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November 2003


Duration of Discontinuation from Silicone Hydrogel Extended Wear Due to Non Infectious Adverse Responses

Katie Edwards, Thomas Naduvilath, Nina Tahhan, Renee Du Toit, Eric Papas, Angela Kalliris, Jerome Ozkan, Deborah F Sweeney . CCLRU, School of Optometry and CRCERT, University of New South Wales, Kensington, Australia.


Most adverse ocular events (AE) occurring with extended wear of silicone hydrogels resolve with temporary discontinuation of lens wear. A retrospective study to assess the average length of discontinuation due to AEs was conducted.
282 subjects wore bilateral silicone hydrogel lenses on a 30N EW schedule. Subjects were reviewed at 1 night, 1 week, 1 month, then at 3 monthly intervals, and if experiencing unusual signs or symptoms. If an AE was diagnosed, lens wear was discontinued until the condition had completely resolved. AEs were graded in severity on a scale of 1-4 and classified as Corneal Inflammatory Events (CIE): Contact Lens Peripheral Ulcer (CLPU), Contact Lens induced Acute Red Eye (CLARE), Infiltrative Keratitis (IK), and Mechanical Events (ME): Superior Epithelial Arcuate Lesion (SEAL), Corneal Erosion (CE). The length of discontinuation due to different AEs was compared and the associations with severity ratings and clinical variables examined.
On average, CIEs caused longer durations of discontinuation (15±15 days) than MEs (5±3 days)(p<0.01). There were no differences in length of discontinuation between different types of CIEs (CLPU: 11±8; CLARE: 12±8; IK: 17±17; p=1.0), or between different types of MEs (SEAL: 5±4; CE: 5±3; p=1.0). Length of discontinuation following CIEs, but not with MEs, correlated with severity rating (r=0.46, p<0.01), density of infiltrate (r=0.27, p=0.04), and depth of corneal staining (r=0.27, p=0.03).
Most AEs with silicone hydrogels are self limiting, with lens wear resuming on average within 15 days of CIEs and 5 days of MEs. Denser infiltrates and deeper staining in CIEs are associated with longer periods of discontinuation from lens wear.
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