PURPOSE. To review adverse reactions associated with continuous wear of silicone-hydrogel contact lenses and compare the occurrence for different age groups.
METHOD. We retrospectively analysed records of a large contact lens practice. Patients were fit with Focus Night & Day (CibaVision) and PureVision (Bausch & Lomb) silicone-hydrogel contact lenses for 30 day continuous wear for up to 3 years. Adverse reactions were defined as infectious ulceration, contact lens associated acute red eye, contact lens related peripheral ulcer, other corneal infiltration, and symptomatic corneal erosion. Discontinuations due to contact lens related papillary conjunctivitis and comfort problems were not included. Each individual was included only once for statistical purposes.
RESULTS. Data from one hundred and sixteen patients was available for analysis. Three infectious ulcers were diagnosed in two patients. Adverse reactions occurred in 11 out of 21 (52%) people aged under 21, 3 of 32 (9%) aged 21 to 31, 4 of 33 (12.1%) aged 31-41, 2 of 19 (10.5%) aged 41-51 and 1 of 11 (9.1%) aged over 51. The difference in occurrence of adverse reactions between age groups was highly statistically significant (p=0.004).
CONCLUSIONS. Younger people were at increased risk of developing adverse reactions in the sample group tested here. The basis for the greater risk is not immediately obvious; certainly, there were no apparent differences in the degree of compliance between age groups. A prospective study is recommended to determine whether this finding can be replicated. In the meanwhile, it is appropriate to consider patient age as a risk factor when advising patients on the suitability for continuous wear.