The use of daily disposable lenses in problematic reusable contact lens wearers

Purpose: Replacing soft contact lenses (CLs) on a daily basis brings a number of advantages, most notably, reduced exposure to deposits, disinfectants, allergens, and other contaminants. This retrospective study estimated the prevalence of problems in current wearers df reusable soft CLs and tested the effect of refitting "problem" patients with daily disposable (DD) hydrogel lenses. Methods: Prevalence was estimated from 398 current reusable CL wearers for: frequent/constant discomfort or dryness, >2 h of uncomfortable wear, >grade 2 conjunctival hyperaemia (0-4), or >grade 3 corneal staining (0-15). In the second part of the study, 217 reusable CL wearers classified as problem patients were randomly refitted with DD lenses manufactured from one of two materials: etafilcon A (n=96) or nelfilcon A (n=121) and reassessed 1 week later. Results: Thirty-nine percent (154/398) had some qualifying criterion: reduced comfortable wearing time (CWT), 20%; dryness, 20%; irritation, 5%; corneal staining, 8%; and hyperaemia, 7%. After refitting with DDs, the prevalence of reduced CWT was decreased from 65% to 51% (P=0.0039), dryness from 60% to 41% (P<0.0001) and corneal staining from 28% to 21% (P=0.04). There was no significant change in the prevalence of irritation, or hyperaemia. Some differences were noted between the two lens materials. Conclusions: A high proportion of reusable soft lens wearers encounter clinically relevant signs or symptoms with their current CLs. This study provides evidence that refitting with DD lenses is a useful strategy for alleviating some of the common problems of CL wear. (C) 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.