Performance evaluation of delefilcon a water gradient daily disposable contact lenses in first-time contact lens wearers

Purpose

To evaluate the tolerability of and subject and investigator satisfaction with delefilcon A (DAILIES TOTAL1^®) daily disposable contact lenses in first-time contact lens wearers.

Eye care professionals’ perceptions of the benefits of daily disposable silicone hydrogel contact lenses

PurposeTo gain a better understanding of eye care professionals’ (ECPs) perceptions regarding the benefits of silicone hydrogel (SiH) daily disposable contact lenses (DDCL), particularly with respect to health, comfort and patient satisfaction.MethodsA survey was conducted with 300 ECPs in the United States, United Kingdom and Japan during November 2017. The survey comprised 34 statements relating to SiH DDCLs, to which the ECPs provided their level of agreement using a 6 point Likert scale. A minimum of 70% agreement was set to define majority agreement. Categories of statements included Health, Comfort, Patient Experience, and Standard of Care.ResultsECPs rated the highest levels of agreement to perceptions within the Patient Experiences and Health categories. The six statements receiving the highest ratings were “Silicone hydrogel 1 day lenses satisfy today’s patients’ demanding lifestyles” (93% agreement); “Silicone hydrogel 1 day lenses are the best choice to safeguard my patients’ eye health related to contact lens wear” (92%); “Silicone hydrogel 1 day lenses provide the best benefits to my patients” (92%); “Silicone hydrogel 1 day lenses provide better long term eye health for my patients than hydrogel 1 day lenses” (91%); “Silicone hydrogel is the healthiest lens material for my daily disposable patients” (90%); and “Silicone hydrogel 1 day lenses provide a better wearing experience for my patients than hydrogel 1 day lenses” (90%).ConclusionECPs perceive that SiH DDCLs offer long-term eye health and comfort for the patient and although the ECPs surveyed would not necessarily prescribe SiH DDCLs to all their patients, they would prescribe them to most of their patients. The results support the premise that while ECPs consider SiH 1 day contact lenses as the current “standard of care”; the principal barrier continues to be the perceived higher cost of these lenses.     

A multi-country assessment of compliance with daily disposable contact lens wear

PurposeTo investigate compliance with daily disposable contact lens (DDCL) wear and investigate re-use of lenses according to country and DDCL material worn.MethodsOptometrists invited eligible DDCL patients from their practices to participate in a survey on DDCL wear in Australia, Norway, the United Kingdom (UK) and the United States (US). Eligible participants completed an online or paper version of the survey.Results805 participants completed the survey (96% online): Australia 13%, Norway 32%, UK 17%, US 38%. The median age was 38 years; 66% were female. Silicone hydrogel (SiHy) DDCLs were worn by 14%. Overall, 9% were non-compliant with DDCL replacement; Australia 18%, US 12%, UK 7% and Norway 4%. There were no differences with respect to sex, years of contact lens wear experience or DDCL material (SiHy versus hydrogels). The primary reason for re-use was “to save money” (60%). Re-use of DDCLs resulted in inferior comfort at insertion and prior to lens removal (p = 0.001). 75% reported occasional napping and 28% reported sleeping overnight for at least one night in the preceding month, while wearing their DDCLs.ConclusionNon-compliance with replacement of DDCLs occurred in all countries investigated; the rate was highest in Australia and lowest in Norway. Re-use of DDCLs was associated with reduced comfort. DDCL wearers often reported wearing lenses overnight. It is important for optometrists to counsel their patients on the importance of appropriate lens wear and replacement for DDCLs.     

An investigation into disposal and recycling options for daily disposable and monthly replacement soft contact lens modalities

