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BLOG: LipiFlow increases contact lens wearing time
How many times have you found yourself examining a contact lens wearer who expresses surprise that she is “all of a sudden” having trouble wearing her contacts? There is often a quote along the lines of: “I’ve worn contacts for 10/20/30+ years, and I’ve never had a problem before.” It is a gender-neutral, age-independent phenomenon. If the contact lens world is important to your practice, you hear this on a daily basis.
It should be obvious to most anterior segment docs of either the MD/DO or OD stripe that the most likely culprit is some sort of dry eye disease. The odds are that your patient has meibomian gland dysfunction and an associated dysfunctional tear syndrome. Because contact lenses are all drying agents it is only a matter of time before the ocular surface decompensates and they become uncomfortable.
Caroline Blackie, OD, and her group just published a study looking at contact lens wearing time and LipiFlow (Johnson & Johnson Vision). In her study, a single LipiFlow treatment increased contact lens wearing time by more than 4 hours per day on average in comparison with pretreatment levels. There was also an 8+ point reduction in average SPEED scores and the expected increase in meibomian gland secretion in treated subjects.
Literally millions of individuals discontinue the use of soft contact lenses of all types because of discomfort. In a DED practice, we get more than our fair share of these individuals, though sadly when many of them have suffered enough ocular surface inflammatory changes that they are now symptomatic with or without wearing their contact lenses. Imagine the impact on the contact lens world if we could keep these folks comfortably and safely in their lenses?
Early treatment of MGD and associated ocular surface disease prevents at least some of the chronic problems that can be seen years downstream. The symptom of reduced comfortable contact lens wearing time is a tip-off that there is a problem. It appears that LipiFlow vectored thermal pulsatile treatment is a viable solution that can be offered to these patients. Even a single treatment is likely to increase contact lens wearing time.
Which in my experience tends to decrease chair time as well.
Disclosure: White reports he is a consultant to Allergan, Shire, Sun, Kala, Ocular Science, Rendia, TearLab, Eyevance and Omeros; is a speaker for Shire, Allergan, Omeros and Sun; and has an ownership interest in Ocular Science and Eyevance.