Purpose: Reduced comfort and increased symptoms of dryness often accompany soft contact lens wear. Previous studies have investigated the influence of lubricants on conventional hydrogel (CH) wearers but not on silicone hydrogel (SH) lens wearers. We sought to investigate the influence of three solutions (saline, Refresh® and Cellufresh®) of varying viscosity, on post-insertion and six-hour comfort with SH lens wear.

Method: Fifteen subjects participated in a non-dispensing, single masked clinical trial. On four different days, subjects randomly used either no solution or one of the three solutions with contralateral wear of SH lenses (Focus® Night and DayTM) and CH lenses (Acuvue2®). Lenses and solutions were randomly assigned. Solutions were instilled (2 drops bilaterally) following lens insertion, then after 2 and 4 hours. Lens and solution allocation was randomised. At each visit, comfort was rated at pre-lens insertion, immediately after lens insertion and post-six hours lens wear. Comfort was rated using a 1-100 numerical rating scale. Dryness was rated on a 0-4 scale.

Results: Post-insertion comfort was rated higher with the use of solutions (p<0.001) for both SH and CH. After six-hours wear, SH were rated as less comfortable compared to CH (p=0.001), both with and without solution use.

Furthermore, at six hours, SH wearers rated their lenses as less dry with the use of the more viscous lubricants Refresh® and Cellufresh® (p<0.002), compared to saline use. CH wearers had no significant difference for dryness symptoms with six-hours wear at any of the four visits.

Conclusion: Post-insertion use of solutions, both saline and more viscous lubricants, was effective in improving initial comfort with SH wear, as was previously shown by Brennan et al (1991) for CH lenses. Six-hour comfort was not significantly influenced by any solution use with either lens type. The use of viscous lubricants (Refresh® and Cellufresh®), but not saline, resulted in reduced dryness symptoms with SH wearers. Saline and lubricants appear to be a means of establishing vital initial comfort, both with CH and SH lens wear.