-K lenses preferred, despite reduced high-contrast, glare acuity
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Despite having reduced high-contrast and glare visual acuity with toric orthokeratology lenses, study participants preferred them over soft toric multifocal lenses, researchers reported in Optometry and Vision Science.
“There are limited treatment options for myopia management of patients with higher levels of astigmatism. These patients are often excluded from randomized, controlled trials,” Erin S. Tomiyama, OD, PhD, FAAO, assistant professor of optometry at Marshall B. Ketchum University in California, told Healio. “We wanted to compare our current treatment options: toric orthokeratology and soft toric multifocal contact lenses. We aimed to explore both modalities for vision and subjective acceptance.”
To identify clinical differences between the lenses, Tomiyama and colleagues examined both subjective patient satisfaction as well as objective visual acuity measurements in 30 adults with refractive myopia and astigmatism.
To measure visual acuity, researchers analyzed high contrast, low contrast and glare visual acuity using Smart System 1 (M&S Technologies). Over the course of the study, participants wore each type of lens for 10 ± 2 days, with a 2-week washout period in between, according to the study.
In addition to visual acuity measurements, participants also completed two patient satisfaction surveys, as well as a two-alternative forced choice survey at the culmination of the study to determine their preferred contact lens.
After visual acuity measurements, researchers reported toric ortho-K lenses had a one-line reduction in both high contrast and glare acuity compared with soft toric multifocal lenses (P .003).
In terms of patient satisfaction, participants preferred toric ortho-K lenses for vision (P .03) and soft multifocal for handling (P .006). At the end of the study, when participants were forced to choose one lens over the other, they preferred toric ortho-K lenses for both vision and overall (P .007).
“These results are part of a larger study exploring the differences in peripheral refraction and higher-order aberrations with these two lens types,” Tomiyama told Healio. “Toric orthokeratology induces more peripheral myopic defocus and greater higher-order aberrations compared to soft toric multifocal lenses, two theories as to how these lenses slow myopia progression.”
She continued, “Further research is needed to understand the use of these toric lenses for myopia management, specifically in children. A longitudinal study would show which toric lens type is more effective at slowing myopia progression in astigmatic children.”
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Tomiyama ES, et al. Optom Vis Sci. 2022;doi:10.1097/OPX.0000000000001969.
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