PURPOSE: Monovision is a widely used approach for correcting presbyopia; however, it can adversely affect binocular vision, night driving performance, and stereopsis in some patients. Multifocal toric (MFT) contact lenses offer an effective alternative for visual correction in individuals with both presbyopia and astigmatism.

CASE REPORT: We present a case series of 10 patients (pts) from five sites who transitioned from monovision to monthly samfilcon A MFT lenses (B+L ULTRA). Cases were collected as part of a wider study with central institutional review board exemption. Seven pts were male and three female, nine were White and one was Asian, and ages ranged from 45 to 74 years at refitting. Prior lens wear duration was between 1 and 12 years. With habitual correction, distance best-corrected visual acuity (BCVA) OU was 20/20 for 6/10 (60%) pts, 20/20− and 20/30+ each in 1/10 (10%) pts, and unknown for 2/10 (20%) pts; near BCVA OU was 20/20 for 4/10 (40%) pts, 20/25− for 1/10 (10%) pts, and unknown for 5/10 (50%) pts. Reasons for switching to samfilcon A MFT lenses included to improve binocularity, reduced monovision tolerance, and the need for more balanced distance and near vision. At initial fit, lens powers included sphere −5.75 to +4.00 D; cylinder −2.25 to −0.75 D; and add low for 7/20 (35%) eyes, high for 11/20 (55%) eyes, and unknown for 2/20 (10%) eyes. Distance BCVA OU through over-refraction at initial fit was 20/20 for 6/10 (60%) pts, 20/25 for 1/10 (10%) pts, and unknown for 3/10 (30%) pts. Near BCVA OU through over-refraction at initial fit was 20/20 in 2/10 (20%) pts, 20/25, 20/30 and 20/60 each in 1/10 (10%) pts, and unknown in 5/10 (50%) pts. At most recent fit, 7 days–6 years after initial lens fit, all pts continued to wear samfilcon A MFT lenses, with adjustments due to refractive changes in eight pts (15 eyes). Lens powers at most recent fit included sphere −5.50 to +4.00 D; cylinder −2.25 to −0.75 D; add low for 3/20 (15%) eyes, high for 15/20 (75%) eyes, and unknown for 2/20 (10%) eyes. Distance BCVA OU without over-refraction at most recent fit was 20/20 for 7/10 (70%) pts, 20/25 and 20/30+ for 1/10 (10%) pts each, and unknown for 1/10 (10%) pts. Near BCVA OU without over-refraction at most recent fit was 20/20 for 4/10 (40%) pts, 20/25+ for 1/10 (10%) pts, 20/25 for 2/10 (20%) pts, 20/40 and 0.5M each in 1/10 (10%) pts, and unknown for 1/10 (10%) pts (Figure). At initial and most recent fitting visits, the lens MF fitting guide was used for 16/20 (80%) and 11/15 (73%) eyes, respectively, and good lens centration and movement were achieved for all pts. No adverse events (AEs) were reported.

CONCLUSION: This case series demonstrates that transitioning pts from monovision to monthly samfilcon A MFT lenses was associated with good visual acuity outcomes and lens fit, with no AEs reported. These findings support that samfilcon A MFT lenses represent a suitable option for pts wearing monovision lenses and open to moving to monthly MFT lenses.