Does placebo effect exist in contact lens discomfort management? |
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| Affiliation: | 1. Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain;2. Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain;3. Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain;4. Redes temáticas de investigación cooperativa en salud (Oftared), Instituto de Salud Carlos III, Madrid, Spain;1. Health Sciences University Samsun Training and Research Hospital, Department of Ophthalmology Samsun, Turkey;2. Department of Ophthalmology, Van Yuzuncu Yil University, Faculty Of Medicine, Turkey;1. Department of Optometry and Vision Sciences, Australia;2. Department of Microbiology and Immunology at the Peter Doherty Institute of Infection and Immunity, The University of Melbourne, Parkville, Victoria, 3010, Australia;1. School of Optometry, University of Alabama at Birmingham, Birmingham, AL, USA;2. College of Optometry, The Ohio State University, Columbus, OH, USA;3. College of Optometry, University of Houston, Houston, TX, USA;4. JENVIS Research c/o Ernst Abbe University of Jena, Jena, DE, USA;5. Southern College of Optometry, Memphis, TN, USA;6. Southern California College of Optometry, Marshall B Ketchum, Fullerton, CA, USA;7. Centre for Ocular Research and Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, CA, USA |
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| Abstract: | PurposeTo study the effect of daily disposable contact lens (DDCL) refitting in monthly contact lens (CL) wearers suffering from contact lens discomfort (CLD), and to assess if there is a placebo effect associated with this CLD intervention.MethodsSymptomatic CL wearers, according to the Contact Lens Dry Eye Questionnaire 8 (CLDEQ-8 ≥ 12 points), were divided into two groups. The study group was provided with DDCLs (delefilcon A) and the control group with a masked pair of their habitual monthly CLs (placebo effect) and were assessed after one month. Then, the control group was provided with the same DDCLs and evaluated one month later. The symptoms were recorded with the CLDEQ-8 and global rating of change scale (GRCS). Non-invasive tear break-up time (NITBUT), conjunctival hyperaemia, fluorescein staining, and lid wiper epitheliopathy (LWE) were evaluated. Changes between visits, groups, and the effect of each intervention were analysed.ResultsThirty-one participants (mean age: 23.2 ± 5.3 years) were recruited. The study group (n = 14) showed an improvement of -39.6 ± 25.8 % (p < 0.001) in CLDEQ-8 and 31.3 ± 14.6 points in GRCS (p < 0.001) after one month of DDCL use, while no changes in clinical tests were found. In the control group (n = 17), symptoms improved significantly after wearing the masked monthly CL (CLDEQ-8: -26.1 ± 31.0 %, p = 0.03; GRCS: 14.9 ± 17.0, p = 0.002), however a worsening in bulbar (26.5 ± 40.0 %; p = 0.02) and limbal hyperaemia (21.6 ± 34.7 %, p = 0.02) and an improvement of -19.1 ± 37.0 % (p = 0.049) in LWE was found. When the control group was fitted with the DDCL, improvements in GRCS (20.5 ± 25.5, p = 0.02), NITBUT (37.9 ± 42.3 %, p = 0.002), and conjunctival staining (-47.1 ± 59.9 %, p = 0.005) were noted.ConclusionsRefitting symptomatic monthly CL wearers with Delefilcon A DDCL is effective in reducing symptoms related to CLD. However, clinicians and researchers must be aware of the existence of a placebo effect when assessing the effectiveness of any CL refitting. |
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| Keywords: | Contact lens discomfort Management Daily disposable contact lenses Placebo effect |
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