Evaluation of Systane Complete for the Treatment of Contact Lens 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.

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