Evaluation of Marketed Contact Lens Disinfectant Systems on Eyelid Tissues

The subjects attended the enrollment visit having worn their habitual silicone hydrogel contact lenses for at least six hours on the day of the visit. The enrollment visit was scheduled so that the subjects' habitual lenses were at least 14 ± 3 days old for the subjects replacing their lenses bi-weekly and at least 30 ± 5 days old for those replacing their lenses monthly.

• Hydrogen peroxide-based contact lens care system (Device), also known as CLEAR CARE®/AOSEPT Plus
• PHMB-containing contact lens solution (Device), also known as ReNu® MultiPlus Multi-Purpose solution
• Soft contact lenses (Device): Contact lenses identical to habitual prescription worn per usual replacement regimen

Primary outcomes

• Maximum Papillae [Baseline, Month 3]: Eyelid papillae (bumps on the inner eyelid) were recorded separately for three zones of the upper lid and overall for the lower lid on a 5-point forced choice scale (0 = None; 1 = Slight (diffuse papillae); 2 = Mild (diffuse \& tufts papillae); 3 = Moderate (moderate \& tufts papillae); 4 = Severe (giant papillae). The maximum value represents the worse grade in any zone. Both eyes were included in the model for analysis.
• Maximum Eyelid Hyperaemia [Baseline, Month 3]: Eyelid hyperaemia (redness) was recorded separately for three zones of the upper lid and overall for the lower lid on a 5-point forced choice scale (0 = Clear; 1 = Slight redness; 2 = Mild redness; 3 = Moderate redness; 4 = Severe redness). The maximum value represents the worst grade in any zone. Both eyes were included in the model for analysis.
• Upper Lid Redness [Baseline, Month 3]: The contact lenses were removed and upper lid redness was objectively measured through digital images. The coverage of the palpebral surface by blood vessels is expressed as percentage of the total surface measured. Both eyes were included in the model for analysis.
• Change From Baseline in Upper Eyelid Margin Staining at Month 3 [Baseline, Month 3]: The contact lens was removed and ophthalmic dye was instilled. Upper eyelid margin staining was objectively measured through digital images. The extent of true staining (i.e., the total area of lid margin covered by staining) was recorded. Both eyes were included in the model for analysis.

Secondary outcomes

• Median Non-Invasive Pre-Lens Tear Film Break Up Time (PL-NIBUT) [Baseline, Month 3]: The pre-lens tear film is the layer of tears located on top of the contact lens (i.e., between the eyelid and the contact lens). The time required for a dry spot to appear on the pre-lens surface after blinking is referred to as the pre-lens tear film break up time. PL-NIBUT was evaluated using a biomicroscope with a diffuse illumination source, i.e., Tearscope. A longer PL-NIBUT indicates a more stable tear film and greater on-eye lens wettability. Three PL-NIBUT measurements were recorded, and the median value was used for analysis. Both eyes were included in the model for analysis.
• Protective Index [Baseline, Month 3]: A digital video recording was made of the interblink period. The percentage of area of the visible contact lens covered by the tear film was calculated (Protected Area). The Protective Index is defined as the average tear coverage over the whole interblink period. Both eyes were included in the model for analysis.
• Median Front Lens Deposits [Baseline, Month 3]: Deposits present on the front surface of the lens were assessed with a biomicroscope while the lens was on eye. Deposits were rated on a 5-point forced choice scale (0 = none; 1 = slight; = mild; 3 = moderate; 4 = severe) in five lens zones. The median of the five zones was used for analysis. Both eyes were included in the model for analysis.
• Total Lipid Uptake Per Lens [Baseline, Month 3]: The contact lens was aseptically removed from the eye. Lipids were extracted and analyzed using a proprietary High Performance Liquid Chromatography technique. A lower value would indicate a cleaner lens surface.

Sex: All, ages: 18 Years to any

Inclusion Criteria:

* Read and understand Participant Information Sheet;
* Read, sign, and date Informed Consent;
* Successfully wearing silicone hydrogel contact lenses under a frequent replacement (biweekly or monthly) daily wear modality;
* Using a PHMB-containing multipurpose contact lens solution;
* Symptomatic, as specified in protocol;
* Best corrected visual acuity of 6/9 or better in each eye;
* Other protocol-defined inclusion criteria may apply.

Exclusion Criteria:

* Any known sensitivity or intolerance to the contact lenses or len care products to be used;
* Systemic disease/medication which might interfere with contact lens wear or produce dry eye side effects;
* Ocular allergies or ocular disease which might interfere with contact lens wear;
* Use of any concomitant topical ocular medications during the study period;
* Participation in an investigational drug or device study within 30 days of entering the study;
* Other protocol-defined exclusion criteria may apply.

Participant flow

Outcome results

• Maximum Papillae (Primary), Median, Units on a scale: CLEAR CARE/AOSEPT Plus 2.0 (0 to 4); ReNu MultiPlus 2.0 (0 to 3)
• Maximum Eyelid Hyperaemia (Primary), Median, Units on a scale: CLEAR CARE/AOSEPT Plus 2.0 (1 to 4); ReNu MultiPlus 2.0 (1 to 4)
• Median Non-Invasive Pre-Lens Tear Film Break Up Time (PL-NIBUT) (Secondary), Mean, Seconds: CLEAR CARE/AOSEPT Plus 4.05 (0.90 to 32.00); ReNu MultiPlus 5.08 (1.20 to 16.60)
• Upper Lid Redness (Primary), Mean, Percentage of total surface measured: CLEAR CARE/AOSEPT Plus 34.8 +/- 6.8; ReNu MultiPlus 34.9 +/- 6.1
• Change From Baseline in Upper Eyelid Margin Staining at Month 3 (Primary), Mean, square millimeters: CLEAR CARE/AOSEPT Plus -0.014 +/- 3.905; ReNu MultiPlus -0.754 +/- 4.179
• Protective Index (Secondary), Mean, Percent of visible contact lens surface: CLEAR CARE/AOSEPT Plus 95.9 +/- 11.0; ReNu MultiPlus 95.8 +/- 10.2
• Median Front Lens Deposits (Secondary), Median, Units on a scale: CLEAR CARE/AOSEPT Plus 0 (0 to 2); ReNu MultiPlus 0 (0 to 1)
• Total Lipid Uptake Per Lens (Secondary), Mean, micrograms: CLEAR CARE/AOSEPT Plus 38.95 (4.121 to 95.504); ReNu MultiPlus 36.44 (4.150 to 97.875)

Adverse events

Time frame: Adverse events were collected for the duration of the study. The safety population includes all participants exposed to test product.

Serious adverse events by term

Other adverse events by term

• Michel Guillon, PhD, FCOptom, FAAO, CCTI, Principal investigator, OTG Research & Consultancy