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L.B. Szczotka–Flynn, M. Diaz–Insua; Risk of Infiltrates and CLPC With Traditional Hydrogel and Silicone Hydrogel Extended Wear: A Meta Analysis . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2067.
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Purpose: High Dk silicone hydrogel (SH) lenses have been shown to significantly decrease the risk of hypoxic complications compared to traditional low Dk hydrogels (H). However, the risks of inflammatory and mechanical complications with SH compared to H lenses are not as clear. A meta analysis was performed to combine the relevant literature to evaluate the risks of corneal inflammatory events and contact lens papillary conjunctivitis (CLPC) between SH and H extended lens wear. Methods: Twenty–two studies published or presented on either or both arms by November 2004 were selected for analysis. Six studies were published in the 1990s. A total of 6,343 subjects and 12,139 eyes comprised the entire sample. Nineteen studies were prospective studies, of which 89% used a randomized scheme to assign lenses. Nine studies were performed in the US, nine in Europe, three in Australia, and one in India. The follow–up ranged from 4–36 months, with a median of 12 months. Infiltrates were defined as any occurrence of CLPU, CLARE, or IK, or as defined by a given study. A generalized mixed model framework was employed to combine the information from the 22 studies. Values were converted from persons to eyes in studies that only reported results based on number of participants. Results: The probability of an event per 100 eyes in the traditional hydrogel group was 4.34 (2.68, 6.94) and 2.24 (1.27, 3.81) for infiltrates and CLPC, respectively. The pooled estimates of the occurrence of infiltrates were not significantly different between the lens groups (odds ratio 0.99 (0.75, 1.32) for SH compared to H lenses). There was an increased risk for CLPC in the SH group compared to the H group (odds ratio 1.48 (1.09, 2.01)). Conclusions: SH lenses have the same overall risk for corneal infiltrates as H lenses, however, there is a greater risk for CLPC with SH lenses.
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