Abstract and Introduction
Abstract
With the introduction of silicone hydrogel (SiHy) lenses over a decade ago, clinicians have seen both improvements and challenges in contact lens (CL) wear. Regardless of lens design or material, the presence of a CL on the ocular surface induces mechanical complications. Although some of these complications have diminished in frequency and severity with newer generations of SiHy lenses, others persist at previously reported levels. The aim of this review is to provide up-to-date information on mucin balls, superior epithelial arcuate lesions, corneal erosions, CL-induced papillary conjunctivitis, conjunctival epithelial flaps, lid wiper epitheliopathy, and meibomian gland dropout. The conclusions in this review should provide a sound basis for identifying the future areas of research to help minimize mechanically driven adverse events during CL wear with SiHy lenses.
Introduction
Since the advent of silicone hydrogel (SiHy) contact lenses (CLs), many undesirable clinical complications resulting from CL-induced hypoxia have been eliminated. However, a CL on an eye inevitably disrupts the ocular surface by mechanical interactions—the posterior lens surface is in close contact with the entire cornea, limbus, and surrounding bulbar conjunctiva, whereas the anterior surface interacts with the palpebral conjunctiva and upper/lower lid margins. Therefore, it is not surprising that mechanically driven events continually and inevitably occur with SiHy CLs, because these lenses cannot truly mimic the ocular surface.
Mucin balls, superior epithelial arcuate lesions, corneal erosions, and papillary conjunctivitis are some examples of mechanically driven complications associated with CL wear. Since the initial launch of SiHy CLs, these adverse events have been extensively discussed in published review articles. This article provides updates on these topics from the past decade and discussions related to newer findings on complications such as conjunctival epithelial flaps, lid wiper epitheliopathy (LWE), and meibomian gland dropout. This article also aims to identify the areas of research that warrant further investigations that may help minimize the occurrence of these mechanically induced complications during SiHy lens wear.
Eye Contact Lens. 2013;39(1):115-124. © 2013 Lippincott Williams & Wilkins
