Adaptation to Multifocal and Monovision Contact Lens Correction Paulo R.B. Fernandes*, Helena I. F. Neves † , Daniela P. Lopes-Ferreira ‡ , Jorge M.M. Jorge*, and Jose ´ M. Gonza ´lez-Meijome* ABSTRACT Purpose. To compare visual performance with the Biofinity multifocal (MF) contact lens with monovision (MV) with the Biofinity single-vision contact lens. Methods. A crossover study of 20 presbyopic patients was conducted. Patients were randomized first into either an MF or an MV lens for 15 days for each modality, with a washout period between each lens type. Measurements included monocular and binocular high- and low-contrast logarithm of the minimum angle of resolution visual acuity (VA) at distance and near visions, binocular distance contrast sensitivity function, and near stereoacuity. Results. At 15 days, patients lost fewer than two letters (half a line of VA) of binocular distance and near VA, with the MF and MV lens under high- and low-contrast conditions (P 9 0.05 for both comparisons). No statistically significant differences were seen in binocular VA at near or distance with either lens. However, the monocular distance VA improved significantly in the nondominant eye, with the MF lens by one line over the 15-day period under high-contrast (P = 0.023) and low- contrast (P = 0.035) conditions; this effect was not seen with the MV lens. Contrast sensitivity function was within the normal limits with both lenses. The stereoacuity was significantly (P G 0.01) better with MF than with MV. Conclusions. Multifocal contact lens correction provided satisfactory levels of VA comparable with MV without compromising stereoacuity in this crossover study. The near vision significantly improved in the dominant eye, and the distance vision improved in the nondominant eye from 1 to 15 days with the MF lens, suggesting that patients adapted to the multifocality overtime, whereas this was not true for MV. (Optom Vis Sci 2013;90:228Y235) Key Words: monovision, multifocal contact lenses, logMAR visual acuity, stereoacuity, subjective comfort and ability F or the last 2 decades, there has been a progressive aging of the population, with a corresponding increase in the proportion of the world population that becomes presbyopic. Providing satisfactory procedures to correct presbyopia with contact lenses that offer instant and optically clear distance and near vision is the biggest challenge for the industry and contact lens practitioners. The number of contact lens wearers requiring presbyopic cor- rection has also grown significantly in recent years. Although there is considerable variation among countries 1,2 (ranging from 0% to 79% of all soft lens fittings in patients 945 years), only approx- imately 29% and 8% of presbyopes are corrected with multifocal (MF) or monovision (MV) modalities, respectively, whereas more than 60% of presbyopes are still being fitted with nonpresbyopic corrections. 2 Current techniques to correct presbyopia with contact lenses are based on one of three principles: MV, alter- nating vision, or simultaneous vision. Monovision 3 involves fitting one eye for distance (typically the dominant eye) and one eye for near vision, whereas simultaneous vision designs provide concurrent clear vision at two or more distances by broadening the lens-eye system depth of focus. 4 Although previous reports have reported success rates with MV between 59% and 67%, 3 signif- icant decreases in stereopsis 5,6 and vision-related quality of life have been reported. 7 Recent studies have confirmed that the MF option offers similar or superior patient satisfaction by providing better stereoacuity and near range of clear vision 5,8Y10 as well as patient preference over MV. 6,11 The objective of this study was two-fold, that is, to establish if there is a difference in comfort and subjective satisfaction between the new Biofinity balanced MF silicone hydrogel (Comfilcon A) 1040-5488/13/9003-0228/0 VOL. 90, NO. 3, PP. 228Y235 OPTOMETRY AND VISION SCIENCE Copyright * 2013 American Academy of Optometry ORIGINAL ARTICLE Optometry and Vision Science, Vol. 90, No. 3, March 2013 * OD, PhD † OD ‡ OD, MSc Clinical and Experimental Optometry Research Laboratory (CEORLab), Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal (all authors). Copyright © American Academy of Optometry. Unauthorized reproduction of this article is prohibited.