Prostaglandin-inhibitor naproxen does not affect contact lens-induced changes in the human corneal endothelium

A randomized, double-masked, placebo-controlled study was conducted to determine the effect of the prostaglandin-inhibitor naproxen on the bleb response of the corneal endothelium during hydrogel contact lens wear. Naproxen did not significantly alter the bleb response. This finding suggests that the endothelial bleb response is not prostaglandin-mediated

Effect of prostaglandin-inhibitor naproxen on the corneal swelling response to hydrogel contact lens wear

Previous studies have demonstrated that the prostaglandin-inhibitor naproxen can reduce post-surgical corneal oedema, which is largely due to an inflammatory process. To determine whether there is an inflammatory component in the oedematous response of the cornea to contact lens wear, we conducted a randomized, double-masked, placebo-controlled study on the effect of naproxen on contact lens-induced corneal swelling. This drug did not have a significant effect, suggesting that prostaglandins are not involved in the hypoxic oedema response. The discrepancy between the effect of naproxen on lens- and surgically-induced corneal oedema can be attributed to the different aetiologies of these oedema responses

Deswelling of the graft cornea following hypoxic oedema

Both corneas of 12 unilateral graft patients were subjected to 9% hypoxic oedema. Following removal of the hypoxic stimulus, the grafted corneas deswelled at a significantly slower rate (P less than 0.01) than the fellow unoperated corneas. We suggest that this can be attributed to a change in the barrier properties and/or pump efficiency of the endothelium. Monitoring corneal deswelling following hypoxic oedema could form the basis of a clinical test of corneal endothelial function

Effects of long-term extended contact lens wear on the human cornea

The effects of long-term extended wear of soft contact lenses on the human cornea were determined by examining 27 patients who had worn a high water content hydrogel contact lens in 1 eye only for an average of 62 +/- 29 months (mean +/- SD). The other eye, which was either emmetropic or amblyopic, acted as a control. The lens-wearing eye showed a 14.8% reduction in epithelial oxygen uptake (P less than 0.001), a 5.6% reduction in epithelial thickness (P less than 0.05), a 2.3% reduction in stromal thickness (P less than 0.05), the induction of epithelial microcysts, and a 22.0% increase in endothelial polymegathism (P less than 0.001). Endothelial cell density was unaffected by extended lens wear. No interocular differences in any of these physiological characteristics were found in a matched control group of anisometropic and amblyopic subjects who did not wear contact lenses. The patients ceased lens wear for up to one month and recovery of corneal function was monitored during this period. Epithelial oxygen uptake and thickness recovered within 33 days of lens removal. The number of microcysts increased over the first 7 days, but decreased thereafter; some microcysts were still present 33 days after lens removal. Recovery from stromal thinning had not occurred after 33 days following lens removal. There was a slight reduction in polymegathism in some patients, but overall this was not statistically significant. These findings establish (1) that the extended wear of hydrogel lenses induces significant changes in all layers of the cornea; (2) that lens wear suppresses aerobic epithelial metabolism, which may compromise the epithelial barrier to infection; and (3) that changes to the stroma and endothelium are long-lasting. Lens-induced effects on corneal physiology can be minimized by fitting lenses that have greater oxygen transmissibility (are thinner), are more mobile, more frequently removed, and more regularly replaced