Abstract
Abstract: :
Purpose: To determine if corneal staining and comfort associated with FDA group II soft contact lenses disinfected by various care regimens vary with time post–insertion. Methods: 20 soft lens–wearing subjects were enrolled into this investigator–masked, randomized, cross–over study. Subjects were fitted with Bausch & Lomb SofLens 66 (Alphafilcon; FDA group II) lenses and randomly used three multipurpose solutions (MPS) – OPTI–FREE® EXPRESS® Multi–Purpose Disinfecting Solution (OFX; Alcon); Complete® MoisturePLUSTM MPS (COM; Advanced Medical Optics) and ReNu MultiPlus® MPS (RNU; Bausch & Lomb) for consecutive 2–week periods, with new lenses dispensed with each regimen. Subjects were examined at baseline and at 1 day, 1 week and 2 weeks with each regimen. On each visit day, staining and comfort were rated after 2 and 6 hours of lens wear. In addition, lens comfort was graded at the beginning, middle and end of the day. Results: Corneal staining occurred most frequently and at the greatest severity with RNU and least with OFX (p<0.001). OFX showed no significant change in staining (p=NS), with RNU and COM showing greater staining at 2 hours than at 6 hours (p<0.001). At all follow–up visits, COM and RNU demonstrated more staining than OFX (p<0.001). The staining varied from a low grade, micropunctate pattern to clinically significant diffuse staining requiring cessation of lens wear. Subjective comfort ratings decreased significantly from beginning to end of the day (p<0.001) with no significant differences between the three regimens (p=NS). There was no significant correlation between corneal staining and comfort at any time of the day (p=NS). Conclusions: Significant corneal staining can occur with certain FDA group II lenses when used with certain MPSs, but this staining does not appear to influence comfort levels. Lens comfort is not a predictor of corneal health. Patients who experience good lens comfort should have a comprehensive slit lamp examination to evaluate corneal staining. This is particularly relevant after two hours of lens wear, when maximal solution sensitivity appears to be represented.
Keywords: contact lens • cornea: tears/tear film/dry eye • cornea: epithelium