Effect of Lens Care Systems on the Clinical Performance of a Contact Lens

Purpose. To evaluate subjective responses, rates of solution-induced corneal staining (SICS), and corneal infiltrative events (CIEs) associated with a silicone hydrogel when worn under a daily disposable (DD) or daily wear (DW) modality. Methods. Data were obtained from seven prospective clinical trials, involving 283 subjects wearing Senofilcon A contact lenses (Johnson and Johnson Vision Care, Jacksonville, FL). Four groups wore the contact lens on a DW basis using multipurpose solutions (DW-MPS, n = 160), two groups using hydrogen peroxide (DW-H2O2, n = 83), and one group as a DD (n = 40). Participants were followed for 3 months using the same protocol. Subjective ratings were compared between DD and DW groups using a linear mixed model. Rates of SICS and CIE were calculated as the percent frequency of first events within the 3-month study. Association of SICS and CIE with subjective responses was analyzed using a linear mixed model. Results. End-of-day comfort and dryness ratings were significantly better for DD (8.5 +/- 1.7 and 8.6 +/- 1.7, respectively) compared with DW-H2O2 (7.7 +/- 1.8, p = 0.01; 7.6 +/- 1.9, p = 0.006, respectively) and DW-MPS (7.7 +/- 1.7, p = 0.004; 7.6 +/- 2.0, p = 0.003, respectively). Compared with DD, a higher incidence of CIE and SICS was found for DW-MPS (0.0 vs. 3.9%, p = 0.021; 0.9 vs. 8.6%, p = 0.002, respectively). Comfort at insertion and end of day and end-of-day dryness scores were significantly lower for participants who experienced SICS (8.2 +/- 1.6, 7.0 +/- 1.9, and 7.0 +/- 2.2) than those who did not (8.8 +/- 1.2, p = 0.004; 7.9 +/- 1.7, p = 0.002; and 7.9 +/- 1.8, p = 0.003, respectively). Comfort at insertion scores were significantly lower for participants who experienced CIEs than those who did not (8.2 +/- 1.5 vs. 8.8 +/- 1.4, p = 0.032). Conclusions. Senofilcon A clinical response is modulated by the lens care products. All lens care products tested reduced subjective responses relative to DD modality, whereas MPS increased the incidence of CIEs and SICS. Senofilcon A performs best when used on a DD basis. (Optom Vis Sci 2013;90:344-350)