Corneal Epithelium Changes during Three Months of Scleral Contact Lens Wear

Abstract

Purpose : To evaluate the effect of 3 months of scleral lens wear on the corneal epithelium and dendritic cell density.

Methods : 27 neophytes (Mean±SD age: 21.4±3.9 years) wore scleral lenses of fluorosilcone acrylate material (hofocon A; 97 Dk, 15.6-16.0mm diameter; average lens thickness of 424±36µm) for three months. Each subject wore scleral lenses bilaterally at least 5 days a week and at least 8 hours a day without overnight wear. Subjects were randomized to fill their scleral lenses with Addipak (n=12) or PuriLens Plus (n=15) during lens wear. Measurements of corneal epithelial permeability (P_dc) to fluorescein were performed with an automated scanning fluorophotometer (Fluorotron™ Master, Ocumetrics, Mountain View, CA USA) on the central cornea of the right eye and on the temporal corneal periphery of the left eye. Images of the distribution of dendritic cells in corneal stroma were captured in vivo with a confocal laser scanning microscope (Heidelberg Retina Tomograph, Rostock Cornea Module, Heidelberg Engineering, Germany) on the central and inferior peripheral cornea of the left eye for all subjects. P_dc measurements and confocal microscopy examinations were performed at baseline after at least 2 hours of awakening and were repeated after 1 month and 3 months of scleral lens wear.

Results : The mean lnP_dc values did not significantly change from baseline at 1 month and 3 months of lens wear, for both central and temporal corneal periphery (p>0.05). The mean lnP_dc values of the central cornea were lower than the temporal corneal at baseline visit (p=0.029) and at 3-months visit (p=0.015) only. No association was observed between the lnP_dc values and the saline solutions, corneal staining, age, gender, and ethnicity (p>0.05). There was no significant change in dendritic cell density, for both central and inferior corneal periphery, from baseline to 1 month and 3 months of lens wear (p>0.05).

Conclusions : Scleral lens wear for three months did not affect corneal epithelial barrier function and dendritic cell density.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

Results of Mean lnP_dc and Mean Dendritic Cell Density for 3 months of Lens Wear