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T. N. Truong, A. D. Graham, S. Han, A. Wan, M. C. Lin; Subjective Ratings of Comfort and Dryness vs. Clinical Evaluation of Lens Performance and Ocular Response to Silicone Hydrogel Lenses: Evidence From a Multi-Study Database. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4833.
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Centration, movement, and tightness are some common contact lens fitting characteristics practitioners evaluate during a slit-lamp exam. Although these measures are widely used to determine an acceptable lens fit, little is known about the relative importance of each measure in determining comfort during lens wear. In this study, a series of silicone hydrogel contact lens fitting studies were analyzed to determine what lens performance and ocular response measures are associated with subjective ratings of comfort and dryness.
Altogether, 5466 records were examined from 60 studies performed at one research site from 2005-2007. These records came from both eyes of 275 subjects, 59% of whom participated in more than one study. These subjects ranged in age from 18 to 44 yrs (22.6 ± SD yrs; 31% male;35% Asian and 65% non-Asian). Linear mixed effects modeling was employed to account for the multi-level repeated measures, and the internal correlations due to measuring the 2 eyes of each subject repeatedly within and across studies.
Subjective Comfort Rating. Lens tightness, movement, primary and upgaze lag were not significantly associated with comfort rating (p-values > 0.05). Lens fitting characteristics significantly associated with improvement in comfort rating after 6 hours of lens wear, in order of greatest influence, were: (1) decrease in lens surface deposits; (2) decrease in superior conjunctival overlap; (3) decrease in temporal conjunctival overlap; (4) increase in lens surface wettability (p - values < 0.01). Ocular health measures significantly associated with decrease in comfort rating after 6 hours of lens wear were: (1) increased inferior corneal staining; (2) increased depth of central corneal staining (p-values < 0.01). Subjective Dryness Rating. Increased lens surface deposits and decreased lens surface wettability were the only lens fitting characteristics associated with an increase in dryness rating after 3 and 6 hours of lens wear (p-values < 0.01). An increased inferior corneal staining was closely associated with an increase in dryness rating (p-value < 0.01).
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