Comparison of visual performance between peripheral gradient high-addition multifocal soft contact lenses and orthokeratology

Purpose: The aim of this study was to evaluate the short-term effects of peripheral gradient high-addition multifocal soft contact lenses (MFSCLs) and orthokeratology (Ortho-K lenses) on visual performance in myopic children.Methods: Thirty myopic children participated in this prospective study. Each participant wore different sets of lenses in the following sequence: single-vision spectacles (SVSPs) as a control, MFSCLs and Ortho-K lenses. Ocular aberrations, topography, high-contrast visual acuity (HCVA), low-contrast visual acuity (LCVA) and accommodation of the right eye were measured with each type of correction on a different day.Results: Compared with SVSPs, high-addition MFSCLs and Ortho-K lenses significantly increased all items of aberrations (all p < 0.05) except trefoil (p = 0.17). MFSCLs induced less coma, root mean square of the third-order aberration (RMS3) and higher order aberrations than Ortho-K lenses (all p < 0.05). No significant difference in HCVA was found across the three correction types (F = 1.19, p = 0.39). In terms of LCVA, MFSCLs performed significantly poorer than SVSPs (difference, 0.16 logMAR; p = 0.001) and slightly worse than Ortho-K lenses (difference, 0.08 logMAR; p = 0.35). No significant difference in decentration was found between the two types of contact lenses, and no associations were observed between decentration and visual acuity at both high- and low-contrast levels (all p > 0.05). For MFSCLs, decentration was positively related to coma (r = 0.43, p = 0.02) and RMS3 (r = 0.44, p = 0.02), which was not the case for Ortho-K lenses. Accommodative facility was worse with MFSCLs than Ortho-K lenses (p = 0.001).Conclusion: Multifocal soft contact lenses differed from Ortho-K lenses in aberration profile and LCVA, although decentration was similar. Decentration <1 mm had minimal influence on both HCVA and LCVA for either type of correction, but significantly increased third-order aberrations for MFSCLs, but not Ortho-K lenses.