School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW 2052, Australia.
School of Optometry and Vision Science, UNSW Sydney, Sydney, NSW 2052, Australia.
Cont Lens Anterior Eye. 2018 Feb;41(1):110-116. doi: 10.1016/j.clae.2017.09.011. Epub 2017 Sep 20.
Contact lens discomfort remains poorly understood, not least due to lack of associations between clinical signs and symptoms. This study aimed to explore the relationships between osmolarity, comfort and lid wiper epitheliopathy in contact lens wear.
Twenty subjects participated in a randomized, cross-over study where comfilcon A and lotrafilcon A lenses were each worn for 10days separated by a 7days washout period. Tear and contact lens osmolarity, ocular symptoms including comfort, tear stability and production, and lid wiper epitheliopathy were measured.
Comfort and tear stability decreased and upper lid wiper staining and foreign body sensation increased with lens wear. These were not affected by lens type. A reduction in tear production was seen after 10days of comfilcon A lens wear. High proportions of lid wiper epitheliopathy were observed at the upper (range 65%-85%) and lower (range 90%-100%) lid margins. Tear and contact lens osmolarity were unaffected by lens wear or type. Contact lens osmolarity was associated with comfort (r=0.45, p=0.009). Tear osmolarity moderately correlated with tear stability (r=-0.53, p=0.014) and tear production (r=-0.44, p=0.012) but not with lid wiper staining.
A relationship between comfort and contact lens osmolarity and between tear osmolarity and tear stability and production were found, however, this study was unable to demonstrate an association between comfort and tear osmolarity or lid wiper epitheliopathy. Further studies using contact lenses with a wider range of comfort responses are warranted to investigate these associations further.
隐形眼镜不适仍然知之甚少，部分原因是临床体征和症状之间缺乏关联。本研究旨在探讨接触镜佩戴者的渗透压、舒适度和眼睑擦拭上皮病之间的关系。
20 名受试者参与了一项随机、交叉研究，在 7 天的洗脱期内，分别佩戴 comfilcon A 和 lotrafilcon A 镜片 10 天。测量泪液和接触镜渗透压、眼部症状，包括舒适度、泪膜稳定性和泪液分泌以及眼睑擦拭上皮病。
随着镜片佩戴，舒适度和泪膜稳定性下降，上眼睑擦拭染色和异物感增加。这些变化不受镜片类型的影响。佩戴 comfilcon A 镜片 10 天后，泪液分泌减少。上眼睑（范围 65%-85%）和下眼睑（范围 90%-100%）的眼睑擦拭上皮病比例较高。泪液和接触镜渗透压不受镜片佩戴或类型的影响。接触镜渗透压与舒适度相关（r=0.45，p=0.009）。泪液渗透压与泪膜稳定性（r=-0.53，p=0.014）和泪液分泌（r=-0.44，p=0.012）中度相关，但与眼睑擦拭染色无关。
本研究发现舒适度与接触镜渗透压之间存在关系，泪液渗透压与泪膜稳定性和泪液分泌之间存在关系，但无法证明舒适度与泪液渗透压或眼睑擦拭上皮病之间存在关联。需要使用具有更广泛舒适度反应的隐形眼镜进行进一步研究，以进一步探讨这些关联。
