Regular replacement of rigid contact lenses alleviates binding to the cornea

Abstract

The binding of rigid contact lenses to the cornea is a phenomenon that is poorly understood. A variety of strategies have been advocated for the resolution of this problem. Two case reports are presented highlighting the difficulty in managing patients wearing rigid contact lenses who experience lens binding. A prospective, single-center, controlled, double-masked randomized study was conducted to determine if the regular replacement of daily-wear and extended-wear rigid contact lenses influenced the phenomenon of lens binding. Subjects, divided into four groups, wore Quantum 2 lenses (Bausch and Lomb, Rochester, NY; Dk = 120) for 12 months on either a daily-wear or an extended-wear basis: Group I: daily wear, replacement every 3 months; Group II: daily wear, no scheduled replacement; Group III: extended wear, replacement every 3 months; Group IV: extended wear, no scheduled replacement. The occurrence of binding was monitored both subjectively and objectively. Subjective binding assessment appeared to be a reliable indicator as to the occurrence of this phenomenon, whereas objective assessment appeared to provide unreliable results. The regular replacement of lenses worn on an extended-wear basis reduced the level of binding reported subjectively (p<0.05) compared with the non-regular replacement group. Lens binding is shown to occur with the daily wear of rigid lenses, however, irrespective of whether or not lenses are regularly replaced. We advocate the routine assessment of binding by patients wearing rigid lenses on an extended-wear basis. Furthermore, we advise the replacement of lenses every 3 to 6 months to alleviate binding.