Corneal confocal microscopy assessment in contact lens discomfort

Abstract

PurposeThe aim of this study was to analyze whether symptoms of discomfort in CL wearers were associated to changes in the nerve morphology and/or the density of dendritic cells in the corneal sub‐basal nerve plexus.MethodsSixty subjects were included: 20 symptomatic CL wearers (SCLW), 20 asymptomatic CL wearers (ACLW), and 20 non wearers (NCLW). Ocular Surface Disease Index (OSDI), visual acuity, tear osmolarity, biomicroscopy findings, tear film break‐up time, corneal and conjunctival staining, Schirmer test, and confocal microscopy were performed. In the confocal images number and density of nerves, density of nerve branches, grade of nerve tortuosity, and density of dendritic cells were analyzed.ResultsOSDI and lid roughness was higher in the SCLW group (p=0.S009 and p=0.04, respectively), limbal hyperaemia was raised in the ACLW group (p=0.S009), and tear osmolarity was increased in both CL wearers groups (p=0.000), in comparison with the NCLW group. Subjects were divided into low and high density of dendritic cells using a 75 cells/mm2 cut‐off. This distribution was significantly different (p=0.04) between the CL wearers (21 and 19 subjects had low and high cell density, respectively) and the NCLW group (16 and 4, respectively). The CL type was significantly different (p=0.011) between CL wearers with low (4 and 17 subjects wear conventional and silicone hydrogel CLs, respectively) and high (11 and 8, respectively) cell density.ConclusionsSymptoms of discomfort in CL wearers seem not to be related to changes in the nerve morphology or density of dendritic cells in the corneal sub‐basal nerve plexus.