Visual function through 4 contact lens–based pinhole systems for presbyopia

PURPOSE: To evaluate the effects of different contact lens–based artificial pupil designs on visual performance. SETTING: University of Valencia, Burjassot, Spain, and University of Manchester, Manchester, United Kingdom. DESIGN: Comparative case series. METHODS: Presbyopic patients were evaluated using 4 artificial pupil designs in the nondominant eye. Binocular uncorrected distance visual acuity (UDVA), binocular corrected distance visual acuity (CDVA), binocular uncorrected near visual acuity (UNVA), binocular distance‐corrected near visual acuity (DCNVA), defocus curve, binocular distance, and near contrast sensitivity under photopic and mesopic conditions, and stereoacuity were measured after contact lens fitting. RESULTS: The mean UDVA and CDVA ranged from 0.04 ± 0.05 (SD) to −0.01 ± 0.04 logMAR and from −0.02 ± 0.05 to −0.05 ± 0.03 logMAR, respectively. The UNVA and DCNVA ranged from 0.37 ± 0.11 to 0.42 ± 0.20 logMAR and from 0.35 ± 0.17 to 0.38 ± 0.12 logMAR, respectively. The difference in binocular distance contrast sensitivity was statistically significant between the pinhole systems and the control group (distance‐corrected patients without pinhole lens) for 6 cycles per degree (cpd), 12 cpd, and 18 cpd; for near vision, differences were also significant for 3 cpd at the 2 luminance levels (P<.05). Stereoacuity values for near vision were not significantly different between the 4 pinhole systems (P>.05). CONCLUSIONS: Soft contact lens apertures provide good visual acuity at distance, functional intermediate vision, and poor near visual acuity and stereoacuity. An improvement in visual performance with decreasing pupil diameter was not found. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned.