Related Experiment Video
Updated: Mar 20, 2026
Impression Cytology of the Lid Wiper Area
Published on: August 9, 2016
Dual-Polymer Drops, Contact Lens Comfort, and Lid Wiper Epitheliopathy
Jason J Nichols1, Christopher W Lievens, Marc R Bloomenstein
1*OD, PhD, FAAO †OD, MS, FAAO ‡OD, FAAO §PhD ∥OD School of Optometry, University of Alabama at Birmingham, Birmingham, Alabama (JJN); Southern College of Optometry, Memphis, Tennessee (CWL); Schwartz Laser Eye Center, Scottsdale, Arizona (MRB); and Allergan Clinical Research, Irvine, California (HL, PS, JV).
Purpose:
This study compared a new contact lens rewetting drop containing both carboxymethylcellulose and hyaluronic acid (CMC-HA) with a standard drop containing carboxymethylcellulose only (CMC). Symptoms of discomfort typical in lens wear and lid wiper epitheliopathy (LWE) were assessed over a 3-month period in a diverse sample of contact lens wearers.
Methods:
Adapted daily-wear contact lens subjects using hydrogel, silicone hydrogel, or rigid gas permeable lenses were enrolled in this prospective, randomized, double-masked, parallel-group, 90-day study conducted at 15 clinical sites. Subjects were randomized 2:1 to CMC-HA (n = 244) or CMC alone (n = 121) with dosage at least four times per day, along with their habitual lens care system. At baseline and at days 7, 30, 60, and 90, subject-completed questionnaires, bulbar conjunctival staining, LWE, contact lens distance visual acuity (CLDVA), and standard safety measures were assessed.
Results:
At day 90, CMC-HA performed significantly better than CMC in ocular symptoms including dryness throughout the day (p = 0.006), and burning/stinging throughout the day (p = 0.02) and at the end of the day (p < 0.001). CMC-HA also performed numerically better for dryness at the end of day (p = 0.06). LWE staining was improved in the CMC-HA group at day 90 whereas it increased slightly in the CMC alone group, with a significant between-group difference (p = 0.009). CMC-HA also demonstrated greater reduction in conjunctival staining compared with CMC alone at day 90 (p = 0.08). No differences in CLDVA, contact lens wear time, acceptability, and product use were observed, and safety outcomes were similar between groups.
Conclusions:
The addition of HA to a standard CMC rewetting drop improves clinical performance. In this comparison of rewetting drop efficacy in contact lens wearers, LWE was a useful clinical sign for differentiating clinical performance.
