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February 2002



C Skotnitsky, T Naduvilath, DF Sweeney, P Sankaridurg, BA Holden
Cooperative Research Centre for Eye Research and Technology, University of New South Wales, Australia.



To evaluate pre-disposing factors for developing localised CLPC with high Dk silicone hydrogel extended wear (EW) lenses; subject and lens variables were
studied in a retrospective case control study.

20 cases of localised CLPC were matched with 20 controls for spectacle refraction, lens type and duration of high Dk EW and prescribed wearing schedules (6 or 30 nights). High Dk lens wear experience ranged from 6 to 21 months. Keratometry readings and history of allergies were compared between cases and controls. Clinical variables including tarsal conjunctival hyperaemia and roughness, tear film debris, overall blepharitis/meibomitis, corneal staining and fitting and surface characteristics of the lenses were measured between the two groups at regular intervals prior to the event. The two groups were compared at baseline and EW using the Group t-test and Fisher’s Exact Test.
CLPC cases seemed to have a more frequent history of allergy, although not significant at the p<0.05 level (30% cases vs. 5% controls, p=0.09). Mean tarsal conjunctival roughness was mild but significantly greater for the cases as compared to the controls (p<0.05) at baseline and during EW. Similarly, mean tarsal conjunctival and bulbar hyperaemia and lack of patency of meibomian orifices were mild but significantly greater (p<0.01) in the cases as compared to the controls during EW. Lens tightness was very slightly higher for the CLPC cases (47±7% vs. 46±4%, p=0.01) during EW. No notable differences were seen between the 2 groups for other variables.

Our results suggest that greater tarsal conjunctival roughness at baseline and EW, tarsal conjunctival and bulbar hyperaemia, lens tightness and a lack of patency of meibomian orifices during EW are higher in patients that manifest localised CLPC, allowing for identification of some patient and lens related signs and symptoms.

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