Objectives

To evaluate the usefulness of a global rate of change scale (GRCS) to detect variations in contact lens discomfort (CLD).

Methods

Symptomatic contact lens (CL) wearers were recruited according to the ‘Contact Lens Dry Eye Questionnaire-8’ (CLDEQ-8). At the baseline visit, subjects scored their comfort following insertion of their habitual CL using a 0–100 visual analogue scale (VAS). After 4–10 h of CL wear, comfort was again self-evaluated with the VAS and with a GRCS (range, −50 to +50). Then, a daily disposable CL (DDCL) was fitted. After one month of DDCL wear, a follow-up visit was conducted where the same evaluations as the baseline visit were performed. Changes in comfort were estimated using a Student's t-test for normal variables and the Friedman test for multiple comparisons of non-parametric variables. Internal responsiveness was measured by calculating the standardised response mean. Agreement between scales was estimated by the intraclass correlation coefficient (ICC).

Results

Twenty-nine (22 females and 7 males) CL wearers with a mean age of 23.4 ± 5.4 years participated in the study. There was a significant decrease in comfort at both visits detected by the GRCS (baseline = −13.58 ± 17.48, p < 0.001; follow up = −6.86 ± 12.69, p = 0.007). However, the VAS did not detect that change, either at baseline (insertion = 64.28 ± 18.72 vs removal = 52.89 ± 17.64, p = 1.000) or follow-up visit (insertion = 81.97 ± 12.91 vs removal = 76.48 ± 16.02, p = 1.000). Comfort at insertion and removal times was significantly higher with the DDCL (p = 0.008 at insertion and p = 0.004 at removal). The standardised response mean was greater with the GRCS than the VAS at baseline (0.78 vs 0.63) and follow-up (0.54 vs 0.37) visits. Agreement between both scales was moderate and significant (p < 0.001) for both visits, ICC: 0.674 (95 % confidence interval (CI):0.411–0.833) (baseline) and 0.652 (95 % CI:0.377–0.821) (follow-up visit).

Conclusions

The GRCS can detect slight changes in CL wear comfort and shows higher responsiveness than the VAS. This subjective scale can allow detection of changes in comfort in a simple and quick way.

中文翻译：

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全球评级变化量表对隐形眼镜不适评估的有用性

目标

评估全球变化率量表 (GRCS) 在检测隐形眼镜不适 (CLD) 变化方面的有用性。

方法

根据“隐形眼镜干眼问卷-8”（CLDEQ-8）招募有症状的隐形眼镜（CL）佩戴者。在基线访问时，受试者在插入习惯性 CL 后使用 0-100 视觉模拟量表 (VAS) 对他们的舒适度进行评分。在 CL 佩戴 4-10 小时后，再次使用 VAS 和 GRCS 对舒适度进行自我评估（范围，-50 到 +50）。然后，安装了每日一次性 CL (DDCL)。在 DDCL 佩戴一个月后，进行了一次随访，其中进行了与基线访问相同的评估。使用学生的t估计舒适度的变化- 正态变量检验和非参数变量多重比较的弗里德曼检验。通过计算标准化反应平均值来测量内部反应。通过组内系数 (ICC) 估计量表相关性之间的一致性。

结果

29 名（22 名女性和 7 名男性）平均年龄为 23.4 ± 5.4 岁的 CL 佩戴者参与了这项研究。GRCS 检测到的两次就诊的舒适度均显着下降（基线 = -13.58 ± 17.48，p < 0.001；随访 = -6.86 ± 12.69，p = 0.007）。然而，无论是在基线（插入 = 64.28 ± 18.72 vs 移除 = 52.89 ± 17.64，p = 1,000）还是后续访问（插入 = 81.97 ± 12.91 vs 移除 = 76.48 ± 16.02，p = 1,000)。使用 DDCL 时插入和取出时间的舒适度显着提高（插入时 p = 0.008，取出时 p = 0.004）。在基线（0.78 vs 0.63）和随访（0.54 vs 0.37）访问时，GRCS 的标准化反应平均值高于 VAS。对于两次访问，两个量表之间的一致性中等且显着（p < 0.001），ICC：0。

结论

GRCS 可以检测到 CL 佩戴舒适度的细微变化，并显示出比 VAS 更高的响应能力。这种主观规模可以允许以简单快速的方式检测舒适度的变化。