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Is Daily Wear Better than Extended Wear? Arguments in Favor of Daily Wear

The use of contact lenses for extended wear appears to be accompanied by an increase in several complications, the most serious of which is corneal infection. It has been proposed that infection is due to corneal epithelial layer microtrauina and lens care system contamination, but noncompliance, contamination of care systems, and microtrauma [especially among keratoconics and polymethylmethacrylate (PMMA) lens users, for example] are so common in daily wear that we believe they are insufficient to explain the approximately sixfold increase in the rate of corneal infection with extended wear. Perhaps the chronic hypoxic stress of extended wear use of contact lenses substantially reduces the resistance of the epithelium to either injury or microbial infection. Until evidence is provided that new contact lenses have sufficient oxygen transmissibility (Dk/L) to fully satisfy corneal oxygen needs under extended wear conditions, and the extended wear use of such lenses is thoroughly tested in a study population, we believe that the majority of contact lens patients should be maintained on daily wear schedules.