School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia.
CooperVision, Pleasanton, CA, USA.
Cont Lens Anterior Eye. 2021 Apr;44(2):157-191. doi: 10.1016/j.clae.2021.02.004. Epub 2021 Mar 25.
Contact lens materials have undergone significant changes over the past 20 years, particularly with respect to the introduction of silicone hydrogel materials. Whilst this development addressed hypoxic issues, other important areas relating to contact lens success, notably comfort, require further research. Contact lens wettability remains a crucially important part of biocompatibility. Contact lenses can be made more wettable by incorporation of surfactants into blister packs, internal wetting agents, surface treatments or care solutions. However, there remains no clear association between contact lens wettability and comfort, making it challenging to determine the potential for these approaches to be of significant clinical benefit. Most contact lenses are used on a daily wear, reusable basis, which requires them to be disinfected when not worn. The ideal disinfecting solution would also improve comfort during wear. However, balancing these requirements with other factors, including biocompatibility, remains a challenge. Soft lens materials invariably take up and subsequently release certain components of disinfecting solutions onto the ocular surface. This may affect tear film stability and the normal ocular microbiome, and further research is needed in this area to determine whether this has any affect on comfort. Finally, contact lens materials sorb components of the tear film, and these interactions are complex and may change the biochemistry of the tear film, which in turn may affect their comfort. In conclusion, the interaction between lens materials, tear film and disinfection solution plays an important role in the biocompatibility of lenses. However, the exact role and whether this can be altered to improve biocompatibility and comfort during wear remains debatable. This report summarises the best available evidence to examine this complex relationship and the opportunities for practitioners to enhance in-eye comfort of contemporary lenses, along with providing suggestions for areas of study that may provide further information on this topic.
隐形眼镜材料在过去 20 年中发生了重大变化，特别是硅水凝胶材料的引入。虽然这一发展解决了缺氧问题，但与隐形眼镜成功相关的其他重要领域，特别是舒适度，需要进一步研究。隐形眼镜的润湿性仍然是生物相容性的一个至关重要的部分。通过在泡罩包装、内部润湿剂、表面处理或护理液中加入表面活性剂，可以使隐形眼镜更具润湿性。然而，隐形眼镜的润湿性和舒适度之间仍然没有明确的关联，因此很难确定这些方法是否具有显著的临床益处。大多数隐形眼镜都是日戴、可重复使用的，当不佩戴时需要进行消毒。理想的消毒溶液也会在佩戴时提高舒适度。然而，在平衡这些要求与其他因素，包括生物相容性，仍然是一个挑战。软性隐形眼镜材料不可避免地会吸收和随后释放出消毒溶液的某些成分到眼表面。这可能会影响泪膜稳定性和正常的眼微生物群，在这方面需要进一步研究，以确定这是否对舒适度有任何影响。最后，隐形眼镜材料会吸附泪膜的成分，这些相互作用非常复杂，可能会改变泪膜的生物化学性质，从而可能影响其舒适度。总之，镜片材料、泪膜和消毒溶液之间的相互作用在镜片的生物相容性中起着重要的作用。然而，确切的作用以及是否可以改变以提高佩戴时的生物相容性和舒适度仍存在争议。本报告总结了最佳可用证据，以检查这种复杂的关系，以及从业者为提高现代隐形眼镜的眼内舒适度而提供的机会，并为可能进一步提供有关该主题的信息的研究领域提供了建议。
