Abstract
Purpose :
To establish the effect of lipid supplements on tear lipid biochemistry and their influence on lens wear comfort in habitual lens wearers.
Methods :
Forty habitual soft contact lens wearers were recruited to a double-masked, randomized crossover trial. An emulsion drop containing phosphatidylglycerine (Systane Balance, Alcon) or a liposomal spray containing phosphatidylcholine (Tears again, BioRevive) both with saline drop/spray as placebos, were used three times a day for two weeks with 48 hours washout between each intervention. Visits and collections occurred at baseline, 1 day and 14 days during intervention. Ocular comfort was measured using the Ocular Comfort Index. Basal tears (15 µl from each eye) was collected with lenses in-situ and assayed for the concentration and activity of phospholipase (sPLA2) and the concentration of a malondialdehyde (MDA). Electrospray ionization mass spectrometry characterized the tear lipidome.
Results :
Neither of the lipid supplements improved ocular comfort from baseline. The lipid drop and placebo increased the concentration of sPLA2 (p=0.02 & p=0.04) cholesterol esters (p=0.04, p=0.05), free cholesterol (p<0.001, p<0.001), triglycerides (p=0.001, p=0.01), phospholipids (p=0.001, p=0.002), and (O-acyl)-ω-hydroxy fatty acids (OAHFA) (p=0.004, p=0.01) compared to baseline at day 1. However, by day 14, levels of sPLA2 and all lipid classes except cholesterol esters, free cholesterol and OAHFA returned to baseline concentration. The spray treatment had no significant effect on the concentration and activity of sPLA2 and the concentration of MDA and majority of lipid classes either at day 1 or at day 14 compared to baseline (p>0.05). Symptomatic wearers showed higher levels of lysophospholipids with lipid spray (p=0.02) and with lipid drop (p=0.02) at day 14. Ocular comfort improved with lower levels (r=−0.21, p=0.007) and activity of sPLA2 (r=−0.20, p=0.01). Higher levels of sPLA2 resulted higher levels of lysophospholipids (r=0.41, p<0.001 & r=0.40, p=0.001) and, lower levels of OAHFA (r=−0.30, p=0.03).
Conclusions :
Lipid supplements did not affect lens wear comfort. Drop supplements showed a transient effect on tear lipidome. Lysophospholipids and OAHFA could be potential biomarkers in lens wear discomfort.
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.