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Conjunctival epithelial flap in continuous contact lens wear.
- Source :
-
Optometry and vision science : official publication of the American Academy of Optometry [Optom Vis Sci] 2009 Apr; Vol. 86 (4), pp. e324-31. - Publication Year :
- 2009
-
Abstract
- Purpose: Composed of sheets of cells detached from the underlying conjunctiva, conjunctival epithelial flap (CEF) is a recently reported phenomenon associated with contact lens wear with potential consequences for ocular health. Although CEF is generally asymptomatic, it is not known to what extent it might increase the longer-term risk of discomfort, inflammatory response, or infection. In this study, we use survival analysis methods to obtain unbiased estimates of the probability of developing CEF, the mean survival time free of CEF, and the effects of age, gender, ethnicity, and contact lens type.<br />Methods: Two hundred four subjects were recruited for a continuous wear (CW) study of silicone hydrogel (SiH) and gas permeable (GP) contact lenses. Subjects were examined by optometrists throughout contact lens adaptation and CW periods. Statistical methods included the Kaplan-Meier nonparametric estimator of the survival function and the Cox proportional hazards model for estimating the relative effects of covariates.<br />Results: Of the 204 subjects, 72 (35%) developed CEF. In 64% of cases, CEFs were observed bilaterally. The majority of cases (90.3%) presented with CEF in the superior conjunctiva. Mean survival time free of CEF was longer for GP lenses (94.3 days) than for SiH lenses (76.5 days), and the probability of developing CEF was significantly greater for SiH lenses (p = 0.002). Although there was some evidence that women and non-Asians remain free of CEF longer, the effects of age, gender, and ethnicity were not statistically significant.<br />Conclusions: There was a significantly increased risk of CEF in subjects wearing SiH lenses, compared with GP lenses. Subjects wearing SiH lenses remained free of CEF for a shorter time on average. Further study is needed to determine whether the increased incidence of CEF in CW with SiH lenses poses an increased risk of adverse ocular response or infection.
- Subjects :
- Conjunctival Diseases epidemiology
Conjunctival Diseases pathology
Epithelium pathology
Equipment Design
Female
Gases
Humans
Hydrogel, Polyethylene Glycol Dimethacrylate
Incidence
Kaplan-Meier Estimate
Male
Permeability
Proportional Hazards Models
Risk Assessment
Silicones
Time Factors
Young Adult
Conjunctival Diseases etiology
Contact Lenses adverse effects
Subjects
Details
- Language :
- English
- ISSN :
- 1538-9235
- Volume :
- 86
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Optometry and vision science : official publication of the American Academy of Optometry
- Publication Type :
- Academic Journal
- Accession number :
- 19225431
- Full Text :
- https://doi.org/10.1097/OPX.0b013e318199d1f7