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Predicting Extended Wear Complications from Overnight Corneal Swelling

¹ From the School of Optometry and the ² Division of Public Health Biology and Epidemiology of the School of Public Health, University of California, Berkeley; and the ³ School of Optometry, University of Montreal, Quebec, Canada.

PURPOSE. To examine the hypothesis that the corneal overnight swelling response (ONSR) is a predictor of ocular complications in contact lens extended wear (EW).

METHODS. The Berkeley Contact Lens Extended Wear Study (CLEWS) was a randomized, concurrently controlled clinical trial in which more than 200 subjects in EW with rigid gas-permeable (RGP) lenses were observed for 1 year. After adapting to EW, subjects were randomized to either medium or high oxygen-permeable (Dk) RGP lenses and underwent clinical assessments, keratometry, and corneal pachometry at 3-month intervals.

RESULTS. The ONSR was directly related to lens Dk (P = 0.01) and exhibited substantial variability across subjects. The probability of remaining free of complications over time was not significantly lower for subjects with a mild ONSR compared with those with greater edema (P = 0.84). The risk of development of keratopathy was not significantly related to the ONSR (relative risk = 1.00).

CONCLUSIONS. The corneal ONSR is not a good predictor of ocular complications in 1 year of RGP EW. Lenses that cause little or no corneal edema are not necessarily safer for overnight wear.

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				R. Martin, V. de Juan, G. Rodriguez, R. Cuadrado, and I. Fernandez Measurement of Corneal Swelling Variations without Removal of the Contact Lens during Extended Wear Invest. Ophthalmol. Vis. Sci., July 1, 2007; 48(7): 3043 - 3050. [Abstract] [Full Text] [PDF]