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.     

Videokeratoscopic assessment of silicone hydrogel contact lens wettability using a new in-vitro method

PurposeThe aim of the study was to assess the surface wettability of new-generation silicone hydrogel (SiH) contact lenses (CLs) videokeratoscopically using a new in-vitro method under office conditions.MethodVideokeratoscopic methodology was used to compare time-dependent CL wettability on an in-vitro cornea model. The model cornea was a polished chrome surface coating a Teflon form. It was prepared with a base curve of 8.7 mm and a diameter of 15 mm. Laboratory temperature and humidity were controlled. Before and after placing CLs on the on the model cornea, Bausch + Lomb Biotrue® multi-purpose solution (MPS) was dropped to simulate the pre-lens and post-lens film layer. Fanfilcon A, Senofilcon A, Samfilcon A, and Lotrafilcon B CLs with -3.00D were used, and images were taken with the videokeratoscopic method for testing. In the control group, the same procedure was performed without placing CLs. The images of CLs at 0, 60, 90, 120, 150, and 180 s were taken. Distortions and gaps seen in rings were recorded. The areas in rings were calculated in pixels using İmageJ.ResultsWhen CLs were examined, statistical differences were found among average pixel values (p < 0,001). The average pixel value was 131877.4 in the Samfilcon group, 116125.5 in the Senofilcon group, 137893.2 in the Fanfilcon group, 125578.3 in the Lotrafilcon group, and 124984.6 in the control group. No difference was found between the average values of the Lotrafilcon group and the control group. Differences were found between the average values of all other groups.DiscussionThe results obtained showed that videokeratoscopy was an effective method for in-vitro testing of CL wettability. It was found that SiH lenses displayed different performance under office conditions depending on materials and technologies used for wetting the lens surface. It was shown that lens surface wettability could be measured with a repeatable and new method when the factors affecting surface wetness and image quality were ruled out.     

Quantification of contact lens wettability after prolonged visual device use under low humidity conditions

Purpose: Discomfort of silicone hydrogel (SiHy) contact lenses (CL) is associated with longer wearing time, demanding visual tasks, and dry environments. This study investigated the impact of challenging environmental conditions on thewettability of four daily disposable SiHy CL. Methods: Habitual wearers of delefilcon A (n=32) and somofilcon A (n=32) were tested with their habitual lenses and with stenfilcon A and narafilcon A lenses. Digital videos were captured using non-invasive Tearscope illumination after 3 hrs of conventional wear and 3 hrs of computer use at 20% relative humidity (RH). Masked investigators analysed non-invasive break up time (NIBUT), minimum protected area (MPA) ofthe lens surface by the tear film, and dehydration speed (DS) over the interblink period after exposure to 20% RH.Results: For habitual delefilcon A wearers, mean NIBUT was longer with delefilcon A (9.2 sec) than stenfilcon A (6.3 sec, p = 0.052) and narafilcon A (5.1 sec, p = 0.006); mean MPA was significantly higher with delefilcon A (95.4%)than stenfilcon A (84.4%, p = 0.002) and narafilcon A (82.9%, p = 0.006); mean DS was lower with delefilcon A (0.28 mm2/sec) than stenfilcon A (0.81 mm2/sec, p = 0.002) and narafilcon A (0.60 mm2/sec, p = 0.056). For habitual somofilcon A wearers, mean MPA was lower for narafilcon A (76.2%) than for somofilcon A (89.0%, p < 0.001) but not stenfilcon A (88.4%, p = 0.748) and mean DS was higher for narafilcon A (0.96 mm2/sec) than somofilcon A (0.60mm2/sec, p = 0.029) but not stenfilcon A (0.51 mm2/sec, p = 0.701). Conclusions: Delefilcon A CL performed betterthan stenfilcon A and narafilcon A after 6 hrs of wear including 3 hrs intensive visual tasks under challenging environmental conditions. Delefilcon A CL may be preferable for CL wearers with intensive computers and/or digital devices usage.     

