Rigid gas-permeable vs. hydrogel contact lenses for extended wear

A clinical trial was conducted to compare the extended wear performance of rigid gas-permeable (RGP) contact lenses with that of soft lenses. Subjects were fitted with a RGP lens (Boston IV) in one eye and a soft lens (Bausch & Lomb "O" series) in the other eye, and wore them on an extended wear basis for up to 3 months. No subjects developed any acute adverse reactions in the RGP lens-wearing eye. After the initial adaptation period, subject acceptance of RGP extended wear in terms of vision and comfort was superior. The RGP lenses also induced less chronic hypoxic stress than hydrogel lenses of comparable Dk/L, as evidenced by the presence of epithelial microcysts. Several complications of RGP extended wear were observed including lens binding, blepharoptosis, transient pupil size increases, and corneal staining. As hypoxia-induced corneal changes, such as microcysts and striae, were observed in the RGP lens-wearing eyes, we consider that these particular RGP lenses do not have adequate oxygen transmissibility for successful long-term extended wear. However, if RGP lens materials of higher oxygen transmissibility and better designs can be attained, the potential of RGP extended wear would appear promising.