Predicting success with silicone-hydrogel contact lenses in new wearers

Best, Nigel; Drury, Laura and Wolffsohn, James S. Predicting success with silicone-hydrogel contact lenses in new wearers. Contact Lens and Anterior Eye, 36 (5), pp. 232-237.

Abstract

Purpose: to 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. Methods: Non-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). Results: There 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. Conclusion: Silicone-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. © 2013 British Contact Lens Association.

Publication DOI: https://doi.org/10.1016/j.clae.2013.02.013
Divisions: Life & Health Sciences > Optometry
Life & Health Sciences > Ophthalmic Research Group
Life & Health Sciences > Applied Health Research Group
Life & Health Sciences > Health Sciences
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Additional Information: NOTICE: this is the author’s version of a work that was accepted for publication in Contact lens and anterior eye. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Best, N, Drury, L & Wolffsohn, JS, 'Predicting success with silicone-hydrogel contact lenses in new wearers' Contact lens and anterior eye, vol In Press, corrected proof. (2013) DOI 10.1016/j.clae.2013.02.013
Uncontrolled Keywords: comfort,contact lens induced dry-eye,drop-out,neophytes,silicone-hydrogel contact lenses,tear-film,Ophthalmology,Optometry

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