Poster 6: Ocular Response Observed with Silicone Hydrogel Lenses and Multi-Purpose Solution Combinations

Abstract

PURPOSE: To determine the ocular response associated with various combinations of silicone hydrogel lenses and marketed multi-purpose solutions (MPS) based on comfort and corneal staining after 2 and 4 hrs of lens wear. METHODS: A series of clinical studies was conducted at one research site, using a double-masked, randomized, crossover design. Nine to 14 asymptomatic soft contact lens wearers wore silicone hydrogel lenses for 2 and 4 hrs. Prior to wear, new lenses were presoaked in Alcon OPTI-FREE® EXPRESS® (polyquaternium-1), B&L ReNu® MoistureLoc® (alexidine), CIBA Vision AQuify® (polyhexanide), or AMO Complete® MoisturePLUS™ (polyhexamethylene biguanide) for 12 hrs. in a preconditioned lens case. At baseline, 2-hr, and 4-hr visits on the same day, subjects rated comfort and the cornea was examined with fluorescein and a yellow filter. Staining severity (0-4) and area (0-100%) were recorded for five corneal zones per eye. RESULTS: All observed staining type was micropunctate. The combinations with the greatest staining area were Complete MoisturePLUS/ PureVision at 2 hrs (38%) and 4 hrs (33.7%), AQuify/PureVision at 2 hrs (21.3%) and 4 hrs (11.7%), MoistureLoc/Oasys at 4 hrs (8.2%), MoistureLoc/PureVision at 4 hrs (8%), MoistureLoc/O 2 Optix at 4 hrs (7.4%), and AQuify/O 2 Optix at 2 hrs (7.1%). OPTI-FREE® EXPRESS® caused minimal staining, averaging 3.5% at 2 hrs and 3.8% at 4 hrs across all lens brands. Comfort ratings and staining area results were inversely correlated (r = -0.44) at the 4 hr visit. Additional combinations of marketed lenses and MPS are currently being evaluated for corneal staining. CONCLUSIONS: These results demonstrate how certain combinations of silicone hydrogel lenses and MPS may cause clinically meaningful corneal staining within 2-4 hours. Practitioners who dispense these lens materials and solutions should be aware of the potential ocular response and consider examining the patient in the first few hours after lens insertion.