Adverse events with silicone hydrogel continuous wear

Area of Science:

• Ophthalmology
• Contact Lens Technology
• Corneal Physiology

Background:

• Silicone hydrogel lenses offer improved oxygen permeability, addressing hypoxia associated with traditional extended wear.
• Continuous wear of these lenses (up to 30 nights) is gaining popularity.
• Clinical trials show reduced physiological changes like edema, neovascularization, and hyperemia compared to older lens types.

Purpose of the Study:

• To review adverse events associated with continuous wear of silicone hydrogel contact lenses.
• To describe the pathophysiology, etiology, clinical presentation, risk factors, and incidence of these events.
• To present management strategies and methods for minimizing adverse events.

Main Methods:

• Literature review of clinical trials and case studies.
• Analysis of reported adverse events and their characteristics.
• Synthesis of current understanding of pathophysiology and risk factors.

Main Results:

• While silicone hydrogel lenses mitigate some issues, adverse events like contact lens-induced peripheral ulcers (CLPU), contact lens-induced acute red eye (CLARE), infiltrative keratitis (IK), and contact lens papillary conjunctivitis (CLPC) still occur.
• Mechanical factors may contribute to events such as superior epithelial arcuate lesions (SEAL).
• These non-sight-threatening conditions can cause significant discomfort and inconvenience.

Conclusions:

• Continuous wear of silicone hydrogel lenses necessitates vigilance for specific adverse events.
• Accurate identification, management, and preventative strategies are crucial for practitioners and patients.
• Understanding the etiology and risk factors aids in minimizing complications associated with extended contact lens wear.