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The difference in “pre-inflammatory” changes might help to explain why switching from reusable to daily disposable contact lenses often reduces symptoms of eye discomfort, according to the pilot study, led by Cecilia Chao, PhD, MOptom, of The State University of New York College of Optometry. (View here.)
The researchers assessed measures of inflammation in the eyes of 36 long-term contact lens wearers: 22 who wore reusable lenses and 14 who wore daily disposable contact lenses. Most subjects in both groups had no or only mild discomfort or other contact lens-related symptoms.
The reusable contact lens wearers had increased evidence of inflammation, despite the lack of clinical symptoms. A key finding was higher levels of inflammation-promoting (pro-inflammatory) proteins called cytokines in samples of tear fluid.
Subjects who wore reusable contact lenses also had increased cellular changes (metaplasia) on the eye surface—but only in the region covered by contact lenses. In areas not covered by the lens, there was no difference in metaplasia between the reusable and daily disposable contact lens groups.
Symptoms of eye discomfort or dry eye were significantly related to imbalances between certain pro-inflammatory versus anti-inflammatory cytokines. “The balance of proinflammatory and anti-inflammatory cytokines may be helpful to assess the inflammatory status of the eye,” Dr. Chao and coauthors write. They believe the higher cytokine levels in the reusable lens group might be related to the use of contact lens care solutions.
Inflammation contributes to eye discomfort, which is a common complaint among contact lens wearers. Eye discomfort is a primary reason for discontinuing contact lens wear.
For patients with reusable contact lenses, symptoms of eye discomfort improve after refitting with daily disposable lenses, but it is not fully understood what causes this improvement. The study provides new evidence that contact lens replacement schedule can affect measures of inflammation on the eye surface.
The results suggest that reduction in pre-inflammatory changes might contribute to the improvement in comfort after switching to daily disposable lenses. Dr. Chao and colleagues emphasize the need for further studies to evaluate factors affecting eye discomfort and inflammation—not just contact lens replacement schedule, but also lens material and design.