PurposeTo examine the annualised waste and end-of-life disposal options with two representative soft contact lens (CL) modalities.MethodsThe component parts of two representative soft CL modalities were catalogued, separated, weighed and inspected for material identification: somofilcon A soft CLs (clariti elite, CooperVision Inc.) used with multi-purpose solution (MPS) (All in one Light, CooperVision Inc.) and somofilcon A CLs (clariti 1 day, CooperVision Inc). Using a model that assumed compliant wear and care of CLs, the mass of material solid waste generated by CL use over a year was calculated. Disposal options were explored using household and specialist recycling streams in order to develop recommendations for responsible disposal of CL waste.ResultsFull-time daily disposable (DD) CL wear generates 1.06 kg of waste annually compared to 0.83 kg generated by reusable-monthly replacement daily wear (‘reusable’) CLs. Plastic was the dominant material in both modalities. With full-time use of DD CLs, 64% of waste by mass was plastic blister trays. For full-time use of reusable CLs, where figures from lens and MPS packaging are combined, plastics accounted for 67% of waste by mass. MPS bottles alone made up almost half the waste (45%) associated with full-time reusable CL wear.ConclusionFull-time DD wear generates 27% more waste annually than full-time reusable lens wear. Reusable CL wearers can recycle 78% of waste at home. DD lens wearers have access to recycling options that allow them to recycle 100% of CL related waste. Full-time CL lens wear represents just 0.20–0.26% of the 412 kg of household waste generated per person, per year in the United Kingdom. Worn CLs should never be disposed of down the sink or lavatory. CL wearers should be aware of responsible end-of-life recycling and disposal options for all CL waste.     

Trends in the use of silicone hydrogel contact lenses for daily wear

Although the first silicone hydrogel contact lenses introduced onto the world contact lens market in 1999 held approval for both daily wear and extended wear use, the latter modality was promoted much more heavily by the manufacturers. The first silicone hydrogel lenses specifically promoted for daily wear were introduced in 2003. Data that we have gathered from annual contact lens fitting surveys demonstrate an immediate increase in market share whereby this lens type now represents more than one-third of soft lens fits in the United Kingdom. The success of this lens category is attributed to the health and safety benefits of silicone hydrogel materials and the positive impact of lens manufacturers by way of the effective marketing and distribution of these products.     

Prescribing daily disposable contact lenses in the UK.

Patterns of prescribing daily disposable contact lenses in the UK were determined by mining through data gathered from annual contact lens fitting surveys conducted over the past 12 years. Spherical, toric and multifocal design daily disposable lenses represent a substantial proportion of all contact lenses prescribed, reflecting the significant ocular health and lifestyle advantages offered by this lens category.     

Corneal epithelial thickness and corneal curvature changes during the day: The effects of daily disposable contact lens wear

PurposeTo evaluate the changes in corneal epithelial thickness and corneal anterior and posterior curvatures during the day, and the effect of wearing daily disposable soft contact lenses.MethodsThirty-two healthy volunteers were enrolled in a randomized crossover study. At the baseline visit, corneal and epithelial thickness maps (OCT; Optovue, Inc., Fremont, CA, USA) and keratometric measurements (Pentacam, Oculus, GmbH, Germany) were performed in the morning and in the afternoon (8 hours after). Then, each subject was fitted with the following brands of daily disposable contact lenses in random order: Dailies Total 1 (Delefilcon A), Dailies Aqua Comfort (Nelfilcon A), TruEye (Narafilcon A) and Biotrue Oneday (Nesofilcon A) on different days. All fitted lenses had a power of −3.00 diopters (D). Measurements were repeated before putting the contact lens on and after an-eight-hour contact lens wear.ResultsWith no lens wear, the anterior topographic indices showed significant steepening [Kflat: p < 0.0001; Ksteep: p < 0.0001 and maximum keratometry value (Kmax): p = 0.04] and the corneal thickness significantly decreased in the central and temporal portion of the cornea in the afternoon. There were no significant changes in the posterior topographical indices and corneal epithelial thickness. With contact lens wear, no significant change occurred in the corneal and epithelial thickness, and the anterior and posterior curvatures during the day (all p values >0.05). There was no statistically significant difference in the epithelial thickness among the groups wearing different contact lens types (p > 0.05).ConclusionsAnterior corneal topographic indices steepen depending on the natural diurnal variations. Daily wear of soft contact lenses appears to mask this steepening. The corneal epithelial thickness is not affected by daily disposable soft contact lenses.     

Synthesis and characterization of nanosilver-silicone hydrogel composites for inhibition of bacteria growth

Purpose

Nanosilver-silicone hydrogel (NAgSiH) composites for contact lenses were synthesized to asses the antimicrobial effects.

