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J. Diec, V. Evans, T. Naduvilath, V. Thomas, B. A. Holden; The Recurrence Rate of Corneal Inflammatory Events With Silicone Hydrogel Lens and Care Products. Invest. Ophthalmol. Vis. Sci. 2010;51(13):1538.
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To report the recurrence rate of corneal inflammatory events (CIE) in silicone hydrogel contact lenses (SHCL) when used with peroxide (H202) and various multipurpose solutions (MPS).
As previously reported approximately forty patients (Px) wore each of 6 SHCL (lotrafilcon A, lotrafilcon B, galyfilcon A, senofilcon A, balafilcon A, comfilcon A) with each of 4 contact lens care solutions (3% H202, PHMB, Polyquad/Aldox and Polyquad/Aldox/Tearglyde) for 3 months. CIE data was collected at 2 week, 1 month, 3 month and unscheduled visits and the CIE incidence was summarised as a percentage of Px experiencing first events. Logistic regression with robust estimate of variance was used to determine the association of solution type with CIE incidence after accounting for within Px correlations.
A total of 1051 Px, 333 using H202 and 718 using MPS were enrolled in the 24 combinations. Of these, 85 had a first event CIE, an incidence of 8.1%. Seventeen of these Px (20%) were discontinued after the event. The remaining 68 resumed the trial upon resolution of these events and 15 (22%) had a recurrence of a CIE. In the Px-Eyes that had a recurrence, 28.6% had a clinically more severe CIE at the second event. Of all Px with a CIE, the incidence of clinically more severe recurrent CIE was 8.8%.The first event incidence rate was 3.3% (n=11) for Px using H202 and 10.3% (n=74) for Px using MPS. After adjusting for lens type, interaction of lens with solution and prior lens wear experience, MPS was found to be more likely to cause a CIE compared to H202. This likelihood was statistically significant (OR = 3.22 95%CI: 1.70 - 6.13, p<0.001).
Patients who experience a CIE are more than twice as likely to experience a second event than they were to experience the first event, and for a percentage of them it will be a more severe event. H202 was associated with a significantly lower likelihood of first event CIE compared to MPS.
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