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Jason J. Nichols, Kathrine E. Osborn, Terri Henderson; Impact of a Novel Silicone Hydrogel Material on Meibomian Gland Structure. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6301.
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Previous work has suggested that contact lens wear is associated with meibomian gland atrophy, and this may be related to modulus (Arita et al, IOVS, 2009). Thus, the purpose of this work was to compare the structural response of the meibomian glands to low modulus silicone hydrogel contact lens wear in a neophyte sample of patients over a one year period.
This was a randomized, masked clinical trial. At baseline, neophyte subjects between 15 and 39 years of age, with a distance contact lens correction between -0.50 and -6.00 DS and less than 0.75 DC were randomly assigned to 1-Day ACUVUE TruEye (narafilcon B, Johnson & Johnson Vision Care, Inc.) (n = 47) or to continue wearing their own spectacles (n = 47). At baseline, 3 months and 1 year, subjects were evaluated for meibomian gland structural changes changes using a custom made, near infrared non-contact meibographer and previous described grading scale (1 = no partial meibomian glands, 2 = up to 25% partial meibomian glands, 3 = 26-75% partial meibomian glands, 4 = > 75% partial meibomian glands, Nichols, Cornea, 2005). A linear mixed model with group and visit as fixed effects and patient as a random effect was used to analyze the data using SAS® 9.2.
Ninety four subjects were randomized (average age = 22.9 years, 50% female), and 74 subjects completed the one-year follow-up. The average meibography grade at baseline was 1.46 ± 0.68 for subjects randomized to the contact lens group, and 1.51 ± 0.68 for subjects entering the spectacle group. At 3 months, the least squares mean estimate of meibomian gland loss was 1.94 (95% CI = 1.70 - 2.19) for the contact lens wearers, and 2.04 (95% CI = 1.82 - 2.27) for the spectacle lens wearers. At 12 months, the least squares the least squares mean estimate of meibomian gland loss was 2.12 (95% CI = 1.84 - 2.39) for the contact lens wearers, and 2.02 (95% CI = 1.97 - 2.45) for the spectacle lens wearers. Meibomian gland scores were equivalent at all visits and for both modes of correction.
For neophyte subjects wearing daily disposable silicone hydrogel contact lenses, the physiological response of the meibomian glands is comparable to wearing spectacles as no structural changes were induced over the course of a year’s wear.
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