Ocular surface changes in mild and moderate myopes differing in duration of soft contact lens wear
T.A. Veliksar; T.B. Gaidamaka, Dr Sc (Med); G.I. Drozhzhina, Dr Sc (Med), Prof.
Filatov Institute of Eye Diseases and Tissue Therapy, NAMS of Ukraine
TO CITE THIS ARTICLE: Veliksar TA, Gaidamaka TB, Drozhzhina GI. Ocular surface changes in mild and moderate myopes differing in duration of soft contact lens wear. J.ophthalmol.(Ukraine).2018;6:3-9. http://doi.org/10.31288/oftalmolzh2018639
Background: Contact lenses (CL) are widely prescribed for various indications. A rather high incidence of severe complications in CL wearers necessitates a deeper and more detailed investigation of CL-associated ocular surface changes with duration of soft contact lens (SCL) wear.
Purpose: To investigate ocular surface changes in mild and moderate myopes differing in duration of SCL wear.
Materials and Methods: Seventy-nine mild and moderate myopes (152 eyes; mean age, 30.8±0.4 years; mean duration of lens wear, 10.2±0.6 years) wearing silicone hydrogel contact lenses were involved in the study. Patients were divided into groups based on duration of SCL wear (1-5 years, 6-10 years, and > 10 years). They completed an Ocular Surface Disease Index (OSDI) questionnaire and underwent visual acuity assessment, anterior biomicroscopy and the following tests: ocular surface fluorescein staining, lid-parallel conjunctival folds (LIPCOF), lid-wiper epitheliopathy (LWE), fluorescein tear break-up time (FTBUT), Schirmer I and Schirmer II tests, and corneal sensation by the method of Faulkner using a cotton swab applicator. The van Bijsterveld system and the Baylor scale were used to quantify ocular surface staining and corneal staining, respectively.
Results: In mild and moderate myopes wearing soft contact lenses, overall OSDI score, LIPCOF score, LWE score, FTBUT, Baylor corneal staining score, van Bijsterveld ocular surface fluorescein staining score, corneal sensation loss, presence of corneal epithelial edema, presence of corneal fluorescein staining, conjunctival hyperemia, presence and degree of limbal vascularization, presence and degree of corneal vascularization, and presence of corneal opacity were found to statistically significantly depend on duration of SCL wear.
Conclusion: An OSDI test found mild ocular surface disease in myopic patients wearing lenses for ≤ 5 years, and moderate ocular surface disease, in those wearing lenses for > 5 years. There was a high probability of a severe corneal sensation loss (80%) for overall OSDI score ≥32.5 (i.e., moderate ocular surface disease). The most apparent changes in the ocular surface developed in patients wearing SCL for > 10 years. Decreased tear production and quality, lid-wiper epitheliopathy as shown by fluorescein staining, conjunctival folds (LIPCOF test), conjunctival hyperemia, corneal opacities, limbal and corneal vascularization were observed in patients wearing SCL for at least a year. Corneal edema and presence of corneal and conjunctival fluorescein staining were found in patients wearing SCL for at least 6 years. Loss of central corneal sensitivity was noted in patients wearing SCL for > 10 years.
Keywords: cornea, soft contact lenses, duration of lens wear, myopia
8.Rosenthal P, Croteau A. Fluid-ventilated, gas-permeable scleral contact lens is an effective option for managing severe ocular surface disease and many corneal disorders that would otherwise require penetrating keratoplasty. Eye Contact Lens. 2005 May;31(3):130-4.
11.Lee JC, Chiu GB, Bach D, et al. Functional and visual improvement with prosthetic replacement of the ocular surface ecosystem scleral lenses for irregular corneas. Cornea. 2013 Dec;32(12):1540-3.
13.Ciralsky JB, Chapman O, Rosenblatt MI, et al. Treatment of Refractory persistent corneal epithelial defects: A standardized approach using continuous wear PROSE therapy. Ocul Immunol Inflamm. 2015 Jun;23(3):219-24. doi: 10.3109/09273948.2014.894084.
14.Lim P, Ridges R, Jacobs DS, Rosenthal P. Treatment of persistent corneal epithelial defect with overnight wear of a prosthetic device for the ocular surface. Am J Ophthalmol. 2013 Dec;156(6):1095-101. doi: 10.1016/j.ajo.2013.06.006.
15.Abdelkader A. Cosmetic soft contact lens associated ulcerative keratitis in Southern Saudi Arabia. Middle East Afr J Ophthalmol. 2014. 2014 Jul-Sep;21(3):232-5. doi: 10.4103/0974-9233.134677.
16.Dumbleton K, Caffery B, Dogru M. The TFOS International Workshop on Contact Lens Discomfort: Report of the subcommittee on epidemiology. Invest Ophthalmol Vis Sci. 2013 Oct 18;54(11):TFOS20-36. doi: 10.1167/iovs.13-13125.
17.Alipour F, Khaheshi S, Soleimanzadeh M, et al. Contact Lens-related Complications: A Review. J Ophthalmic Vis Res. 2017 Apr-Jun;12(2):193-204. doi: 10.4103/jovr.jovr_159_16.
18.McMonnies CW. How contact lens comfort may be influenced by psychiatric and psychological conditions and mechanisms. Clin Exp Optom. 2014 Jul;97(4):308-10. doi: 10.1111/cxo.12122.
