Objective:

To discuss the pros and cons of silicone hydrogel (SiHy) contact lenses and their implications for specialty contact lens practice, particularly in terms of safety, efficacy, and patient outcomes.

Key Findings:

• SiHy lenses are three times more commonly prescribed than hydrogel lenses, according to recent prescribing reports.
• Daily disposable lenses are preferred over other replacement options, with evidence suggesting lower complication rates.
• There is limited evidence of superiority of SiHy lenses in specialty applications, necessitating further research.

Interpretation:

The high penetration of SiHy materials has largely mitigated historical complications, but robust evidence supporting their superiority in various applications remains limited, highlighting the need for ongoing research.

Limitations:

• Variability in licensing and supply routes complicates market data interpretation, making it difficult to assess true adoption rates.
• Limited high-level evidence comparing SiHy with hydrogel lenses in specific applications restricts understanding of their relative benefits.

Conclusion:

SiHy lenses have transformed contact lens practice over the past 25 years, but further research is needed to establish their advantages in specialty uses, particularly in pediatric and therapeutic contexts.