Original article
Conjunctivochalasis and Contact Lenses

https://doi.org/10.1016/j.ajo.2009.02.018Get rights and content

Purpose

To assess the relationship between age and the incidence and severity of conjunctivochalasis in contact lens (CL) wearers by grading of conjunctivochalasis, and to compare the severity of conjunctivochalasis between CL wearers and nonwearers.

Design

Prospective, nonrandomized consecutive case study.

Methods

A total of 600 CL wearers (94 hard CLs [HCL] and 506 soft CLs [SCL]) aged 11 to 60 years and 579 nonwearers aged 10 to 60 years were enrolled. The age, gender, medical history, ocular history, and the grade and other parameters of conjunctivochalasis at 3 locations (nasal, middle, and temporal areas) were determined in all subjects.

Results

The prevalence of conjunctivochalasis increased dramatically with age in all groups. The mean grade of conjunctivochalasis was higher in CL wearers than in nonwearers (nasal area, P < .00001; temporal area, P < .00001) and was higher in HCL wearers than in SCL wearers (nasal area, P < .00001; temporal area, P = .00003). Parameters such as the downward gaze–dependent or digital pressure–dependent changes of conjunctivochalasis and the presence of superficial punctate keratitis all increased with age in both CL wearers and nonwearers. The gaze-dependent and pressure-dependent changes of conjunctivochalasis showed an increase with age and the duration of CL wear in both SCL and HCL wearers.

Conclusions

This was the first assessment of the severity of conjunctivochalasis in a large series of consecutive CL wearers. Our results strongly suggest that wearing CLs is an important risk factor for conjunctivochalasis.

Section snippets

Subjects

Consecutive CL wearers attending our outpatient clinic between January 1 and June 30, 2007 were enrolled in the study. Almost all of the patients lived in Tokyo or Kanagawa in Japan. Patients with a history of ocular surgery or punctal occlusion, and those with infectious conjunctivitis, proptosis, or eyelid abnormalities such as entropion, ectropion, and trichiasis were excluded. Moreover, patients using both HCL and SCL were excluded so that conjunctivochalasis could be compared between HCL

Results

The prevalence of conjunctivochalasis increased dramatically with age in both CL wearers and nonwearers, as shown in Figure 1. This figure also shows the extent of conjunctivochalasis, demonstrating that it became more extensive with age and the extent was greater in CL wearers than in nonwearers (11 to 20 years; 46.8% vs 17.0%, P < .00001; 21 to 30 years; 66.3% vs 53.1%, P = .01037; 31 to 40 years; 84.1% vs 70.4%, P = .00566; 41 to 50 years; 90.8% vs 88.1%, P = .62463; 51 to 60 years; 100.0%

Discussion

This prospective study showed that the prevalence and grade of conjunctivochalasis was higher in the CL wearers than in nonwearers and the grade in HCL wearers was higher than that in SCL wearers. Conjunctivochalasis is well known to increase with age. Although various authors have reported on dry eye–induced conjunctivochalasis and techniques of conjunctival surgery, no attempt has been made to assess CL-induced conjunctivochalasis. Here we present the first data on the grade of CL-induced

Tatsuya Mimura, MD, is currently at the Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan. He received his MD degree from Yamanashi Medical School in 1997. Dr Mimura's primary research interest is ocular regeneration, and his clinical sub-specialties include medical and surgical treatment of corneal diseases and diabetic retinopathy.

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  • Cited by (0)

    Tatsuya Mimura, MD, is currently at the Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan. He received his MD degree from Yamanashi Medical School in 1997. Dr Mimura's primary research interest is ocular regeneration, and his clinical sub-specialties include medical and surgical treatment of corneal diseases and diabetic retinopathy.

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