Efron Nathan, Morgan Philip B, Makrynioti Dimitra
Institute of Health and Biomedical Innovation and School of Optometry, Queensland University of Technology, Brisbane, Australia.
Cornea. 2007 Aug;26(7):793-9. doi: 10.1097/ICO.0b013e31806c79dc.
To determine the chronic morbidity of corneal infiltrative events (CIEs) associated with contact lens wear.
The central corneas of both eyes of 13 subjects who had suffered a CIE 27 +/- 4 months previously were examined by using slit-lamp biomicroscopy, confocal microscopy, and ultrasound pachometry. Snellen visual acuity was recorded in both eyes. A questionnaire was administered to ascertain the type and extent of changes in contact lens wear and care since suffering from the CIE.
Slit-lamp biomicroscopy revealed the presence of a circular scar, approximately 1.5 mm in diameter, in the central cornea of the right eye of the patient who had suffered the most clinically severe CIE; no residual scar, or any other abnormality, was detected in any of the other 12 patients. No significant difference between the 2 eyes was found with respect to basal epithelial cell density; anterior or posterior keratocyte density; endothelial cell density, polymegethism, or pleomorphism; corneal thickness; or visual acuity. Anecdotally, however, markedly reduced pan-corneal cell counts, increased endothelial polymegethism, and reduced corneal thickness were observed in the affected eye of the patient who had suffered the most clinically severe CIE. After having suffered from a CIE, many patients changed lens type or brand, ceased to routinely sleep in lenses, or wore lenses less often.
In general, contact lens-associated CIEs do not compromise the long-term integrity of the cornea. Changes in lens-related behaviors of patients who have suffered from a CIE seem to be aimed at reducing the risk of a further occurrence. Anecdotally, more severe CIEs may be associated with chronic tissue morbidity.
确定与隐形眼镜佩戴相关的角膜浸润事件(CIEs)的慢性发病率。
对13名在27±4个月前发生过CIE的受试者的双眼中央角膜进行裂隙灯生物显微镜检查、共聚焦显微镜检查和超声测厚。记录双眼的Snellen视力。进行问卷调查以确定自发生CIE以来隐形眼镜佩戴和护理的变化类型及程度。
裂隙灯生物显微镜检查显示,在临床上最严重的CIE患者的右眼中央角膜存在一个直径约1.5mm的圆形瘢痕;在其他12名患者中均未检测到残留瘢痕或任何其他异常。在基础上皮细胞密度、前或后角膜细胞密度、内皮细胞密度、大小不均或多形性、角膜厚度或视力方面,双眼之间未发现显著差异。然而,据观察,在临床上最严重的CIE患者的患眼中,全角膜细胞计数明显减少、内皮大小不均增加且角膜厚度减小。发生CIE后,许多患者更换了镜片类型或品牌,不再常规戴着镜片睡觉,或减少了戴镜频率。
一般来说,与隐形眼镜相关的CIEs不会损害角膜的长期完整性。发生过CIE的患者在镜片相关行为上的改变似乎旨在降低再次发生的风险。据观察,更严重的CIEs可能与慢性组织病变相关。