Microcyst response to high Dk/t silicone hydrogel contact lenses

Purpose: To investigate the microcyst response to extended wear (EW) with high oxygen transmissible (Dk/t) silicone hydrogel lenses. Methods: Microcysts were monitored for 12 months in subjects wearing low Dk/t hydrogel lenses on a 6-night EW schedule or high Dk/t hydrogel lenses on a 30-night EW schedule. Subjects wearing low Dk/t lenses transferred to the high Dk/t EW lenses and schedule after 12 months and were monitored for a further 6 months. Results: The mean number of microcysts did not deviate from baseline in the high Dk/t group. Microcysts in the low Dk/t group increased over 12 months, and more microcysts were observed in low Dk/t lens wearers compared with high Dk/t lens wearers after 3 months. Microcysts increased in 50% of subjects 1 week after transfer to high Dk/t lenses and returned to baseline levels seen with high Dk/t lens wear within 3 months. Conclusions: EW with high Dk/t silicone hydrogel lenses did not cause an increase in microcyst numbers. It is not necessary to discontinue lens wear with patients who transfer from low to high Dk/t lenses because the increase in microcysts is transitory. This result has implications for practitioners when fitting and assessing the success of high Dk/t hydrogel lenses.