Verification of the vertex powers of varifocal rigid contact lenses

Abstract

Introduction: Increasingly aspherical optics are used in contact lens designs to produce a varifocal effect to correct presbyopia. Whilst no current ISO standard describes a method to verify these products, the vertex power needs to be verified by the manufacturer and optometrist. Visionix claim that the VC2001 instrument is able to resolve the vertex power of complex contact lenses and that it has been adopted by contact lens manufacturers as their “gold standard” method of measure. Practitioners rely on the focimeter for contact lens verification and accept that it has poorer resolution. This raises the question of whether practitioners can verify the vertex powers of varifocal contact lenses to a sufficient sensitivity. The purpose of this study is to determine whether a focimeter can differentiate between various vertex powers incorporating differing degrees of asphericity that are used in contact lens designs. Methods: A range of varifocal contact lenses were used with single vision contact lenses as controls. Three types of focimeters were used: a manual focimeter, a projector focimeter and a computerised focimeter (standard and contact lens modes). The VC2001 assessed the vertex powers over the optical zone and was used as a reference for the focimeters. The measures from the VC2001 and the focimeters were analysed by discrepancy analysis. Results: All discrepancy measures fell outside two standard deviations for either the varifocal contact lenses or the single vision contact lenses when the focimeters were compared to the VC2001. This raises the issue of whether the focimeters are measuring the same parameter as the VC2001. Only the analysis of the repeated measurements from the manual focimeter for single vision contact lenses demonstrated an acceptable measure of precision (±0.21, 2S.D.) with a very small degree of bias (mean difference −0.024, ±0.02 [2S.E.]). Conclusion: These results suggest that the manual focimeter can measure the vertex powers for single vision contact lenses to an acceptable degree of precision. The vertex powers of varifocal lenses cannot be verified using standard practice equipment. The VC2001 has poor precision for power measurements and may not be measuring the same parameter as the focimeters and therefore questions the validity of the VC2001 as the “gold standard” for vertex power measurement.