Objective:

To review the evolution and comparison of silicone hydrogel (SiHy) materials to traditional hydrogel materials over the past 25 years, highlighting their clinical significance.

Key Findings:

• SiHy lenses are prescribed three times more than hydrogels, reflecting a significant shift in clinical practice.
• No significant difference in lens-associated papillary conjunctivitis rates between SiHy and hydrogel lenses, suggesting comparable safety.
• Higher incidence of corneal infiltrates in SiHy lenses for daily and extended wear, but not in daily disposables, indicating a need for careful patient selection.
• SiHy lenses show a lower risk of metabolic diseases, which may influence prescribing practices.
• No clear evidence of differences in infectious keratitis or other ocular conditions between SiHy and hydrogel lenses, reinforcing the safety profile of SiHy.

Interpretation:

SiHy lenses have become the preferred choice for many patients, particularly in daily wear, with comparable safety profiles to hydrogels, suggesting a shift in clinical practice.

Limitations:

• The study did not explore long-term effects of SiHy lenses in diverse populations, which may limit generalizability.
• Limited data on pediatric-specific outcomes and considerations, highlighting a gap in current research.

Conclusion:

A comprehensive approach involving risk/benefit analysis and collaboration with medical teams is essential for managing SiHy use, especially in pediatric patients, to ensure optimal outcomes.