Bennett E S, Smythe J, Henry V A, Bassi C J, Morgan B W, Miller W, Jeandervin M, Henderson B, Elliott L, Porter K S, Barr J T
University of Missouri-St. Louis School of Optometry, 63121-4499, USA.
Optom Vis Sci. 1998 Nov;75(11):800-5. doi: 10.1097/00006324-199811000-00020.
Rigid gas permeable (RGP) contact lenses have numerous benefits; however, RGP lens use is not increasing in the United States. An important factor for this trend has been initial comfort. Studies have demonstrated that how RGPs are presented to patients, in addition to lens design, can play an important role in the initial comfort process. Another important factor could be the use of a topical anesthetic during the fitting and dispensing visits. The purpose of this study was to use a multicenter format to determine if topical anesthetic use increased the likelihood of patient satisfaction and success.
A total of 80 subjects, with no previous rigid lens wear experience, was entered into this 1-month study, including 20 subjects from each of 4 institutions. Subjects were randomly divided into the following two groups: (A) anesthetic or (B) placebo, with the former group receiving one drop of a topical anesthetic before lens insertion at both the diagnostic fitting and dispensing visits, whereas the latter group received a placebo. Subjects completed a questionnaire on their perception of rigid lens wear both immediately before fitting and at the 1-month visit. After diagnostic fitting with rigid lenses, subjects completed an adaptation questionnaire after 15 min, 1 week, 2 weeks, and 1 month of lens wear.
Seventy of the 80 subjects completed the study and, of the 10 subjects who discontinued, 8 were in the placebo group. In all categories evaluated, the anesthetic group experienced a more optimum adaptation experience at each visit vs. the placebo group. Specifically, overall comfort was rated significantly higher at both dispensing and 2 weeks. In addition, the anesthetic group exhibited significantly greater overall satisfaction with rigid lens wear at 2 and 4 weeks. Also, the anesthetic group perceived their adaptation, sensitivity, and adaptation time to be significantly better at the 1-month visit. There was no significant difference in corneal staining between these two groups at each visit, with the exception of a greater amount of staining in the central quadrant for the placebo group at the 1-month visit.
The use of a topical anesthetic at the fitting and dispensing visits for first-time wearers of RGP lenses resulted in significantly fewer dropouts, improved initial comfort, an enhanced perception of the adaptation process, and greater overall satisfaction after 1 month of lens wear as compared to the use of a nonanesthetizing placebo at those visits. This result, in combination with both presenting RGP lenses in a nonthreatening manner and optimizing the lens design and fitting relationship, should result in a positive adaptation process and successful wear of RGP contact lenses.
硬性透气性（RGP）隐形眼镜有诸多益处；然而，在美国，RGP镜片的使用量并未增加。这一趋势的一个重要因素是初始舒适度。研究表明，除了镜片设计外，向患者展示RGP镜片的方式在初始舒适度过程中也能发挥重要作用。另一个重要因素可能是在验配和配镜过程中使用局部麻醉剂。本研究的目的是采用多中心研究形式，以确定使用局部麻醉剂是否会增加患者满意度和配镜成功的可能性。
共有80名此前无硬性镜片佩戴经验的受试者参与了这项为期1个月的研究，其中4家机构各有20名受试者。受试者被随机分为以下两组：（A）麻醉剂组或（B）安慰剂组，前一组在诊断性验配和配镜时镜片插入前均滴一滴局部麻醉剂，而后一组接受安慰剂。受试者在验配前和1个月随访时完成一份关于其对硬性镜片佩戴感受的问卷。在用硬性镜片进行诊断性验配后，受试者在佩戴镜片15分钟、1周、2周和1个月后完成一份适应性问卷。
80名受试者中有70名完成了研究，在退出的10名受试者中，有8名在安慰剂组。在所有评估类别中，与安慰剂组相比，麻醉剂组在每次随访时的适应体验更佳。具体而言，在配镜时和2周时，总体舒适度评分显著更高。此外，麻醉剂组在2周和4周时对硬性镜片佩戴的总体满意度显著更高。而且，麻醉剂组在1个月随访时认为其适应性、敏感度和适应时间明显更好。两组在每次随访时角膜染色情况均无显著差异，但在1个月随访时，安慰剂组中央象限的染色量更多。
与在这些过程中使用无麻醉作用的安慰剂相比，在RGP镜片初次佩戴者的验配和配镜过程中使用局部麻醉剂，导致退出者显著减少，初始舒适度提高，对适应过程感受增强，镜片佩戴1个月后的总体满意度更高。这一结果，再加上以无威胁的方式展示RGP镜片以及优化镜片设计和验配关系，应会带来积极的适应过程以及RGP隐形眼镜的成功佩戴。
