EXTENDED WEAR DISPOSABLE SOFT CONTACT-LENSES AS AN ALTERNATIVE TO PHOTOREFRACTIVE KERATECTOMY - REPORT OF 4 YEARS EXPERIENCE

Purpose: To establish whether, in a well-informed population, the use of extended wear disposable soft contact lenses (EWDSCL) poses an unac ceptable risk to vision and corneal health due to complications associ ated with their use. Methods: A 4 year retrospective review of EWDSCL, involving 371 patients in Melbourne from a single general ophthalmolo gy practice. The important aspects of this group were that all patient s were given written instructions about the methods of ensuring initia l and ongoing cleanliness of lenses, no lenses were cleaned and reinse rted, and no solutions other than the saline in the original packaging , and comfort drops, were used. Two types of EWDSCL were used, in powe rs from -9.0 to +6.0 D, and with an initial aim of 4 weeks uninterrupt ed extended wear. Follow-up was from 2 to 52 months, with an average o f 24 months. Results: Of the 354 patients followed up, 236 (66%) regul arly wore them on an extended overnight basis, and of these 180 (76%) wore them for the suggested 4 week period before renewal of lenses. In the 471 eyes of 236 patients, adverse reactions occurred at the follo wing rates: marginal infiltrates (12 cases, 2.5%); corneal oedema (10 cases, 2%); peripheral corneal vascularization (2 cases, 0.4%); and pr esumed infective keratitis (1 case, 0.2%). No eyes lost one or more li nes of Snellen acuity. Conclusions: When disposable soft contact tense s do not come into contact with cleaning solutions, saline from bottle s or aerosol cans, or storage cases, their use on an extended wear bas is (up to 4 weeks continuous) appears to be associated with a low risk of minor or major complications. The results of this review indicate that controlled usage of EWDSCL is safer than previous reports have in dicated.