Silicone hydrogel versus hydrogel soft contact lenses for differences in patient-reported eye comfort and safety

• Published in: Cochrane database of systematic reviews 2023-09, Vol.9 (9), p.CD014791
• Main Authors: Haworth, Kristina, Travis, Darian, Leslie, Louis, Fuller, Daniel, Pucker, Andrew D
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Contact Lenses, Hydrophilic - adverse effects; Face; Female; Humans; Hydrogels; Medicine General & Introductory Medical Sciences; Patient Reported Outcome Measures; Randomized Controlled Trials as Topic; Silicones; Young Adult
• ISSN: 1469-493X; 1469-493X
• DOI: 10.1002/14651858.CD014791.pub2

Ocular discomfort is the leading cause of permanent discontinuation of soft contact lens (SCL) wear. Silicone hydrogel and hydrogel materials are the two major categories of SCLs, with silicone hydrogel materials being newer and more breathable than hydrogel materials. Whether comfort is associated with SCL material is controversial despite numerous studies. Similarly, the difference between these materials in terms of safety outcomes (e.g. frequency of microbial keratitis) is unclear. To evaluate the comparative effectiveness and safety of silicone hydrogel compared with hydrogel SCLs on self-reported comfort, dry eye test results, and adverse events in SCL-wearing adults 18 years of age or older. The Cochrane Eyes and Vision Information Specialist searched the electronic databases for randomized controlled trials (RCTs). There were no restrictions on language or date of publication. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, including the Cochrane Eyes and Vision Trials Register; 2022, Issue 6), MEDLINE Ovid, Embase.com, PubMed, LILACS (Latin American and Caribbean Health Science Information database), ClinicalTrials.gov, and World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We also searched the reference lists of identified studies, review articles, and guidelines for information about relevant studies that may not have been identified by our search strategy. Furthermore, we contacted investigators regarding ongoing trials. The most recent database search was conducted on 24 June 2022. Our search selection criteria included RCTs, quasi-RCTs, and cross-over RCTs. We applied standard Cochrane methodology. We included seven parallel-group RCTs conducted in the USA, the UK, Australia, Germany, India, and Turkey. A total of 1371 participants were randomized. The duration of SCL wear ranged from one to 52 weeks. Study characteristics and risk of bias The median number of participants per trial was 120 (interquartile range: 51 to 314), and the average age ranged from 20.7 to 33.0 years. Women represented the majority of participants (range 55% to 74.9%; 5 RCTs). Collectively, the included trials compared eight different silicone hydrogel SCLs with three different hydrogel SCLs. Five trials compared daily disposable SCLs, and two compared extended wear SCLs (worn for seven days and six nights). New SCL wearers were enrolled in three trials. Two trials included both new and established SCL wear