The efficacy of SimulVue and Unilens RGP aspheric bifocal contact lenses in the treatment of esotropia associated with a high accommodative convergence/accommodation ratio.

PURPOSE: This was a prospective study assessing the efficacy of the SimulVue bifocal contact lens and the Unilens RGP aspheric multifocal contact lens (Unilens, Largo, Fla.) in the treatment of high accommodative convergence/accommodation (AC/A) esotropia in an adolescent and postadolescent population. METHODS: Those patients meeting the inclusion criteria were fit with contact lenses with use of full cycloplegic refraction and later retested by an examiner masked to the previous binocular status. Particular attention was given to the sensory status and the motor fusion of each patient in their bifocal spectacles and then in their bifocal contact lenses. All patients were followed up for at least 6 months after the contact lenses were fitted. RESULTS: Five of the six patients demonstrated larger angles of esophoria or tropia at near with the contact lenses than with bifocal spectacles. The only patient who maintained excellent stereopsis in bifocal contact lenses was the one who normalized her AC/A ratio during this study and no longer required a bifocal in her spectacle correction for fusion. The two patients who initially had no stereopsis but good alignment in spectacle correction had a large esotropia at near fixation with bifocal contact lenses. CONCLUSIONS: The SimulVue and Unilens RGP aspheric bifocal contact lenses did not adequately treat adolescent patients who had esotropia associated with a high AC/A ratio.

A prospective evaluation of Unilens soft multifocal contact lenses in 100 patients.

One-hundred patients were fit with Unilens soft multifocal contact lenses over a 2-year period. The Unilens was selected for two reasons: the initial comfort of a soft contact lens and Unilens' purported ability to correct a wide range of refractive errors with simultaneous vision optics. The goal of this study was to find a consistent and simplified multifocal contact lens system that would satisfy a majority of the patients in the study. Forty-eight patients had no previous contact lens experience, whereas 52 patients were wearing some type of single-vision contact lens. All patients were charged the clinic's customary fee for multifocal contact lens fitting with no incentives provided for participating in the study. Success rates were very similar between first time wearers and previous contact lens wearers (71% for first time wearers and 76% for previous contact wearers). Of the four base curves available, the Unilens soft multifocal contact lenses in the 8.4 base curve demonstrated the highest success rate (81%), especially in patients with up to +2.25 D add and 1.50 D or less of cylinder.