June 2013
Volume 54, Issue 15
Free
ARVO Annual Meeting Abstract  |   June 2013
In vivo confocal microstructural analysis of corneal epithelial cell changes related to daily wear use of silicone hydrogel contact lenses
Author Affiliations & Notes
  • Jessica Lee
    Ophthalmology, University Hospitals Case Medical Center, Cleveland, OH
  • Xiaolin Zhang
    Ophthalmology, University Hospitals Case Medical Center, Cleveland, OH
  • Christine Marchetti
    Ophthalmology, University Hospitals Case Medical Center, Cleveland, OH
  • Ying Jiang
    Epidemiology & Biostatistics, University Hospitals Case Medical Center, Cleveland, OH
  • Yan Sun
    Ophthalmology, University Hospitals Case Medical Center, Cleveland, OH
  • Sara Debanne
    Epidemiology & Biostatistics, University Hospitals Case Medical Center, Cleveland, OH
  • Jessie Lemp
    Alcon Laboratories, Fort Worth, TX
  • Beth Ann Benetz
    Ophthalmology, University Hospitals Case Medical Center, Cleveland, OH
  • Pearlman Eric
    Ophthalmology, University Hospitals Case Medical Center, Cleveland, OH
  • Loretta Szczotka-Flynn
    Ophthalmology, University Hospitals Case Medical Center, Cleveland, OH
  • Footnotes
    Commercial Relationships Jessica Lee, Alcon Laboratories (F); Xiaolin Zhang, None; Christine Marchetti, Alcon Laboratories (F); Ying Jiang, Alcon (F), Vistakon (F); Yan Sun, None; Sara Debanne, None; Jessie Lemp, Alcon (E); Beth Ann Benetz, None; Pearlman Eric, None; Loretta Szczotka-Flynn, Alcon Laboratories (F), Alcon Laboratories (R), Vistakon (F), Bausch & Lomb (R)
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science June 2013, Vol.54, 5459. doi:https://doi.org/
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      Jessica Lee, Xiaolin Zhang, Christine Marchetti, Ying Jiang, Yan Sun, Sara Debanne, Jessie Lemp, Beth Ann Benetz, Pearlman Eric, Loretta Szczotka-Flynn; In vivo confocal microstructural analysis of corneal epithelial cell changes related to daily wear use of silicone hydrogel contact lenses. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5459. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To analyze clinical and in vivo microstructural corneal epithelial cell changes related to daily wear use of silicone hydrogel contact lenses.

Methods: In vivo confocal microscopy (Nidek ConfoScan 4; Nidek Technologies) of the central cornea was performed at the baseline and 5 month visits on 218 patients enrolled in the Daily Wear Corneal Infiltrative Event Study. All subjects wore daily wear lotrafilcon A lenses and were randomized to either a PHMB preserved multipurpose (MPS) or a peroxide based care solution. The morphological changes of the superficial epithelial cells (hyper-reflectivity) and basal cell density were analyzed by two masked experienced observers. Covariates of interest included solution use, corneal staining patterns, and substantial bioburden on lids, lenses and storage cases.

Results: Epithelial Hyper-reflectivity: The use of the PHMB preserved MPS (compared to peroxide) was associated with a significantly greater number of hyper-reflective cells at 5 months (p=0.006) as well as > grade 2 corneal staining (MPS 46%, peroxide 10%, p<0.0001). Subjects that had solution induced corneal staining (SICS) in either eye were more likely to have at least 1 hyper-reflective cell in either eye (57% of SICS subjects had >=1 hyper-reflective cell vs. 29% non-SICS subjects). Substantial bioburden on lenses, lids, or cases did not show a statistical difference in the number of hyper-reflective cells as compared to subjects that had no such bioburden. (p>=0.07). Basal Cell density: In subjects that had substantial lens-associated bacterial bioburden there was decreased basal epithelial cell density from the baseline visit (p=0.03). Abnormal bacterial bioburden on lids and cases did not show a significant change in basal epithelial cell density (p>=0.09).

Conclusions: The PHMB-preserved solution tested increased epithelial cell hyper-reflectivity during daily wear of lotrafilcon A lenses; corneal staining is likely an intermediate step in this pathway. Substantial lens bioburden decreased basal cell density, suggesting that micro-organisms in contact with the corneal surface have an effect on corneal metabolism.

Keywords: 477 contact lens • 596 microscopy: confocal/tunneling • 482 cornea: epithelium  
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