The influence of lens care systems on eyelid tissue changes during silicone hydrogel contact lens wear

Purpose: To compare the effects of a hydrogen peroxide (H2O2)-based lens care solution and a polyhexamethylene biguanide (PHMB) multi-purpose solution on the eyelids when used with silicone hydrogel (SiHy) contact lenses. Methods: A total of 74 symptomatic wearers of ACUVUE (R) OASYS (R) (senofilcon A; n = 39) or PureVision (R) (balafilcon A; n = 35) contact lenses were randomised 1:1 to either CLEAR CARE (R) Cleaning & Disinfecting Solution or renu (R) fresh (TM) multi-purpose solution (n = 37 each). Assessments of hyperaemia, papillae and lid margin staining of eyelid tissue were evaluated subjectively by a masked investigator at enrolment (with the subjects' habitual SiHy contact lenses and PHMB-preserved care systems), at dispensing visit (when no lenses were worn) and at 3-months' follow-up. Results: There were no differences in eyelid assessments between the two lens care groups at dispensing visit (p = 0.086 to 0.947). After 3 months, the papillae response was significantly less marked with H2O2-based solution than with PHMB-based solution (p = 0.017). Lid hyperaemia (p < 0.001) and papillae (p = 0.002) were also significantly reduced. Although lid hyperaemia was also reduced with PHMB-based solution (p < 0.001), there was no concurrent decrease in papillae response (p = 0.051). No improvements were found in eyelid margin staining either over time or between the two lens care groups. Conclusion: In symptomatic contact lens wearers, a H2O2-based lens care solution used with senofilcon A and balafilcon A lenses was better tolerated by eyelid tissues than was a PHMB-based solution and led to a decrease in clinical markers of eyelid inflammation.