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.     

Uptake and release of polyhexamethylene biguanide (PHMB) from hydrogel and silicone hydrogel contact lenses using a radiolabel methodology

PurposeThe purpose of this study was to evaluate the uptake and release of radiolabelled polyhexamethylene biguanide (PHMB) on reusable daily wear contact lenses (CLs) over 7 days.MethodsThree silicone hydrogel (SH) contact lens materials (lotrafilcon B, balafilcon A, senofilcon A) and two conventional hydrogel (CH) materials (etafilcon A, omafilcon A) were examined. In experiment 1 (1-day study), CLs were soaked in 2 mL of phosphate buffered solution (PBS) containing radiolabelled ¹⁴C PHMB (1 µg/mL) for 8 h. The release kinetics of ¹⁴C PHMB from the CLs was measured at t = 0.25, 0.5, 1, 2, 4, 8, and 24 h in fresh 2 mL PBS. In experiment 2 (7-day study), the CLs were soaked in the ¹⁴C PHMB (1 µg/mL) solution for 8 h followed by a 16-hour release in 2 mL PBS. The lens cycle was repeated daily for 7 days. After both experiments, the residual amount of PHMB remaining within the lenses was extracted to determine the total uptake of PHMB.ResultsIn experiment 1, the total uptake of PHMB for etafilcon A was significantly greater than senofilcon A (p = 0.01). There were no significant differences in total uptake of PHMB between other lens materials (p > 0.05). Etafilcon A released more PHMB compared to all other lens types over a 24-hr period (p < 0.001). In experiment 2, all CL materials continued to sorb more PHMB over time (p < 0.001). By day 7, the amount of PHMB sorbed by etafilcon A was significantly greater than senofilcon A (p = 0.02). After day 2, the CH materials released significantly more PHMB than the SH materials (p < 0.01).ConclusionThe CL materials continued to sorb PHMB with no signs of saturation after 7 days. All lens materials released a consistent amount of PHMB each day. Radioactive labelling provides a sensitive method of assessing the uptake and release of PHMB from CL materials.     

Zeta potential of tear samples: A tool to explore the effects of wear of contact lenses

PurposeThe aim was to develop a method to assess the electrostatic properties of human tear samples, and to evaluate their modifications induced by the wear of contact lenses (CLs).MethodThe barrier method was developed for the measurement of the isoelectric point (IEP) on relatively small quantities. The method was applied to compare three groups: tears (T_NW) of non-wearers, tears (T_{W_etaf}) of regular wearers of etafilcon A CLs, and tears (T_{W_omaf}) of regular wearers of omafilcon A CLs. Zeta potential (ζ) as a function of pH was measured by a Zetasizer Nano ZS90 (Malvern Instruments) on 40%-diluted samples, obtained by mixing 57 μL of tears of different subjects of the same group with 85 μL of HCl aqueous solution. IEP was deduced as the pH at which ζ is zero, i.e. the net electric charge on tear constituents being neutralized.ResultsWithin an error of about 0.05, IEPs were found to be 2.90 (T_NW), 2.80 (T_{W_omaf}), and 3.16 (T_{W_etaf}). On average, a lower H⁺ concentration is needed to neutralize the surface charge of the tear components of etafilcon A wearers, compared to both T_NW and T_{W_omaf}.ConclusionIEP measurements on tear samples of wearers of different types of CLs are proposed in order to enhance the knowledge on the modifications of the profile of charged species in tears. The T_{W_etaf} results, compared to those of the other groups, are compatible with an increase, due to the wear of etafilcon A CLs, of the relative concentration of high-IEP proteins.     

