Chao Cecilia, Stapleton Fiona, Willcox Mark D P, Golebiowski Blanka, Richdale Kathryn
1College of Optometry, State University of New York, New York, New York 2School of Optometry and Vision Science, The University of New South Wales, Sydney, New South Wales, Australia *
Optom Vis Sci. 2017 Nov;94(11):1003-1008. doi: 10.1097/OPX.0000000000001129.
Established reusable contact lens (CL) wearers show higher tear inflammatory cytokine concentrations and greater conjunctival metaplasia in the region covered by standard soft CLs. The balance of proinflammatory to anti-inflammatory cytokines, but not individual tear cytokine concentrations, was associated with self-reported CL discomfort.
Daily disposable (DD) lenses are often used to improve CL discomfort, but the effect on ocular inflammatory responses has not been fully investigated. This study aimed to compare the concentrations of tear cytokines and conjunctival cell morphology in healthy habitual DD and reusable soft CL wearers.
Thirty-six established daily CL wearers, including 14 DD and 24 reusable wearers, were enrolled. Symptoms and ocular surface integrity were evaluated. The concentration of tear cytokines (interleukin 1β [IL-1β], IL-6, IL-10, IL-12(p70), IL-17A, and tumor necrosis factor α) were determined using Multiplex assays. The ratios of proinflammatory and anti-inflammatory cytokines were calculated. Impression cytology was performed on the conjunctiva, and goblet cell density and epithelial squamous metaplasia were quantified. Differences in variables by CL replacement schedules and the associations between variables were analyzed.
Reusable CL wearers had higher concentrations (in pg/mL) of IL-1β (26 ± 7 vs. 16 ± 11), IL-6 (42 ± 14 vs. 25 ± 20), IL-10 (83 ± 23 vs. 49 ± 36), IL-12(p70) (145 ± 44 vs. 91 ± 68), IL-17A (93 ± 26 vs. 54 ± 44), and tumor necrosis factor α (312 [171 to 468] vs. 189 [6 to 447]) (all P < .01) and greater conjunctival metaplasia in the region covered by CLs (0.7 [0.2 to 1.6] vs. 0.4 [0.04 to 1.2], P = .01) compared with DD wearers. There was a positive association between CL discomfort and ratios of IL-1β to IL-10 and IL-12(p70) to IL-10 (ρ = 0.42 and ρ = 0.33, P < .05).
Higher ocular inflammatory responses, as indicated by higher tear cytokine concentrations and higher conjunctival epithelial metaplasia, were found in reusable CL wearers than in DD CL wearers. The balance of proinflammatory and anti-inflammatory cytokines may be helpful to assess the inflammatory status of the eye.
长期佩戴可重复使用隐形眼镜（CL）的人在标准软性CL覆盖区域显示出更高的泪液炎症细胞因子浓度和更严重的结膜化生。促炎细胞因子与抗炎细胞因子的平衡，而非单个泪液细胞因子浓度，与自我报告的CL不适相关。
日抛型（DD）镜片常用于改善CL不适，但对眼部炎症反应的影响尚未得到充分研究。本研究旨在比较健康的习惯性DD和可重复使用软性CL佩戴者的泪液细胞因子浓度和结膜细胞形态。
招募了36名长期佩戴CL的人，包括14名DD佩戴者和24名可重复使用佩戴者。评估了症状和眼表完整性。使用多重检测法测定泪液细胞因子（白细胞介素1β[IL-1β]、IL-6、IL-10、IL-12(p70)、IL-17A和肿瘤坏死因子α）的浓度。计算促炎和抗炎细胞因子的比例。对结膜进行印片细胞学检查，并对杯状细胞密度和上皮鳞状化生进行定量。分析了CL更换时间表对变量的影响以及变量之间的关联。
与DD佩戴者相比，可重复使用CL佩戴者的IL-1β（26±7对16±11）、IL-6（42±14对25±20）、IL-10（83±23对49±36）、IL-12(p70)（145±44对91±68）、IL-17A（93±26对54±44）和肿瘤坏死因子α（312[171至468]对189[6至447]）浓度更高（均P<.01），且CL覆盖区域的结膜化生更严重（0.7[0.2至1.6]对0.4[0.04至1.2]，P=.01）。CL不适与IL-1β与IL-10以及IL-12(p70)与IL-10的比例呈正相关（ρ=0.42和ρ=0.33，P<.05）。
与DD CL佩戴者相比，可重复使用CL佩戴者的眼部炎症反应更高，表现为泪液细胞因子浓度更高和结膜上皮化生更严重。促炎和抗炎细胞因子的平衡可能有助于评估眼部的炎症状态。
