Effects of Daily Irrigation on Corneal Epithelial Permeability and Adverse Events With Silicone Hydrogel Contact Lens Continuous Wear

Meng C. Lin, Heather M. French, Andrew D. Graham, Timothy L. Sanders
2014 Investigative Ophthalmology and Visual Science  
Citation: Lin MC, French HM, Graham AD, Sanders TL. Effects of daily irrigation on corneal epithelial permeability and adverse events with silicone hydrogel contact lens continuous wear. Invest Ophthalmol Vis Sci. PURPOSE. To determine whether daily irrigation with sterile saline solution during silicone hydrogel (SiH) contact lens continuous wear (CW) can mitigate increases in corneal epithelial permeability (P dc ) and reduce the risk of adverse events. METHODS. In this study, 161 non-contact
more » ... dy, 161 non-contact lens wearers were fit with SiH contact lenses and randomized to either a treatment (n ¼ 81) or control (n ¼ 80) group for 30-day CW. Subjects in the treatment group irrigated every morning and whenever dryness symptoms occurred; subjects in the control group did not. Mixed effects models were employed to assess the changes in P dc , and survival analysis methods were employed to estimate the risk for adverse events. RESULTS. Epithelial permeability increased over 30-day CW with SiH lenses (P ¼ 0.001). Risk of inflammatory (odds ratio [OR] ¼ 1.94) and lens-induced (OR ¼ 1.90) adverse events increased with irrigation; these events also occurred sooner, on average, in the irrigation group. Although the overall risk for Asians was higher than for non-Asians, irrigation had no significant impact on risk among Asians, but significantly increased risk among non-Asians. CONCLUSIONS. Thirty-day CW results in a measurable increase in epithelial permeability. Risk of inflammatory and lens-induced adverse events also increase over time during CW. Daily irrigation with sterile saline solution did not mitigate increases in epithelial permeability or decrease risk of adverse events.
doi:10.1167/iovs.13-13508 pmid:24425854 fatcat:hg7czooqlbc7zmhdx35ixnxnwq