Predicting success with silicone-hydrogel contact lenses in new wearers |
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| Affiliation: | 1. Specsavers, 41 High Row, Darlington, Co Durham DL3 7QW, UK;2. Aston University, Life and Health Science, Ophthalmic Research Group, Birmingham, UK;1. Centre for Contact Lens Research, School of Optometry, University of Waterloo, 200 University Avenue West, Waterloo, ON, Canada N2L 3G1;2. School of Medicine (Optometry), Deakin University, 75 Pigdons Rd, Waurn Ponds, VIC 3214, Australia;1. Schepens Eye Research Institute, Massachusetts Eye and Ear and Department of Ophthalmology, Harvard Medical School, Boston, MA, USA;2. Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-Consejo Superior de Investigaciones Científicas, and International Brain Research Organization, Alicante, Spain;3. Complutense University of Madrid and Hospital Clinico San Carlos, Madrid, Spain;4. University of Oxford, Oxford, UK;5. Section of Ophthalmology, Division of Clinical Neuroscience, University of Nottingham, Nottingham, UK;6. School of Optometry, University of Alabama, Birmingham, AL, USA;7. PharmaLogic Development, Inc., San Rafael, CA, USA;8. Laboratory for Experimental Ophthalmology, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany;9. School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia;10. Ophthalmic Research Group, Life and Health Sciences, Aston University, Birmingham, UK;1. Optics Department, Faculty of Physics, University of Valencia, Spain;2. Ophthalmic Research Group, Aston University, Birmingham, UK;3. Visioncare Research, Farnham, UK;1. Pacific University College of Optometry, Forest Grove, OR, USA;2. Eye-Contact-Lens Research & Education, Amsterdam, The Netherlands;3. Optimec Systems Ltd, Malvern, United Kingdom |
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| Abstract: | Purposeto evaluate changes in tear metrics and ocular signs induced by six months of silicone-hydrogel contact lens wear and the difference in baseline characteristics between those who successfully continued in contact lens wear compared to those that did not.MethodsNon-invasive Keratograph, Tearscope and fluorescein tear break-up times (TBUTs), tear meniscus height, bulbar and limbal hyperaemia, lid-parallel conjunctival folds (LIPCOF), phenol red thread, fluorescein and lissamine-green staining, and lid wiper epitheliopathy were measured on 60 new contact lens wearers fitted with monthly silicone-hydrogels (average age 36 ± 14 years, 40 females). Symptoms were evaluated by the Ocular Surface Disease Index (OSDI). After six months full time contact lens wear the above metrics were re-measured on those patients still in contact lens wear (n = 33). The initial measurements were also compared between the group still wearing lenses after six months and those who had ceased lens wear (n = 27).ResultsThere were significant changes in tear meniscus height (p = 0.031), bulbar hyperaemia (p = 0.011), fluorescein TBUT (p = 0.027), corneal (p = 0.007) and conjunctival (p = 0.009) staining, LIPCOF (p = 0.011) and lid wiper epitheliopathy (p = 0.002) after six months of silicone-hydrogel wear. Successful wearers had a higher non-invasive (17.0 ± 8.2 s vs 12.0 ± 5.6 s; p = 0.001) and fluorescein (10.7 ± 6.4 s vs 7.5 ± 4.7 s; p = 0.001) TBUT than drop-outs, although OSDI (cut-off 4.2) was also a strong predictor of success.ConclusionSilicone-hydrogel lenses induced significant changes in the tear film and ocular surface as well as lid margin staining. Wettability of the ocular surface is the main factor affecting contact lens drop-out. |
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