Contact Lens & Anterior Eye 36 (2013) 118–125 Contents lists available at SciVerse ScienceDirect Contact Lens & Anterior Eye j ourna l ho me p ag e: ww w.elsevier.com/locate/clae Ocular physiology and comfort in neophyte subjects fitted with daily disposable silicone hydrogel contact lenses Philip B. Morgan a,∗ , Paul Chamberlain a , Kurt Moody b , Carole Maldonado-Codina a a Eurolens Research, The University of Manchester, Manchester, United Kingdom b Johnson & Johnson Vision Care Inc., Jacksonville, FL, USA a r t i c l e i n f o Article history: Received 19 June 2012 Received in revised form 6 November 2012 Accepted 5 December 2012 Keywords: Contact lenses Silicone hydrogels Comfort Ocular physiology Neophytes Narafilcon A Daily disposable a b s t r a c t Purpose: To evaluate the performance of a silicone hydrogel daily disposable lens in neophyte subjects over 12 months. Methods: Seventy four subjects with no previous contact lens experience were randomised to wear narafilcon A (1 DAY ACUVUE ® TruEye TM ) lenses (LW group) or to wear no contact lenses (NLW group) for 12 months. Biomicroscopy (performed by a masked investigator), visual acuity and subjective response scores were recorded at an initial visit and six follow-up visits, in addition to lens fit and surface evaluation for the LW group. Comfort was recorded with SMS messaging. Results: Fifteen of the LW group discontinued before the end of the study, compared with six of the NLW group. Measured visual acuity was about half a line better for the NLW group as these subjects were provided with their full sphero-cylindrical over-refraction, compared to the LW group in their best spherical corrected contact lenses; subjective scores for vision were similar for the two groups. Bulbar conjunctival hyperaemia, limbal hyperaemia, corneal staining, conjunctival staining and papillary conjunctivitis were clinically equivalent for the two groups whereas conjunctival staining was higher in the LW group. Comfort scores assessed by SMS were equivalent for the LW and NLW groups; there was a measurable improvement in comfort during the first month of wear for the LW group. Conclusion: This work has demonstrated that modern soft lenses (narafilcon A daily disposable silicone hydrogel lenses) offer an excellent, comfortable form of vision correction, and are able to exhibit minimal alterations to ocular physiology. © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved. 1. Introduction Two major innovations in the contact lens field in the past 20 years have been the introduction of daily disposable lenses in the mid 1990s [1], and the launch of silicone hydrogel lens materials at the millennium [2]. The daily disposable modality eliminates the need for cleaning and disinfection solution systems; also, the fre- quency of lens replacement overcomes the problems of lens ageing, especially the build-up of surface deposition. As a result of these fac- tors, daily disposable lenses offer increased user convenience [3], reduced incidence of deposit- and solution-related ocular compli- cations [3] and avoidance of vision deterioration with lens ageing [4]. Whilst this lens type is not usually associated with a measurable reduction in the likelihood of contact lens-associated infections [5,6], recent evidence points to a marked reduction in inflammatory ∗ Corresponding author at: Eurolens Research, The University of Manchester, Carys Bannister Building, Manchester, M13 9PL, United Kingdom. Tel.: +44 161 306 4441; fax: +44 161 306 4442. E-mail address: philip.morgan@manchester.ac.uk (P.B. Morgan). events with daily disposables [7]. Despite these overall benefits, the use of daily disposable lenses around the world has been vari- able, with significant use (around 40% of soft lens fits) in markets such as Japan, the United Kingdom and Norway and limited uptake (10% of soft lens fits or fewer) in the United States, Canada and the Netherlands [8]. Silicone hydrogel materials offer demonstrably higher levels of oxygen permeability [9] than conventional contact lens hydrogels [10]; they provide near-natural levels of oxygen delivery to the ocu- lar surface during wear, facilitating high levels of corneal oxygen consumption [10]. As such, contact lens adverse responses due to hypoxia are essentially eliminated, particularly in extended wear [2]. In daily wear, the key physiological advantage which has been demonstrated between the use of silicone hydrogels and conven- tional hydrogels wear is reduced limbal redness with the former material [11]. In contrast to the variable international use of daily disposable lenses, silicone hydrogels are widely prescribed for daily wear in most countries especially since the marketing of these materials for daily wear use from 2004 [12]. The purpose of this work was to investigate the performance of a new contact lens fabricated from narafilcon A material (1 DAY 1367-0484/$ – see front matter © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.clae.2012.12.001