The effects of 2 week senofilcon-A silicone hydrogel contact lens daily wear on tear functions and ocular surface health status
ABSTRACT To prospectively investigate the effects of 2 week senofilcon A contact lens (CL) daily wear on the functional visual acuity (VA), ocular surface and tear film.
Seventeen right eyes of 17 senofilcon A CL wearers without any ocular or systemic diseases were examined before and 2 weeks after lens wear. Visual acuity measurements, tear evaporation rate, ELISA for tear cytokines, strip meniscometry, tear lipid layer interferometry, tear film break-up time (BUT), in vivo confocal microscopy, corneal sensitivity, ocular surface vital staining, Schirmer I test and brush cytology for MUC5AC mRNA expression were performed before and after CL wear.
The best corrected Landolt VA, functional VA parameters, the mean lipid layer interferometry grades, tear evaporation rates, Schirmer test values, vital staining scores and in vivo confocal microscopy parameters did not show any significant differences after 2 weeks of CL wear. The tear film BUT showed a significant decrease together with a significant down regulation of MUC5 AC mRNA expression after CL wear. A statistically significant elevation in the mean tear interleukin (IL)-6 concentration was also observed after 2 weeks of CL wear.
Two week senofilcon A daily CL wear seems to be associated with tear instability, a decrease in MUC5AC expression, and elevation of IL-6 in tears without significant alterations in epithelial damage scores or in the morphology or density of in vivo keratoconjunctival cells and nerves. Alterations associated with long term wear and patients with dry eye disease need to be studied in future trials.
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ABSTRACT: Mucins adhere to contact lenses (CLs), reflecting the renewal of the preocular fluid and enzymatic activity at the ocular surface. In this study, we aimed to analyze mucin fragmentation on materials new to the ocular surface and investigate whether this correlates with wearing comfort. Lenses were obtained from new CL wearers after 2 weeks each of wearing vifilcon A, followed by senofilcon A, and then by vifilcon A lenses. Symptoms were evaluated using the Ocular Surface Disease Index (OSDI). CLs were extracted in a mixture of guanidinium hydrochloride and radioimmunoprecipitation assay buffer. Mucin mobility was analyzed after electrophoresis, Western blotting, and visualization with antibodies against mucin peptide core. Mobilities, normalized to total reactivity in the lane, were compared between visits for each subject and were expressed as shifts. Mucin (MUC)5AC polymers exceeding 260 kDa were observed in agarose gels; NuPAGE resolved polymers from 260 to 3.5 kDa: when large mucins were detected, the smallest fragments were missing. Fragmentation patterns were significantly different between lens types for MUC1 (analysis of variance, P = 0.006) and MUC4 (P < 0.001) but not for MUC5AC or MUC16 (P > 0.293). Mobility shifts of MUC1 and MUC4 were significantly negatively correlated (Pearson, r = -0.908; P = 0.002). For OSDI scores >15, mucin fragmentation was unchanged, whereas for OSDI scores <15, MUC4 and MUC5AC fragments were longer on vifilcon A than on senofilcon lenses (unpaired t test, P = 0.046), irrespective of the direction of change (analysis of variance, P > 0.366). Changes in MUC1 breakdown were significantly negatively correlated to the overall OSDI score (r = -0.891, P = 0.001). In asymptomatic CL wearers, only changes in mucin fragmentation in response to a new material were consistent and fast, irrespective of CL order. Lack of change seems, therefore, to be connected with discomfort during CL wear.Cornea 02/2012; 31(7):770-6. DOI:10.1097/ICO.0b013e3182254009 · 2.36 