Prolonging contact lens wear and making contact lens wear safer.

PURPOSE: To summarize the present status of safety and efficacy of contact lens wear.
DESIGN: Literature review.
METHODS: Ovid Medline searches were performed on records from 1966 through 2005 using keywords: keratitis, contact lens complications, extended-wear contact lenses, and silicone-hydrogel contact lenses.
RESULTS: Patients desire comfort, clarity of vision, and prolonged contact lens wear when contact lenses are used to correct refractive error. Practitioners desire patient satisfaction but also require maintenance of the integrity of the eye and no complications that jeopardize vision or health of the eye. Improvements in the oxygen permeability of the contact lens materials, design of the contact lens and its surface, and solutions for the maintenance of the lens have reduced but not eliminated the risks of infection, inflammation, and conjunctival papillary reaction associated with contact lens wear. The lessons of past and recent history suggest that patient education and practitioner participation in the management of contact lens wear continue to be critical factors for patient satisfaction and safety in the extended wear of contact lenses.
CONCLUSIONS: The availability of highly oxygen permeable contact lenses has increased the tolerance and safety of extended contact lens wear, but patient instruction and education in proper use and care of lenses is required and caution is advised.