Efficacy of Toric Contact Lenses in Fitting and Patient-Reported Outcomes in Contact Lens Wearers

Objectives: To assess whether patient-reported measures are improved with soft toric contact lenses (TCLs) compared with soft spherical contact lenses (SCLs) and whether clinical time needed to fit TCL is greater than SCL. Methods: Habitual contact lens wearers with vertexed spherical refraction +4.00 to +0.25 D or -0.50 to -9.00 D and cylinder -0.75 to -1.75 DC were randomly assigned to be binocularly fitted into a TCL or SCL, and masked to treatment assignment. Time to successful fit was recorded. After 5 days, the National Eye Institute Refractive Error Quality of Life Instrument (NEI-RQL-42) and modified Convergence Insufficiency Symptom Survey (CISS) were completed. After washout, subjects were fit into the alternative lens design (TCL or SCL). Outcomes were evaluated using linear mixed models for the time to fit and CISS score, generalized linear model for the successful fit, and Wilcoxon tests for the NEI-RQL-42. Results: Sixty subjects (71.7% women, mean age [+/- SD] = 27.5 +/- 5.0 years) completed the study. The mean time to fit the TCL was 10.2 +/- 4.3 and 9.0 +/- 6.5 min for the SCL (least square [LS] mean difference (TCL-SCL) = 1.2, P = 0.22). Toric contact lens scored better than SCL in global NEI-RQL-42 score (P = 0.006) and the clarity of vision (P = 0.006) and satisfaction with correction subscales (P = 0.006). CISS showed a 15% reduction in symptoms (LS mean difference [TCL-SCL] = 22.20, P = 0.02). Conclusion: TCLs are a good option when trying to improve the vision of patients with low-to-moderate astigmatism given the subjective improvements in outcomes.