19.Stapleton F, Keay L, Edwards K, et al. The incidence of contact lens-related microbial keratitis in Australia. Ophthalmology. 2008 Oct;115(10):1655-62. doi: 10.1016/j.ophtha.2008.04.002.
20.Willcox MD, Naduvilath TJ, Vaddavalli PK, et al. Corneal erosions, bacterial contamination of contact lenses, and microbial keratitis. Eye Contact Lens. 2010 Nov;36(6):340-5. doi: 10.1097/ICL.0b013e3181f57b05.
21.Abdelfattah NS, Amgad M, Zayed AA, et al. Clinical correlates of common corneal neovascular diseases: A literature review. Int J Ophthalmol. 2015 Feb 18;8(1):182-93. doi: 10.3980/j.issn.2222-3959.2015.01.32.
22.Papas E. Corneal vascularisation and contact lenses. Arch Soc Esp Oftalmol. Arch Soc Esp Oftalmol. 2006 Jun;81(6):309-12.
23.Shah SS, Yeung KK, Weissman BA. Contact lens-related deep stromal vascularization. Int Contact Lens Clin. 1998;25:128–36.
24.Liesegang TJ. Physiologic changes of the cornea with contact lens wear. CLAO J. 2002 Jan;28(1):12-27.
25.Su SB, Lu CW, Sheen JW, et al. Tear secretion dysfunction among women workers engaged in light-on tests in the TFT-LCD industry. BMC Public Health. 2006 Dec 16;6:303.
26.Szczotka-Flynn L, Chalmers R. Incidence and epidemiologic associations of corneal infiltrates with silicone hydrogel contact lenses. Eye Contact Lens. 2013 Jan;39(1):49-52. doi: 10.1097/ICL.0b013e318271d3dc.
27.Szczotka-Flynn LB, Pearlman E, Ghannoum M.. Microbial contamination of contact lenses, lens care solutions, and their accessories: a literature review. Eye Contact Lens. 2010 Mar;36(2):116-29. doi: 10.1097/ICL.0b013e3181d20cae.
28.Thomas PA, Kaliamurthy J. Mycotic keratitis: Epidemiology, diagnosis and management. Clin Microbiol Infect. 2013 Mar;19(3):210-20. doi: 10.1111/1469-0691.12126.
29.Zaidi T, Mowrey-Mckee M, Pier GB. Hypoxia increases corneal cell expression of CFTR leading to increased Pseudomonas aeruginosa binding, internalization, and initiation of inflammation. Invest Ophthalmol Vis Sci. 2004 Nov;45(11):4066-74.
30.Alarcon I, Tam C, Mun JJ, et al. Factors impacting corneal epithelial barrier function against Pseudomonas aeruginosa traversal. Invest Ophthalmol Vis Sci. 2011 Mar 14;52(3):1368-77. doi: 10.1167/iovs.10-6125.
31.Fleiszig SMJ. The Glenn A. Fry award lecture 2005. The pathogenesis of contact lens-related keratitis. Optom Vis Sci. 2006 Dec;83(12):866-73.
32.Cheng KH, Leung SL, Hoekman HW. Incidence of contact-lens-associated microbial keratitis and its related morbidity. Lancet. 1999 Jul 17;354(9174):181-5.
33.Schein OD, McNally JJ, Katz J, et al. The incidence of microbial keratitis among wearers of a 30-day silicone hydrogel extended-wear contact lens. Ophthalmology. 2005 Dec;112(12):2172-9.
34.Seal DV, Kirkness CM, Bennett HG, et al. Population-based cohort study of microbial keratitis in Scotland: Incidence and features. Cont Lens Anterior Eye. 1999;22(2):49-57.
35.Yildiz EH, Abdalla YF, Elsahn AF, et al. Update on fungal keratitis from 1999 to 2008. Cornea. 2010 Dec;29(12):1406-11. doi: 10.1097/ICO.0b013e3181da571b.
36.Alfonso EC, Miller D, Cantu-Dibildox J, et al. Fungal keratitis associated with non-therapeutic soft contact lenses. Am J Ophthalmol. 2006 Jul;142(1):154-5.
37.Suvajac G. [Soft-contact-lenses-induced complications]. Vojnosanit Pregl. 2008 Jan;65(1):15-20. Serbian.
38.Wolkoff P, Kärcher T, Mayer H. Problems of the “outer eyes” in the office environment: An ergophthalmologic approach. J Occup Environ Med. 2012 May;54(5):621-31. doi: 10.1097/JOM.0b013e31824d2e04.
39.Lamer L. Extended wear contact lenses for myopes: A follow-up study of 400 cases. Ophthalmology. 1983 Feb;90(2):156-61.
40.Alemany A, Redal P. Giant papillary conjunctivitis in soft and rigid lens wear. Contactologica. 1991;13:14–7.
41.Donshik PC. Contact lens chemistry and giant papillary conjunctivitis. Eye Contact Lens. 2003 Jan;29(1 Suppl):S37-9.
42.Sorbara L, Jones L, Williams-Lyn D. Contact lens induced papillary conjunctivitis with silicone hydrogel lenses. Cont Lens Anterior Eye. 2009 Apr;32(2):93-6. doi: 10.1016/j.clae.2008.07.005.
43.Porazinski AD, Donshik PC. Giant papillary conjunctivitis in frequent replacement contact lens wearers a retrospective study. CLAO J. 1999 Jul;25(3):142-7.