Department of Biomedical Engineering, Wroclaw University of Science and Technology, Wroclaw, Poland.
Department of Optics and Photonics, Wroclaw University of Science and Technology, Wroclaw, Poland.
Optom Vis Sci. 2020 Mar;97(3):178-185. doi: 10.1097/OPX.0000000000001488.
Tear osmolarity has been reported as one of the best diagnostic tests for dry eye disease and its management. Contact lens wear is thought to influence tear homeostasis. Understanding how regular wear of contact lenses and their type affect tear osmolarity is important.
The purpose of this study was to assess changes in tear osmolarity and ocular symptoms over a period of 12 months following refitting contact lens wearers with daily disposable contact lenses.
Fifty subjects aged (mean ± SD) 26 ± 4 years were refitted with either silicone-hydrogel (delefilcon A, SiHy, n = 34) or hydrogel (omafilcon A, Hy, n = 16) daily disposable soft contact lenses. Study included seven visits: baseline measurements without contact lenses; two visits for contact lens fit and selection; follow-up measurements after 3, 6, and 12 months of contact lens wear; and a post-study visit without contact lenses. Lens type selection was based on a set of objective measurements. Subjects were instructed to follow strict wearing rules. Impedance-based osmometer was used to collect samples from the lower tear meniscuses. The Ocular Surface Disease Index (OSDI) and the eight-item Contact Lens Dry Eye Questionnaire were used to assess subject-reported ocular symptoms and contact lens discomfort, respectively.
Downward trend of tear osmolarity was noted over the time course of study. Statistically significant differences were noted in tear osmolarity (Friedman test, χ = 21.91 [P < .001], and χ = 13.89 [P = .003]) for the right and left eyes, respectively. A statistically significant decrease in tear osmolarity was apparent only for initially symptomatic subjects (for OSDI ≥13: χ = 26.25, P < .001; for OSDI <13: χ = 5.65, P = .13). Statistically significant differences were not noted in OSDI and the eight-item Contact Lens Dry Eye Questionnaire between the baseline and 12-month visit (χ = 5.92 [P = .12] and R = 0.015 [P = .87], respectively). There was a difference between baseline and post-study visits (P = .002) in OSDI, showing lower score at the latter visit.
Refitting with daily disposable contact lenses was demonstrated to lower tear osmolarity.
泪液渗透压已被报道为干眼症及其治疗的最佳诊断测试之一。隐形眼镜的佩戴被认为会影响泪液的动态平衡。了解隐形眼镜的日常佩戴及其类型如何影响泪液渗透压非常重要。
本研究旨在评估在为隐形眼镜佩戴者重新配适日戴型软性隐形眼镜后的 12 个月内，泪液渗透压和眼部症状的变化。
50 名年龄（平均值±标准差）为 26±4 岁的受试者被重新配适硅水凝胶（delefilcon A，SiHy，n=34）或水凝胶（omafilcon A，Hy，n=16）日戴型软性隐形眼镜。研究包括七次就诊：不戴隐形眼镜时进行基线测量；两次就诊以确定隐形眼镜的适配和选择；在佩戴隐形眼镜 3、6 和 12 个月后进行随访测量；以及不戴隐形眼镜时进行研究后就诊。隐形眼镜类型的选择基于一系列客观测量。要求受试者严格遵守佩戴规则。使用基于阻抗的渗透压计从下泪膜收集样本。使用眼表疾病指数（OSDI）和八项隐形眼镜干眼病问卷分别评估受试者报告的眼部症状和隐形眼镜不适。
研究过程中观察到泪液渗透压呈下降趋势。右眼和左眼的泪液渗透压均有统计学显著差异（Friedman 检验，χ=21.91[P<.001]，χ=13.89[P=.003]）。仅对最初有症状的受试者观察到泪液渗透压明显下降（OSDI≥13：χ=26.25，P<.001；OSDI<13：χ=5.65，P=0.13）。在基线和 12 个月就诊时，OSDI 和八项隐形眼镜干眼病问卷之间没有统计学显著差异（χ=5.92[P=0.12]，R=0.015[P=0.87]）。在 OSDI 中，基线和研究后就诊时存在差异（P=0.002），后者就诊时的评分较低。
用日戴型隐形眼镜重新配适被证明会降低泪液渗透压。
