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P. Ramamoorthy, L. T. Sinnott, J. J. Nichols; Treatment, Material, Care, and Patient-Factors in Contact Lens Related Dry Eye. Invest. Ophthalmol. Vis. Sci. 2008;49(13):4862. doi: https://doi.org/.
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To examine the association between contact lens-related dry eye (CLDE) and various treatments for CLDE, general contact lens and material characteristics, care solutions, and patient-related factors.
The data for this analysis were derived from clinical and self-reported factors from a contact lens and ophthalmic history survey and a sociodemographic survey administered as a part of the Contact Lens and Dry Eye Study, which has been described extensively previously. Separate univariate and multiple logistic regression models were used to examine the association between CLDE and the following: 1) current treatments for CLDE (e.g., recent contact lens refit, lubricants, lid scrubs, punctual occlusion), 2) contact lens factors (rigid vs. soft, FDA grouping, silicone vs. non-silicone hydrogel, modality), 3) specific hydrogel lens materials (included if cell sample > 10), 4) care solution factors (individual solutions and type of preservative), and 5) patient characteristics (e.g., lens wear duration, satisfaction with wearing time, overall satisfaction, overall vision, dry eyes when not wearing lenses, eye sensitivity to smog, forced air). All models were controlled for age, gender and significant treatment factors.
Treatment factors significantly associated with dry eye status included a recent contact lens refitting (p = 0.0005) and use of artificial tears/rewetting drops (p = 0.01. FDA groups 2 and 4 were more likely to be associated with dry eye status than FDA group 1 (p = 0.006). Rigid vs. soft lens wear (p = 0.45), wear modality (p = 0.28), the overall effect from specific lens materials (p = 0.08) and care solutions (p = 0.99) did not show significant association with CLDE. Significant patient-related factors included decreased overall satisfaction (p < 0.0001), dry eye in the absence of contact lens wear (p < 0.0001), reduced daily lens wear duration (p = 0.0007), and reduced ability to wear lenses as long as desired (p = 0.005).
The current treatment options for management of CLDE seem inadequate and ineffective as reflected by the strong association between dry eye status and greater/ more frequent use of some treatment modalities. Ionic and non-ionic high water content materials were strongly related to dry eye in lens wearers, while care solutions were not. CLDE was also associated with several patient-related factors such as greater ocular discomfort (without lenses), dissatisfaction, and inability to wear lenses for desired durations. These findings imply a need to identify more effective treatments, and better care solutions and lens materials.
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