Post-lens Lubrication and Subjective Responses during Mini-scleral Contact Lens Wear
Fiona Stapleton, Rajini Peguda, Jaya Sowjanya Siddireddy, Nancy Briggs and Jacqueline Tan
School of Optometry and Vision Sciences, UNSW Sydney, Australia
Poster presented at AAO, Nashville (Virtual meeting), Oct 2020 (Link)
To compare the effect on subjective responses up to 6 hours post-lens insertion, when two different lubricating eye drops are instilled in mini-scleral contact lenses (CLs) prior to CL insertion, compared to filling with saline alone.
Experienced soft CL wearers aged 18-45 years (inclusive), with spherical refractive error between +6.00 and -8.00D (inclusive) and cylinder power ≤0.75D were enrolled in this prospective, randomized, double-masked, three arm comparison cross-over study. Subjects were fitted with KATT 16.5mm diameter Boston XO material mini-scleral CLs, ordered to their prescription. Subjects attended visits on three separate days at least 48 hours apart, and were randomized to receive instillation of an HP Guar/nanoemulsion drop (test #1) or an HP Guar/hyaluronate acid (HA) eye drop (test #2) into the mini-scleral CL prior to filling with saline, or filling with saline alone (control). Subjective responses were collected up to 6 hours post-insertion. Generalized linear mixed models with multinomial distribution and cumulative logit link were used to compare the rate that responses improved post-CL insertion for the different treatments. A random effect for individuals was included to account for correlation due to repeated measures.
Eleven males and 13 females aged 29.3 ± 5.4 years completed the study. Dryness symptoms were more likely to improve at a slower rate post-CL insertion with saline alone compared to the addition of test drop #1 (p = 0.005) or test drop #2 (p = 0.049) prior to lens insertion. Furthermore, the addition of test eye drop #1 was more effective than saline alone in improving symptoms of fluctuating vision (p = 0.011), grittiness/burning/stinging (p = 0.001) and foreign body sensation (p=0.006) more quickly. Overall, average subjective ratings for comfort, vision and overall satisfaction were high during mini-scleral CL wear in this population of neophytes to this modality.
Instillation of HP Guar/nanoemulsion or HP Guar/HA based lubricating eye drops prior to filling mini-scleral CLs with saline is beneficial for improving lens comfort. Vision also stabilized more quickly with the HP Guar/nanoemulsion eye drop evaluated compared to filling mini-scleral CLs with saline alone. The use of post-lens lubrication may be useful in enhancing adaptation to mini-scleral CLs.