Epidemiology of contact lens-induced giant papillary conjunctivitis: a retrospective study

Purpose: The purpose of the study is to determine the correlation between the incidence of giant papillary conjunctivitis induced by the use of contact lenses (CLPC) and contact lens material, replacement schedule or wearing time. The emergence of new materials and designs of contact lenses along with modifications in the replacement and wearing schedule have changed the structure of complications in users of soft contact lenses (SCLs). At present, infectious and hypoxic complications are extremely rare; on the other hand, toxic-allergic reactions that arise in users of contact lenses (CLs) have come to the fore.

Material and methods. A retrospective cohort clinical study involved 1 668 users of SCL of various materials and with different replacement and wearing schedules. Patients were monitored from 2008 to 2018.

Results. As a result of the study, it was found that the CLPC incidence correlate with the wearing time and replacement schedule of the SCLs.

Conclusion. Any SCL user, regardless of the SCL material and lens replacement schedule may potentially have CLPC. The severity of the CLPC process depends on SCLs wearing time and replacement schedule. Daily disposable SCLs are safer as opposed to 2-week disposable and monthly contact lenses. In case of wearing daily SCLs, the risk of CLPC is the same for hydrogel and silicone-hydrogel lenses. Focusing on compliance with the rules of SCLs, use and care is the major measure that helps to prevent the formation of CLPC.

1. Aaron B., Zimmerman A.N. Contemporary CL complication. Tips for when eyes experience insults due to hypoxia, mechanical irritation, toxicity, or microbial contamination. December 1, 2018. https://www.clspectrum.com/issues/2018/ december-2018/contemporary-cl-complications

2. Efron N. Why are we still fitting reusable soft contact lenses? Clin Exp Optom. 2014;97:386-388. doi.10.1111/cxo.12170

3. International contact lens prescribing in 2018. Our 18th annual report in Contact Lens Spectrum explores the variations in worldwide contact lens prescribing. СLSpectrum, 1-2019. https://www.clspectrum.com/issues/2019/january-2019/international-contact-lens-prescribing-in-2018

4. Donshik P.C. Giant papillary conjunctivitis. Am J Ophthalmol. 1994;92:687–744.

5. Molinari J.F., Stanek S. Meibomian gland status and prevalence of giant papillary conjunctivitis in contact lens wearers. Optometry. 2000;71(7):459-461.

6. Weisman B. Giant papillary conjunctivitis. 2011; 26.

7. Tagliaferri A., Love T E., Szczotka-Flynn L. Risk factors for contact lens induced papillary conjunctivitis associated with silicone hydrogel contact lens wear. Eye Contact Lens. 2014;40(3):117-122. doi:10.1097/ICL.0000000000000019

8. Donshik P C, Poranzinski A D. Giant papillary conjunctivitis in Frequent Replacement Contact Lens Wearers: A Retrospective Study. Trans Am Ophthalmol Soc. 1999;97:205–216.

9. Kivaev A.A., Lapina L.A. Complications and their prevention when using soft contact lenses. Glaz.1998;2:12-14. (In Russ.)

10. Allansmith M.R., Baird R.S., Greiner J.V. Vernal conjunctivitis and contact lens-associated giant papillary conjunctivitis compared and contrasted. Am J Ophthalmol. 1979;87(4):544-555. doi:10.1016/0002-9394(79)90247-2

11. Allansmith M.R., Korb D.R., Greiner J.V. Giant papillary conjunctivitis induced by hard or soft contact lens wear: quantitative histology. Ophthalmology. 1978;85(8):766–778. doi: 10.1016/s0161-6420(78)35612-8

12. Chang S.H., Chang C.J. Delayed tear lens clearance in contact lens associated papillary conjunctivitis. Curr Eye Res. 2001;22:253-257.

13. Irkec M.T., Orhan M., Erdener U. Role of tear inflammatory mediators in contact lensassociated giant papillary conjunctivitis in soft contact lens wearers. Ocul Immunol Inflamm. 1999;7:35-38.

14. Astley R.A., Kennedy R.C., Chodosh J. Structural and cellular architecture of conjunctival lymphoid follicles in the baboon (Papio anubis). Exp Eye Res. 2003;76(6):685-694.

15. Knop N., Knop E. Conjunctiva-associated lymphoid tissue in the human eye. Invest Ophthalmol Vis Sci. 2000;42:1270-1279. doi:10.1016/S0002-9394(00)00700-5

16. Liu H., Meagher C.K., Moore C.P., Phillips T.E. M cells in the follicle-associated epithelium of the rabbit conjuncti va preferentially bind and translocate latex beads. Invest Ophthalmol Vis Sci. 2005;46:4217-4223. doi:10.1167/iovs. 05-0280

17. Meagher C.K., Liu H., Moore C.P., Phillips T.E. Conjunctival M cells selectively bind and translocate Maackia amurensis leukoagglutinin. Exp Eye Res. 2005;80(4):545-653. doi:10.1016/ j.exer.2004.11.005

18. Neutra M.R., Frey A., Kraehenbuhl J.P. Epithelial M cells: gateways for mucosal infection and immunization. Cell. 1996; 86(3):345-348. doi:10.1016/s0092-8674(00)80106-3

19. Zhong X., Liu H., Pu A., Xia X., Zhou X. M cells are involved in pathogenesis of human contact lens-associated giant papillary conjunctivitis. Arch Immunol Ther Exp (Warsz). 2007;55(3): 173-177. doi:10.1007/s00005-007-0022-x

20. Elhers W.H., Donshik P.C. Giant papillary conjunctivitis. Curr Opin Allergy Clin Immunol. 2008;8(5):445-449. doi: 10.1097/ ACI.0b013e32830e6af0

21. Zhao Z., Fu H., Skotnitsky C.C., Sankaridurg P.R., Willcox M.D. IgE antibody on worn highly oxygen-permeable silicone hydrogel contact lenses from patients with contact lens-induced papillary conjunctivitis (CLPC). Eye Contact Lens. 2008;34(2):117-138. doi:10.1097/ICL.0b013e318145a4e5

22. Myagkov A.V., Sogolovskaya E.E., Laptev D.S., Alibekova Zh.O. Clinic, diagnosis and treatment of giant papillary conjunctivitis in users of contact lenses. Moscow; 2011. 16 p. (In Russ.)

23. Skotnitsky C.C., Naduvilath T.J., Sweeney D.F., Sankari durg P.R. Two presentations of contact lens-induced papillary conjunctivitis (CLPC) in hydrogel lens wear: local and general. Optom Vis Sci. 2006;83(1):27-36. doi: 10.1097/01. opx. 0000195565.44486.79

24. Jones L., Senchyna M., Glasier M.A., Schickler J., Forbes I., Louie D. et al. Lysozyme and lipid deposition on silicone hydrogel contact lens materials. Eye Contact Lens. 2003;29 (1 Suppl):75-84.