Impact of lipid degradation and tear film stability on silicone hydrogel contact lens wearers with discomfort

Cont Lens Anterior Eye. 2025 Apr;49(2):102616. doi: 10.1016/j.clae.2026.102616. Epub 2026 Jan 12.

ABSTRACT

PURPOSE: To investigate the potential impact of lipid degradation deposition and tear film stability on contact lens discomfort in silicone hydrogel soft contact lens (SCL) wearers.

METHODS: A total of 38 eyes from 38 SCL wearers were enrolled (mean age, 25.3 ± 4.2 years). Participants used a frequent-replacement silicone hydrogel SCL (Comfilcon A lens). Tear break-up time (BUT), meibomian gland morphology, subjective symptoms, and lipid deposition on SCLs were assessed before and after 2 weeks of SCL wear. Lipid deposition, including the ratio of saturated and unsaturated fatty acids of the same carbon number (C16:0/C16:1 and C18:0/C18:1), was evaluated using gas chromatograph-mass spectrometer. Symptomatic SCL wearers were divided based on the Japanese version of the 8-item contact lens dry eye questionnaire (J-CLDEQ-8) score < 11 points.

RESULTS: Symptomatic SCL wearers had a significantly higher fatty acid ratio than asymptomatic wearers (C16: p < 0.05; C18: p < 0.05) and a shorter non-invasive BUT (NIBUT) (p < 0.05) after wearing SCLs for 2 weeks. J-CLDEQ-8 total score significantly correlated with the fatty acid ratio (C16: r = 0.643, p < 0.01; C18: r = 0.507, p < 0.01) and NIBUT (r = - 0.353, p < 0.05). Moreover, before wearing SCLs, fluorescein BUT and upper eyelid MG morphology were significantly shorter (p < 0.05) and worse (p < 0.05) in symptomatic SCL wearers compared with asymptomatic wearers.

CONCLUSION: Symptomatic wearers had a higher fatty acid ratio and shorter NIBUT. The fatty acid ratio can be used to effectively identify SCL wearers experiencing discomfort.

PMID:41529586 | DOI:10.1016/j.clae.2026.102616