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Dorota Helena Szczesna-Iskander, Paulina Jamiol, Malgorzata Biazik, Angelika Ogar; Tear film parameters and contact lens discomfort. Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):6106.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the correspondence of Tear film Surface Quality (TFSQ) and Stability (TFSS) assessed in vivo using interferometry and videokeratoscopy, with contact lens discomfort (CLD), standard anterior eye examination observation and tear film osmolarity.
Non-invasive dynamic High-Speed Videokeratoscopy (HSV) and Lateral Shearing Interferometry (LSI), tear film osmolarity (TearLab), fluorescein tear break-up times (FBUT), tear meniscus height (TMH) - slit lamp graticule and OCT based), fluorescein and lissamine-green staining, and lid wiper epitheliopathy were measured on 14 experienced contact lens wearers with normal tear film (TF) fitted with daily disposable silicone-hydrogel lens (SHL) and hydrogel lens (HL) (average age 23±4 years, 11F/3M). Symptoms were evaluated by the Ocular Surface Disease Index (OSDI) and Contact Lens Dry Eye Questionnaire (CLDEQ-8). After two weeks daily (11.8±1.8 h per day) contact lens wear the above metrics were re-measured for each pair of lenses. One week of washout between lenses was applied. For evaluation of contact lens materials the group median of each parameter was calculated. The statistical analyses included standard descriptive statistics and a nonparametric one way ANOVA (Kruskal-Wallis). Correlation analysis was used to assess links between objective measures and subjective comfort.
HL material worsened TFSQ and TFSS less than SHL in respect to pre-corneal TF. Significant differences in average TFSQ and TFSS were noticed between lens materials on the first day of wear (p=0.008), but not two weeks after (p=0.16). SHL resulted in significantly higher staining score of conjunctival regions than HL (p=0.02). SHL was evaluated as more comfortable than HL by the majority of subjects. In 7 cases changes in tarsal conjunctiva or Marx line were observed. Correspondingly, in 5 cases worsening of TFSQ occurred. No statistically significant correlation between TF osmolarity, TMH, TFSQ, TFSS, and CLD was found.
Although LSI and HSV techniques have the ability to distinguish between lens materials in vivo, in this pilot study no correspondence between the subjective comfort and TFSQ and TFSS assessed by those methods was shown for contact lens wearers. Further studies involving larger group of subjects and longer time of lens wear are needed to confirm lack of those associations.
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