Purpose
Normal sight depends on complex neurosecretory and immunologic mechanisms that regulate the tear film and ocular surface. Perturbations in this system by various means can disturb the ocular surface and cause significant dry eye often unresponsive to conventional treatments.  Highly oxygen permeable silicone hydrogel contact lenses may provide a new therapeutic adjunct in the treatment of dry eye disease.  Focus® Night and Day™ lenses are approved by the FDA for 30-day continuous wear and separately as bandage contact lenses.  The object of this study is to determine the safety and efficacy of continuous wear bandage contact lenses in the management of moderate to severe dry eye signs and symptoms.

Methods
Seven patients were recruited, six of whom had graft versus host disease.  All had moderate to severe dry eye disease determined by the Ocular Surface Disease Index questionnaire (OSDI).  All were fit bilaterally with low power Focus® Night and Day™ silicone hydrogel lenses. Lenses were worn continuously with weekly removal for cleaning.  OSDI scores, visual acuity, Schirmer testing, vital dye staining and tear break up time were compared at baseline and at one month.

Results
All seven patients had significant improvement comparing baseline to one month data.  Visual acuity scores were: (logMAR Va + SD): OD 0.32 + 0.13 vs. 0.06 + 0.089 (p < 0.007); OS: 0.26 + 0.114 vs. 0.02 + 0.044 (p < 0.016). OSDI scores (+ SD) were: 76.2 + 16.49 vs. 39.6 + 18.92 (p < 0.006).  Changes in Schirmer testing, corneal staining and tear break up time were not significant.  No adverse events were reported or observed.

Conclusion
Focus® Night and Day™ soft contact lenses improved visual acuity and subjective symptoms associated with moderate to severe dry eye disease.  Contact lenses were worn continuously for one week without adverse reactions.  This treatment modality deserves further study.

This study was supported by a grant from the Illinois Society for the Prevention of Blindness.