Official Title

Evaluation of Systane Complete for the Treatment of Contact Lens Discomfort
  • Phase

    Phase 4
  • Study Type

    Interventional
  • Study Participants

    46
Clinicians commonly use artificial tears off label for treating contact lens (CL) discomfort and the dry eye associated with CLs because new artificial tear formulations have the potential to outperform the available CL rewetting drops. While off-label, McDonald et al. have previously shown that using a common artificial tear, Systane Ultra, before and after CL use is an effective means for treating daily disposable CL wears who have CL discomfort. Recently, a new formulation of artificial tears, Systane Complete, was released to the market. Systane Complete is a unique formulation that has combined elements from both Systane Ultra (indicated for aqueous deficient dry eye) and Systane Balance (indicated for evaporative dry eye) to create an artificial tear with an indication for aqueous deficient, evaporative, and mixed (both aqueous deficient and evaporative) dry eye. Thus, the goal of this study is to determine in a randomized clinical trial if Systane Complete is able to effectively improve the symptoms of patients who have CL discomfort.
Soft contact lenses (CL) are the most common CL modality with over 140 million users world. Despite many improvements in CL materials and solutions, the advent of daily disposable CLs, and the addition of rewetting drops to improve CL comfort, research has shown that between 21% to 64% of CL wearers permanently discontinue CL use because of eye discomfort. Contact Lens Discomfort (CLD) as defined by the Tear Film and Ocular Surface Society (TFOS) "is a condition characterized by episodic or persistent adverse ocular sensations related to lens wear, either with or without visual disturbance, resulting from reduced compatibility between the CL and the eye's environment, which can lead to decreased wearing time and discontinuation of CL wear." TFOS further states that CLD is a multifactorial condition that stems from both CL (e.g., material design, fit, care system) and environmental factors (patient factors, medication compliance, external environmental factors, ocular environment). While environmental factors related to the patient such as age and sex are inherent, rewetting drops or artificial tears can be used to treat tear film deficiencies associated with CLD. The U.S. Food & Drug Administration (FDA) defines rewetting/lubricating drops as "an in-eye solution for use with CLs" that contains "one or more active ingredients (e.g., ophthalmic demulcents) in sufficient concentration to alleviate symptoms of discomfort from CL wear by physical means." Clinicians also commonly use artificial tears off label for treating CLD and the dry eye associated with CLs because artificial tear formulations have the potential to outperform CL rewetting drops. The FDA separately classifies artificial tears as topical drops that contain specific types of demulcents or emollients. While off-label, McDonald et al. have previously shown that using a common artificial tear, Systane Ultra, before and after CL use is an effective means for treating daily disposable CL wears who have CLD. Recently, a new formulation of artificial tears, Systane Complete, was released to the market. Systane Complete is a unique formulation that has combined elements from both Systane Ultra (indicated for aqueous deficient dry eye) and Systane Balance (indicated for evaporative dry eye) to create an artificial tear with an indication for aqueous deficient, evaporative, and mixed (both aqueous deficient and evaporative) dry eye. Thus, the Research Goal of this study is to determine in a randomized clinical trial if Systane Complete is able to effectively improve the symptoms of CLD suffers.
Study Started
Nov 19
2018
Primary Completion
Mar 23
2019
Study Completion
Mar 23
2019
Results Posted
Apr 06
2020
Last Update
Apr 06
2020

Drug Systane Complete

Systane Complete is an artificial tear indicated for patients who have evaporative, aqueous deficient, or mixed dry eye.

Systane Complete Experimental

Subjects randomized to this group will be asked to use Systane Complete once before and after contact lens use.

No Treatment No Intervention

Subjects randomized to this group will not receive a treatment.

Criteria

Inclusion Criteria:

Self-reported contact lens discomfort
Contact Lens Dry Eye Questionnaire (CLDEQ)-8 scores ≥ 12
Daily disposable contact lens wearer
Best-corrected visual acuity of 20/30 or better

Exclusion Criteria:

All other contact lens types (e.g., currently wearing two week or monthly replacement contact lenses or hard contact lenses)
Non-compliant daily disposable contact lens wearers (must regularly replace contact lenses daily)
Systemic health conditions known to alter tear film physiology
History of ocular surgery within the past 12 months
History of severe ocular trauma, active ocular infection, or inflammation
Currently using Accutane or eye medications
Pregnant or breast feeding

Summary

Systane Complete

No Treatment

All Events

Event Type Organ System Event Term

Contact Lens Symptoms

Improvement in contact lens symptoms as measured with the Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) and CLDEQ-4 at 2 weeks compared to baseline. The CLDEQ-8 score range is 0 to 37 with 0 being the best score. Subjects were required to have a CLDEQ-8 of at least 12 in order to participate. The CLDEQ-4 is a subset of the CLDEQ-8, and it was also reported because it is a unidimensional measure of ocular discomfort in contact lens wearers. The CLDEQ-4 has a score range of 0 to 18 with 0 being the best score.

