{"id":20644,"date":"2025-05-19T11:13:18","date_gmt":"2025-05-19T10:13:18","guid":{"rendered":"https:\/\/saera.eu\/en\/?p=20644"},"modified":"2025-11-11T13:05:50","modified_gmt":"2025-11-11T13:05:50","slug":"multifocal-contact-lenses-in-myopia-control-and-parameters-affecting-their-efficacy","status":"publish","type":"post","link":"https:\/\/saera.eu\/en\/2025\/05\/19\/multifocal-contact-lenses-in-myopia-control-and-parameters-affecting-their-efficacy\/","title":{"rendered":"Multifocal Contact Lenses in Myopia Control and Parameters Affecting their Efficacy"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"20644\" class=\"elementor elementor-20644\" data-elementor-post-type=\"post\">\n\t\t\t\t<div class=\"elementor-element elementor-element-22cbc298 e-flex e-con-boxed e-con e-parent\" data-id=\"22cbc298\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t<div class=\"elementor-element elementor-element-41b4f978 e-con-full e-flex e-con e-child\" data-id=\"41b4f978\" data-element_type=\"container\">\n\t\t<div class=\"elementor-element elementor-element-43717f45 e-flex e-con-boxed e-con e-child\" data-id=\"43717f45\" data-element_type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-2c708843 elementor-widget elementor-widget-text-editor\" data-id=\"2c708843\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.22.0 - 26-06-2024 *\/\n.elementor-widget-text-editor.elementor-drop-cap-view-stacked .elementor-drop-cap{background-color:#69727d;color:#fff}.elementor-widget-text-editor.elementor-drop-cap-view-framed .elementor-drop-cap{color:#69727d;border:3px solid;background-color:transparent}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap{margin-top:8px}.elementor-widget-text-editor:not(.elementor-drop-cap-view-default) .elementor-drop-cap-letter{width:1em;height:1em}.elementor-widget-text-editor .elementor-drop-cap{float:left;text-align:center;line-height:1;font-size:50px}.elementor-widget-text-editor .elementor-drop-cap-letter{display:inline-block}<\/style>\t\t\t\t<h2 style=\"text-align: justify;\"><span style=\"color: #000066;\">Multifocal Contact Lenses in Myopia Control and Parameters Affecting their Efficacy<\/span><\/h2>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-33d58c52 elementor-align-right elementor-widget elementor-widget-post-info\" data-id=\"33d58c52\" data-element_type=\"widget\" data-widget_type=\"post-info.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<link rel=\"stylesheet\" href=\"https:\/\/saera.eu\/en\/wp-content\/plugins\/elementor\/assets\/css\/widget-icon-list.min.css\"><link rel=\"stylesheet\" href=\"https:\/\/saera.eu\/en\/wp-content\/plugins\/pro-elements\/assets\/css\/widget-theme-elements.min.css?ver=1747297119\">\t\t<ul class=\"elementor-inline-items elementor-icon-list-items elementor-post-info\">\n\t\t\t\t\t\t\t\t<li class=\"elementor-icon-list-item elementor-repeater-item-0d080fc elementor-inline-item\" itemprop=\"datePublished\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-calendar\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M12 192h424c6.6 0 12 5.4 12 12v260c0 26.5-21.5 48-48 48H48c-26.5 0-48-21.5-48-48V204c0-6.6 5.4-12 12-12zm436-44v-36c0-26.5-21.5-48-48-48h-48V12c0-6.6-5.4-12-12-12h-40c-6.6 0-12 5.4-12 12v52H160V12c0-6.6-5.4-12-12-12h-40c-6.6 0-12 5.4-12 12v52H48C21.5 64 0 85.5 0 112v36c0 6.6 5.4 12 12 12h424c6.6 0 12-5.4 12-12z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text elementor-post-info__item elementor-post-info__item--type-date\">\n\t\t\t\t\t\t\t\t\t\t<time>19\/05\/2025<\/time>\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t<li class=\"elementor-icon-list-item elementor-repeater-item-e2c89b4 elementor-inline-item\" itemprop=\"about\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-icon\">\n\t\t\t\t\t\t\t\t<svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-tags\" viewBox=\"0 0 640 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M497.941 225.941L286.059 14.059A48 48 0 0 0 252.118 0H48C21.49 0 0 21.49 0 48v204.118a48 48 0 0 0 14.059 33.941l211.882 211.882c18.744 18.745 49.136 18.746 67.882 0l204.118-204.118c18.745-18.745 18.745-49.137 0-67.882zM112 160c-26.51 0-48-21.49-48-48s21.49-48 48-48 48 21.49 48 48-21.49 48-48 48zm513.941 133.823L421.823 497.941c-18.745 18.745-49.137 18.745-67.882 0l-.36-.36L527.64 323.522c16.999-16.999 26.36-39.6 26.36-63.64s-9.362-46.641-26.36-63.64L331.397 0h48.721a48 48 0 0 1 33.941 14.059l211.882 211.882c18.745 18.745 18.745 49.137 0 67.882z\"><\/path><\/svg>\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<span class=\"elementor-icon-list-text elementor-post-info__item elementor-post-info__item--type-terms\">\n\t\t\t\t\t\t\t\t\t\t<span class=\"elementor-post-info__terms-list\">\n\t\t\t\t<a href=\"https:\/\/saera.eu\/en\/tag\/myopia\/\" class=\"elementor-post-info__terms-list-item\">Myopia<\/a>, <a href=\"https:\/\/saera.eu\/en\/tag\/optometry\/\" class=\"elementor-post-info__terms-list-item\">Optometry<\/a>\t\t\t\t<\/span>\n\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t<\/li>\n\t\t\t\t<\/ul>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-194009d7 elementor-widget elementor-widget-text-editor\" data-id=\"194009d7\" data-element_type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<h3><!