Xu Yangyang, Xu Zhiqiang, Shu Xupeng, Liu Qiaoli, Wang Yuzhou, Xia Jiahui, Li Yong, Qu Jia, Hu Liang
Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.
National Clinical Research Center for Ocular Diseases, Wenzhou, China.
Front Med (Lausanne). 2022 Mar 11;9:833962. doi: 10.3389/fmed.2022.833962. eCollection 2022.
The purpose of the study is to investigate the dynamic changes in ocular surface indicators in first-time contact lens (CL) wearers and identify the most influential factors in CL discomfort (CLD).
A total of 26 healthy non-CL wearers (26 eyes) were recruited and fitted monthly with disposable hydrogel CLs. Each participant underwent a full ocular surface evaluation, which include Efron grading, tear film breakup time, Schirmer's I test, corneal dendritic cell (DCs) imaging by confocal microscopy (IVCM), and conjunctival microvasculature evaluation by functional slit-lamp biomicroscopy. CLD was assessed using the Ocular Surface Disease Index questionnaire at baseline, 1 week, 1, 3, and 6 months after wearing it and another 6 months after discontinuing it.
Clinical signs and CLD were significantly increased in the first week ( < 0.05). The microvascular response and DC activation peaked at the 1-month interval ( < 0.05). During CL wear, CLD is positively correlated with corneal staining ( = 0.238, = 0.002), papillary conjunctivitis ( = 0.245, < 0.001), and microvascular blood flow velocity ( = 0.353, < 0.001). After discontinuation, only DC activation remained elevated at 6 months, whereas the other signs recovered.
The first week of CL wear was the main period for the appearance of ocular surface clinical signs, and the first month was the main period for the activation of subclinical inflammation. Corneal staining and conjunctival microvascular response are the main factors affecting CLD. Even if the clinical signs recover after discontinuing wear, subclinical inflammation may persist.
本研究旨在调查初次佩戴隐形眼镜（CL）者眼表指标的动态变化，并确定导致CL不适（CLD）的最主要影响因素。
共招募了26名健康的非CL佩戴者（26只眼），每月佩戴一次性水凝胶CL。每位参与者都接受了全面的眼表评估，包括埃弗龙分级、泪膜破裂时间、泪液分泌试验、共焦显微镜（IVCM）下的角膜树突状细胞（DCs）成像以及功能性裂隙灯生物显微镜下的结膜微血管评估。在佩戴CL的基线、1周、1个月、3个月和6个月以及停止佩戴后的另外6个月，使用眼表疾病指数问卷评估CLD。
第一周临床体征和CLD显著增加（P<0.05）。微血管反应和DC激活在1个月时达到峰值（P<0.05）。在佩戴CL期间，CLD与角膜染色（r = 0.238，P = 0.002）、乳头性结膜炎（r = 0.245，P<0.001）和微血管血流速度（r = 0.353，P<0.001）呈正相关。停止佩戴后，仅在6个月时DC激活仍处于升高状态，而其他体征恢复。
佩戴CL的第一周是眼表临床体征出现的主要时期，第一个月是亚临床炎症激活的主要时期。角膜染色和结膜微血管反应是影响CLD的主要因素。即使停止佩戴后临床体征恢复，亚临床炎症仍可能持续。
