Topical anaesthetic use prior to rigid gas permeable contact lens fitting

TitleTopical anaesthetic use prior to rigid gas permeable contact lens fitting
Publication TypeJournal Article
Year of Publication2017
AuthorsGill, F., P. Murphy, and C. Purslow
JournalContact Lens and Anterior Eye
Keywordsadolescent, adult, Anaesthesia, Anesthetics, Anxiety, Article, cohort analysis, Comfort, Contact lenses, controlled study, cornea disease, Corneal staining, dose response, Dose-Response Relationship, double blind procedure, Double-Blind Method, Drug, drug effects, etiology, extended wear contact lens, Extended-Wear, eye drops, eye refraction, female, follow up, Follow-Up Studies, GP contact lenses, human, human experiment, Humans, hyperemia, Local, local anesthetic agent, male, middle aged, normal human, Ocular, Ophthalmic Solutions, patient satisfaction, physiology, prevention and control, priority journal, propoxycaine, Prospective Studies, prospective study, proxymetacaine, psychology, randomized controlled trial, Refraction, refraction error, Refractive Errors, skin conductance, State Trait Anxiety Inventory, Success, topical anesthesia, Visual acuity, visual analog scale, young adult

Purpose To investigate effect of topical anaesthetic (TA) during gas permeable (GP) contact lens (CL) fitting on subjective and objective measures of patient anxiety. Methods 47 subjects (mean ± sd age = 26.9 ± 4.9 years; soft CL wearers, 18, neophytes, 29). Each subject randomly assigned to Group A or B, and attended on two occasions, one week apart. First visit: subject received bilaterally either a single drop of TA (0.5% proxymetacaine) (Group A) or placebo (0.9% saline) (Group B) prior to GP CL application. No drops were instilled at second visit. Each visit mimicked a GP CL fitting. At each visit, patient anxiety was assessed either subjectively (visual analogue scale (VAS)) or objectively (skin conductance (SC)), as well as anterior ocular health. Results Visit 1: GP CL trial produced small increases in hyperaemia and corneal staining, but no difference associated with TA use. Visit 2: increases in staining and hyperaemia were observed, but hyperaemic responses significantly less than at Visit 1, for both groups. Corneal staining also less, but not statistically significant. VAS scores indicated subjects who received TA during Visit 1 were significantly less anxious at Visit 2. Visit 2: comfort slightly reduced for subjects who received TA at Visit 1, and significantly increased for subjects who received placebo. Use of TA reduced anxiety during lens adaptation period compared with subjects receiving placebo. Conclusions TA use during GP CL fitting has potential patient benefits: improved first-time GP CL wear comfort, reduced anxiety during adaptation, reduced anxiety prior to subsequent GP CL wear. © 2017 British Contact Lens Association