-- wp:paragraph {\"align\":\"right\"} --><\/h3>\n<p class=\"has-text-align-right\">\u00a0By<strong> Christina P. Myronidou,\u00a0<\/strong>student of the\u00a0<a href=\"https:\/\/saera.eu\/en\/optometry\/\">Master in Clinical Optometry and Vision Therapy<\/a><\/p>\n<p><!-- \/wp:paragraph --><!-- wp:paragraph --><\/p>\n<h2>\u00a0Abstract<\/h2>\n<p style=\"text-align: justify;\">\u00a0Alarming prevalence of myopia and associated ocular complications highlight the need for immediate interventions. Multifocal contact lenses (MFCLs) appear to have a potential as an optical strategy in the field of myopia control. This literature review aims to examine current evidence in relation to their efficacy in slowing myopia progression and axial elongation and identify critical parameters affecting their performance. Efficacy of MFCLs in myopia control is presented among several randomized clinical trials, showing an average percentage of 40-50% reduction in myopia progression and similar numbers to axial elongation. However, outcomes vary across studies, since several parameters interfere in the control process with each factor playing a distinct role. Center-distance designs and concentric rings have been effective in inducing peripheral myopic defocus, which is the primary mechanism of their action. Higher add powers and adequate wearing time provides stronger treatment effect, while pupil size affects the amount of defocus delivered to the peripheral retina. Age of initiation, visual performance and adaptation are considerable parameters for a long-term success. Despite their advantages, their implementation in clinical practice is limited and therefore, specific guidelines should be given.<\/p>\n<p><strong>Keywords<\/strong>:<em> multifocal contact lenses, myopia control, lens design, add power, visual performance, pupil size<\/em><\/p>\n<p>            <div class=\"ppv_wrapper ppv_container\" style=\"position: relative;width:100%; height:600px;\">\n                <div class=\"ppv-loading\">PDF Loading&#8230;<\/div>\n                <iframe id=\"s_pdf_frame\" src=\"\/\/docs.google.com\/gview?embedded=true&#038;url=https:\/\/saera.eu\/en\/wp-content\/uploads\/2025\/05\/Myronidou-C.-P.-2025.-Multifocal-Contact-Lenses-in-Myopia-Control-and-Parameters-Affecting-their-Efficacy.-SAERA.pdf\" style=\"float:left; padding:10px;width:100%; height:600px;\" frameborder=\"0\"><\/iframe>\n                            <\/div>\n            \n            <\/p>\n<p>Download the full Research Work:\u00a0<a href=\"https:\/\/saera.eu\/en\/wp-content\/uploads\/2025\/05\/Myronidou-C.-P.-2025.-Multifocal-Contact-Lenses-in-Myopia-Control-and-Parameters-Affecting-their-Efficacy.-SAERA.pdf\">Myronidou, C. P. (2025). Multifocal Contact Lenses in Myopia Control and Parameters Affecting their Efficacy.SAERA<\/a><\/p>\n<p><!-- \/wp:paragraph --><!-- wp:shortcode --><\/p>\n<p><!-- \/wp:shortcode --><!-- wp:paragraph --><\/p>\n<p><!-- \/wp:paragraph --><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t<div class=\"elementor-element elementor-element-789fd107 e-con-full e-flex e-con e-child\" data-id=\"789fd107\" data-element_type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-34727d0f elementor-widget elementor-widget-spacer\" data-id=\"34727d0f\" data-element_type=\"widget\" data-widget_type=\"spacer.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.22.0 - 26-06-2024 *\/\n.elementor-column 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elementor-position-top elementor-widget elementor-widget-image-box\" data-id=\"20513169\" data-element_type=\"widget\" data-widget_type=\"image-box.