Pre-contact lens and pre-corneal tear film kinetics

PurposeContact lenses (CL) insulate the corneal surface from the environment. It is possible that they influence the corneal sensory mechanism that contribute to spontaneous blinking. The study objective was to quantify the pre-CL and pre-corneal tear film kinetics (TFK) over blink period.MethodsThe study population was 202 soft CL wearers, 133 non-lens wearers. TFK were quantified via post-hoc masked analysis of HD Tearscope videos. The parameters were: Non-Invasive Break Up Time (NIBUT), Exposed Area % at initial break (EA 1st Break) and at blink (EA Blink), Interblink period (IB), Protective Index (PI) and exposure speed of surface dehydration (ES mm2/s). The TFK of CL wearers were compared to non-lens wearers. The hypothesis was that pre-CL TFK was inferior to pre-corneal, specifically greater tear film anomalies presence at blink.ResultsThe pre-corneal NIBUT was longer than pre-CL NIBUT (9.1 vs. 5.1s, p < 0.001). The EA 1st Break was smaller for pre-corneal than pre-CL (0.003 vs. 0.43%, p < 0.001). The mean IB time was similar for pre-CL and pre-corneal (9.4 vs. 9.8s, p = 0.213). The EA Blink % was smaller for pre-corneal than pre-CL (0.03 vs. 6.66%, p < 0.001). The ES was faster for pre-CL than pre-corneal (0.339 vs. 0.004, p < 0.001). The PI was greater for pre-corneal than pre-CL (99.9 vs. 97.1%, p < 0.001).ConclusionsPre-CL TFK were significantly inferior than pre-corneal, confirmed the hypothesis. The NIBUT was shorter. Once the initial break occurred, ES was faster, and EA was much greater for pre-CL than pre-corneal. The differences identified may be an aetiological component of CL discomfort and the relationship between TFK and discomfort in contact lens wearers should be investigated.     

Non-invasive pre-lens tear film assessment with high-speed videokeratoscopy

Purpose

To evaluate the effect of two types of daily contact lenses (delefilcon A and omafilcon A) on the tear film and establish whether it is dependent on pre-corneal tear film characteristics using a new method to analyse high-speed videokeratoscopy recordings, as well as to determine the sensitivity of the method in differentiating between contact lens materials on eye.

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.     

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.     

Provocation of the ocular surface to investigate the evaporative pathophysiology of dry eye disease

PurposeTo investigate whether standard clinical measures of tear film stability, meniscus height and symptomology reflect changes in evaporation rate induced by ocular surface provocations.MethodsForty participants (23.8 ± 4.5 years, 53 % female) with healthy to mild dry eyes underwent two tear film provocations in random sequence on separate occasions: playing a tablet computer high concentration game (http://slither.io/) for 30 min; and receiving treatment with humidity goggles for 10 min followed by liposomal spray application. Measures at baseline and 30 min later were: Symptom Assessment iN Dry Eye (SANDE) questionnaire, tear film lipid layer thickness (LLT), non-invasive tear film break-up time (NIBUT), tear meniscus height (TMH), dynamic tear film lipid layer pattern (DLP) and tear film evaporation (TFE).ResultsThere were no differences in the baseline measurements before each provocation (p > 0.05). Dry eye symptoms significantly worsened with concentration task (p < 0.001) and improved with treatment (p < 0.001). DLP and LLT significantly increased with treatment (p < 0.05), but was unaffected with the concentration task (p > 0.05). NIBUT declined with the concentration task (p = 0.015), but was not enhanced with treatment (p = 0.142). TMH increased after treatment (p = 0.001) and decreased with the concentration task (p = 0.006). While evaporation decreased with the concentration task (p < 0.001), treatment had no effect (p = 0.333). LLT was associated with evaporation (p = 0.036) and additionally with symptom severity (p = 0.002) and tear volume (p = 0.017).ConclusionsSub-classifying dry eye based on an ‘evaporative’ component to inform treatment seems over-simplistic. However objective TMH, NIBUT and LLT seem to be the key clinical metrics that drive ocular comfort.     

