Contact lens fitting profile in Portugal in 2005: strategies for first fits and refits

To evaluate the standards of contact lens practice in Portugal, with particular attention paid to the characteristics of first fits and refits regarding aspects such as symptoms of dryness, overnight wear, silicone hydrogel and multifocal prescriptions, and care systems.

A questionnaire was distributed to 300 contact lens practitioners in Portugal, and they were asked to complete them with the following first 10 fittings (only right eye of each patient). Fifty-six questionnaires were returned to total 529 fittings.

The mean age of contact lens wearers was 28.1 +/- 10.1 years, and 94.4% of the wearers were fitted with soft contact lenses (67.9% hydrogel lenses, 21.2% silicone hydrogel lenses, and 5.2% biomimetic soft contact lenses). Sixty percent of patients wore their contact lenses for 9 to 12 hours per day. The lenses were replaced on a monthly basis in 71% of cases, and 82.8% of wearers used a multipurpose solution for lens cleaning and disinfection. Significant differences were found between first fits and refits regarding the prevalence of dryness symptoms (higher incidence of frequent symptoms in the evening in the refitting group, P<0.01, chi2), replacement schedule (lower incidence of monthly disposable lenses in refits compared to first fits, P<0.05, chi2), and care regimen (lower incidence of multipurpose solutions and higher incidence of hydrogen peroxide in refits, P<0.01, chi2).

Statistical analysis of the current trends in the Portuguese contact lens fitting profile showed that contact lens practitioners in Portugal are receptive to use innovations in contact lens products, such as silicone hydrogel and biomimetic materials, and daily-disposable contact lenses to refit patients who have not succeeded with previous lenses. Multifocal lenses also experienced a significant increase in their prevalence among refits and new fits. Rigid gas-permeable materials maintained and even experienced a slight increase in refits. Conversely, there is still a low incidence of extended-wear prescriptions, most of them being made with low-Dk soft contact lenses.