Dataset Information

Dual-Polymer Drops, Contact Lens Comfort, and Lid Wiper Epitheliopathy.

ABSTRACT: This study compared a new contact lens rewetting drop containing both carboxymethylcellulose and hyaluronic acid (CMC-HA) with a standard drop containing carboxymethylcellulose only (CMC). Symptoms of discomfort typical in lens wear and lid wiper epitheliopathy (LWE) were assessed over a 3-month period in a diverse sample of contact lens wearers.Adapted daily-wear contact lens subjects using hydrogel, silicone hydrogel, or rigid gas permeable lenses were enrolled in this prospective, randomized, double-masked, parallel-group, 90-day study conducted at 15 clinical sites. Subjects were randomized 2:1 to CMC-HA (n = 244) or CMC alone (n = 121) with dosage at least four times per day, along with their habitual lens care system. At baseline and at days 7, 30, 60, and 90, subject-completed questionnaires, bulbar conjunctival staining, LWE, contact lens distance visual acuity (CLDVA), and standard safety measures were assessed.At day 90, CMC-HA performed significantly better than CMC in ocular symptoms including dryness throughout the day (p = 0.006), and burning/stinging throughout the day (p = 0.02) and at the end of the day (p < 0.001). CMC-HA also performed numerically better for dryness at the end of day (p = 0.06). LWE staining was improved in the CMC-HA group at day 90 whereas it increased slightly in the CMC alone group, with a significant between-group difference (p = 0.009). CMC-HA also demonstrated greater reduction in conjunctival staining compared with CMC alone at day 90 (p = 0.08). No differences in CLDVA, contact lens wear time, acceptability, and product use were observed, and safety outcomes were similar between groups.The addition of HA to a standard CMC rewetting drop improves clinical performance. In this comparison of rewetting drop efficacy in contact lens wearers, LWE was a useful clinical sign for differentiating clinical performance.

SUBMITTER: Nichols JJ

PROVIDER: S-EPMC4972480 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Dual-Polymer Drops, Contact Lens Comfort, and Lid Wiper Epitheliopathy.

Nichols Jason J JJ Lievens Christopher W CW Bloomenstein Marc R MR Liu Haixia H Simmons Peter P Vehige Joseph J

Optometry and vision science : official publication of the American Academy of Optometry 20160801 8

<h4>Purpose</h4>This study compared a new contact lens rewetting drop containing both carboxymethylcellulose and hyaluronic acid (CMC-HA) with a standard drop containing carboxymethylcellulose only (CMC). Symptoms of discomfort typical in lens wear and lid wiper epitheliopathy (LWE) were assessed over a 3-month period in a diverse sample of contact lens wearers.<h4>Methods</h4>Adapted daily-wear contact lens subjects using hydrogel, silicone hydrogel, or rigid gas permeable lenses were enrolled ...[more]

PMID: 27254807

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Project description:To analyze quantitatively the alterations in the microvascular network of the upper tarsal conjunctiva, lid wiper, and bulbar conjunctiva relative to ocular discomfort after contact lens wear.A prospective, crossover clinical study.Functional slit-lamp biomicroscopy was used to image the microvascular network of the upper tarsal conjunctiva, lid wiper, and bulbar conjunctiva. The microvascular network was automatically segmented, and fractal analyses were performed to yield the fractal dimension (Dbox) that represented vessel density. Sixteen healthy subjects (9 female and 7 male) with an average age of 35.5 ± 6.7 years (mean ± standard deviation) were recruited. The right eye was imaged at 9 AM and 3 PM at the first visit (day 1) when the subject was not wearing contact lenses. During the second visit (day 2), the right eye was fitted with a contact lens for 6 hours. Microvascular imaging was performed before (at 9 AM) and after lens wear (at 3 PM). Ocular comfort was rated using a 50-point visual analog scale before and after 6 hours of lens wear, and its relationships with microvascular parameters were analyzed.There were no significant differences in Dbox among the upper tarsal conjunctiva, lid wiper, and bulbar conjunctiva among the measurements at 9 AM (day 1 and day 2) and 3 PM (day 1) when the subjects were not wearing the lenses (P > .05), whereas after 6 hours of lens wear, the microvascular network densities were increased in all 3 of these locations. Dbox of the lid wiper increased from 1.411 ± 0.116 to 1.548 ± 0.079 after 6 hours of contact lens wear (P < .01). Dbox of the tarsal conjunctiva was 1.731 ± 0.026 at baseline and increased to 1.740 ± 0.030 (P < .05). Dbox of the bulbar conjunctiva increased from 1.587 ± 0.059 to 1.632 ± 0.060 (P < .001). The decrease in ocular discomfort was strongly related to the Dbox change in the lid wiper (r = 0.61, P < .05). There were no correlations between the changes of ocular comfort and the microvascular network densities of either the tarsal or bulbar conjunctivas (P > .05).This study is the first to show that the microvascular network of the lid wiper can be quantitatively analyzed in contact lens wearers. The microvascular responses of the lid wiper were significantly correlated with contact lens discomfort.

Project description:PurposeTo investigate whether carrying out various interventions part way through the day influences comfort in symptomatic daily disposable (DD) contact lens wearers.MethodsA subject-masked, randomized, controlled clinical trial was conducted in thirty symptomatic soft lens wearers who wore their habitual DD contact lenses bilaterally for 12 h on two separate days. Five hours after lens application, one of the following three interventions or a control was performed on each eye: replacing the existing lens with a new lens; removing and reapplying the same lens; performing a 'scleral swish'; and no action (control). Comfort scores were recorded using SMS text messages every hour following lens application using a 0 (causes pain) to 100 (excellent comfort) scale. Comfort scores before lens application, at 6 mins post-application, and at 6 mins post-intervention were also recorded.ResultsThere was a significant reduction in comfort from pre-lens application to 6 mins post-application for all groups (all p<0.05). Comfort gradually decreased from 6 mins to 5 h after lens application for each group (p<0.0001) with no significant difference between groups over the 5-h period (p = 0.09). There was no significant difference in comfort 6 mins post-intervention for any group (all p>0.05). After the intervention, comfort continued to decline (p<0.0001) with slightly lower mean scores for the control group compared to the new lens group (p = 0.003). Change in comfort relative to pre-intervention (5 h) was similar for all groups (p = 0.81). There was no difference in comfort at 12 h between groups (p = 0.83).ConclusionThis work has confirmed that comfort shows a continual and significant decline over a 12-h wearing period in symptomatic DD contact lens wearers. None of the interventions investigated had any significant impact on end-of-day comfort. These data suggest discomfort in lens wearers is more heavily influenced by changes to the ocular environment rather than to the lens itself.Trial registrationControlled-Trials.com ISRCTN10419752 http://www.controlled-trials.com/ISRCTN10419752.

Dataset Information

Dual-Polymer Drops, Contact Lens Comfort, and Lid Wiper Epitheliopathy.

Publications

Dual-Polymer Drops, Contact Lens Comfort, and Lid Wiper Epitheliopathy.

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