Extended-wear silicone hydrogel soft contact lenses in the management of moderate to severe dry eye signs and symptoms secondary to graft-versus-host disease.
OBJECTIVE
To determine the safety and efficacy of the Focus NIGHT & DAY (CIBA Vision, Duluth, GA) silicone hydrogel contact lens in the management of refractory, moderate to severe dry eye signs and symptoms secondary to graft-versus-host disease (GVHD).


METHODS
Seven patients with GVHD and moderate to severe dry eye disease as determined by the Ocular Surface Disease Index (OSDI) questionnaire were fitted with a near plano Focus NIGHT & DAY soft contact lens (SCL) used on a 7-night continuous-wear basis. Visual acuity, objective measures of dry eye disease (i.e., Schirmer I, tear breakup time, and corneal fluorescein staining), and OSDI scores were compared before SCL wear and after 1 week and 1 month of SCL wear.


RESULTS
There was significant improvement in subjective assessment of dry eye symptoms (initial vs. 1-month OSDI score, 76.8 +/- 13.6 vs. 31.2 +/- 17.8, P<0.0005, paired t test). In addition, patients had significant improvement in best-corrected visual acuity after 1 month of SCL wear (initial vs. 1-month logMAR visual acuity for the right eye, 0.23 +/- 0.050 vs. 0.04 +/- 0.027, P<0.007; initial vs. 1-month logMAR visual acuity for the left eye, 0.22 +/- 0.049 vs. 0.04 +/- 0.020, P<0.007, analysis of variance, Dunnett post hoc). There were no significant changes in results of Schirmer I testing, corneal fluorescein staining, or tear breakup time. No adverse events or complications of SCL wear were observed.


CONCLUSIONS
The Focus NIGHT & DAY contact lens can improve subjective dry eye symptoms and visual acuity in patients with refractory dry eye disease secondary to GVHD.
Russo
Peter A
PA
Department of Ophthalmology, Loyola University Medical Center, Maywood, IL 60153, USA. prusso2@lumc.edu
Bouchard
Charles S
CS
Galasso
John M
JM
D000328:Adult; D000368:Aged; D003262:Contact Lenses, Extended-Wear; D003263:Contact Lenses, Hydrophilic; D003315:Cornea / Q000378:metabolism; D015352:Dry Eye Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D019793:Fluorescein; D005456:Fluorescent Dyes; D006086:Graft vs Host Disease / Q000150:complications*; D006801:Humans; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012828:Silicones; D013194:Staining and Labeling; D011795:Surveys and Questionnaires; D013666:Tears / Q000378:metabolism; D016896:Treatment Outcome; D014792:Visual Acuity
D005456:Fluorescent Dyes; D012828:Silicones; D020136:Hydrogel, Polyethylene Glycol Dimethacrylate; D019793:Fluorescein