A multi-country assessment of compliance with daily disposable contact lens wear
Introduction
Daily disposable contact lenses (DDCLs) are becoming increasingly popular among patients and eye care practitioners (ECPs) worldwide [1], [2]. In addition to the benefits and convenience of a fresh new lens each day and no requirement for a contact lens care system, this modality of lens wear has been shown to offer many health benefits when compared with reusable contact lenses [3]. Superior comfort, vision and relief from allergies have also been reported with the use of DDCLs [4], [5], [6], [7]. While very few complications have been reported to occur with DDCL wear when compared with spectacle wear, [8] serious complications have been reported to occur with this modality [9], [10].
Unfortunately, not all patients wearing DDCLs are compliant with their replacement. In previous studies conducted in Canada and the United States, non-compliance with DDCL replacement has been reported to occur at rates between 12 and 13% [11], [12], [13]; however, the numbers of DDCL wearers in these studies were relatively low and the figures reported may not be representative of compliance with wear and replacement of DDCLs in other countries. At the time that these studies were conducted, silicone hydrogel DDCLs [14], [15] were not available commercially, and compliance rates for replacement of these lenses has not been investigated to date.
The purpose of this survey was to further evaluate compliance with replacement of DDCLs since the introduction of these new materials, and to investigate any differences in compliance with the replacement of DDCL among several countries around the world. The survey was also designed to investigate the reasons for non-compliance; the frequency of overnight lens wear with DDCLs; the regular source of purchase of the participants’ lenses; the lens storage procedures and care system commonly used during non-replacement; an estimation of the participants understanding of the risk of non-replacement; and the reported subjective comfort of DDCLs when they are re-used.
Section snippets
Methods
This survey was conducted in four countries: Australia, Norway, the United Kingdom (UK) and the US. These countries were selected because they have different approaches to lens prescribing and supply [1]. Norway has an extremely high proportion of DDCL wearers (44%) [16]. The UK also has a high proportion of DDCL wearers (38%) [16] and it is thought that the vast majority of patients who are prescribed their lenses by their eye care practitioner in the UK are linked with a Direct Banking
Participant demographics and lenses worn
A total of 805 participants completed the questionnaire (770 on-line and 35 using a paper version); since only 4% of the questionnaires received were completed on paper, the results from all the questionnaires were combined and no separate analyses were conducted from the paper versions. The participant demographics are shown in Table 1. The median number of years of contact lens wear was 14 (range of 6 months to “greater than 20 years”) and 56% of participants had worn DDCLs for at least five
Discussion
Participant demographics did not vary between countries with respect to sex, and overall 66% of the participants completing the questionnaire were female, which is consistent with the proportion of DDCL wearers internationally [1]. With a median age of 38 years, the participants were slightly older than the mean reported for worldwide contact lens prescribing [1], [16]. This finding is consistent with the recent findings of Efron et al. [1]. There was some variation between the countries
Conclusion
A similar level of non-compliance with DDCL replacement (re-use on a subsequent day) was found in this survey to that previously reported; however, there was some considerable variation in compliance with replacement across the four countries investigated. No differences in compliance with lens replacement were found with respect to total length of contact lens wear, sex, days per week of lens wear or lens material.
The primary reason given for re-using DDCLs was to save money, but simply
Funding
This survey was funded by Alcon Laboratories, Fort Worth, TX, USA.
Acknowledgements
We thank Dr. Tyler Anderson for his help in developing the online questionnaire and all the optometrists in Australia, Norway, the United Kingdom and the United States, and their office staff members for their assistance in this survey.
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