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The Impact of Contact Lens Care Solutions on the Thickness of the Tear Film and Contact Lens

Nichols, Jason J OD, MPH, PhD; Mitchell, G Lynn MAS; King-Smith, P Ewen PhD

Clinical Sciences

Purpose: To determine the impact of compositional differences in contact lens care solutions on the thickness of the tear film during contact lens wear.

Methods: A randomized, crossover, investigator-masked clinical trial was conducted to compare AMO's Complete MoisturePlus to Alcon's Opti-Free Express in 31 subjects. The primary outcome of this study was a comparison of prelens tear film (PLTF) and postlens tear film (PoLTF) thickness values obtained during the first 2 hours of etafilcon A hydrogel lens wear. Each solution was used by each participant for a period of 7 days, separated by a washout period of 1 day. Alternative outcomes studied included prelens tear film thinning rates, solution preference, and dry eye-related symptom scores. Tear film thickness measurements were made using a noninvasive wavelength-dependent interferometric system.

Results: The average overall PLTF thickness over the 120-minute time period after using Complete MoisturePlus was 3.02 ± 1.07 μm, whereas the average overall PLTF thickness in this same time interval after using Opti-Free Express was 2.72 ± 0.86 (P = 0.003). For both solutions, the PLTF could be fitted by the sum of an exponential decay plus a constant. The PLTF decay amplitudes did not statistically differ when the solutions were compared (P = 0.11). There was no difference in overall PoLTF thicknesses when the average values after using each solution were compared (P = 0.57), although there was a difference immediately after the lens was applied to the eye (Complete MoisturePlus average = 4.10 versus Opti-Free Express average = 3.48, P = 0.02). The PoLTF also demonstrated an exponential decay for both solutions. The PoLTF decay amplitudes did not statistically differ (P = 0.14). Twenty subjects (64.5%) preferred Complete MoisturePlus to Opti-Free Express (35.5%) (P = 0.11), and nearly every subject (90.3%) suggested “comfort” as their reason for preference.

Conclusions: Complete MoisturePlus is associated with a thicker PLTF when compared with Opti-Free Express in contact lens wearers without dry eye symptoms, especially during the first 5 minutes following lens insertion.

From the College of Optometry, The Ohio State University, Columbus, OH.

Received for publication August 11, 2004; revision received December 17, 2004; accepted December 18, 2004.

This work was supported by a grant from Advanced Medical Optics, Inc. The authors have no financial or commercial interests in any of the materials or methods discussed in this manuscript.

Reprints: Jason J. Nichols, OD, MPH, PhD, College of Optometry, The Ohio State University, 320 West 10th Avenue, PO Box 182342, Columbus, OH 43218-2342 (e-mail:

© 2005 Lippincott Williams & Wilkins, Inc.