Contact lens discomfort (CLD) has been widely recognised as one of the primary factors influencing contact lens (CL) drop out^1,2. As noted in my other CL article (see below), CL wear affects various tear film characteristics, with disruption of the pre-lens lipid layer being identified as critical change that may contribute to CLD¹.

In a double-masked, randomised study, researchers at the Ocular Surface Lab (OSL) evaluated whether application of lipid-containing eye drops immediately prior to lens wear can protect pre-lens tear film lipid layer characteristics more successfully than aqueous-based eye drops. Our findings revealed that pre-application of such drops (Systane Complete) provided lesser depletion of pre-lens lipid layer thickness (LipiView II, J&J) than aqueous-based drops (Systane Ultra). However, the use of either drops prior to lens insertion did not provide measurable protective benefits on lipid layer grade, tear meniscus height, or non-invasive tear film breakup time when compared with no drops.

This study highlights the inherently disruptive effect of CLs on the tear film, simply from their physical presence. It is encouraging that lipid-based drops show short-term benefits in enhancing pre-lens lipid layer thickness, but their long-term impacts on mitigating tear film disruption caused by CL wear requires further investigation in establishing the full extent of the benefit possible with lipid-containing vs aqueous-based drops in CLD management.

References

1.Craig JP, Willcox MD, Argueso P, Maissa C, Stahl U, Tomlinson A, et al. The TFOS International Workshop on Contact Lens Discomfort: report of the contact lens interactions with the tear film subcommittee. Invest Ophthalmol Vis Sci. 2013;54(11):TFOS123-56.

2.Jones L, Efron N, Bandamwar K, Barnett M, Jacobs DS, Jalbert I, et al. TFOS Lifestyle: Impact of contact lenses on the ocular surface. Ocul Surf. 2023;29:175-219.

Dr Kalika Bandamwar is a research fellow with OSL, in the Department of Ophthalmology at the University of Auckland, and a fellow of the British Contact Lens Association. Her research interests include DED, the ocular surface and contact lenses.