Effects of extended-wear soft contact lenses on the ocular surface and central corneal thickness.
OBJECTIVE
New contact lens materials with high oxygen permeability are said to be convenient for the extended-wear (EW) schedule. We evaluated the short-term effect of EW soft contact lens usage on ocular surface and central corneal thickness.


METHODS
Fifty-two eyes of 26 patients were included in the study. Sixteen of the patients used the high oxygen-permeable lenses for a 30-day extended-wear schedule (group I). Ten patients used the lenses on a daily wear basis (DW, group II). All patients were evaluated for visual acuity and central corneal thickness by corneal and conjunctival biomicroscopy, Schirmer and tear break-up time (BUT) tests. Impression cytology was performed in the superior/temporal, inferior/nasal quadrants of the conjunctiva, 1 mm from the limbus, with cellulose acetate filter paper. The specimens were graded under light microscopy according to Nelson's classification.


RESULTS
Three patients in the EW group were excluded from the study as they discontinued lens usage due to slight discomfort and hyperemia. Biomicroscopic findings and tear function tests indicated no increased pathological results. Central corneal thickness decreased from 554 +/- 9.55 to 546 +/- 9.30 microm (mean +/- SEM) in the EW group (p = 0.002), whereas no significant change occurred in the DW group. Cytological evaluation of the EW group showed an 88% increase in metaplasia (p = 0.007), especially close to the limbal areas and in the superior quadrants; this ratio was 30% in the DW group. Snake-like chromatin changes were found to be increased, from 4 to 6 patients, in the EW group while it remained the same in the DW group (p > 0.05). Individual comparisons of the initial and final pathological conditions of the ocular surfaces in the two groups showed that there was an increase in pathology in the EW group while there was no significant difference in the DW group.


CONCLUSIONS
On a 30-day extended-wear basis with high oxygen-permeable lenses, the possible development and increase of conjunctival cytologic changes secondary to mechanical trauma is one of the main remaining problems. Conjunctival and related immunologic pathologies should not be overlooked when prescribing an extended-wear lens schedule.
Gürdal
Canan
C
Department of Ophthalmology, PTT Education and Research Hospital, Istanbul, Turkey. gurdalcm@yahoo.com
Aydin
Sevda
S
Kirimlioğlu
Hale
H
Toprak
Ebru
E
Sengör
Tomris
T
D000293:Adolescent; D000328:Adult; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000209:etiology*; D003262:Contact Lenses, Extended-Wear / Q000009:adverse effects*; D003315:Cornea / Q000378:metabolism / Q000473:pathology*; D015715:Corneal Edema / Q000175:diagnosis / Q000209:etiology*; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D008297:Male; D008679:Metaplasia; D010100:Oxygen / Q000378:metabolism; D010539:Permeability; D013666:Tears / Q000378:metabolism; D014792:Visual Acuity
D010100:Oxygen