Abstract
PurposeThis work set out to investigate if there was an association between subjective comfort and both subjective and measured vision during the use of contemporary daily disposable soft toric contact lenses. MethodsThirty-eight habitual soft contact lens wearers wore each of three daily disposable toric lenses for one week in a prospective, crossover, randomised, single-masked study. The following clinical measures were recorded at dispensing and follow-up visits: biomicroscopy scores, lens fitting (including rotation and rotational stability), high and low contrast visual acuity, subjective vision quality and subjective ocular surface comfort. Subjective scores were collected using 0–10 numerical grading scales. Comfort scores were analysed using a linear regression model with age, sex, visit, phase of crossover (‘phase’), lens type, lens rotation, lens rotational stability, visual acuity, cylinder power and subjective vision quality as factors of interest and then refined using backward stepwise regression. ResultsThirty six participants (31.1 ± 13.5 years) completed the study. Comfort scores were found to be associated with subjective vision quality (F = 127.0 ; p < 0.0001), phase (F = 7.2; p = 0.001) and lens type (F = 4.9; p = 0.009). Greater comfort scores were observed with greater subjective vision quality scores. Visual acuity was not statistically significant in the model. ConclusionThis work suggests that symptoms of ocular discomfort may be more intense if there is also perceived visual compromise in daily disposable soft toric lenses. There was a stronger positive correlation between comfort and subjective vision quality compared with comfort and measured visual acuity.
Highlights
For more than two decades discomfort has been cited as the primary reason for established contact lens users limiting their wear time and abandoning their lenses [1,2,3,4,5]
The three daily disposable toric lenses investigated in this work are outlined in Table 1 [clariti 1 day toric (C1DT)(somofilcon A, Cooper Vision Inc.), 1-Day Acuvue Moist for Astigmatism (1DAMfA)(etafilcon A, Johnson & Johnson Vision) and DAILIES AquaComfort Plus Toric (DACPT)(nelfilcon A, Alcon)]
Of the 38 participants who were dispensed lenses, 36 completed the study, one participant was lost to follow-up and one participant was discontinued due to unac ceptable orientation of the toric lens
Summary
For more than two decades discomfort has been cited as the primary reason for established contact lens users limiting their wear time and abandoning their lenses [1,2,3,4,5]. Despite major innovations in the field over this period, perhaps most notably the introduction of silicone hydrogel materials, contact lens discomfort re mains a major unresolved issue for the contact lens industry These drop-out rates have been reported to range from 12 % to 51 % [1,3, 10,11,12] depending on the methodology and patient populations used to classify the discontinued wearers and from published international prescribing data, it has been estimated that as many wearers discontinue from their lenses as commence in any given year [13]. Much effort has been invested into trying to understand how the various physical aspects of a lens [15] or how the ocular surface char acteristics of a patient [16] can affect ocular surface comfort but rela tively little work has been carried out to try to understand the contribution of factors such as vision
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