title: Effects of daily irrigation on corneal epithelial permeability and adverse events with silicone hydrogel contact lens continuous wear.
abstract: OBJECTIVE
  To determine whether daily irrigation with sterile saline solution during silicone hydrogel (SiH) contact lens continuous wear (CW) can mitigate increases in corneal epithelial permeability (Pdc) and reduce the risk of adverse events.
  
  
  METHODS
  In this study, 161 non-contact lens wearers were fit with SiH contact lenses and randomized to either a treatment (n = 81) or control (n = 80) group for 30-day CW. Subjects in the treatment group irrigated every morning and whenever dryness symptoms occurred; subjects in the control group did not. Mixed effects models were employed to assess the changes in Pdc, and survival analysis methods were employed to estimate the risk for adverse events.
  
  
  RESULTS
  Epithelial permeability increased over 30-day CW with SiH lenses (P = 0.001). Risk of inflammatory (odds ratio [OR] = 1.94) and lens-induced (OR = 1.90) adverse events increased with irrigation; these events also occurred sooner, on average, in the irrigation group. Although the overall risk for Asians was higher than for non-Asians, irrigation had no significant impact on risk among Asians, but significantly increased risk among non-Asians.
  
  
  CONCLUSIONS
  Thirty-day CW results in a measurable increase in epithelial permeability. Risk of inflammatory and lens-induced adverse events also increase over time during CW. Daily irrigation with sterile saline solution did not mitigate increases in epithelial permeability or decrease risk of adverse events.
authors.affiliation: Clinical Research Center, School of Optometry, University of California, Berkeley, Berkeley, California.
authors.forename: Meng C
authors.initials: MC
authors.lastname: Lin
authors.forename: Heather M
authors.initials: HM
authors.lastname: French
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Graham
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Sanders
mesh_terms: D000293:Adolescent; D000328:Adult; D044466:Asian People; D003263:Contact Lenses, Hydrophilic / Q000009:adverse effects*; D019573:Epithelium, Corneal / Q000378:metabolism*; D005260:Female; D015590:Fluorophotometry; D006801:Humans; D007634:Keratitis / Q000208:ethnology / Q000209:etiology*; D008297:Male; D010539:Permeability; D011446:Prospective Studies; D012826:Silicone Elastomers; D012965:Sodium Chloride / Q000008:administration & dosage* / Q000378:metabolism; D016019:Survival Analysis; D007507:Therapeutic Irrigation; D055815:Young Adult
chemical_list: D012826:Silicone Elastomers; D012965:Sodium Chloride
keywords: adverse events; continuous contact lens wear; corneal epithelial permeability; daily contact lens wear; fluorometry; irrigation; survival analysis