EFFECT OF TOPICAL ANESTHETIC USE ON INITIAL PATIENT SATISFACTION AND OVERALL SUCCESS WITH RIGID GAS-PERMEABLE CONTACT-LENSES

Background. Rigid gas permeable (RGP) contact lenses have numerous ben efits; however, RGP lens use is not increasing in the United States. A n important factor for this trend has been initial comfort. Studies ha ve demonstrated that how RGPs are presented to patients, in addition t o lens design, can play an important role in the initial comfort proce ss. Another important factor could be the use of a topical anesthetic during the fitting and dispensing visits. The purpose of this study wa s to use a multicenter format to determine if topical anesthetic use i ncreased the likelihood of patient satisfaction and success. Methods. A total of 80 subjects, with no previous rigid lens wear experience, w as entered into this 1-month study, including 20 subjects from each of 4 institutions. Subjects were randomly divided into the following two groups: (A) anesthetic or (B) placebo, with the former group receivin g one drop of a topical anesthetic before lens insertion at both the d iagnostic fitting and dispensing visits, whereas the latter group rece ived a placebo. Subjects completed a questionnaire on their perception of rigid lens wear both immediately before fitting and at the 1-month visit. After diagnostic fitting with rigid lenses, subjects completed an adaptation questionnaire after 15 min, 1 week, 2 weeks, and 1 mont h of lens wear. Results. Seventy of the 80 subjects completed the stud y and, of the 10 subjects who discontinued, 8 were in the placebo grou p. In all categories evaluated, the anesthetic group experienced a mor e optimum adaptation experience at each visit vs, the placebo group. S pecifically, overall comfort was rated significantly higher at both di spensing and 2 weeks. In addition, the anesthetic group exhibited sign ificantly greater overall satisfaction with rigid lens wear at 2 and 4 weeks. Also, the anesthetic group perceived their adaptation, sensiti vity, and adaptation time to be significantly better at the 1-month vi sit. There was no significant difference in corneal staining between t hese two groups at each visit, with the exception of a greater amount of staining in the central quadrant for the placebo group at the 1-mon th visit. Conclusions. The use of a topical anesthetic at the fitting and dispensing visits for first-time wearers of RGP lenses resulted in significantly fewer dropouts, improved initial comfort, an enhanced p erception of the adaptation process, and greater overall satisfaction after 1 month of lens wear as compared to the use of a nonanesthetizin g placebo at those visits. This result, in combination with both prese nting RGP lenses in a nonthreatening manner and optimizing the lens de sign and fitting relationship, should result in a positive adaptation process and successful wear of RGP contact lenses.