Abstract
Purpose: :
CL related dryness is the primary cause for CL dropouts. The use of loteprednol for previous CL failures was studied.
Methods: :
23 patients refitted into daily wear PureVision lenses and ReNu MultiPlus care systems were seen in crossover, randomized, investigator-masked study comparing loteprednol and rewetter drops. There were two four week phases: Loteprednol phase (LOT): loteprednol BID without lenses and Renu Rewetting drops up to QID with lenses on and rewetter phase (REW): Renu Rewetting drops BID without lenses and Renu Rewetting drops up to QID with lenses on.
Results: :
For "Ocular Surface Disease Index" (OSDI), no significant differences were seen between visits for REW phase. Statistically significant improvement in OSDI scores was seen for LOT from baseline to 4 weeks (baseline mean 35.47 SD 31.51, 4 weeks mean 23.67 SD 21.55; p= .049) For "Subjective Evaluation of Symptoms of Dryness" (SESoD) (scores 0 to 4), no significant difference seen between visits for REW phase. For LOT, significant improvement in SESoD scores occurred from baseline to 4 weeks (baseline mean 2.61 SD 0.86, 4 weeks mean 2.0 SD 1.18; p= .019) For fluorescein conjunctival staining (scores 0 to 4 over 6 zones), LOT showed significant decrease in staining in superior nasal (superior nasal baseline mean 1.80 SD 0.83, at 4 weeks mean 1.38 SD .79; p= .01) and inferior nasal zones (inferior nasal baseline mean 1.76 SD .95, at 4 weeks mean 1.26 SD .98; p= .01). REW showed significant increase in staining for inferior nasal zones. (inferior nasal baseline mean 1.42 SD .85, at 4 weeks mean 1.97 SD .92; p= .01). REW showed directional trend towards an increase in staining for superior nasal zone. (superior nasal baseline mean 1.73 SD 0.83, at 4 weeks mean 1.97 SD .92; p= .07) There were no significant differences for the other zones. For corneal staining (scores 0 to 4 over 5 zones), LOT showed a significant reduction of staining in superior cornea (baseline mean 0.14 SD 0.35, at 4 weeks mean 0.11 SD 0.32;p= .02). REW showed no significant reduction in superior zone. There was a significant increase for LOT in temporal zone (baseline mean .04 SD .21, at 4 weeks mean .26 SD 0.7; p= .04). There was no significant reduction in the other zones for LOT or REW.
Conclusions: :
0.5% loteprednol improved both signs and symptoms of CL dryness for previous failures.
Clinical Trial: :
www.clinicaltrials.gov NCT00817557
Keywords: contact lens • cornea: tears/tear film/dry eye • cornea: clinical science