Systane Complete

2 week cldeq-4 (worse eye)

7.14
Score on a Scale (Mean)
Standard Deviation: 3.50

2 week cldeq-8 (worse eye)

12.86
Score on a Scale (Mean)
Standard Deviation: 6.40

Baseline cldeq-4 (worse eye)

10.91
Score on a Scale (Mean)
Standard Deviation: 3.28

Baseline cldeq-8 (worse eye)

20.41
Score on a Scale (Mean)
Standard Deviation: 5.40

No Treatment

2 week cldeq-4 (worse eye)

10.13
Score on a Scale (Mean)
Standard Deviation: 2.83

2 week cldeq-8 (worse eye)

17.92
Score on a Scale (Mean)
Standard Deviation: 5.30

Baseline cldeq-4 (worse eye)

10.38
Score on a Scale (Mean)
Standard Deviation: 2.41

Baseline cldeq-8 (worse eye)

18.92
Score on a Scale (Mean)
Standard Deviation: 4.92

End of Day Eye Comfort

Improvement in eye symptoms as measured with the Standardized Patient Evaluation of Eye Dryness (SPEED) at 2 weeks compared to baseline. The scale range is 0 to 28 with 0 being the best score.

Systane Complete

Speed Score 2 weeks (worse eye)

7.55
score on a scale (Mean)
Standard Deviation: 4.31

Speed Score Baseline (worse eye)

10.27
score on a scale (Mean)
Standard Deviation: 3.60

No Treatment

Speed Score 2 weeks (worse eye)

9.29
score on a scale (Mean)
Standard Deviation: 4.14

Speed Score Baseline (worse eye)

9.67
score on a scale (Mean)
Standard Deviation: 3.93

Corneal Staining

Improvement in conjuctivial staining at two weeks compared to baseline using the Brien Holden Vision Institute (BHVI) scale, which measures five regions of the eye on a (0-4) scale (max of 20 per metric). A score 0 is the best possible score.

Systane Complete

Corneal Staining Depth (2 weeks)

0.91
Units on a scale (Mean)
Standard Deviation: 1.38

Corneal Staining Depth (baseline)

1.22
Units on a scale (Mean)
Standard Deviation: 1.54

Corneal Staining Extent (2 weeks)

1.41
Units on a scale (Mean)
Standard Deviation: 2.42

Corneal Staining Extent (baseline)

1.73
Units on a scale (Mean)
Standard Deviation: 2.45

Corneal Staining Type (2 weeks)

0.86
Units on a scale (Mean)
Standard Deviation: 1.36

Corneal Staining Type (baseline)

1.18
Units on a scale (Mean)
Standard Deviation: 1.56

No Treatment

Corneal Staining Depth (2 weeks)

1.04
Units on a scale (Mean)
Standard Deviation: 1.30

Corneal Staining Depth (baseline)

0.92
Units on a scale (Mean)
Standard Deviation: 1.32

Corneal Staining Extent (2 weeks)

1.75
Units on a scale (Mean)
Standard Deviation: 1.98

Corneal Staining Extent (baseline)

1.63
Units on a scale (Mean)
Standard Deviation: 2.50

Corneal Staining Type (2 weeks)

0.92
Units on a scale (Mean)
Standard Deviation: 1.06

Corneal Staining Type (baseline)

0.92
Units on a scale (Mean)
Standard Deviation: 1.32

Schirmer's I Test Without Anesthetic

Improvement in tear volume as measured in mm of wetting with a Schirmer's strip at 5 mins at 2 weeks compared to baseline. The score ranges is 0 mm to 35 mm with 35 mm being the best score.

Systane Complete

Schirmers Strip (2 weeks)

15.41
mm (Mean)
Standard Deviation: 9.29

Schirmers Strip Baseline

15.68
mm (Mean)
Standard Deviation: 9.70

No Treatment

Schirmers Strip (2 weeks)

18.3
mm (Mean)
Standard Deviation: 10.69

Schirmers Strip Baseline

20.88
mm (Mean)
Standard Deviation: 10.65

Tear Break-Up Time (TBUT)

Improvement in tear break up time as measured with a slit-lamp biomicroscope and sodium fluorescein in seconds at 2 weeks compared to baseline. Scores range for 0 to 60 seconds with 60 seconds being the best score.

Systane Complete

Tear Break Up Time (seconds) (2 weeks)

8.57
Seconds (Mean)
Standard Deviation: 4.73

Tear Break Up Time (seconds) (baseline)

7.7
Seconds (Mean)
Standard Deviation: 5.20

No Treatment

Tear Break Up Time (seconds) (2 weeks)

8.8
Seconds (Mean)
Standard Deviation: 5.08

Tear Break Up Time (seconds) (baseline)

8.5
Seconds (Mean)
Standard Deviation: 5.10

Total

46
Participants

Age, Continuous

30.75
Years (Mean)
Inter-Quartile Range: 18.0 to 69.0

Race and Ethnicity Not Collected

0
Participants

Region of Enrollment

Sex: Female, Male

Overall Study

Systane Complete

No Treatment