The Stability Of Dryness Symptoms With Silicone Hydrogel Contact Lenses Over 3 Years

Schafer, Jeffery M. Ohio State University

CO-AUTHORS:  G Lynn Mitchell (MAS, FAAO), Bill Long (BS, FAAO, FBCLA), Sally M Dillehay (OD, MS, FAAO), Joseph T. Barr (OD, MS, FAAO), Peter D. Bergenske (OD, FAAO), Peter Donshik (MD), Glenda B. Secor (OD, FAAO), John Yoakum (OD), Robin L. Chalmers (OD, FAAO)

PURPOSE: To assess the stability of dryness symptoms among patients refit from low Dk/t hydrogels to silicone hydrogel (SiHy) contact lenses in a 3-year study. A second purpose was to determine if early dryness symptoms with SiHy lenses were predictive of retention in the study.

METHODS: 278 hydrogel lens wearers were dispensed in the 3 year study to wear lotrafilcon A (NIGHT & DAY, CIBA Vision, Duluth, GA) SiHy contact lenses for continuous wear of up to 30 nights. Data from questionnaires at baseline, 1 week and 3 years captured the frequency and intensity of dryness symptoms during and at the end of the wearing day. Responses of subjects at 1 week and 3 years were compared to their baseline response by Bowker’s test of symmetry and the median change in response was tested with Wilcoxon Sign Rank test. The proportion of subjects with frequency > “sometimes” and severity > “mild” is shown for descriptive purposes.

RESULTS: There was a significant decrease in the frequency of dryness during the day from baseline to 1 week and 3 years from 57.2% to 33.1% after 1 week and to 28.8% after 3 years (p=<0.0001, Wilcoxon all comparisons). Frequency of end of the day dryness also decreased significantly from 61.1% at baseline to 41.0% after 1 week and 35.9% after 3 years (p<0.0001, Wilcoxon all comparisons). After the improvement from basline to 1 week, the proportion of subjects with dryness symptoms was stable throughout the 3-year study. Frequency and severity of dryness at the 1 week visit were significantly associated with discontinuation from the study (during the day: frequency p=0.007, severity p=0.017; end-of-day frequency p=0.002, severity 0.003, Chi-square).

CONCLUSIONS: Dryness symptoms improved after 1 week of refitting with lotrafilcon A and remained substantially improved through 3 years. The continued presence of dryness symptoms at 1 week was associated with discontinuation from the study. In many lens wearers, refitting with SiHy lenses reduced the frequency and severity of dryness symptoms that were present during low Dk/t hydrogel lens wear.