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Topical anesthetic useful for fitting, dispensing RGP lenses
ST. LOUIS - New patients fitted with rigid gas-permeable (RGP) lenses after instillation of a topical anesthetic reported greater satisfaction and dropped out less frequently, according to a study conducted by practitioners at four schools of optometry.
Each school had 20 first-time wearers. Two bottles were used: one contained an anesthetic and the other contained a placebo, according to Edward Bennett, OD, MS, co-chief of the Contact Lens Clinic of the University of Missouri's School of Optometry. Other schools involved in the study included Pacific University College of Optometry, Southern College of Optometry and the College of Optometry at Ohio State University.
The patients were randomly assigned to a group. Prior to fitting and again prior to dispensing of the fitted lenses, a drop - either anesthetic or a placebo that felt like an anesthetic - was placed in each eye.
Better adaptation
"The study was double masked," Dr. Bennett said. "A resident gave out the appropriate bottles. We gave patients questionnaires to fill out every week for a month, about their adaptation and their perceptions concerning RGP comfort and adaptation.
"We found no increased staining," he continued. "We found that the anesthetic group perceived their adaptation, long-term wear, comfort, adaptation time and fit experience was better at the 1-month visit in comparison to the placebo group. Also, eight of the 10 who dropped out during the first month were in the placebo group."
Dr. Bennett said he would love to see a company develop a drop with a minor amount of anesthetic packaged in a unit dose vial.
"The fact that patients use anesthetic on a schedule prescribed by a doctor following refractive surgery means there is a potential market out there," he said.
He has heard of a number of practitioners who, although technically not permitted, make up wetting solutions that contain a small amount of anesthetic for their patients to use the first week.
"The drop would not have to be 0.5% proparacaine," he added.
For apprehensive patients
Dr. Bennett never favored using anesthetic in RGP fitting or dispensing, but many other doctors in the field told him they favored the practice.
Then one day Dr. Bennett discussed contact lenses with a niece who had a bad first experience with a rigid lens fitting. So, to ensure that his niece would have a good experience, he tried a little anesthetic before her fitting. It worked well. "I started using anesthetic at the fitting about 6 or 7 years ago, and now I use it on all new fits," he said.
Dr. Bennett said he has heard from many practitioners at the RGP Lens Institute "who say 'we don't need it because we communicate RGPs effectively and we know how to handle patients,' and I totally agree with them. This is for the new practitioner or for the practitioner who is apprehensive or has an apprehensive patient."
This practice also makes the fitting more efficient, which may be an advantage in this era of managed care.
For Your Information:
- Edward Bennett, OD, MS, is co-chief of the Contact Lens Clinic at the University of Missouri School of Optometry, where he is also associate professor. He may be reached at University of Missouri, 8001 Natural Bridge Road, School of Optometry, 331 Marillac Hall, St. Louis, MO 63121; (314) 516-5606; fax: (314) 516-5150; e-mail: sebenne@umslvma.umsl.edu. Dr. Bennett serves as executive director of the RGP Lens Institute of the Contact Lens Manufacturers' Association. Dr. Bennett has no direct financial interest in the products mentioned in this article, nor is he a paid consultant for any companies mentioned.
- Susan E. Marren, OD, FAAO, can be reached at Smarren@aol.com or (609) 829-4229. Dr. Marren has no direct financial interest in the products mentioned in this article, nor is she a paid consultant for any companies mentioned.