The use of daily disposable lenses in problematic reusable contact lens wearers

PurposeReplacing soft contact lenses (CLs) on a daily basis brings a number of advantages, most notably, reduced exposure to deposits, disinfectants, allergens, and other contaminants. This retrospective study estimated the prevalence of problems in current wearers of reusable soft CLs and tested the effect of refitting “problem” patients with daily disposable (DD) hydrogel lenses.MethodsPrevalence was estimated from 398 current reusable CL wearers for: frequent/constant discomfort or dryness, ≥2 h of uncomfortable wear, ≥grade 2 conjunctival hyperaemia (0–4), or ≥grade 3 corneal staining (0–15). In the second part of the study, 217 reusable CL wearers classified as problem patients were randomly refitted with DD lenses manufactured from one of two materials: etafilcon A (n = 96) or nelfilcon A (n = 121) and reassessed 1 week later.ResultsThirty-nine percent (154/398) had some qualifying criterion: reduced comfortable wearing time (CWT), 20%; dryness, 20%; irritation, 5%; corneal staining, 8%; and hyperaemia, 7%. After refitting with DDs, the prevalence of reduced CWT was decreased from 65% to 51% (P = 0.0039), dryness from 60% to 41% (P < 0.0001) and corneal staining from 28% to 21% (P = 0.04). There was no significant change in the prevalence of irritation, or hyperaemia. Some differences were noted between the two lens materials.ConclusionsA high proportion of reusable soft lens wearers encounter clinically relevant signs or symptoms with their current CLs. This study provides evidence that refitting with DD lenses is a useful strategy for alleviating some of the common problems of CL wear.     

Health beliefs affect the correct replacement of daily disposable contact lenses: Predicting compliance with the Health Belief Model and the Theory of Planned Behaviour

Purpose

To assess the compliance of Daily Disposable Contact Lenses (DDCLs) wearers with replacing lenses at a manufacturer-recommended replacement frequency. To evaluate the ability of two different Health Behavioural Theories (HBT), The Health Belief Model (HBM) and The Theory of Planned Behaviour (TPB), in predicting compliance.

In vitro power profiles of daily disposable contact lenses

PurposeTo evaluate and compare the distribution of refractive power within the optic zone of different soft contact lenses and to investigate the effect of lens decentration on the power profiles.MethodsThe Nimo TR1504 instrument was used to measure the optical power across different aperture diameters (from 1.5 mm to 5.5 mm in steps of 0.5 mm) of four daily disposable contact lenses: DAILIES TOTAL1, Proclear 1-Day, SofLens daily disposable and 1-DAY ACUVUE MOIST. Measurements were performed using a wet cell. Power data were evaluated when contact lenses were in its centered position and after inducing different amounts of lens decentration (from 0.2 mm to 1.0 mm in steps of 0.2 mm).ResultsAll contact lenses showed an increase – more negative – in lens power with distance from the lens center. The amount of change varied depending on the lens. It was about 10% of lens power for DAILIES TOTAL1 (−0.29 diopters (D)), SofLens daily disposable (−0.36 D), and Proclear 1-Day (−0.32 D) whereas 1-DAY ACUVUE MOIST showed a percentage variation of 3.3% (−0.10 D). After inducing a lens decentration up to 1 mm, the power curves were shifted in the negative direction. However, the change obtained in lens power compared with well-centered position was always lower than a quarter of diopter both for all the lenses and aperture diameters.ConclusionsOur results showed a variation of the refractive power from the lens center, becoming more negative toward the periphery, with a negligible effect of the decentration for all disposable contact lenses studied.     

In-vitro dewetting properties of planned replacement and daily disposable silicone hydrogel contact lenses

