Purpose: To determine if the ocular comfort of symptomatic contact lens (CL) wearers can be substantially influenced by choosing a better or worse performing CL–lens care product (LCP) combination.
Methods: Twenty-four symptomatic and 13 nonsymptomatic CL wearers were enrolled into a prospective, crossover, randomized clinical trial. Two CL-LCP combinations were chosen from studies previously conducted at the Brien Holden Vision Institute that were found to provide the best (galyfilcon A/polyhexanide, combination 1) and worst performance (balafilcon A/polyquaternium-1 and myristamidopropyl dimethylamine + TearGlyde, combination 2) in terms of end-of-day comfort. Subjects were not informed whether they were categorized as symptomatic or nonsymptomatic nor were they aware of the rankings of each CL-LCP combination. Subjects were randomly allocated to one of the CL-LCP combinations for 8 days on a daily wear basis. Contact lens fitting was assessed after insertion from the packaging solution. Take-home questionnaires assessing ocular comfort and dryness (1 to 10 numeric rating scale) were completed on insertion and after 2 and 8 hours of wear on days 2, 4, and 6. Ocular symptoms were assessed on days 2, 4, and 6 after 8 hours of wear. A 48-hour washout period during which CLs were not worn was applied, with the procedure repeated using the second combination.
Results: In symptomatic subjects, combination 1 was rated significantly better than combination 2 after 8 hours of wear for ocular comfort (7.7 ± 1.3 vs. 7.1 ± 1.5, p = 0.01) and ocular dryness (7.5 ± 1.6 vs. 7.0 ± 1.6, p = 0.045), with less frequent symptoms of ocular dryness (p < 0.01) and lens awareness (p < 0.01) reported. No significant differences were found in nonsymptomatic subjects.
Conclusions: Ocular comfort and symptoms in symptomatic CL wearers can be perceptibly improved by switching to an alternative CL-LCP combination. This finding provides justification for the efforts of both eye care practitioners and researchers to improve the comfort of CL wearers.