Effect of Lens and Solution Choice on the Comfort of Contact Lens Wearers

Purpose. To determine if the ocular comfort of symptomatic contact lens (CL) wearers can be substantially influenced by choosing a better or worse performing CL-lens care product (LCP) combination. Methods. Twenty-four symptomatic and 13 nonsymptomatic CL wearers were enrolled into a prospective, crossover, randomized clinical trial. Two CL-LCP combinations were chosen from studies previously conducted at the Brien Holden Vision Institute that were found to provide the best (galyfilcon A/polyhexanide, combination 1) and worst performance (balafilcon A/polyquaternium-1 and myristamidopropyl dimethylamine + TearGlyde, combination 2) in terms of end-of-day comfort. Subjects were not informed whether they were categorized as symptomatic or nonsymptomatic nor were they aware of the rankings of each CL-LCP combination. Subjects were randomly allocated to one of the CL-LCP combinations for 8 days on a daily wear basis. Contact lens fitting was assessed after insertion from the packaging solution. Take-home questionnaires assessing ocular comfort and dryness (1 to 10 numeric rating scale) were completed on insertion and after 2 and 8 hours of wear on days 2, 4, and 6. Ocular symptoms were assessed on days 2, 4, and 6 after 8 hours of wear. A 48-hour washout period during which CLs were not worn was applied, with the procedure repeated using the second combination. Results. In symptomatic subjects, combination 1 was rated significantly better than combination 2 after 8 hours of wear for ocular comfort (7.7 +/- 1.3 vs. 7.1 +/- 1.5, p = 0.01) and ocular dryness (7.5 +/- 1.6 vs. 7.0 +/- 1.6, p = 0.045), with less frequent symptoms of ocular dryness (p < 0.01) and lens awareness (p < 0.01) reported. No significant differences were found in nonsymptomatic subjects. Conclusions. Ocular comfort and symptoms in symptomatic CL wearers can be perceptibly improved by switching to an alternative CL-LCP combination. This finding provides justification for the efforts of both eye care practitioners and researchers to improve the comfort of CL wearers. (Optom Vis Sci 2013; 90: 411-418)