No abstract

CL discomfort appears not to be associated with alterations in the corneal sub-basal nerve plexus. Hydrogel CL wear might be involved in the recruitment of dendritic cells into the cornea, being a possible origin its lower oxygen permeability compared to silicone hydrogel materials. Future studies are required to confirm these results.

Lower RH seems to increase CL dehydration being further accelerated with the AF presence. The dehydration pattern is material dependent, thus current marketed CLs behave differently under several controlled environmental conditions. Future in vivo studies should confirm these outcomes.

To assess the consecutive implementation of habitual contact lens discomfort (CLD) management strategies: lid hygiene, daily disposable CL (DDCL) fitting, and artificial tear (AT) supplementation. Methods: Contact lens (CL) wearers with CLD symptoms (CLDEQ-8 $12 points) were included in the study. Subjects with Meibomian gland dysfunction (MGD) were instructed to perform lid hygiene. All participants were fitted with a DDCL (delefilcon A) and evaluated 1 month later. After, half of them were randomly assigned to use AT (Povidone-2%) at least three times/day, and all participants were evaluated 1 month later. Tests performed were: lower tear meniscus area (LTMA), bulbar, limbal, and tarsal hyperemia, noninvasive tear break-up time (NITBUT), and corneal and conjunctival staining. Weighted combined clinical scores (CS) were created to analyze signs. Changes in symptoms (CLDEQ-8) and CS were analyzed using linear mixed models. Results: Forty-two subjects (mean age: 23.264.9 years) completed the study. Two CS were created, CS 1 was composed of bulbar, limbal, and tarsal hyperemia and corneal staining, and CS 2 by NITBUT, LTMA, and conjunctival staining. CLDEQ-8 was reduced after lid hygiene (mean: 22.7362.13; P¼0.012) and DDCL use (mean: 210.163.54; P,0.01), but not after AT use (P¼0.62). CS 1 did not change after any intervention. CS-2 was higher (P¼0.04) in DGM subjects after lid hygiene, it decreased (P¼0.04) after DDCL use. Conclusions: Lid hygiene is effective for reducing CLD symptoms in MGD patients. Refitting subjects with delefilcon A is an effective intervention for CLD to reduce symptoms and achieve a healthier ocular surface. Simultaneous administration of AT did not further improve CLD.