title: Corneal staining and comfort observed with traditional and silicone hydrogel lenses and multipurpose solution combinations.
abstract: BACKGROUND
  Assessment of ocular responses associated with lens and contact lens solution combinations was undertaken to address recent reports of toxicity caused by lens solutions resulting in high levels of corneal staining.
  
  
  METHODS
  Double-masked, randomized, crossover, clinical studies were conducted at one research site. Before wear, new lenses were soaked at least 12 hours in marketed lens care solutions. Unisol 4 Preservative Free Saline (Alcon Labs, Fort Worth, Texas) was also assessed and served as a control. Corneal staining [severity (0-4) and area (0-100%)] and comfort were evaluated.
  
  
  RESULTS
  The majority of observed staining was micropunctate. PureVision lenses in combination with the biguanide-preserved solutions resulted in excessive staining area at 2 hours (ReNu MultiPlus, 73%; Complete MoisturePlus, 48%; AQuify, 21%). Staining tended to decrease throughout the wearing day, but several biguanide solution/lens combinations continued to exhibit excessive staining at 4 hours. Similar to saline, Opti-Free Express and RepleniSH as well as Clear Care exhibited minimal staining area, averaging 7% or less at 2 hours across all lens brands. Subjective comfort tended to decrease with higher levels of corneal staining area.
  
  
  CONCLUSIONS
  Some solution/lens combinations may cause excessive corneal staining 2 to 4 hours after lens insertion. Patients with high levels of corneal staining may experience decreased comfort.
authors.affiliation: gandrask@columbus.rr.com
authors.forename: Gary
authors.initials: G
authors.lastname: Andrasko
authors.forename: Kelly
authors.initials: K
authors.lastname: Ryen
mesh_terms: D000328:Adult; D018639:Contact Lens Solutions / Q000494:pharmacology*; D003263:Contact Lenses, Hydrophilic; D003315:Cornea / Q000473:pathology*; D018592:Cross-Over Studies; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017755:Prosthesis Fitting / Q000379:methods*; D012030:Refractive Errors / Q000473:pathology / Q000628:therapy*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012826:Silicone Elastomers; D013194:Staining and Labeling / Q000379:methods*
chemical_list: D018639:Contact Lens Solutions; D012826:Silicone Elastomers