The study examined 19 scleral lens-wearing patients with moderate to severe dry eye disease. Patients wore their habitual scleral lenses for one month and were assessed for dry eye symptoms (with the Ocular Surface Disease Index [OSDI] survey), dry eye signs (tear film break-up time, ocular surface staining, lid wiper epitheliopathy), conjunctival papillae, and self-reported contact lens comfort (Contact Lens Dry Eye Questionnaire-8 [CLDEQ-8] survey).
Patients were given scleral lenses with the same parameters as their own lenses but with Tangible Hydra-Peg coating; patients wore the new lenses for one month.
Related: Blog: Why dry eye?
Tangible Hydra-Peg is a polyethylene glycol lubricant that is permanently bonded to the contact lens surface during manufacturing. It is designed to improve wettability and repel surface lens debris, according to the company. The Food & Drug Administration (FDA) has approved this coating on the majority of gas permeable contact lens materials, including Boston (Bausch + Lomb), Optimum (Contamac), and even SimplifEyes 1-Day Disposable soft contact lens from SynergEyes.
Statistically significant improvements were seen in all categories when patients wore the Tangible Hydra-Peg coated lenses, according to the study. Patients not only reported improvement in contact lens comfort, but also in vision consistency. They experienced foggy vision at almost half the rate of occurrence than in their uncoated lenses.
Dr. Mickles says she was surprised there was such a dramatic improvement in contact lens and dry eye comfort and clinical signs with just the addition of a coating, but it has led her to incorporate this technology in her practice.
Also by Dr. Lyerly: An OD's experience with online contact lens disruptors
What patients need to know
Dr. Mickles shares that while Tangible Hydra-Peg can be a great solution for patient comfort and experience in contact lenses, it is essential that doctors educate their patients about its different handling and cleaning needs.
The Tanigble Hydra-Peg coating makes the lenses more slippery
Because Tangible Hydra-Peg purposefully improves the lubricity and reduces the friction of the contact lens on-eye to improve comfort, it can also make the lens more difficult to remove. Fingers may slip right off when attempting to grasp the lens.
If patients use a plunger to remove scleral lenses, they may not experience this challenge. However, patients wearing soft or hybrid lenses may have difficulty.
Synergeyes recommends patients use a tissue draped over their fingers to remove the lens. Consider sharing this video with patients for further instructions: https://www.youtube.com/watch?v=d5Vd-ms56_0
It’s important to use the appropriate solutions
Abrasive or alcohol-based cleaners can damage the Tangible Hydra-Peg coating.
Dr. Mickles says she is careful to prescribe specific solutions for her patients and educate why this is the solution they need to use going forward.
Tangible Science has launched new solution Tangible Clean that is FDA approved to clean both soft and gas permeable (GP) lenses safely with this coating.
Sclerals for dry eye
Dr. Mickles says that she has had great success with fitting scleral lenses for patients with moderate to severe dry eye.
In her experience, scleral lenses for dry eye work best for patients for whom aqueous deficiency is the primary cause of dry eye. Patients with significant meibomian gland dysfunction are more likely to have challenges with scleral lens comfort and clarity because the dysfunctional meibum can coat and fog the lens surface.
1. Aldridge C. Breaking the cycle of contact lens dropout. CL Spectrum. Available at: https://www.clspectrum.com/issues/2015/november-2015/breaking-the-cycle-.... Accessed 7/25/19.
2. Mickles C, Harthan J, Barnett M. A surface treatment solution for scleral lens wearers with dry eye. Tangible Science. Available at: https://tangiblescience.com/wp-content/uploads/2019/01/Final-GSLS-2019-M.... Accessed 7/25/19.