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Clinical evaluation of long-term users of two contact lens care preservative systems

Young, Graeme, Keir, Nancy, Hunt, Chris and Woods, Craig A. 2009, Clinical evaluation of long-term users of two contact lens care preservative systems, Eye and contact lens, vol. 35, no. 2, pp. 50-58, doi: 10.1097/ICL.0b013e31819630d3.

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Title Clinical evaluation of long-term users of two contact lens care preservative systems
Author(s) Young, Graeme
Keir, Nancy
Hunt, Chris
Woods, Craig A.ORCID iD for Woods, Craig A. orcid.org/0000-0002-5942-6247
Journal name Eye and contact lens
Volume number 35
Issue number 2
Start page 50
End page 58
Total pages 9
Publisher Lippincott Williams & Wilkins
Place of publication Philadelphia, Pa.
Publication date 2009-03
ISSN 1542-233X
1542-2321
Keyword(s) soft contact lenses
care products
corneal staining
dry eye
Summary Purpose: To clinically evaluate long-term users of two different contact lens care preservative systems and to investigate whether prolonged use is associated with an increase in the prevalence of dry eye.

Methods: Eighty-nine wearers of group IV hydrogel or silicone hydrogel lenses participated in this one-visit, investigator-masked study. Subjects were required to have consistently used a polyhexamethylene biguanide (PHMB) or polyquaternium-1 (PQT) based solution for 2 years. Consistent use was defined as 80% for the past 2 years and 100% for the past year. Clinical assessments included: average and comfortable wear time; overall and end-of-day comfort; signs of dryness, discomfort, burning or stinging, grittiness or scratchiness and visual changes; non-invasive and fluorescein break-up-time; pre-ocular tear film lipids, tear meniscus height, Schirmer and fluorescein clearance tests; limbal and bulbar hyperemia; palpebral roughness; corneal and conjunctival staining; lens front surface wetting; and lens film deposits.

Results: Significantly more grittiness or scratchiness was reported by subjects using a PHMB-containing system (67% vs. 44%; P = 0.02). Palpebral roughness and hyperemia were significantly greater in the PHMB group wearing group IV lenses (P = 0.01 and P = 0.05, respectively). Corneal staining was significantly higher in the PHMB users in all four peripheral sectors (P < 0.01). Nasal and temporal conjunctival staining was also significantly higher for users of PHMB-containing systems (P < 0.05). Front surface lens wettability was significantly better for group IV PQT users compared to PHMB users (P = 0.008), with 84% vs. 72%, respectively, with lenses graded by the investigator as having good or excellent wettability. Significantly higher levels of lens front surface film deposits were noted with PHMB users (P = 0.007), with 58% of group IV lenses treated with PHMB compared with 38% of group IV lenses treated with PQT showing some lens front surface film deposition. No significant differences between the two preservative system groups were noted for the range of dry eye evaluations nor the remaining clinical assessments.

Conclusions: Differences in both ocular and lens characteristic were observed between long-term users of two preservative systems used in many contact lens multi-purpose solutions. The findings from this study did not support the hypothesis that prolonged use of PHMB-containing solutions leads to dry eye. Additional studies including a larger sample size and perhaps longer use of the systems could help to further elucidate differences in clinical performance between systems.
Language eng
DOI 10.1097/ICL.0b013e31819630d3
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2009, Lippincott Williams & Wilkins
Persistent URL http://hdl.handle.net/10536/DRO/DU:30047479

Document type: Journal Article
Collection: School of Medicine
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