Comparisons between Age, Gender, Lens Type and Lid Wiper Epitheliopathy with Soft Contact Lens Comfort

Abstract

Purpose: Comfort is an important component of successful contact lens (CL) wear. The purpose of this study was to investigate if there are differences in comfort levels among soft CL (SCL) wearers when wearing their habitual lenses.

Methods: Subjective comfort with their habitual lenses was assessed in 246 SCL wearers who attended a screening visit at one of three sites of a multi-centre study. Participants attended the visit wearing their habitual SCLs, and answered questions regarding their habitual CL experience using the Contact Lens User Experience (CLUE^TM) questionnaire. CLUE comfort scores range from 0 to 120, with higher scores indicating a more positive response. After removal of the habitual CLs, lid wiper epitheliopathy (LWE) was assessed using lissamine green and sodium fluorescein dyes (0-3 Korb scale). For each participant, a final LWE grade was calculated as the averaged grade of the two dyes and then categorized into no LWE (grade 0), mild (0.25-1.00), moderate (1.25-2.00), and severe (2.25-3.00). Comparisons of comfort scores across age group (19-29, 30-39, 40-49, 50+), gender, habitual lens types and categorized LWE groups were conducted using t-tests on least-square means (LSM) from a linear mixed model. The step-down Dunnett’s method was used to control type I error inflation.

Results: Comfort scores (LSM±StError) with habitual lenses were significantly higher in females than in males (69.9±2.5 vs 64.1±2.9; p=0.037). There was also a significant difference in CLUE comfort for age group, with the 40-49 year olds showing significantly greater comfort than the 18-29 age group (74.0±3.5 vs 60.2±2.1; p<0.001). There were no differences in comfort scores between LWE categories, with comfort scores of 62.7±4.0 (no LWE), 66.3±2.6 (mild), 67.1±2.8 (moderate) and 71.9±4.3 (severe; all p=0.376). There was a significant difference in comfort scores depending on habitual lens type (p=0.020). Narafilcon A (80.6±6.1) was found to have higher comfort scores (all p<0.04) compared to senofilcon A (66.3±3.6), lotrafilcon B (59.4±3.9), comfilcon A (59.6±4.0) and “other” (65.5±2.6), with no difference (p>0.05) compared to etafilcon A (70.3±5.3).

Conclusions: CLUE comfort was significantly different depending on age and gender, while there was no difference for categorical LWE. Narafilcon A wearers reported the highest comfort with habitual CLs.