Artificial tear improved dry eye symptoms in contact lens wearers
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The use of a hyaluronic acid-trehalose artificial tear solution by contact lens wearers improved dry eye disease symptoms, as well as corneal and conjunctival quality, according to research published in Contact Lens & Anterior Eye.
“In order to mitigate the development of dry eye or its associated symptoms, the use of tear supplements and wetting agents has been proposed and can be useful as a treatment to reduce discomfort in patients with dry eye,” Elena Fernandez-Jimenez, of Complutense University of Madrid, and colleagues wrote. “In this pilot study, preservative-free [hyaluronic acid (HA)]-trehalose artificial tear supplement has been used to demonstrate reduced signs and symptoms of [contact lens discomfort (CLD)] in contact lens wearers.”
Fernandez-Jimenez and colleagues conducted a prospective, single-arm, observational study that included 33 contact lens wearers, aged 18 to 45 years, with symptoms of ocular discomfort. Participants used one drop of a preservative-free, hypotonic 0.15% HA-3% trehalose artificial tear solution four times a day for 84 days.
On days 0 and 84, researchers used the Visual Analogue Scale (VAS) to assess dry eye symptoms, as well as the Berkley Dry Eye Flow-Chart (DEFC), the Ocular Surface Disease Index (OSDI) and the Contact Lens Dry Eye questionnaire (CLDEQ-8). They also evaluated tear break-up time (TBUT), ocular surface staining, quality of tear meniscus and visual acuity on days 0, 35 and 84.
Researchers found that most VAS assessments, as well as OSDI, CLDEQ-8 and DEFC, improved significantly (P < .05) from baseline to day 84, most notably dry eye sensation (reduction of 28.40 ± 24.48), blurry vision (reduction of 15.37 ± 26.28), photophobia (11.56 ± 31.90) and foreign body sensation (9.92 ± 31.97). They also noted statistically significant improvements (P < .05) in corneal and conjunctival quality from day 0 to day 84.
The only symptoms that did not show significant improvement were tingling/burning and sticky eye feeling, “although these symptoms were reduced with respect to the baseline visit,” researchers reported.
Further, TBUT, conjunctival staining and tear meniscus quality decreased, but not to a statistically significant extent, and visual acuity did not change from baseline to day 84, according to the study. There were no adverse events.
“The results demonstrated potential efficacy of the artificial tear HA-trehalose to improve the comfort of contact lens use, which would justify the design of a properly designed long-term study,” Fernandez-Jimenez and colleagues concluded, acknowledging limitations with the results of this study, including small sample size, short duration and uncontrolled design. “However, the present study showed promising results and justifies further research.”
Perspective
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This study is applicable to practicing clinicians. As the article states, CLD is a major concern in practice because it can lead to decreased contact lens wear or abandonment. This study looks at both objective and subjective signs and symptoms of ocular surface disease and relates it to contact lens use. The study provides strong evidence that both signs and symptoms of ocular surface disease in contact lens wearers can be improved by the addition of 0.15% hyaluronic acid 3% trehalose artificial tears. Therefore, it is safe to say that clinicians can improve the ocular surface conditions of their patients wearing this type of contact lens by adding this artificial tear.
Shortcomings of this study include small sample size, short duration and some uncontrolled design limits. In addition, only one type of contact lens and one type of artificial tear was tested. If similarly designed studies could be developed with different variables, it may yield further clinically relevant information.
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