Dryness Symptoms Reduce When HEMA SCL Wearers Change to Lotrafilcon SiH

Long, Bill (CIBA Vision Corporation), Sally M Dillehay (OD, MS, FAAO), John J. McNally (OD, FAAO), Joseph T. Barr (OD, MS, FAAO), Peter D. Bergenske (OD, FAAO), Peter Donshik (MD), Glenda B. Secor (OD,FAAO), John Yoakum (OD)

TITLE: Subjective Dryness Symptoms Improve When Adapted Hema Soft Contact Lens Wearers

PURPOSE: Dry eye symptoms among contact lens wearers have been reported as a leading cause of discontinuation of contact lens wear.[1] Patient reported symptoms of dryness are often the only diagnostic criteria used by practitioners for diagnosing and managing dry eye.[2], [3], [4] Some investigators have reported improvement in contact lens-related dry eye symptoms when adapted HEMA hydrogel wearers change to silicone hydrogel (SiHy) lenses.[5], [6] Five trials with lotrafilcon A and B lenses were analyzed retrospectively to investigate the performance of this material for improvement of dryness symptoms.

METHODS: Five trials involving 1,279 adapted HEMA wearers who were changed to lotrafilcon A or B SiHy lenses were analyzed for subjective patient evaluations of dryness during the day (DD) and dryness at the end of day (ED): 1 trial with lotrafilcon A for up to 30 night wear, 3 trials with lotrafilcon A for daily wear, and 1 trial with lotrafilcon B lenses for daily wear. Subjective evaluations with habitual HEMA lenses were compared to evaluations after wearing lotrafilcon SiHy lenses.

RESULTS: At 1 month, statistically significant improvements with lotrafilcon A for up to 30 night continuous wear were found for DD (p<0.0001, n=282) and ED (p=0.002, n=282). At 1 month, statistically significant improvements with lotrafilcon A for daily wear were found for DD (p<0.001, n=81; p<0.0001, n=60; p<0.0001, n=96) and ED (p=0.0017, n=81, p=0.0001, n=60, p<0.0001, n=96). At 2 weeks, statistically significant improvements with lotrafilcon B for daily wear were found for DD (p<0.0001, n=750) and ED (p<0.0001, n=750). On average, 46% (range 33% to 51%) of subjects reported improved DD and 32% (range 28% to 51%) improved ED.

CONCLUSIONS: Changing to lotrafilcon A or B silicone hydrogel contact lenses provides improvment for some adapted HEMA wearers from symptoms of contact lens-related dryness during the day and dryness at the end of day. HANGE TO LOTRAFILCON SILICONE HYDROGEL SOFT CONTACT LENSES

KEY WORDS:  Contact lenses - extended wear, Tears/Dry eye/Lacrimal system