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Yureeda Qazi, Andrea Cruzat, Neda Baniasadi, Lixin Zheng, Deborah Witkin, Douglas B. Critser, Amy Watts, Jill Beyer, Christine W. Sindt, Pedram Hamrah; Early Effects of Contact Lens Wear on Immune Cell Density of the Ocular Surface: Preliminary Results of a Laser In Vivo Confocal Microscopy Study. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6551.
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© ARVO (1962-2015); The Authors (2016-present)
To assess the subclinical immune response to various contact lens (CL) solutions in naive CL wearers.
Multicenter, randomized, double-blinded, clinical trial. Thirty eyes of 15 naïve CL wearers, fitted with silicone hydrogel CL, were enrolled into one of 3 CL solutions groups (OPTI-FREE RepleniSH® (OFR, n=10); Clear Care® (CC, n=8); ReNu MultiPlus® (RM+, n=12). Corneal, limbal, and conjunctival staining, as well as laser in vivo confocal microscopy (IVCM; HRT3/RCM, Heidelberg Engineering, Heidelberg, Germany) of the central and peripheral corneal quadrants were performed at baseline and 1 week post-CL wear. Two masked observers analyzed the images for dendritic cell (DC) and non-dendritic inflammatory cell (IC) density.
Minimal to no conjunctival or limbal staining was observed in either group. While the CC and RM+ groups showed mild staining of the inferior cornea, no corneal staining was observed in the OFR group. IVCM demonstrated increased DC density in 40-50% of participants in all groups. At week 1, increased DC density was statistically significant between the three groups (p=0.046) for the temporal cornea but not for other areas. The CC group demonstrated the highest DC density (103±69 cells/mm2), with no significant difference between OFR (66±44 cells/mm2) and RM+ (57±24 cells/mm2). Increase in peripheral IC density approached significance (p=0.08) between groups, and was lowest with OFR. No correlation was found between clinical staining and the IVCM parameters.
IVCM revealed increased immune cell infiltration in all groups at 1 week after CL wear, which was undetected by routine clinical examinations. Our preliminary data suggest that the increase in DC and IC density was partly due to the CL solution. Moreover, our data suggest that routine slit-lamp examination is not sensitive enough to detect subclinical corneal inflammatory changes.
Clinical Trial: :
http://www.clinicaltrials.gov NCT 01250925
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