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D. Tilia, N. A. Carnt, V. E. Evans, V. Thomas, M. D. P. Willcox, B. A. Holden; Duration of Interruption of Lens Wear Due to Corneal Inflammation in Silicone Hydrogel Daily Wear. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4834.
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Corneal inflammatory adverse events result in interruption to lens wear and may cause patient frustration and increase chair time. Previous analysis of corneal inflammation in silicone hydrogel extended wear reported a mean duration of interruption of lens wear of 15±15 days. Factors associated with interruption in silicone hydrogel daily wear were analysed to help the practitioner better manage the patient and minimise follow up appointments.
Data from more than 500 participants who wore a at least one combination of 6 silicone hydrogel lenses (lotrafilcon A, lotrafilcon B, galyfilcon A, senofilcon A, balafilcon A, comfilcon A) with 4 lens care solutions (H2O2, PHMB, 2 x POLYQUAD+ALDOX) for 3 months were retrospectively analysed. Duration of interruption of lens wear from 76 resolved cases of corneal infiltrates was log transformed for normalisation and analysed for multiple factors using linear mixed model.
The median duration of interruption was 8 days (range 2-92) with the majority resolving within 2 weeks. Events occurring in patients over 40 years took longer to recover (p=0.04). Events occurring in summer (p<0.01) and accompanied by a cold or flu (p<0.01) were associated with longer interruption. Events presenting with mucous discharge (p=0.02) and in which infiltrates were located in both limbal and paracentral corneal areas, (p<0.01) were also associated with longer interruption from lens wear.
The interruption of lens wear associated with corneal inflammation in silicone hydrogel daily wear is generally not more than 2 weeks, but can vary widely. The time to recovery from an infiltrative event is multifactorial. Infiltrative events that are more extensive and associated with mucous discharge tend to take longer to resolve. However other factors such as older age, associated sickness and climatic conditions have a detrimental effect on recovery time. Awareness of the effects of these factors will aid in patient management during these events by enabling practitioners to better counsel patients and minimise follow up appointments.
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