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G. Fuentes–Paez, M.J. Gonzalez–Garcia, A. Gonzalez–Saiz, A. Morilla–Grasa, A. Enriquez de Salamanca, C. Garcia–Vazquez, J.M. Herreras, M. Calonge; Evaluation of Clinical Tolerance to Soft Contact Lens (SCL) Care Systems . Invest. Ophthalmol. Vis. Sci. 2006;47(13):107.
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There are several soft contact lens (SCL) care systems in the market, with proved efficacy against microorganisms that achieves an adequate disinfection of the CL. However, the chemical composition of the care systems can cause adverse reactions in the ocular surface that can influence the tolerance of the CL. The purpose of this study is to evaluate and compare symptomatology and clinical response of SCL wearers using different care systems after 2 months of SCL use.
45 SCL wearers were randomly assigned to use either Ever Clean® –hydrogen peroxide–based system with Self Action®– (EC) or one of the next three care systems: ReNu Multiplus® multipurpose solution (RN), Opti–Free Express® multipurpose disinfecting solution (OF) or Oxysept Comfort® –hydrogen peroxide–based system– (OX) for 2–month periods with 1 week of washout. Subjects were fitted with FDA group IV SCL and new lenses were dispensed with each care regimen. Subjects were evaluated at baseline, 1 month (V1) and 2 months (V2) of SCL use. Clinical endpoints were: comfort with SCL, dry eye–related symptoms, visual acuity, contrast sensitivity, NIBUT, bulbar and limbal hyperemia, tarsal conjunctival reaction (redness and presence of tarsal papillae), corneal fluorescein staining and lissamine green conjunctival staining. Changes were statistically evaluated over time for each care system (Student’s t test) and among care systems (multiple comparison procedure of Scheffe).
Some care systems started to elicit symptoms and signs as soon as 1 month after (V1), always increasing at two months (V2). All care systems induced conjunctival hyperemia and some degree of ocular surface vital staining. NIBUT was only decreased with the use of multipurpose solution (RN, OF) and unaltered with the oxygen–based care systems. In general, peroxide–based systems (specially EC) behaved better than multipurpose solutions, specifically in NBUT, vital staining, and upper tarsal reaction.
Some of the changes observed over time (2 months) may have been due to the presence of a contact lens, but some seemed to be care system–dependent. The use of some SCL care systems seemed to alter the ocular surface less than others. This could be due to a higher cleaning efficacy and/or a better tolerance.
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