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N. A. Carnt, L. Keay, T. Naduvilath, B. Holden, M. Willcox; Risk Factors Associated With Corneal Inflammation in Soft Contact Lens Daily Wear. Invest. Ophthalmol. Vis. Sci. 2007;48(13):4326.
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Corneal inflammatory adverse events (CIE) in contact lens wear result in disruption to lens wear and can lead to discontinuation. This study examined the risk factors associated with these events during soft contact lens daily wear.
Data from several non-randomized interventional clinical studies using various single commercially available lens and solutions in each trial were conducted over an 18 month period and were analysed retrospectively. Seven hundred and twelve (712) subjects wore various commercially available soft lenses bilaterally on a daily wear schedule for 3 months with overnight disinfection using marketed lens care solutions. Fifty-two (52) eyes that developed CIE were compared to eyes without these events. Patient characteristics, lens performance, slit lamp assessment and lens parameter and material properties were analysed. Data collected prior to lens wear, at visits prior to an event for cases and at all scheduled visits for non affected eyes were used for analysis. Multivariate logistic regression, after adjusting for within subject correlation, was used to develop the statistical model.
Significant factors associated with a higher risk of CIE included: the use of multipurpose (MPS) compared to peroxide disinfection (p=0.025), lower lens movement (p=0.006), and the presence of mucin balls (p=0.003). The strongest effect was seen with MPS solutions (OR 10.3x). A decrease of 0.2mm in lens movement resulted in 4.5x and presence of mucin balls resulted in 3.6x increased risk of CIE. The statistical model had acceptable fit and discrimination.
This analysis suggests that likelihood of a corneal inflammatory event in soft contact lens daily wear is significantly influenced by care system. The likelihood of a corneal inflammatory event is also increased, to a lesser extent, in lenses which exhibit low on-eye movement and when mucin balls are present.
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