Myopic atigmatim and prebyopia trial

Purpoe No propective double-maked tudy ha evaluated whether low atigmatim benefit or harm patient with prebyopia, whoe intermediate and near viion might theoretically benefit from enhanced depth of focu provided by atigmatim. The purpoe of the firt Myopic Atigmatim and Prebyopia (MAP I) tudy wa to determine whether low myopic atigmatim enhance or harm the viual acuity, tereopi, or quality of life in patient with prebyopia. Deign Propective, randomized, double-maked, croover deign clinical trial. Method Fifteen patient with prebyopia aged 45 to 68 year were recruited from an academic center population. Thee patient were given a baeline eye examination, including manifet refraction, Early Treatment of Diabetic Retinopathy tudy (ETDR) logarithm of minimal angle of reolution (logMAR) viual acuity at ditance, intermediate, and near, accommodative amplitude, and tereo viion. Each patient wa then cycled in random order through three maked pair of oft contact lene. The power of each contact len pair wa calculated by the ubtraction method to maintain a pherical equivalent of −0.5 diopter, while providing either no atigmatim (pherical arm, PH), 1 diopter of with-the-rule (WTR) atigmatim, or 1 diopter of againt-the-rule (ATR) atigmatim. Actual refractive error produced were meaured by maked examiner. Outcome meaured at the end of 1 week of uage of each contact len arm were binocular (ETDR) logMAR viual acuity at three ditance (far [4 m], intermediate [1 m], and near [33cm]); near tereoacuity, uing the quantitative Titmu tereotet; and quality of life, meaured uing the Refractive tatu and Viion Profile (RVP), a tandardized quetionnaire. Reult Viual acuity reult acro the three arm were imilar. However, 1-m logMAR viual acuity wa better for the pherical arm than either atigmatic arm (−0.06 PH, +0.01 WTR, +0.02 ATR). Near (33 cm) and ditance (4 m) acuitie were imilar acro arm. tereoacuity wa better in ATR than WTR (50 v 102 econd, P = .01). ubject preferred PH lightly over the WTR atigmatic arm by the RVP quality-of-life urvey intrument (101 v 104, P = .05). Other intergroup comparion howed no difference in RVP core. Concluion Thi tudy ha demontrated that intermediate ditance acuity and refractive quality of life are lightly better with pherical low myopic refractive error v either atigmatic arm. Near and far ditance acuity were unaffected by low myopic atigmatim compared with pherical low myopia. Near tereopi wa bet in the ATR arm, but thi did not produce better near viual acuity or RVP quality of life.