Non-invasive assessment of corneal and conjunctival deterioration in soft contact lens users using anterior segment optical coherence tomography

Background: The aim was to evaluate the corneal and bulbar conjunctival thicknesses of soft contact lens (SCL) wearers using anterior segment optical coherence tomography (AS-OCT).

Methods: The epithelial and overall thicknesses of both the central cornea and the infero-temporal bulbar conjunctiva of SCL wearers (30 subjects) were obtained by Cirrus HD-OCT and compared with those of refraction-matched controls (30 subjects) and patients with emmetropia (30 subjects).

Results: The mean corneal epithelial thicknesses in SCL wearing, spectacle-wearing and emmetropic groups were 48.97 ± 5.45, 52.18 ± 4.84 and 53.18 ± 5.05 µm, respectively. The corneal epithelium of members of the SCL group was significantly thinner than in both the spectacles and emmetropic groups (p = 0.044 and 0.006, respectively), whereas the central corneal thickness did not differ between groups (p = 0.210). The mean conjunctival epithelial thicknesses in SCL, spectacles and emmetropic groups were 41.50 ± 7.75, 54.33 ± 8.39 and 49.10 ± 7.11 µm, respectively. Conjunctival epithelium in the SCL group was significantly thinner than in both spectacle-wearing and emmetropic groups (p < 0.001 and p = 0.001, respectively). The conjunctiva was significantly thinner in the SCL group compared to the spectacles group (p = 0.001) but not the emmetropic group.

Conclusions: Contact lens wear is related to thinning of both corneal and conjunctival layers. AS-OCT is a non-invasive and clinically applicable technique for assessing the involvement of the cornea and conjunctiva in contact lens wearers.