Dumbleton Kathryn A, Guillon Michel, Theodoratos Panagiotis, Patel Trisha
*PhD, FAAO †BSc(Hons), MSc ‡BSc(Hons) OCULAR TECHNOLOGY GROUP-International London, United Kingdom (KD, MG, PT, TP); and School of Life and Health Science, Aston University, Birmingham, United Kingdom (MG).
Optom Vis Sci. 2016 Aug;93(8):820-7. doi: 10.1097/OPX.0000000000000920.
The purpose of this investigation was to evaluate the diurnal variation in symptoms associated with ocular discomfort in contact lens (CL) wearers and non-CL wearers.
The study population comprised 604 individuals attending pre-screening visits at the OTG-i research clinic; 60% were current soft CL wearers (hydrogel and silicone hydrogel) and 40% were non-CL wearers. Symptomatology status was determined by the OSDI questionnaire (58% asymptomatic, 42% symptomatic). Participants were asked to grade their comfort, vision, and other symptoms during the day and in the evening (before lens removal for CL wearers) on 0 to 100 visual analogue scales.
Diurnal decrease in comfort was significantly greater for CL wearers (-16.0 vs. -6.3, p < 0.001) and symptomatic participants (p = 0.015). Diurnal decrease in subjective vision was also significantly greater for CL wearers (-10.4 vs. -6.9, p = 0.005) and symptomatic participants (p = 0.001), and the interaction between these factors was also significant (p = 0.019). Dryness, grittiness, and irritation increased significantly more for CL wearers (p < 0.001, p = 0.012, and p = 0.004, respectively) and grittiness, irritation, and stinging for symptomatic participants (p = 0.016, p < 0.001, and p < 0.001, respectively). For the CL wearers, there was a significant interaction between dryness and age (p = 0.026) with the diurnal increase in dryness being greater in those under 40 (+15.6 vs. +10.0).
The diurnal decrease in comfort and subjective vision, and the diurnal increase in dryness, grittiness, and irritation, were significantly more marked for CL wearers than non-CL wearers. Diurnal changes in comfort, grittiness, stinging, irritation, and vision were influenced by the subject's overall symptomatology as assessed by the OSDI questionnaire. For dryness symptoms, the diurnal decrease was most marked in young CL wearers. For the symptoms of stinging and vision, the diurnal changes were most pronounced in the symptomatic groups.
本研究旨在评估佩戴隐形眼镜（CL）者和非佩戴者眼部不适相关症状的昼夜变化。
研究人群包括604名在OTG-i研究诊所进行预筛查的个体；60%为当前的软性CL佩戴者（水凝胶和硅水凝胶），40%为非CL佩戴者。症状状态通过OSDI问卷确定（58%无症状，42%有症状）。参与者被要求在白天和晚上（CL佩戴者在摘除镜片前）使用0至100的视觉模拟量表对他们的舒适度、视力和其他症状进行评分。
CL佩戴者（-16.0对-6.3，p<0.001）和有症状的参与者（p = 0.015）的舒适度昼夜下降幅度明显更大。CL佩戴者（-10.4对-6.9，p = 0.005）和有症状的参与者（p = 0.001）的主观视力昼夜下降幅度也明显更大，并且这些因素之间的相互作用也很显著（p = 0.019）。CL佩戴者的干涩感、磨砂感和刺激感增加得更显著（分别为p<0.001、p = 0.012和p = 0.004），有症状的参与者的磨砂感、刺激感和刺痛感增加得更显著（分别为p = 0.016、p<0.001和p<0.001）。对于CL佩戴者，干涩感和年龄之间存在显著的相互作用（p = 0.026），40岁以下人群的干涩感昼夜增加幅度更大（+15.6对+10.0）。
与非CL佩戴者相比，CL佩戴者的舒适度和主观视力的昼夜下降以及干涩感、磨砂感和刺激感的昼夜增加更为明显。舒适度、磨砂感、刺痛感、刺激感和视力的昼夜变化受OSDI问卷评估的受试者总体症状的影响。对于干涩症状，年轻CL佩戴者的昼夜下降最为明显。对于刺痛和视力症状，昼夜变化在有症状的组中最为明显。
