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Andrew David Pucker, Lisa Jordan, Sruthi Srinivasan, Daniel R Powell, Justin Kwan, Sebastian Marx, Wolfgang Sickenberger, Lyndon William Jones; Is Compliance and Ocular Surface Factors Associated with Contact Lens Dropout?. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3933.
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Discontinuation from contact lens (CL) wear is estimated to be approximately equal to the numbers of new wearers per year, resulting in virtually no growth in the global CL market. The purpose of this study was to determine factors associated with successful wear that may impact CL dropout.
This five-site study recruited subjects 18-45 years of age who had ceased CL wear within the past 6-12 months due to discomfort. Dropout subjects were compared to age- and sex-matched successful CL wearers (≥8 hours/day for ≥5 days/week). Each subject was administered a study-specific questionnaire that queried general CL history and compliance. Clinical testing included non-invasive tear break-up time and tear meniscus height (OCULUS Keratograph 5M), blepharitis assessment, and meibum quality and expression. Comparisons were made with paired t-tests for means or McNemar’s test for agreement for frequencies.
25 matched-pairs (50 total subjects) were recruited across sites. The mean ± SD age of the subjects were 28.6 ± 7.1 years (range = 18 to 44); the sample was 73.7% female. Successful CL wearers had worn CLs for 10.6 ± 5.5 years while CL dropouts had worn CLs for 6.8 ± 5.9 years (p = 0.03). CL dropout was not associated with exposing CLs to tap water (p = 1.00), replacing CLs on time (p = 0.99), replacing their CL case at least every 3 months (p = 0.73), sleeping in CLs (p = 0.32), or wearing CLs longer than their clinician recommended (p = 1.00); current CL wearers, however, napped more frequently in their CLs (p = 0.03). Non-invasive tear break-up time (p = 0.19), tear meniscus height (p = 0.33), upper (p = 0.27) and lower (p = 0.26) eyelid blepharitis, lower eyelid meibum quality (p = 0.92) and lower eyelid meibum expressibility (p = 0.33) were also not associated with CL dropout; nevertheless, upper eyelid meibum quality (p = 0.03) and expressibility (p = 0.002) were associated with CL dropout.
CL compliance does not appear to be associated with CL dropout, but this study did collect some evidence indicating that decreased meibomian gland function may reduce one’s ability to successfully wear CLs. These data support the need for early meibomian gland dysfunction prevention and treatment because interventions may promote better long-term ocular health and the ability to comfortably wear CLs.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
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