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