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Andrew D. Graham, Robert E. Fusaro, Kenneth A. Polse, Meng C. Lin, Claude J. Giasson; Predicting Extended Wear Complications from Overnight Corneal Swelling. Invest. Ophthalmol. Vis. Sci. 2001;42(13):3150-3157.
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purpose. To examine the hypothesis that the corneal overnight swelling response
(ONSR) is a predictor of ocular complications in contact lens extended
methods. The Berkeley Contact Lens Extended Wear Study (CLEWS) was a randomized,
concurrently controlled clinical trial in which more than 200 subjects
in EW with rigid gas-permeable (RGP) lenses were observed for 1 year.
After adapting to EW, subjects were randomized to either medium or high
oxygen-permeable (Dk) RGP lenses and underwent clinical assessments,
keratometry, and corneal pachometry at 3-month intervals.
results. The ONSR was directly related to lens Dk (P = 0.01)
and exhibited substantial variability across subjects. The probability
of remaining free of complications over time was not significantly
lower for subjects with a mild ONSR compared with those with greater
edema (P = 0.84). The risk of development of
keratopathy was not significantly related to the ONSR (relative
risk = 1.00).
conclusions. The corneal ONSR is not a good predictor of ocular complications in 1
year of RGP EW. Lenses that cause little or no corneal edema are not
necessarily safer for overnight wear.
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