The application of in vivo confocal microscopy and tearLDH measurement in assessing corneal response to contact lens and contactlens solutions.

PURPOSE. To evaluate differences in corneal responseto daily wear (DW) of soft contact lens (CL) wear with different CL solutionsand to assess the ability of in vivo confocal microscopy (CM) andtear lactate dehydrogenase (LDH) measurement to detect such differences inNZW rabbits. METHODS. Daily treatment of lenses consisted of a rub and rinse cleaning,then overnight soak in one of five solutions: Sauflon All in One (ALL), CompoundA (CoA), OPTI-FREE[sup ® ] Rinsing, Disinfecting, and Storage Solution(OPT), ReNu[sup ®]<?PUB CARET>Multipurpose Solution (REN), and UNISOL[sup ®] Saline Solution (UNI). Rabbits (4/test group) wore 71% H[sub 2] O/type4 soft lenses approximately 7 hours daily. On days 0, 1, 3 and7, slit lamp examination, tear LDH measurement, and in vivo CM wereperformed after removal of lenses. Using in vivo CM, epithelial thickness,epithelial cell area, and stromal thickness were measured, both centrallyand peripherally. RESULTS. Epithelial thickness in ALL, CoA, and UNI-treated eyes showeda significant decrease of 15.6%, 13.3%, and 10.6% (p < 0.05 in all groups),centrally, while CoA, OPT, and UNI showed a significant decrease of 9.3%,7.1%, and 4.4% (p < 0.05 in all groups), peripherally. ALL showed a significant9.5% (p < 0.05) decrease of central cell area, while CoA showed a significant21.5% (p < 0.01) decrease peripherally. UNI demonstrated a significant3.2% (p < 0.05) decrease in central stromal thickness. ALL, CoA, and UNIshowed a significant increase in LDH level of 152.1%, 192.1%, and 308.2% (p< 0.05 in all groups) at day 3, respectively, but values declined at day7. Significant changes in basal epithelial morphology were also observed withCoA on day 7 on in vivo CM. CONCLUSIONS. Overall, lens care solutions in combination with CL wear mayinteract to cause increased epithelial desquamation leading to decreased surfacecell area and epithelial thickness. The clinical significance of these changeswill require further investiga... [ABSTRACT FROM AUTHOR]