Ocular surface response and subjective symptoms associated to lens care solutions in Palestine

PURPOSE: To compare the biocompatibility and subjective symptoms of four multipurpose solutions marketed in Palestine with hydrogel contact lenses. METHODS: 50 habitual soft contact lens wearers were recruited in this interventional crossover study. Subjects were asked to attend the optometry clinic five times. A new pair of hydrogel lenses (Bioxifilcon-B) were fitted each time. This pair was soaked randomly overnight in one of the following four-multipurpose solutions (NEOPLUS(®), AvizorUnicaSensitive(®), ReNuMultiPlus(®) and COMPLETERevitaLens(®)) which contain different disinfecting agents (PHMB, Phx, PAPB, and PQ-1 + Alexidine, respectively), or non-preserved saline. At each visit, corneal staining, ocular redness and subjective symptoms were assessed. RESULTS: The percentage of corneal staining increased significantly (P ≤ 0.050) after soaking the lenses with PHMB (86%), PAPB (64%) and Phx (32%) based-solutions. However, a non-significant increase was noticed after the use of PQ-1 + Alexidine based solution (30%, P = 0.083). Ocular redness evaluation showed a significant increase (P ≤ 0.050) in limbal hyperemia after the use of all solutions, while bulbar redness was significantly increased after the use of biguanide-based solutions (P ≤ 0.050). The subjective assessment analysis showed a non-significant change in comfort, dryness, photophobia and scratchiness (P ≥ 0.050) at 2-h intervention using all solutions, except for the PHMB based solution which showed a significant change in subjective symptoms (P ≤ 0.050). CONCLUSION: The combination of Bioxifilcon-B hydrogel contact lenses and solution containing PHMB, PAPB and Phx-disinfectants induced a significant increase in corneal staining after 2 h of CL-wear with a higher severity when the PHMB-based solution was used, while the PQ-1 + Alexidine-based solution did not. Only the PHMB-based solution triggered a significant change in subjective symptoms which might which suggests that it might be related to the severity of staining rather than the induction of staining.