Prolonging contact lens wear and making contact lens wear safer

University of Louisville, School of Medicine, Louisville, Kentucky 40202, USA.
American Journal of Ophthalmology (Impact Factor: 4.02). 03/2006; 141(2):369-373. DOI: 10.1016/j.ajo.2005.08.047
Source: PubMed

ABSTRACT To summarize the present status of safety and efficacy of contact lens wear.
Literature review.
Ovid Medline searches were performed on records from 1966 through 2005 using keywords: keratitis, contact lens complications, extended-wear contact lenses, and silicone-hydrogel contact lenses.
Patients desire comfort, clarity of vision, and prolonged contact lens wear when contact lenses are used to correct refractive error. Practitioners desire patient satisfaction but also require maintenance of the integrity of the eye and no complications that jeopardize vision or health of the eye. Improvements in the oxygen permeability of the contact lens materials, design of the contact lens and its surface, and solutions for the maintenance of the lens have reduced but not eliminated the risks of infection, inflammation, and conjunctival papillary reaction associated with contact lens wear. The lessons of past and recent history suggest that patient education and practitioner participation in the management of contact lens wear continue to be critical factors for patient satisfaction and safety in the extended wear of contact lenses.
The availability of highly oxygen permeable contact lenses has increased the tolerance and safety of extended contact lens wear, but patient instruction and education in proper use and care of lenses is required and caution is advised.

  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Demonstrate that successful soft contact lens wearers using competitive multipurpose solutions report improvement in comfort with OPTI-FREE((R)) RepleniSH((R)) Multi-Purpose Disinfecting Solution (MPDS). This 30-day, multicentered, open-label study enrolled 109 eligible soft contact lens wearers using COMPLETE((R)) Multi-Purpose Solution (MPS) Easy Rub((R)) or ReNu MultiPlus((R)) MPS. The test solution (OPTI-FREE((R)) RepleniSH((R)) MPDS) was dispensed for use in place of habitual care solutions. Subjects assessed their experience with their habitual solution (baseline) and the test solution (Day 30) using Likert-style questions. Contact lens acuity and biomicroscopy findings were recorded at each visit. The test solution was associated with a statistically significant improvement in instillation comfort (P = 0.02), end of day comfort (P < 0.0001), clear vision (P < 0.0001) and overall satisfaction (P < 0.001). Subjects reported the test solution enhanced their overall lens-wearing experience more effectively than their previous solution (P < 0.0001) and that they would continue test solution use after the study (P < 0.0001). The test solution was effective at improving comfort and overall contact lens experience compared to COMPLETE((R)) MPS Easy Rub((R)) or ReNu MultiPlus((R)) MPS in successful contact lens wearers. These results indicate that changing contact lens care solutions, even in successful lens wearers, may improve comfort and overall lens-wearing experience.
    Clinical Ophthalmology 02/2010; 4:47-57. · 0.76 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To prospectively evaluate the effect of controlled adverse chamber environment (CACE) exposure on tear function, including tear osmolarity, in subjects wearing narafilcon A versus those wearing etafilcon A soft contact lens (SCL). Thirty-one healthy subjects with no history of contact lens wear (13 women, 18 men; average age, 30.5 ± 6.5 years) were randomly divided into age- and sex-matched groups (15 subjects wearing narafilcon A SCL; 16 subjects wearing etafilcon A SCL) and entered a CACE for 20 minutes. All subjects underwent tear osmolarity, tear evaporation rate, strip meniscometry, tear film breakup time, fluorescein vital staining, and functional visual acuity measurement before and after exposure to the controlled adverse chamber. The mean blink rate increased with significant deteriorations in the mean symptom VAS scores, mean tear osmolarity, tear evaporation rate, strip meniscometry score, and tear stability with CACE exposure along with a decrease in visual maintenance ratio in functional visual acuity testing in etafilcon A wearers. The mean symptom VAS scores, mean tear evaporation rate, tear stability, blink rates, and visual maintenance ratios did not change significantly in narafilcon A wearers after CACE exposure. This study suggested marked tear instability, higher tear osmolarity, and increased tear evaporation with marked dry eye and visual symptomatology in nonadapted hydrogel SCL wearers, suggesting that silicone hydrogel SCLs may be suitable for persons who live and work in cool, low-humidity, and windy environments, as tested in this study.
    Investigative ophthalmology & visual science 11/2011; 52(12):8811-7. DOI:10.1167/iovs.10-6841 · 3.66 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: To determine whether a combination of early amniotic membrane transplantation (AMT) and early topical corticosteroid treatment could be a safe adjuvant therapy during antibacterial treatment in severe bacterial keratitis (BK) for relieving pain, avoiding iatrogenic epithelial toxicity, and allowing earlier use of topical steroids. In a prospective noncomparative case series, 12 patients with severe microscopically-proven BK were treated with immediate maximal topical antibiotics followed by AMT at 48 hours (single-layer epithelial side-down or multilayer epithelial side-up), plus topical steroid treatment at 72 hours. Pain relief (NRS-11 numeric rating pain scale) and the corneal epithelium healing were measured. The follow-up rate was 7.5 person-months, with AMT performed once in 2 patients and twice in 10 patients with BK caused by Pseudomonas aeruginosa (5), Klebsiella pneumoniae (1), Moraxella cattharalis (1), Staphylococcus aureus (1), Staphylococcus epidermidis (2), or Streptococcus pneumoniae (1). A significant decrease in the pain score was noted from the admission day (median, 8; range, 7-10) to shortly after AMT (at day 3: median, 2; range, 1-3). Epithelial healing was achieved between 8 and 45 days (mean, 25.5 +/- 9.7 days). Neither perforation nor neovascularization was observed. Early AMT combined with topical corticosteroid in severe BK provides immediate pain relief and allows epithelial healing.
    Cornea 02/2007; 26(1):27-33. DOI:10.1097/ICO.0b013e31802b28df · 2.36 Impact Factor