Two presentations of contact lens-induced papillary conjunctivitis (CLPC) in hydrogel lens wear: local and general.
ABSTRACT The purpose of this study was to confirm that two distinct clinical presentations of contact lens-induced papillary conjunctivitis (CLPC), local and general, occur in hydrogel lens wear.
Retrospective analyses of 124 CLPC events were identified. The classification of CLPC was based on location and extent of papillae. CLPC was classified as local if papillae were present in one to two areas of the tarsal conjunctiva and general if papillae occurred in three or more areas. The CLPC events were compared with an asymptomatic control group in prospective clinical trials conducted from 1993 until 2003 at two clinical sites, Australia and India. Two hundred sixteen subjects from Australia and 914 subjects from India wore either high Dk silicone hydrogel or low Dk hydrogel lenses on a 6-night (6N) or 30-night extended-wear (EW) schedule. The physiological responses of the ocular surface, including tarsal conjunctiva redness and roughness, number of papillae present, lens fit and performance, and subjective patient symptoms, were measured during each visit at each site. These variables listed were compared between local CLPC groups and asymptomatic controls and general CLPC groups and asymptomatic controls.
Two types of CLPC in hydrogel lens wearers have been confirmed. Of the 124 CLPC events, there were 61 local and 63 general events. Local and general CLPC cases reported significantly greater frequency of symptoms compared with the asymptomatic controls, in particular itching, lens awareness, secretion, and blurred vision (p < 0.1).
The classification of CLPC into two types, local and general, in hydrogel lens wear was confirmed based on presentations at both sites. This distribution of papillae between local and general CLPC may indicate separate etiologies involved in the pathogenesis of the condition.
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ABSTRACT: Contact lens-induced papillary conjunctivitis (CLPC) continues to be a major cause of dropout during extended wear of contact lenses. This retrospective study explores risk factors for the development of CLPC during extended wear of silicone hydrogel lenses. Data from 205 subjects enrolled in the Longitudinal Analysis of Silicone Hydrogel Contact Lens study wearing lotrafilcon A silicone hydrogel lenses for up to 30 days of continuous wear were used to determine risk factors for CLPC in this secondary analysis of the main cohort. The main covariates of interest included substantial lens-associated bacterial bioburden and topographically determined lens base curve-to-cornea fitting relationships. Additional covariates of interest included history of adverse events, time of year, race, education level, gender, and other subject demographics. Statistical analyses included univariate logistic regression to assess the impact of potential risk factors on the binary CLPC outcome and Cox proportional hazards regression to describe the impact of those factors on time-to-CLPC diagnosis. Across 12 months of follow-up, 52 subjects (25%) experienced CLPC. No associations were found between the CLPC development and the presence of bacterial bioburden, lens-to-cornea fitting relationships, history of adverse events, gender, or race. Contact lens-induced papillary conjunctivitis development followed the same seasonal trends as the local peaks in environmental allergens. Lens fit and biodeposits, in the form of lens-associated bacterial bioburden, were not associated with the development of CLPC during extended wear with lotrafilcon A silicone hydrogel lenses.Eye & contact lens 03/2014; · 1.68 Impact Factor
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ABSTRACT: To investigate the differences of functional visual acuity (FVA) and high order aberrations (HOAs) in relation to tinted and clear hydrogel soft contact lens (SCL) wear. A prospective comparative study was performed in 16 eyes of 16 healthy volunteers. Dynamic visual acuity (using a FVA measurement system) and higher-order aberrations (using a wavefront sensor) were compared in subjects wearing two types of soft contact lenses: 1-day Acuvue(®) (Vistakon, Jacksonville, FL) clear and the 1-day Acuvue(®) Define(TM) (Vistakon, Jacksonville, FL) tinted lens. The blink rates were recorded during FVA testing. The correlation between the difference of HOAs and differences in FVA values was analyzed. The mean LogMAR FVA scores with clear and tinted SCLs were 0.07±0.13 and 0.14±0.17 (P<0.05). The mean blink frequencies with clear and tinted SCL wear were 18.4±8.3 and 25.3±4.7blinks/min (P<0.05). Both 3rd-order aberrations and total HOAs showed statistically significant differences between the two types of soft contact lenses for 6mm pupil measurements (P<0.05). A significant positive linear correlation was observed between ΔHOAs and ΔLogMAR FVA for 6mm pupil measurements (R=0.53, P=0.04). Tinted contact lens wear appears to induce a reduction in optical quality. Functional visual acuity measurement is a useful procedure to study the changes of visual performance and quality in tinted contact lens wear.Contact lens & anterior eye: the journal of the British Contact Lens Association 04/2014;
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ABSTRACT: Purpose: Average roughness (Ra) is generally used to quantify roughness; however it makes no distinction between spikes and troughs. Shape parameters as kurtosis (Rku) and skewness (Rsk) serve to distinguish between two profiles with the same Ra. They have been reported in many biomedical fields, but they were no applied to contact lenses before. The aim of this study is to analyze surface properties of four silicone hydrogel contact lenses (CL) by Atomic Force Microscopy (AFM) evaluating Ra, Rku and Rsk. Methods: CL used in this study were disposable silicone hydrogel senofilcon A, comfilcon A, balafilcon A and lotrafilcon B. Unworn CL surfaces roughness and topography were measured by AFM (Veeco, multimode-nanoscope V) in tapping modeTM. Ra, Rku and Rsk for 25 and 196 μm2 areas were determined. Results: Surface topography and parameters showed different characteristics depending on the own nature of the contact lens (Ra/Rku/Rsk for 25 and 196 μm2 areas were: senofilcon A 3,33/3,74/0,74 and 3,76/18,16/1,75; comfilcon A: 1,56/31,09/2,93 and 2,76/45,82/3,60; balafilcon A: 2,01/33,62/-2,14 and 2,54/23,36/-1,96; lotrafilcon B: 26,97/4,11/-0,34 and 29,25/2,82/-0,23). In lotrafilcon B, with the highest Ra, Rku showed a lower degree of peakedness of its distribution. Negative Rsk value obtained for balafilcon A showed a clear predominance of valleys in this lens. Conclusions: Kku and Rsk are two statistical parameters useful to analyse CL surfaces, which complete information from Ra. Differences in values distribution and symmetry were observed between CL.Proceedings of SPIE - The International Society for Optical Engineering 05/2011; · 0.20 Impact Factor