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t<style>\/*! elementor - v3.22.0 - 26-06-2024 *\/\n.elementor-widget-image-box .elementor-image-box-content{width:100%}@media (min-width:768px){.elementor-widget-image-box.elementor-position-left .elementor-image-box-wrapper,.elementor-widget-image-box.elementor-position-right .elementor-image-box-wrapper{display:flex}.elementor-widget-image-box.elementor-position-right .elementor-image-box-wrapper{text-align:end;flex-direction:row-reverse}.elementor-widget-image-box.elementor-position-left .elementor-image-box-wrapper{text-align:start;flex-direction:row}.elementor-widget-image-box.elementor-position-top .elementor-image-box-img{margin:auto}.elementor-widget-image-box.elementor-vertical-align-top 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                          <\/a> \r\n                                <\/div>                             \r\n                                \r\n                                <div class=\"blog-content\">                                    \r\n                                                                               <ul class=\"blog-meta\">\r\n                                                                                                                                            <li><i class=\"fa fa-calendar-check-o\"><\/i> 17 March 2026<\/li>\r\n                                                                                                                                                                                <\/ul>\r\n                                                                                \r\n                                        <h3 class=\"title dd\"><a href=\"https:\/\/saera.eu\/en\/2026\/03\/17\/speech-in-noise-testing-in-arabic-a-literature-review-and-clinical-implications-for-lebanese-arabic\/\">Speech-in-Noise Testing in Arabic: A Literature Review and Clinical Implications for Lebanese Arabic<\/a><\/h3>\r\n                                                                                <div class=\"btn-btm d-flex align-items-center justify-content-between\">\r\n                                                                                                                                        <div class=\"btn-part\">\r\n                                                    <a class=\"readon-arrow\" href=\"https:\/\/saera.eu\/en\/2026\/03\/17\/speech-in-noise-testing-in-arabic-a-literature-review-and-clinical-implications-for-lebanese-arabic\/\">\r\n                                                        Read More <i class=\"fa fa fa-angle-right\"><\/i>\r\n                                                    <\/a>\r\n               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src=\"https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/03\/Rajeev-S.-2026.-Tinnitus-Management-and-Rehabilation.-SAERA.png\" class=\"attachment-full size-full wp-post-image\" alt=\"\" srcset=\"https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/03\/Rajeev-S.-2026.-Tinnitus-Management-and-Rehabilation.-SAERA.png 1536w, https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/03\/Rajeev-S.-2026.-Tinnitus-Management-and-Rehabilation.-SAERA-300x200.png 300w, https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/03\/Rajeev-S.-2026.-Tinnitus-Management-and-Rehabilation.-SAERA-1024x683.png 1024w, https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/03\/Rajeev-S.-2026.-Tinnitus-Management-and-Rehabilation.-SAERA-768x512.png 768w\" sizes=\"(max-width: 1536px) 100vw, 1536px\" \/>                                    <\/a> \r\n                                <\/div>                             \r\n                                \r\n                                <div class=\"blog-content\">                                    \r\n                                                                               <ul class=\"blog-meta\">\r\n                                                                                                                                            <li><i class=\"fa fa-calendar-check-o\"><\/i> 5 March 2026<\/li>\r\n                                                                                                                                                                                <\/ul>\r\n                                                                                \r\n                                        <h3 class=\"title dd\"><a href=\"https:\/\/saera.eu\/en\/2026\/03\/05\/tinnitus-management-and-rehabilitation\/\">Tinnitus Management and Rehabilitation: The Efficiency of Tinnitus Masker and Cognitive Behavioral Therapy in Patients with Normal Hearing and Mild to Moderate Hearing Loss<\/a><\/h3>\r\n                                                                                <div class=\"btn-btm d-flex align-items-center justify-content-between\">\r\n                                                                                                                                        <div class=\"btn-part\">\r\n                                                    <a class=\"readon-arrow\" href=\"https:\/\/saera.eu\/en\/2026\/03\/05\/tinnitus-management-and-rehabilitation\/\">\r\n                                                        Read More <i class=\"fa fa fa-angle-right\"><\/i>\r\n                                                    <\/a>\r\n                                                <\/div>\r\n                                                                                    <\/div>\r\n\r\n                                <\/div>                                \r\n                            \r\n                            <\/div>\r\n                                                    \r\n                    <\/div>\r\n\t\t\t\t\t\t\t\t\t\t\r\n\t\t\t\t\t<div class=\"grid-item col-lg-12  filter_audiology filter_blog filter_masters-thesis \">\r\n\r\n                                                    <div class=\"no-gutter blog-item rs-blog-grid1\">\r\n                                                           \r\n                                <div class=\"image-part\">\r\n                                    <a href=\"https:\/\/saera.eu\/en\/2026\/02\/17\/comparative-sound-processing-strategies-in-cochlear-implants\/\">\r\n                                        <img loading=\"lazy\" decoding=\"async\" width=\"1536\" height=\"1024\" src=\"https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/02\/Khalil-E.-M.-2026.-Comparative-Sound-Processing-Strategies-in-Cochlear-Implants-Cochlear-ACE-MED-EL-FS4-and-Advanced-Bionics-HiResOptima.-SAERA.png\" class=\"attachment-full size-full wp-post-image\" alt=\"\" srcset=\"https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/02\/Khalil-E.-M.-2026.-Comparative-Sound-Processing-Strategies-in-Cochlear-Implants-Cochlear-ACE-MED-EL-FS4-and-Advanced-Bionics-HiResOptima.-SAERA.png 1536w, https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/02\/Khalil-E.-M.-2026.-Comparative-Sound-Processing-Strategies-in-Cochlear-Implants-Cochlear-ACE-MED-EL-FS4-and-Advanced-Bionics-HiResOptima.-SAERA-300x200.png 300w, https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/02\/Khalil-E.-M.-2026.-Comparative-Sound-Processing-Strategies-in-Cochlear-Implants-Cochlear-ACE-MED-EL-FS4-and-Advanced-Bionics-HiResOptima.-SAERA-1024x683.png 1024w, https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/02\/Khalil-E.-M.-2026.-Comparative-Sound-Processing-Strategies-in-Cochlear-Implants-Cochlear-ACE-MED-EL-FS4-and-Advanced-Bionics-HiResOptima.-SAERA-768x512.png 768w\" sizes=\"(max-width: 1536px) 100vw, 1536px\" \/>                                    <\/a> \r\n                                <\/div>                             \r\n                                \r\n                                <div class=\"blog-content\">                                    \r\n                                                                               <ul class=\"blog-meta\">\r\n                                                                                                                                            <li><i class=\"fa fa-calendar-check-o\"><\/i> 17 February 2026<\/li>\r\n                                                                                                                                                                                <\/ul>\r\n                                                                                \r\n                                        <h3 class=\"title dd\"><a href=\"https:\/\/saera.eu\/en\/2026\/02\/17\/comparative-sound-processing-strategies-in-cochlear-implants\/\">Comparative Sound-Processing Strategies in Cochlear Implants: Cochlear (ACE), MED-EL (FS4), and Advanced Bionics (HiRes\/Optima)<\/a><\/h3>\r\n                                                                                <div class=\"btn-btm d-flex align-items-center justify-content-between\">\r\n                                                                                                                                        <div class=\"btn-part\">\r\n                                                    <a class=\"readon-arrow\" href=\"https:\/\/saera.eu\/en\/2026\/02\/17\/comparative-sound-processing-strategies-in-cochlear-implants\/\">\r\n                                                        Read More <i class=\"fa fa fa-angle-right\"><\/i>\r\n                                                    <\/a>\r\n                                                <\/div>\r\n                                                                                    <\/div>\r\n\r\n                                <\/div>                              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srcset=\"https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/02\/WhatsApp-Image-2026-02-11-at-11.45.17-e1770815562912.jpeg 1200w, https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/02\/WhatsApp-Image-2026-02-11-at-11.45.17-e1770815562912-300x171.jpeg 300w, https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/02\/WhatsApp-Image-2026-02-11-at-11.45.17-e1770815562912-1024x585.jpeg 