Duration of Discontinuation from Silicone Hydrogel Extended Wear Due to Adverse Responses

Abstract

Abstract: : Purpose: Most adverse ocular events (AE) occurring with extended wear of silicone hydrogels resolve with temporary discontinuation of lens wear. A retrospective study to assess the average length of discontinuation due to AEs was conducted. Methods: 282 subjects wore bilateral silicone hydrogel lenses on a 30N EW schedule. Subjects were reviewed at 1 night, 1 week, 1 month, then at 3 monthly intervals, and if experiencing unusual signs or symptoms. If an AE was diagnosed, lens wear was discontinued until the condition had completely resolved. AEs were graded in severity on a scale of 1-4 and classified as Corneal Inflammatory Events (CIE): Contact Lens Peripheral Ulcer (CLPU), Contact Lens induced Acute Red Eye (CLARE), Infiltrative Keratitis (IK), and Mechanical Events (ME): Superior Epithelial Arcuate Lesion (SEAL), Corneal Erosion (CE). The length of discontinuation due to different AEs was compared and the associations with severity ratings and clinical variables examined. Results: On average, CIEs caused longer durations of discontinuation (15±15 days) than MEs (5±3 days)(p<0.01). There were no differences in length of discontinuation between different types of CIEs (CLPU: 11±8; CLARE: 12±8; IK: 17±17; p=1.0), or between different types of MEs (SEAL: 5±4; CE: 5±3; p=1.0). Length of discontinuation following CIEs, but not with MEs, correlated with severity rating (r=0.46, p<0.01), density of infiltrate (r=0.27, p=0.04), and depth of corneal staining (r=0.27, p=0.03). Conclusions: Most AEs with silicone hydrogels are self limiting, with lens wear resuming on average within 15 days of CIEs and 5 days of MEs. Denser infiltrates and deeper staining in CIEs are associated with longer periods of discontinuation from lens wear.

Keywords: contact lens