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Abstract

Purpose
Despite the widespread practice of gradually adapting all new soft contact lens wearers (neophytes), there is little evidence-based research underpinning such practice. This work determined if a gradual adaptation period is necessary for neophytes when fitted with modern hydrogel or silicone-hydrogel daily disposable contact lenses.

Method
At four sites, neophytes (19–32 years) were randomly assigned to an adaptation schedule: fast (10 h wear from the first day) or gradual (4 h on the first day, increasing their wear-time by 2 h on each subsequent day until they had reached 10 h) with hydrogel (n = 24 fast; n = 21 gradual) or silicone-hydrogel (n = 10 fast; n = 10 gradual) contact lenses. Masked investigators graded ocular surface physiology and non-invasive tear breakup time (NIBUT). A range of subjective scores (using 0–100 visual analogue scales) were recorded at the initial visit and after 10 h of lens wear, 4–6 days and 12–14 days after initial fitting. Subjective scores were also repeated after 7 days.

Results
There was no difference (p > 0.05) in ocular surface physiology between the fast and gradual adaptation groups at any time point in either lens type. NIBUT was similar at all time points for both adaptation groups in both lens types with the exception that the gradual adaptation silicone-hydrogel wearers had a slightly longer NIBUT (p = 0.007) than the fast adaptation group at 12-14 days. Subjective scores were also similar across the visits and lens types with the exception of ‘lens awareness’ and ‘ease of lens removal’ which were better (p < 0.05) in the fast compared with the gradual adaptation hydrogel lens group at day 7. Additionally, ‘end-of-day discomfort’ was better (p = 0.02) in the fast compared with the gradual adaptation hydrogel lens group at 12–14 days.

Conclusion
There appears to be no benefit in daily disposable soft contact lens adaptation for neophytes with modern contact lens materials.

Publication Type:	Article
Additional Information:	© Elsevier 2019. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/
Publisher Keywords:	Soft contact lens, Daily disposable, Adaptation, Neophyte, Fast, Gradual
Subjects:	R Medicine > RE Ophthalmology
Departments:	School of Health & Psychological Sciences > Optometry & Visual Sciences
SWORD Depositor:	Symplectic Administrator

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