1024w, https:\/\/saera.eu\/en\/wp-content\/uploads\/2026\/02\/WhatsApp-Image-2026-02-11-at-11.45.17-e1770815562912-768x438.jpeg 768w\" sizes=\"(max-width: 1200px) 100vw, 1200px\" \/>                                    <\/a> \r\n                                <\/div>                             \r\n                                \r\n                                <div class=\"blog-content\">                                    \r\n                                                                               <ul class=\"blog-meta\">\r\n                                                                                                                                            <li><i class=\"fa fa-calendar-check-o\"><\/i> 11 February 2026<\/li>\r\n                                                                                                                                                                                <\/ul>\r\n                                                                                \r\n                                        <h3 class=\"title dd\"><a href=\"https:\/\/saera.eu\/en\/2026\/02\/11\/saera-contributes-standardised-assessment-tools-to-ricpp-testing-laboratory\/\">SAERA Contributes Standardised Assessment Tools to RICPP Testing Laboratory<\/a><\/h3>\r\n                                                                                <div class=\"btn-btm d-flex align-items-center justify-content-between\">\r\n                                                                                                                                        <div class=\"btn-part\">\r\n                                                    <a class=\"readon-arrow\" href=\"https:\/\/saera.eu\/en\/2026\/02\/11\/saera-contributes-standardised-assessment-tools-to-ricpp-testing-laboratory\/\">\r\n                                                        Read More <i class=\"fa fa fa-angle-right\"><\/i>\r\n                                                    <\/a>\r\n                                                <\/div>\r\n                                                                                    <\/div>\r\n\r\n                                <\/div>                                \r\n                            \r\n                            <\/div>\r\n                                                    \r\n                    <\/div>\r\n\t\t\t\t\t                 \r\n                         \r\n                <\/div>   \r\n                               \r\n            \t    \r\n                              \r\n\t\t<\/div>\r\n\t   \t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Multifocal Contact Lenses in Myopia Control and Parameters Affecting their Efficacy \u00a0By Christina P. Myronidou,\u00a0student of the\u00a0Master in Clinical Optometry and Vision Therapy \u00a0Abstract \u00a0Alarming prevalence of myopia and associated ocular complications highlight the need for immediate interventions. Multifocal contact lenses (MFCLs) appear to have a potential as an optical strategy in the field of&#8230;<\/p>\n","protected":false},"author":1,"featured_media":20645,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"elementor_header_footer","format":"standard","meta":{"footnotes":""},"categories":[176,89,93],"tags":[109,97],"class_list":["post-20644","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-blog","category-masters-thesis","category-optometry","tag-myopia","tag-optometry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Multifocal Contact Lenses in Myopia Control and Parameters Affecting their Efficacy<\/title>\n<meta name=\"description\" content=\"This literature review aims to examine current evidence in relation to their efficacy in slowing myopia progression and axial elongation and identify critical parameters affecting their performance. Efficacy of MFCLs in myopia control is presented among several randomized clinical trials, showing an average percentage of 40-50% reduction in myopia progression and similar numbers to axial elongation.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/saera.eu\/en\/2025\/05\/19\/multifocal-contact-lenses-in-myopia-control-and-parameters-affecting-their-efficacy\/\" \/>\n<meta property=\"og:locale\" content=\"en_GB\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Multifocal Contact Lenses in Myopia Control and Parameters Affecting their Efficacy\" \/>\n<meta property=\"og:description\" content=\"This literature review aims to examine current evidence in relation to their efficacy in slowing myopia progression and axial elongation and identify critical parameters affecting their performance. 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