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M. M. Hom; Fluorescein and Lissamine Green Conjunctival Staining in Silicone Hydrogel Wearers. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5298.
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© ARVO (1962-2015); The Authors (2016-present)
Vital dyes are used for diagnosis and monitoring of ocular surface disease. Two of the most prominent dyes used clinically are fluorescein (FL) and lissamine green (LG). Conjunctival effects of soft lenses have been under more scrutiny since the advent of silicone hydrogels (SiHy). Conjunctival staining grades with FL and LG was observed with SiHy lens wearers.
Over a total of 206 visits, 51 subjects were stained with first FL followed by LG. Patients were observed at one and two weeks of CL wear. Conjunctival staining with graded in 6 zones per eye, grades 0 to 4.
Across all zones, FL has exhibited higher grades of staining than LG. Temporal zone: FL mean 1.56, SD 1.16, LG mean 0.57, SD 0.905 (p<.0001); superior temporal: FL mean 1.42, SD 0.934, LG mean .067, SD 0.304 (p<.0001); inferior temporal: FL mean 1.31, SD 1.08, LG mean .089, SD 0.387 (p<.0001); nasal: FL mean 2.21, SD 1.12, LG mean 1.30, SD 1.12 (p<.0001); superior nasal: FL mean 1.79, SD 0.866, LG mean 1.30, SD 1.12 (p<.0001); inferior nasal: FL mean 1.72, SD 0.972, LG mean 0.143, SD 0.479 (p<.0001).
When compared to fluorescein, lissamine green consistently yielded lower staining grades for silicone hydrogel contact lens wearers. Past literature has shown LG to be a reliable indicator of symptoms. LG may signal when the ocular surface conditions are more severe when compared to FL. The presence of LG staining may indicate the need for further treatment measures.
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