Proclear Toric Lenses and MGD

[Eli]

Hi Dr. G,
Like everyone else here, I feel compelled to thank you for generously giving your time to us.
I have worn contacts (proclear torics) for about a year up until about December 20, 2006 when my dry eye symptoms took a nose dive. My doctor said he didn't see any florescein staining and tear volume, though slightlylower than normal looked O.K. However, I do have some plugged meibomian glands and blepharitis which I am being treated for. Two quick questions:
1)Would I be absolutely nuts to try wearing contacts again and;
2)If it wouldn't be crazy, in your opinion what are some brands that are more dry eye "friendly" than the proclears? I'm a little confused about how a higher water content dries out your eyes faster.

Thank you sir,
Eli

[DrG]

Eli,

I don't think you would be nuts to try contacts again. I would stick with lenses that are known to work well with dry eyes, such as the Proclear, and the silicone-hydrogels. Your eyes will quickly tell you if they are compatible.

The reason that high water lenses tend not to work as well with dry eye is the high rate of evaporative loss. The water flux is very high and quickly moves from the surface of the cornea through the lens where it evaporates from the surface. Proclears are a little different because the phosphorylcholine molecule has many binding sited for water on the surface. This tends to repel lipids and retain water on the surface, making it more "biocompatible."

Here is a little known factoid. The company who invented the Proclear lens developed an entire technology around phosphorylcholine. This has been used in coatings for blood tubing, stents, and various implantable devices to resist clotting. They also developed a paint for ship hulls that would repel barnacles -- and it works. The Proclear lens is very deposit resistant....and is guaranteed not to attract barnacles.