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the ocular tear interleukin (IL)-6 and IL-8 concentrations within the first 6 months of contact lens (CL) wear in eyes of neophyte CL users who had been commenced on either silicone hydrogel CL (SH-CL) or conventional hydrogel CL (CH-CL). Twenty-four subjects with no history of CL wear received either SH-CL (n=12) or CH-CL (n=12) for a period of 6 months in this prospective study. Tear IL-6 and IL-8 concentrations were determined before CL wear (0 months) and at 1, 3, and 6 months after CL commencement. The sera of all the subjects were tested and graded (grades 0-6) for grass, weed, and tree pollen-specific immunoglobulin E (IgE) levels. Tear IL-6 concentrations at 0, 1, 3, and 6 months for SH-CL and CH-CL users were 7.1 ± 6.4, 10.5 ± 8.9, 18.6 ± 17.0, 33.1 ± 15.0 pg/mL and 10.9 ± 8.2, 6.4 ± 4.0, 24.2 ± 13.2, 34.4 ± 17.5 pg/mL, respectively. In both groups, IL-6 levels were significantly elevated at 6 months compared with those at 0 months (P<0.001). Tear IL-8 concentrations at 0, 1, 3, and 6 months for SH-CL and CH-CL users were 107.4 ± 56.8, 106.0 ± 47.4, 319.5 ± 154.8, 412.6 ± 104.1 pg/mL and 176.4 ± 59.7, 196.2 ± 145.0, 410.7 ± 121.2, 456.7 ± 19.2 pg/mL, respectively. In both groups, tear IL-8 levels were significantly elevated at 6 months compared with those at 0 months (P<0.001). The tear IL-6 and IL-8 levels were found to be similar within the 2 groups at the 6-month time point (P>0.05). The serum grass, weed, and tree pollen-specific IgE levels were similar between groups (P>0.05) and less than 0.35 kU/L (grade 0) in 22 of 24 (91.7%) participants tested. The SH-CL and CH-CL wear is associated with elevation of IL-6 and IL-8 levels in the tears of healthy, nonatopic neophyte CL users.Eye & contact lens 03/2012; 38(3):146-9. DOI:10.1097/ICL.0b013e3182482910 · 1.68 Impact Factor
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ABSTRACT: PURPOSE.: To report on the development and validation of a short form of the Contact Lens Dry Eye Questionnaire (the CLDEQ-8) to enable it to reflect status of and change in overall opinion ("opinion") of soft contact lenses (SCLs). METHODS.: Item reduction for the CLDEQ was achieved by correlation with overall opinion of SCLs at follow-up visits in a sample of 38 SCL wearers at one academic clinical site. The CLDEQ-8 score (frequency plus late day intensity of dryness, discomfort, and "blurry vision"; frequency of "closing eyes to rest them" and "removing CLs to relieve discomfort") was then tested in 379 SCL wearers in a multicenter study with analysis stratified by opinion ratings at baseline and 2 weeks postrandomization to new silicone hydrogel SCLs. The sum of CLDEQ-8 scores (maximum 37) was correlated with opinion by Spearman's rank correlation coefficient and analyzed for change in opinion by analysis of variance (ANOVA). RESULTS.: The CLDEQ-8 scores in the validation sample were highly correlated with habitual baseline opinion (-0.44, p < 0.0001) and responsive to change in opinion postrandomization (-0.58, p < 0.0001). Baseline CLDEQ-8 scores by opinion status were as follows: Fair: 17.4 ± 8.7, Good 13.7 ± 6.4, Very Good 9.1 ± 4.7, and Excellent 6.4 ± 3.7 (ANOVA, F = 291.1, p < 0.0001). After 2 weeks, change in CLDEQ-8 scores by improvement status was as follows: Much Improved: -16.7 ± 10.0, Unchanged: -2.3 ± 5.0, to Much Worse +8.5 ± 5.8 (ANOVA, F = 16.5, p < 0.001). CONCLUSIONS.: The CLDEQ-8 score significantly reflected baseline status and change in overall opinion after refitting with two types of silicone hydrogels. The CLDEQ-8 score is a valid outcome measure in SCL clinical trials to reflect opinion of SCLs.Optometry and vision science: official publication of the American Academy of Optometry 09/2012; 89(10):1435-42. DOI:10.1097/OPX.0b013e318269c90d · 2.04 Impact Factor