Agreement and repeatability of four different devices to measure non-invasive tear breakup time (NIBUT)

PurposeSince tear film stability can be affected by fluorescein, the Dry Eye Workshop (DEWSII) recommended non-invasive measurement of tear breakup time (NIBUT). The aim of this study was to investigate the agreement and repeatability of four different instruments in the measurement of NIBUT.Methods72 participants (mean 24.2 ± 3.6 years) were recruited for this multi-centre, cross-sectional study. NIBUT was measured three times from one eye using each of the instruments in randomized order on two separate sessions during a day, separated by at least 2 h. NIBUT was performed at three sites (Switzerland, Germany and UK) using three subjective instruments, Tearscope Plus (Keeler, Windsor, UK) (TS), Polaris (bon Optic, Lübeck, Germany) (POL), EasyTear Viewplus (Easytear, Rovereto, Italy) (ET) and the objective Keratograph 5 M (Oculus Optikgeräte GmbH, Wetzlar, Germany) (KER). As the latter instrument only analyses for 24 s, all data was capped at this value.ResultsNIBUT measurements (average of both sessions) between the four instruments were not statistically significantly different: TS (median 10.4, range 2.0–24.0 s), POL (10.1, 1.0–24.0 s), ET (10.6, 1.0–24.0 s) and KER (11.1, 2.6–24.0 s) (p = 0.949). The objective KER measures were on average (1.2 s ± 9.6 s, 95 % confidence interval) greater than the subjective evaluations of NIBUT with the other instruments (mean difference 0.4 s ± 7.7 s, 95 % confidence interval), resulting in a higher limits of agreement. The slope was -0.08 to 0.11 indicating no bias in the difference between instruments with the magnitude of the NIBUT. Repeated measurements from the two sessions were not significantly different for TS (p = 0.584), POL (p = 0.549), ET (p = 0.701) or KER (p = 0.261).ConclusionsThe four instruments evaluated for their measurement of tear stability were reasonably repeatable and give similar average results.     

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.

Fast versus gradual adaptation of soft daily disposable contact lenses in neophyte wearers

PurposeDespite the widespread practice of gradually adapting all new soft contact lens wearers (neophytes), there is little evidence-based research underpinning such practice. This work determined if a gradual adaptation period is necessary for neophytes when fitted with modern hydrogel or silicone-hydrogel daily disposable contact lenses.MethodAt four sites, neophytes (19–32 years) were randomly assigned to an adaptation schedule: fast (10 h wear from the first day) or gradual (4 h on the first day, increasing their wear-time by 2 h on each subsequent day until they had reached 10 h) with hydrogel (n = 24 fast; n = 21 gradual) or silicone-hydrogel (n = 10 fast; n = 10 gradual) contact lenses. Masked investigators graded ocular surface physiology and non-invasive tear breakup time (NIBUT). A range of subjective scores (using 0–100 visual analogue scales) were recorded at the initial visit and after 10 h of lens wear, 4–6 days and 12–14 days after initial fitting. Subjective scores were also repeated after 7 days.ResultsThere was no difference (p > 0.05) in ocular surface physiology between the fast and gradual adaptation groups at any time point in either lens type. NIBUT was similar at all time points for both adaptation groups in both lens types with the exception that the gradual adaptation silicone-hydrogel wearers had a slightly longer NIBUT (p = 0.007) than the fast adaptation group at 12-14 days. Subjective scores were also similar across the visits and lens types with the exception of ‘lens awareness’ and ‘ease of lens removal’ which were better (p < 0.05) in the fast compared with the gradual adaptation hydrogel lens group at day 7. Additionally, ‘end-of-day discomfort’ was better (p = 0.02) in the fast compared with the gradual adaptation hydrogel lens group at 12–14 days.ConclusionThere appears to be no benefit in daily disposable soft contact lens adaptation for neophytes with modern contact lens materials.     

