Fast versus gradual adaptation of soft monthly contact lenses in neophyte wearers

James S. Wolffsohn, Neema Ghorbani-mojarrad, Marta Vianya-estopa, Manbir Nagra, Byki Huntjens, Louise Terry, Laura Elaine Sweeney, Debarun Dutta, Mahesh Raj Joshi, Daniel Wright, Heather Bruce, Emily Hallam, Louise Jolly, Ying Bing Chung, Joanne Ru En Tsen, Anya Bishop, Rhona Davison, Carole Maldonado-codina

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Aim: To determine if a gradual adaptation period is necessary for neophytes when fitted with modern hydrogel or silicone hydrogel reusable disposable contact lenses. Method: Across four sites, 74 neophytes (18-28 years) were randomly assigned to a reusable lens: Proclear® (hydrogel) or Biofinity® (silicone hydrogel) and an adaptation schedule: fast (10 hours wear from the first day) or gradual (4 hours on the first day, increasing their wear time by 2 hours on each subsequent day until they had reached 10 hours). Masked investigators graded ocular surface physiology and non-invasive tear breakup time (NIBUT) and a range of comfort, vision and lens handling subjective ratings (0-100 visual analogue scales) were recorded at the baseline visit and after 10 hours of lens wear, 4-6 days and 12-14 days after lens fitting. Subjective scores were also repeated after 7 days. Results: There was no difference (p>0.05) in ocular surface physiology or NIBUT between fast and gradual adaptation groups at any time point in either lens type with the exception of increased corneal staining (p=0.019) in the silicone hydrogel fast adaptation group after 4-6 days. Subjective scores were also similar across the visits and lens types with the exception of ‘lens awareness’ (p=0.019) which was less in the gradual versus the fast adaptation silicone hydrogel lens group at 12-14 days. Conclusion: There seems to be no clinical benefit for recommending a gradual adaptation period in new wearers fitted with modern soft reusable disposable contact lenses. The findings of this work add to a growing body of evidence suggesting that such advice is unnecessary in regular soft contact lens wear, which has important ramifications for the initial clinical management of these patients.
Original languageEnglish
Pages (from-to)101469
JournalContact Lens and Anterior Eye
Early online date22 May 2021
Publication statusPublished - 22 May 2021


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