Clinical and overnight corneal swell comparison of the 1-Day Acuvue lens versus the Medalist, Surevue, Biomedics, and Acuvue lenses.

PURPOSE: We characterized the clinical performance of the 1-Day Acuvue contact lens by direct comparison with four frequently prescribed daily wear lenses. METHODS: Forty-eight patients participated in four prospective, randomized masked clinical trials using the 1-Day Acuvue in one eye and the Medalist, Surevue, Acuvue (regular), and Biomedics 55 lenses in the other eye. Each trial lasted 2 weeks. Thirteen symptom variables and overall lens preference were evaluated using a patient preference questionnaire and a symptom-ranking questionnaire. Overnight corneal swell studies were also performed. RESULTS: In the non-allergic (58.4%) subgroup, the overall lens preference variable revealed a significant preference for the Medalist (P = .004), Surevue (P < .001), and Biomedics 55 (P < .001) lenses. In contrast, in the allergic (41.6%) subgroup, the overall lens preferences for the Medalist, Surevue, and Biomedics 55 lenses were completely absent. Multivariate regression analysis in the non-allergic subgroup revealed that lens comfort (.58, P < .001), lens handling upon insertion (.41, P < .001), and quality of vision (.35, P < .001) were significant variables contributing to patient responses regarding overall lens preference. However, in the allergic subgroup, only the lens comfort (.92, P < .001) variable is significant and appears to dominate the decision making. The overnight corneal swell evaluation revealed no significant differences between the 1-Day Acuvue and the Medalist lens. Patients wearing regular Acuvue had significantly less corneal swelling upon awakening (P = .005) and at 60 minutes after awakening (P = .003). CONCLUSIONS: The Medalist, Surevue, and Biomedics 55 lenses outperformed the 1-Day Acuvue lens in the non-allergic subgroup. In the allergic subgroup, there was no statistically significant difference between the 1-Day Acuvue lens and all other lenses tested.

Corneal topography in contact lens wearers following penetrating keratoplasty.

We examined the effects of contact lens wear on corneal topography following penetrating keratoplasty (PK). We present the long-term follow-up of 23 eyes of 22 patients who underwent PK and rigid gas permeable contact lens fitting. Computerized corneal topography, manual keratometry, and refraction were conducted prior to contact lens fitting and then at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year post-fitting. At least 6 months follow up was obtained for 23 eyes of 22 patients, and at least 12 months follow-up was obtained for 18 eyes of 17 patients. Seventy four percent of the eyes were stable (+/- 1.00 D) by manual keratometry, computerized corneal topography, and refraction (both spherical equivalent and cylinder). Those patients who changed showed a trend toward a small decrease in refractive cylinder and spherical equivalent. Measurements obtained from both computerized corneal topography and manual keratometry showed a small but significant amount of flattening (P < 0.003 and P < 0.04, respectively).

Comparison of the clinical performance of the Acuvue disposable contact lens and CSI lens in patients with giant papillary conjunctivitis.

Anecdotal reports have suggested that the use of disposable contact lenses is an effective treatment for giant papillary conjunctivitis. In a prospective randomized double-masked study, we compared the clinical performance of the Acuvue (Vistakon, Jacksonville, Florida) disposable contact lens to the traditional daily-wear lens of choice, CSI (Pilkington Barnes Hind, Sunnyvale, California), in 37 patients with previously diagnosed giant papillary conjunctivitis who were examined at one-month intervals for six months. A survey questionnaire for grading symptoms disclosed significant improvement in itching, discharge, and blurred vision in both groups early in the study. Evaluation of patient preference showed that the CSI lens was strongly preferred with regard to lens handling (76% vs 8%). In contrast, the Acuvue lens was strongly preferred with regard to lens comfort (62% vs 11%). For the variable of overall lens preference, there was no significant difference between the two lenses (CSI, 43% and Acuvue, 41%). Multiple regression analysis disclosed that both lens comfort (P < .002) and lens handling (P = .05) contributed significantly to the choices made regarding the dependent variable of overall lens preference. Lens comfort (beta = .71) was observed to be approximately 50% more powerful than lens handling (beta = .48). There was no significant difference in the rate or cost of torn lenses between groups, suggesting that the Acuvue lens can withstand the physical manipulation associated with daily-wear use for up to one month. The results of this study suggest that the use of disposable contact lenses for the treatment of giant papillary conjunctivitis is at least as effective as the traditional daily-wear lens of choice.