AimTo compare the in-vitro videokeratoscopic surface dewetting properties of new-generation silicone hydrogel (SiH) planned replacement contact lenses (CL) with those of daily disposable CLs.MethodA chrome coated cornea model was used for the in-vitro evaluation of surface dewetting. Pre-lens and post-lens film layers were formed by instilling a normal preservative-free normal saline solution (PFNs) (0.9 %) before and after the placement of the CL on the model cornea. The tests were carried out on fanfilcon A, lotrafilcon B, samfilcon A, and senofilcon A lenses, as well as such daily disposable lenses as delefilcon, nesofilcon A and senofilcon one day. Using videokeratoscopic methods, images were obtained at 30-second intervals up to 180 s in the lens and control groups and were analyzed by the ImajeJ® program.ResultsThe mean measured area of the keratoscopic rings was largest in the fanfilcon group (67.56 mm²), followed by 61.53 mm² in the lotrafilcon A group and 64.60 mm² in the samfilcon group, while the smallest area was measured in the senofilcon A group, at 56.90 mm². The area was measured as 64.33, 63.09 and 68.39 mm² for the delefilcon, nesofilcon and Senofilcon one day CLs, respectively. The dewetting patterns and properties differed in the CL groups (p < 0.05), while no significant differences were found between the measured areas of the planned replacement and daily disposable CL groups (p > 0.05).DiscussionVideokeratoscopy using in-vitro cornea models has been identified as a reproducible and reliable method for the analysis of the surface dewetting of CLs. The dewetting characteristics of CL groups have been found to differ from each other, despite all being produced from SiH materials. The surface wetting coating has been shown to affect CL dewetting performance.     

Spherical aberration in contact lens wear

INTRODUCTION: The aim of the present studies was to investigate the effect on spherical aberration of different non custom-made contact lenses, both with and without aberration control. METHODS: A wavefront analyser (Zywave, Bausch & Lomb) was used to measure the aberrations in each subject's right eye uncorrected and with the different contact lenses. The first study evaluated residual spherical aberration with a standard lens (Focus Dailies Disposable, Ciba Vision) and with an aberration controlled contact lens (ACCL) (Definition AC, Optical Connection Inc.). The second study evaluated the residual spherical aberrations with a monthly disposable silicone hydrogel lens with aberration reduction (PureVision, Bausch & Lomb). RESULTS: Uncorrected spherical aberration was positive for all pupil sizes in both studies. In the first study, residual spherical aberration was close to zero with the standard lens for all pupil sizes whereas the ACCL over-corrected spherical aberration. The results of the second study showed that the monthly disposable lens also over-corrected the aberration making it negative. The changes in aberration were statistically significant (p<0.05) with all lenses. CONCLUSION: Since the amount of aberration varies individually we suggest that aberrations should be measured with lenses on the eye if the aim is to change spherical aberration in a certain direction.     

The effect of hydrogel and silicone hydrogel contact lenses on the measurement of intraocular pressure with rebound tonometry

Purpose

To assess the accuracy of intraocular pressure (IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) and silicone hydrogel (senofilcon A) contact lenses (CLs) of different powers.

Methods

The experimental group comprised 36 subjects (19 male, 17 female). IOP measurements were undertaken on the subject's right eyes in random order using a rebound tonometer (ICare). The CLs had powers of +2.00D, −2.00D and −6.00D. Six measurements were taken over each contact lens and also before and after the CLs had been worn.

Results

A good correlation was found between IOP measurements with and without CLs (all r ≥ 0.80; p < 0.05). Bland Altman plots did not show any significant trend in the difference in IOP readings with and without CLs as a function of IOP value. A two-way ANOVA revealed a significant effect of material and power (p < 0.01) but no interaction. All the comparisons between the measurements without CLs and with hydrogel CLs were significant (p < 0.01). The comparisons with silicone hydrogel CLs were not significant.

Conclusions

Rebound tonometry can be reliably performed over silicone hydrogel CLs. With hydrogel CLs, the measurements were lower than those without CLs. However, despite the fact that these differences were statistically significant, their clinical significance was minimal.     

Struggle with hydrogel CL wear increases with age in young adults

Purpose

To report the symptoms and experiences associated with habitual hydrogel (Hyd) and silicone hydrogel (SiHy) contact lenses (CLs) among young adults and measure their association with age.

Methods

Questionnaire responses from 699 Hyd and 183 SiHy wearers were analyzed to test the association of age with features indicating struggle with CL wear. Prevalence by age was compared between groups with Pearson's chi-square and within groups with Spearman's correlation coefficient.

