Young Graeme, Veys Jane, Pritchard Nicola, Coleman Sarah
Visioncare Research Ltd, Famham, Surrey, UK.
Ophthalmic Physiol Opt. 2002 Nov;22(6):516-27. doi: 10.1046/j.1475-1313.2002.00066.x.
Discontinuation from contact lens wear has been identified as a contributing factor in the lack of growth of contact lens use in Europe. The purpose of this study was to determine the proportion of lapsed contact lens wearers that can be refitted successfully with contact lenses and to evaluate the reasons for discontinuation from contact lens wear.
This was a multi-site clinical study involving 15 UK investigators and 236 lapsed contact lens wearers who had previously tried contact lenses and discontinued. The reasons for discontinuation were assessed by subjects, who were then refitted with contact lenses. Investigators subsequently evaluated factors associated with their initial discontinuation. Short-term success was defined as the successful completion of 1 month of contact lens wear with absence of complications that would prevent further wear. Subjects were interviewed by telephone 6 months after being refitted to determine whether they were still wearing contact lenses. Those who were not wearing lenses were questioned about the reasons for discontinuation and their likelihood of resuming lens wear.
A majority of subjects (51%) cited discomfort as the principal reason for having previously given up contact lens wear. Problems with vision were the second most common reason (13%), either with reading (6%) or general vision (7%). The most common type of discomfort was dryness (40%). In almost all cases (97%), the investigator's assessment of the reasons for discontinuation agreed with the subject's own assessment but investigators also cited product-related and practitioner-related factors as contributing to previous failure. The short-term success rate for refitting lapsed wearers was found to be 77% (Cl: 70-82%). The highest short-term success rates were for 2-weekly/monthly soft spherical lenses (91%) and daily disposable lenses (89%). Lower success rates were found for soft toric (69%) and soft bifocal (53%) lenses. At the 6-month stage, 73% of those who continued in lenses after the 1-month visit were still wearing contact lenses and a further 18% indicated that they were either 'very likely' or 'likely' to resume lens wear.
A high proportion of lapsed contact lens wearers can be successfully refitted with contact lenses. The prime reason for previous discontinuation from contact lenses is discomfort and, in particular, dryness-related discomfort. In many cases, previous contact lens failure is product or practitioner-related rather than because of patient-specific problems. Once refitted with contact lenses, lapsed wearers cite vision problems rather than discomfort as the most common reason for discontinuing. This finding suggests that recent advances in contact lens material, design, replacement frequencies and care systems have improved the prospects for avoiding lens-related discomfort and for continuing contact lens wear.
在欧洲，停止佩戴隐形眼镜已被认定为隐形眼镜使用量增长不足的一个促成因素。本研究的目的是确定能够成功重新佩戴隐形眼镜的已停用隐形眼镜佩戴者的比例，并评估停止佩戴隐形眼镜的原因。
这是一项多中心临床研究，涉及15名英国研究者和236名已停用隐形眼镜的佩戴者，这些佩戴者此前曾尝试佩戴隐形眼镜但后来停止了。由受试者评估停止佩戴的原因，然后为他们重新佩戴隐形眼镜。研究者随后评估与他们最初停止佩戴相关的因素。短期成功定义为成功佩戴隐形眼镜1个月且无妨碍进一步佩戴的并发症。在重新佩戴6个月后通过电话采访受试者，以确定他们是否仍在佩戴隐形眼镜。对于那些未佩戴隐形眼镜的受试者，询问他们停止佩戴的原因以及重新佩戴的可能性。
大多数受试者（51%）表示不适是他们此前放弃佩戴隐形眼镜的主要原因。视力问题是第二常见的原因（13%），其中阅读视力问题（6%）或一般视力问题（7%）。最常见的不适类型是眼干（40%）。在几乎所有病例中（97%），研究者对停止佩戴原因的评估与受试者自己的评估一致，但研究者也指出产品相关和从业者相关因素是导致此前佩戴失败的原因。重新为已停用佩戴者配镜的短期成功率为77%（置信区间：70 - 82%）。短期成功率最高的是两周抛/月抛软性球面镜片（91%）和日抛型镜片（89%）。软性散光镜片（69%）和软性双焦点镜片（53%）的成功率较低。在6个月阶段，在1个月随访后继续佩戴隐形眼镜的人中，73%仍在佩戴，另有18%表示他们“非常可能”或“有可能”重新佩戴隐形眼镜。
很大比例的已停用隐形眼镜佩戴者能够成功重新佩戴隐形眼镜。此前停止佩戴隐形眼镜的主要原因是不适，尤其是与眼干相关的不适。在许多情况下，此前隐形眼镜佩戴失败是与产品或从业者相关，而非患者自身特定问题。一旦重新佩戴隐形眼镜，已停用佩戴者表示视力问题而非不适是停止佩戴的最常见原因。这一发现表明，隐形眼镜材料、设计、更换频率和护理系统方面的最新进展改善了避免与镜片相关不适以及持续佩戴隐形眼镜的前景。