Introducing a novel in vivo method to access visual performance during dewetting process of contact lens surface

PurposeTo introduce a novel in vivo method (Visual Acuity Dry Up; VADU) for testing the visual performance during the dewetting of the pre-lens tear film on a contact lens (CL).MethodsThirty-nine subjects were fitted with daily disposable CL (Nelfilcon A). Visual performance and dewetting characteristics of the pre-lens tear film were simultaneously assessed using a modified multifunctional topographer (Keratograph 5 M, OCULUS Optikgeräte GmbH, Wetzlar, GERMANY) and the Non-Invasive Keratograph Dry-Up Time (NIKDUT) method. Measures were taken after five minutes and eight hours of CL wear and included the Visual Acuity Dry-Up Time (VADUT; time between last blink and visual breakdown) and the Visual Acuity Dry-Up Area (VADUA; dewetted CL area at visual breakdown) at one (VA_+0.1logMAR), two (VA_+0.2logMAR) and three (VA_+0.3logMAR) log units below maximal visual acuity (VA).ResultsParticipants lost one, two or three log units of VA after 13.1 ± 17.4 s, 20.83 ± 21.81, 34.67 ± 29.11 (VADUT), corresponding to a dewetted CL area of 4.82 ± 6.64 mm², 9.5 ± 8.26 and 13.0 ± 8.68 (VADUA), respectively. Differences in VADUT und VADUA for all visual requirements were significant (all p < 0.05). VADUT and VADUA did not vary with CL wear duration (all p > 0.05). A median VA loss of one log unit occurred five seconds after the first dewetting.ConclusionsThe novel VADU method can be used to analyze the role of the tear film stability on the visual performance during CL wear. Hereby, visual loss is quantified based on the threshold definition of the psychometric function.     

Does placebo effect exist in contact lens discomfort management?

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.     

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.     

Compatibility of phospholipid liposomal spray with silicone hydrogel contact lens wear

Purpose

To assess the effects of two weeks of regular phospholipid liposomal spray application on lipid layer grade, tear film stability, subjective comfort, visual acuity, and lipid deposition in silicone hydrogel contact lens wearers.

Clinical performance and “ex vivo” dehydration of silicone hydrogel contact lenses with two new multipurpose solutions

PurposeTo compare the performance of two novel multipurpose disinfecting solutions (MPDS) in preventing silicone hydrogel contact lens dehydration, provide higher scores of subjective comfort and stable optical quality during a month of lens wear in neophyte volunteers.MethodThis is a prospective, double-blind, contralateral and randomised study involving the contra lateral use of Complete RevitaLens^® and Biotrue MPDS. Twenty-five neophytes wore Air Optix Aqua for 1 month. Volunteers were evaluated on day 1 and day 30 at 2 and 10 h after lens insertion. Tear film stability using Tearscope Plus (Keeler, UK), whole eye aberrations for 4.5 mm pupil size (IRx3, ImaginEyes, France) and subjective comfort (0–10 score) along with the dehydration values obtained with a gravimetric method were collected at each follow-up visit.ResultsNIBUT values decreased significantly with both care systems from baseline to 10 h visit on day 1 (p = 0.032 and 0.016, mean difference = −6.7 s and −7.0 s, for Complete Revitalens and Biotrue, respectively). Dehydration rates and ocular aberrations did not change significantly over the month of follow-up (p > 0.05, ANOVA with Bonferroni post hoc corrections), nor between visits within the same day (p > 0.05, paired sample T-test). End-of-day dryness sensation worsened similarly with both MPDS after 1 month (p = 0.021 and 0.005, mean difference = −1.4 and −1.3, for Complete Revitalens and Biotrue, respectively).ConclusionsRegardless of their different chemical compositions in terms of moisture additives both MPDS solutions evaluated performed similarly regarding objective measures of dehydration, tear stability and optical quality but presented significant differences in subjective symptoms.