Preventing Contact Lens Dropout

During the past 20 years, there have been numerous studies that have tried to determine the rate at which patients drop-out of wearing contact lenses.  In spite of the development of silicone hydrogel lenses, the drop-out rate has remained fairly constant at about 20%.  Trying to determine the main reason for contact lens drop-out has also led to a consistent result – discomfort, especially related to the symptoms of dryness.

There are three areas that must be considered when trying to improve comfort when wearing lenses:

Material – prescribing a material that resists dehydration is essential. For example, Proclear lenses maintain over 96% of their water content after 12 hours of wear.  In fact, they are made from the only material that the FDA as cleared to be labeled: “may provide improved comfort for cl wearers who experience mild discomfort or symptoms relating to dryness during lens wear associated with Evaporative Tear Deficiency or  Aqueous Tear Deficiency (non-Sjorgen’s only)”

Modality - One day disposable lenses accumulate less surface deposits which enhance tear spread across the lens surface and improves lubricity.  That equates to an increase in comfortable wearing time.

Material/Disinfecting Solution interaction – certain lenses seem to work better with specific lens disinfecting solutions.  Choosing a lens that has little negative interaction with all solutions will, hopefully, increase comfortable lens wear.  As an example, according to the Andrasko Staining Grid, Biofinity has demonstrated minimal staining with all of the solutions with which it was tested.

Ideally, a one day lens (that eliminates the need for any solution related concern) that resists dehydration will provide the best chance for comfortable lens wear.  In a recent study reported in Contact Lens and Anterior Eye1, patients experiencing problems (discomfort, dryness, irritation) with reusable contact lenses were refit with daily disposable lenses.  After being refit with daily disposable contact lenses, the frequency of reduced comfortable wearing time was decreased from 65% to 51% and dryness from 60% to 41%.

This would certainly indicate that if you have patients complaining of reduced wearing time due to discomfort or dryness, refitting them with daily disposable lenses may provide a more comfortable wearing experience.


Reference: Hickson-Curran S, Spyridon M, Hunt C, Young G. The use of daily disposable lenses in problematic reusable contact lens wearers. Cont Lens Anterior Eye. 2014 Apr 4
[Epub ahead of print]

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