title: The influence of lens conditioning on signs and symptoms with new hydrogel contact lenses.
abstract: BACKGROUND
  Daily disposable contact lenses are considered to be the pinnacle of safe contact lens wear, yet it has been suggested that it takes some period of wear for the lens surface to reach optimal compatibility with the ocular surface. This study assesses the influence of brief treatment with a conditioning drop on the ocular response to new contact lenses over a single day of wear.
  
  
  METHODS
  The study was a single-masked, paired (contralateral) comparison of the signs and symptoms with wear of new Acuvue 2 contact lenses pretreated with a conditioning agent containing carboxymethylcellulose (carmellose, CMC) against new lenses inserted directly from the blister pack. Sixty-one subjects participated in the study, of whom 59 were considered eligible for data analysis. Subjects were also divided into symptomatic and asymptomatic lens wearers based on their overall comfort level in lens wear. Symptoms and signs were recorded at lens delivery and following eight hours of wear.
  
  
  RESULTS
  A set of slitlamp signs, comprising corneal staining (p <0.05), limbal redness (p <0.05), bulbar conjunctival hyperaemia (p <0.05), bulbar conjunctival staining (p <0.01) and palpebral conjunctival redness (p <0.05) showed small but statistically significant (p <0.05) end-of-day mean values in favour of the lens that was conditioned with the rewetting agent. These data were supported by the proportion of subjects showing lower gradings with conditioned lenses versus unconditioned lenses, as follows: corneal staining (35 per cent versus 12 per cent, p <0.05), limbal redness (43 per cent versus 22 per cent, p <0.05), bulbar conjunctival hyperaemia (50 per cent versus 15 per cent, p <0.05), bulbar conjunctival staining (46 per cent versus 30 per cent, p <0.1) and palpebral conjunctival hyperaemia (28 per cent versus 17 per cent, NS). For those subjects reporting symptoms with lens wear (n=12), there was a statistically significant (p <0.05) preference in terms of comfort as a result of preconditioning.
  
  
  CONCLUSIONS
  The results of the investigation suggest that use of a conditioning agent can provide a more physiologically suitable environment for a new lens, thereby reducing the clinical signs associated with lens discomfort. The protocol used here, which is based on a statistical paradigm using standard pictorial grading scales, allows high sensitivity in detecting small changes in ocular parameters.
authors.affiliation: Brennan Consultants Pty Ltd, 110 Auburn Road, Auburn Village, Melbourne, VIC, 3122, Australia.
authors.forename: M-L Chantal
authors.initials: ML
authors.lastname: Coles
authors.forename: Noel A
authors.initials: NA
authors.lastname: Brennan
authors.forename: Vicki
authors.initials: V
authors.lastname: Shuley
authors.forename: Jill
authors.initials: J
authors.lastname: Woods
authors.forename: Chris
authors.initials: C
authors.lastname: Prior
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Vehige
authors.forename: Peter A
authors.initials: PA
authors.lastname: Simmons
mesh_terms: D000328:Adult; D002266:Carboxymethylcellulose Sodium / Q000008:administration & dosage* / Q000627:therapeutic use*; D003261:Contact Lenses / Q000009:adverse effects*; D005123:Eye / Q000473:pathology*; D005260:Female; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D007908:Lens, Crystalline / Q000187:drug effects*; D008297:Male; D009883:Ophthalmic Solutions; D016037:Single-Blind Method; D012996:Solutions
chemical_list: D009883:Ophthalmic Solutions; D012996:Solutions; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D002266:Carboxymethylcellulose Sodium