Effects on Ocular Surface and Compliance of Orthokeratology Wear in Adults with Contact Lens Discomfort

PURPOSE: To evaluate the effects on the ocular surface and the compliance of overnight orthokeratology lenses wear in normal myopic adults experiencing contact lens discomfort. METHODS: In this study, 28 eyes of 14 subjects were analyzed using overnight orthokeratology (OOK). This prospective study investigated the compliance of OOK wear using questionnaires, spherical equivalents, keratometry, and central corneal thickness. Ocular surface disease index, tear osmolarity, Schirmer's test I, tear film break-up time, and ocular surface staining score were evaluated as ocular surface parameters. Meibomian gland function was evaluated by assessing lid margin abnormality and meiboscore using noncontact meibography. The tests were performed before and 1 and 6 weeks after OOK wear. RESULTS: The mean age of the subjects was 26.67 ± 3.26 years, and the average duration of previous contact lens use was 2.64 ± 2.41 years. The questionnaire results showed that OOK lenses were more comfortable to wear than conventional lenses. Significant changes in spherical equivalents, keratometry, and central corneal thickness were observed at 6 weeks compared with baseline values (all p 0.05). CONCLUSIONS: Based on the findings, OOK is a relatively safe modality with good compliance for normal myopic adults experiencing contact lens discomfort.

The Impact of Written Information on the Compliance with Contact Lens Care

PURPOSE: To evaluate the impact of written information on the compliance with proper contact lens (CL) care. METHODS: The patients prescribed CLs by a single ophthalmologist in a clinic from January 2008 to August 2009 were enrolled in the present study. The patients were randomly divided into 2 groups, the verbal and written information (VWI) group and verbal information (VI) group. The patients in the VWI group received verbal and written information on proper CL care and the VI group received the same information only verbally. Patients who were followed-up more than 2 weeks after CL wear were asked 10 questions regarding CL care and statistical analysis was performed for each question on CL care. The Mann Whitney U-test was used for comparison between the 2 groups and Pearson's test was used for the correlation analyses. RESULTS: A total of 23 patients were included in this study. Ten patients were assigned to the VWI group, and 13 patients to the VI group. The most desirable score for the CL care was 100 points. The VWI group showed 85.2 +/- 13.4 points and the VI group showed 71.5 +/- 10.1 points (p = 0.030, Mann-Whitney U-test). Of the 10 questions, daily replacement of the lens care solution and the use of tap water showed significant correlation with the discomfort induced by the CL and rinsing process before CL insertion showed significant correlation with the CL intolerance (p = 0.008, p = 0.004 and p = 0.015, respectively, Pearson's correlation test). CONCLUSIONS: The patients in the written information group showed better compliance for overall CL care. Adding the written information to the verbal explanation can enhance the patient's compliance with the proper CL care. Enhancing the compliance of CL care with written information can be expected to decrease the complications and improve the comfort of wearing CLs.