PROSPECTIVE TRIAL OF DAILY AND EXTENDED WEAR DISPOSABLE CONTACT-LENSES

Purpose. The current study prospectively evaluates the response to dai ly and extended wear of disposable lenses with each patient acting as his/her own control. This paradigm allowed for elimination of individu al variation as a confounding factor, as well as determining whether a n intrinsic factor, other than lens wear, predisposed patients to comp lications. Methods. One hundred thirty-four patients were randomly ass igned to contralateral daily wear (DW) or extended wear (EW) with Acuv ue lenses for 1 year. All lenses were disposed of on a weekly basis. B ilateral bacteriology of lids, conjunctivae, lenses, and fingers was c arried out on those patients presenting with complications. Results, T he results after 1 year indicate a higher incidence of complications i n the EW eye (peripheral infiltrative keratopathy, 12%; corneal striae , 3%). No significant clinical complications occurred in the DW eye. M icrobiological cultures did not reveal any significant difference betw een those eyes with keratopathy and those of controls, The most common pathogen was Staphyloccocus epidermidis. No gram-negative organisms g rew from any of the culture sites. Conclusions, The results of this st udy indicate that extended wearing schedules, and not the lens entity, predispose the patient to a higher risk of keratopathy with disposabl e contact lenses. No microbiological association with the adverse even ts could be determined, and no intrinsic patient factor could be demon strated that would predict the likelihood of complications.