title: Effects of contact lens wearing on keratoconus: a confocal microscopy observation.
abstract: OBJECTIVE
  To evaluate the corneal cell morphology of new keratoconus patients wearing two different types of rigid gas-permeable (RGP) contact lenses for 1y.
  
  
  METHODS
  Thirty nine eyes of 39 new keratoconus patients were selected and randomly fitted with two types of RGP contact lenses. Group 1 had 21 eyes with regular rigid gas-permeable (RRGP) contact lens and rest 18 eyes were in group 2 with specially designed rigid gas-permeable (SRGP) contact lens. Corneal cell morphology was evaluated using a slit scanning confocal microscope at no-lens wear and after 1y of contact lens wearing.
  
  
  RESULTS
  After 1y of contact lens wearing in group 1, the mean anterior and posterior stromal keratocyte density were significantly less (P=0.006 andP=0.001, respectively) compared to no-lens wear. The mean cell area of anterior and posterior stromal keratocyte were also significantly different (P=0.005 andP=0.001) from no-lens wear. The anterior and posterior stromal haze increased by 18.74% and 23.81%, respectively after 1y of contact lens wearing. Whereas in group 2, statistically significant changes were observed only in cell density & area of anterior stroma (P=0.001 andP=0.001, respectively) after 1y. While, level of anterior and posterior stromal haze increased by 16.67% and 11.11% after 1y of contact lens wearing. Polymegathism and pleomorphism also increased after 1y of contact lens wearing in both the contact lens groups.
  
  
  CONCLUSIONS
  Confocal microscopy observation shows the significant alterations in corneal cell morphology of keratoconic corneas wearing contact lenses especially in group 1. The type of contact lens must be carefully selected to minimize changes in corneal cell morphology.
authors.affiliation: Optometry and Visual Sciences Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.
authors.forename: Somnath
authors.initials: S
authors.lastname: Ghosh
authors.affiliation: Optometry and Visual Sciences Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.
authors.forename: Haliza A
authors.initials: HA
authors.lastname: Mutalib
authors.affiliation: Optometry and Visual Sciences Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.
authors.lastname: Sharanjeet-Kaur
authors.affiliation: Optometry and Visual Sciences Program, Faculty of Health Sciences, University Kebangsaan Malaysia, Kuala Lumpur 50300, Malaysia.
authors.forename: Rituparna
authors.initials: R
authors.lastname: Ghoshal
authors.affiliation: Department of Ophthalmology, Hospital Sungai Buloh, Jalan Hospital, Sungai Buloh 47000, Malaysia.
authors.forename: Shamala
authors.initials: S
authors.lastname: Retnasabapathy
keywords: confocal microscopy; contact lens; cornea; keratoconus