Wydanie 2/2007

Terapeutyczne zastosowanie silikonowo-hydrożelowych miękkich soczewek kontaktowych z Senofilconu A u pacjentów z pierwotnymi i wtórnymi zaburzeniami filmu łzowego w przebiegu schorzeń rogówki

Therapeutic Use of the Silicone-Hydrogel Senofilcon A Soft Contact Lens in Patients with Primary and Secondary Tear Film Disorders Due to the Corneal Conditions

Magdalena Korwin-Rujna, Agata Bełżecka-Majszyk, Anna M. Ambroziak

Katedra i Klinika Okulistyki II Wydziału Lekarskiego Akademii Medycznej w Warszawie Samodzielny Publiczny Kliniczny Szpital Okulistyczny w Warszawie Kierownik: prof. dr hab. n. med. Jerzy Szaflik

Summary: Aim: The aim of the study was to determine therapeutic use of the soft silicone-hydrogel senofilcon A contact lenses of Dk/t 147, BC 8.4 and diameter of 14.0 with surface modification with Hydraclear? Plus system in patients with primary and secondary tear film disorders due to the various corneal conditions. Material and Methods: 40 patients (40 eyes), 32 women and 8 men, whose corneal condition qualified for therapeutic lens application. Those were patients with following ocular conditions: bullous keratopathy (4 eyes), burns (3 eyes), corneal erosions (6 eyes), neurogennic keratitis (3 eyes), descemetocele (4 eyes), corneal ulcers (4 eyes) keratitis (3 eyes), uveitis (2 eyes), acne rosacea (2 eyes), Graves-Basedov ophthalmopathy (2 eyes), Sjögren?s syndrome (7 eyes). In all patients following examinations were performed at baseline: distance and near BCVA, complete ophthalmologic examination in the slit-lamp, intraocular pressure, according to the possibilities ? using Goldman applanation or palpation method, evaluation using TEARSCOPE-PLUS?, NBUT, Schirmers I test after conjunctival anesthesia, color photo of the anterior segment with white light, cobalt blue filter and yellow filter, fluorescein / lysamine green staining, LIPCOF folds, tear meniscus, tear prism After contact lens application in all patients the same examinations were performed as during the baseline evaluation plus subjective wearing comfort evaluation by the patient and subjective patient?s evaluation before lens application, during lens wearing and after lens removal. The objective evaluation was performed using following scales: limbal hyperaemia, corneal staining, conjunctival staining, stromal edema. Tolerability and comfort was evaluated based on the form created by authors, which was filled by patients during follow-up visits. Follow-up time was 6 months. Results and Conclusions: In all fitted patients good or very good and satisfactory tolerability with special focus on wearing comfort was observed. As it is well known each type of contact lens deteriorates pre-lens film and tear film stability. It is also well established in cases of hydrogel lenses one may not be able to see any pre-lens tear film at all or the tear film is extremely unstable. We have observed satisfactory parameters of the pre-contact lens tear film. On the basis of our study we can recommend senofilcon A contact lens as a very good choice for all types of patients both for therapeutic and optic indications.