Comparison of refraction, presbyopia, and dry eye-related parameters between monofocal and multifocal contact lens users

PURPOSE: To investigate factors associated with multifocal contact lens (CL) use or prescription for presbyopia correction. STUDY DESIGN: Retrospective cross-sectional METHODS: Overall, 3264 CL users were assessed and categorized into three age groups; 40s (aged 40-49 years), 50s (aged 50-59 years), and 60s (aged 60-69 years). Refraction, near add power, dry eye-related parameters, and visual acuity were compared between monofocal and multifocal CL users in each age group. The odds ratios of factors for using multifocal CLs were calculated. RESULTS: Multifocal CL users tended to be older across all age groups and were more likely to be male, aged in their 40s and 50s, and have lower degrees of myopia and astigmatism. In the 50s and 60s groups, multifocal CL users also showed better CL-corrected visual acuity, smaller differences between best-corrected and CL-corrected vision, and less under-correction. Near addition of CL was significantly higher in multifocal CL users in the 40s group. Among dry eye-related parameters, multifocal CL users had higher Schirmer values in the 40s and 60s groups, longer tear break-up time in the 50s group, and fewer keratopathies in the 40s and 50s groups. Odds ratios for multifocal CL use were significant for age, spherical equivalent, and astigmatism across all age groups, Schirmer values in the 40s and 50s groups, and tear break-up time and keratopathy were significantly higher in the 50s group. CONCLUSION: Multifocal CLs were more likely to be prescribed for users with lower refractive errors and healthier ocular surfaces. The current findings may contribute to optimizing CL prescriptions and presbyopia management strategies.