Results

Hyd and SiHy groups were similar for sex and age distribution. Diagnosis of dry eye increased with age in the Hyd wearers from 10.6% to 21.1% (18-24 vs. 30-35 years), but was approximately 19% in the SiHy wearers across age. Adverse environments caused more discomfort with Hyd than SiHy lenses and Hyd wearers’ discomfort increased with age (smoky (p = 0.0001), dry air environments (p = 0.002), after napping or sleeping (p = 0.004). More Hyd wearers considered discontinuation of CL wear with age, from 4.6% to 14.2% (18-24 vs. 30-35 years, p < 0.04), but the proportion remained steady at 9% across age for SiHy wearers (p = 0.46).

Conclusions

From 18 to 35 years, hydrogel CL wearers reported increasing struggle with CL wear and more negative ratings compared to SiHy wearers. Older hydrogel CL wearers were also more likely to consider discontinuing CL wear compared with younger hydrogel or silicone hydrogel CL wearers in general. Young adult CL wearers should be routinely queried directly about specific aspects of CL wear in order to determine whether different lens types should be prescribed to avoid abandonment of CL wear.     

The influence of lens care systems on eyelid tissue changes during silicone hydrogel contact lens wear

Purpose

To compare the effects of a hydrogen peroxide (H₂O₂)-based lens care solution and a polyhexamethylene biguanide (PHMB) multi-purpose solution on the eyelids when used with silicone hydrogel (SiHy) contact lenses.

Ten years of disposable contact lenses - a review of benefits and risks

The performance and benefits as well as the risks and complications of disposable soft lenses (single use disposable or re-used 2-4 weeks) are reviewed in relation to corneal physiology. Modern designs and advanced technology have resulted in disposable lenses providing excellent visual performance. Fewer subjective symptoms (e.g. dryness and grittiness), slit-lamp findings (such as injection and tarsal abnormalities), and inflammatory responses (papillary conjunctivitis; contact lens-induced acute red eye) have been reported with disposable lenses than with conventional soft lenses. The risk of contact lens-induced keratitis (CLIK) has been reported to be higher for daily wear of disposable lenses than for other lens types by UK investigators. Other studies have shown the risk of CLIK with disposable lenses to be equal to that with conventional soft lenses, and in two extensive Swedish studies, the incidence of severe keratitis was found to be significantly lower for daily wear (DW) of disposable lenses than for DW of conventional soft and rigid gas permeable lenses. Both the total complication rate and the number of unscheduled visits are found to be significantly lower for disposable lenses than for conventional soft lenses in several studies. Comfort has been reported to be significantly better and overall satisfaction significantly greater with disposable lenses than with conventional soft lenses according to many studies. These may be important reasons why the success rate for disposable lens wear is reported to be fairly high, generally 70-90%. The importance of appropriate care for 're-usable disposable lenses' must be stressed. One day disposable lenses, if used as directed, will eliminate the risk factors of inadequate cleaning and disinfection as well as contaminated lens cases.     

Corneal shape changes induced by first and second generation silicone hydrogel contact lenses in daily wear

Purpose

To compare the corneal topographical changes induced by two first and second generation silicone-hydrogel (SiH) contact lenses after 3 months of daily wear (DW).

Methods

Prospective, consecutive case-series in which patients wore one of 3 different contact lenses (either the first generation SiH Focus Night & Day, the second generation SiH Acuvue Oasys or the monthly disposable Soflens 38 hydrogel lens as control group) on a DW basis for 3 months. Over-refraction, visual acuity, mean keratometry, corneal astigmatism, corneal eccentricity, superficial regularity and superficial asymmetry indices were monitored over the 3-month period.

Results

Nineteen eyes of 10 patients completed the study. Seven Focus Night & Day, 7 Acuvue Oasys and 5 Soflens 38 contact lenses were fitted. There were no significant changes between any of the parameters measured at the 3-month visit in any of the SiH groups (non-parametric Wilcoxon test, p > 0.05). However, the control group (Soflens 38) showed statistically significant changes regarding mean keratometry, corneal astigmatism and corneal eccentricity (p < 0.05). Three patients wearing the first generation SiH showed adverse events of different degree related to their high modulus of elasticity.

Conclusions

After 3 months of DW, wearers of first and second generation SiH lenses showed greater corneal stability than hydrogel monthly disposable contact lenses users regarding commonly used topographic corneal shape indices. However, complications related to the mechanical properties of first generation SiH were seen in three patients in the follow-up time.