Ocular surface response and subjective symptoms associated to lens care solutions in Palestine / Respuesta de la superficie ocular y síntomas subjetivos asociados a las soluciones para el cuidado de las lentillas en Palestina

PURPOSE: To compare the biocompatibility and subjective symptoms of four multipurpose solutions marketed in Palestine with hydrogel contact lenses. METHODS: 50 habitual soft contact lens wearers were recruited in this interventional crossover study. Subjects were asked to attend the optometry clinic five times. A new pair of hydrogel lenses (Bioxifilcon-B) were fitted each time. This pair was soaked randomly overnight in one of the following four-multipurpose solutions (NEOPLUS(R), AvizorUnicaSensitive(R), ReNuMultiPlus(R) and COMPLETERevitaLens(R)) which contain different disinfecting agents (PHMB, Phx, PAPB, and PQ-1 + Alexidine, respectively), or non-preserved saline. At each visit, corneal staining, ocular redness and subjective symptoms were assessed. RESULTS: The percentage of corneal staining increased significantly (P ≤ 0.050) after soaking the lenses with PHMB (86%), PAPB (64%) and Phx (32%) based-solutions. However, a non-significant increase was noticed after the use of PQ-1 + Alexidine based solution (30%, P = 0.083). Ocular redness evaluation showed a significant increase (P ≤ 0.050) in limbal hyperemia after the use of all solutions, while bulbar redness was significantly increased after the use of biguanide-based solutions (P ≤ 0.050). The subjective assessment analysis showed a non-significant change in comfort, dryness, photophobia and scratchiness (P ≥ 0.050) at 2-h intervention using all solutions, except for the PHMB based solution which showed a significant change in subjective symptoms (P ≤ 0.050). Conclusion: The combination of Bioxifilcon-B hydrogel contact lenses and solution containing PHMB, PAPB and Phx-disinfectants induced a significant increase in corneal staining after 2h of CL-wear with a higher severity when the PHMB-based solution was used, while the PQ-1+Alexidine-based solution did not. Only the PHMB-based solution triggered a significant change in subjective symptoms which might which suggests that it might be related to the severity of staining rather than the induction of staining

OBJETIVO: Comparar la biocompatibilidad y los síntomas subjetivos de cuatro soluciones multiusos comercializadas en Palestina con lentillas de hidrogel. MÉTODOS: En este estudio intervencionista cruzado, reunimos a 50 usuarios habituales de lentillas blandas. Solicitamos a los sujetos que acudieran cinco veces a la clínica optométrica. Cada vez ajustamos un nuevo par de lentillas de hidrogel (Bioxifilcon-B). Dicho par se sumergió aleatoriamente por la noche en una de las siguientes soluciones multiuso (NEOPLUS(R), AvizorUnicaSensitive(R), ReNuMultiPlus(R) y COMPLETERevitaLens(R)), que contienen diferentes agentes desinfectantes (PHMB, Phx, PAPB, y PQ-1 + Alexidina, respectivamente), o solución salina sin conservantes. Durante cada visita, valoramos la coloración de la córnea, el enrojecimiento ocular y los síntomas subjetivos. RESULTADOS: El porcentaje de coloración de la córnea se incrementó significativamente (P ≤ 0,05) tras sumergir las lentillas en soluciones basadas en PHMB (86%), PAPB (64%) y Phx (32%). Sin embargo, se observó un incremento no significativo tras utilizar la solución basada en PQ-1 + Alexidina (30%, P = 0,083). La evaluación del enrojecimiento ocular reflejó un incremento significativo (P ≤ 0,05) de la hiperemia limbal tras el uso de todas las soluciones, mientras el enrojecimiento bulbar se incrementó significativamente tras utilizar soluciones basadas en biguanida (P ≤ 0,05). El análisis de valoración subjetiva reflejó un cambio no significativo en cuanto a comodidad, sequedad, fotofobia y picazón (P ≥ 0,05) durante la intervención de dos horas utilizando todas las soluciones, exceptuando la solución basada en PHMB, que reflejó un cambio significativo en cuanto a síntomas subjetivos (P ≤ 0,05). CONCLUSIÓN: La combinación de las lentillas de hidrogel Bioxifilcon-B y la solución con contenido de desinfectantes PHMB, PAPB y Phx indujo un incremento significativo de la coloración de la córnea tras 2 h de uso de lentillas, con una severidad superior al utilizarse la solución basada en PHMB, hecho que no se produjo con la solución basada en PQ-1 + Alexidina. Únicamente la solución basada en PHMB desencadenó un cambio significativo en cuanto a síntomas subjetivos, lo cual podría sugerir que podría guardar relación con la severidad de la coloración, en lugar de la inducción de la misma

Ocular surface response and subjective symptoms associated to lens care solutions in Palestine.

PURPOSE: To compare the biocompatibility and subjective symptoms of four multipurpose solutions marketed in Palestine with hydrogel contact lenses. METHODS: 50 habitual soft contact lens wearers were recruited in this interventional crossover study. Subjects were asked to attend the optometry clinic five times. A new pair of hydrogel lenses (Bioxifilcon-B) were fitted each time. This pair was soaked randomly overnight in one of the following four-multipurpose solutions (NEOPLUS®, AvizorUnicaSensitive®, ReNuMultiPlus® and COMPLETERevitaLens®) which contain different disinfecting agents (PHMB, Phx, PAPB, and PQ-1+Alexidine, respectively), or non-preserved saline. At each visit, corneal staining, ocular redness and subjective symptoms were assessed. RESULTS: The percentage of corneal staining increased significantly (P≤0.050) after soaking the lenses with PHMB (86%), PAPB (64%) and Phx (32%) based-solutions. However, a non-significant increase was noticed after the use of PQ-1+Alexidine based solution (30%, P=0.083). Ocular redness evaluation showed a significant increase (P≤0.050) in limbal hyperemia after the use of all solutions, while bulbar redness was significantly increased after the use of biguanide-based solutions (P≤0.050). The subjective assessment analysis showed a non-significant change in comfort, dryness, photophobia and scratchiness (P≥0.050) at 2-h intervention using all solutions, except for the PHMB based solution which showed a significant change in subjective symptoms (P≤0.050). CONCLUSION: The combination of Bioxifilcon-B hydrogel contact lenses and solution containing PHMB, PAPB and Phx-disinfectants induced a significant increase in corneal staining after 2h of CL-wear with a higher severity when the PHMB-based solution was used, while the PQ-1+Alexidine-based solution did not. Only the PHMB-based solution triggered a significant change in subjective symptoms which might which suggests that it might be related to the severity of staining rather than the induction of staining.