Risk factors for contact lens-induced papillary conjunctivitis associated with silicone hydrogel contact lens wear.

BACKGROUND: Contact lens-induced papillary conjunctivitis (CLPC) continues to be a major cause of dropout during extended wear of contact lenses. This retrospective study explores risk factors for the development of CLPC during extended wear of silicone hydrogel lenses. METHODS: Data from 205 subjects enrolled in the Longitudinal Analysis of Silicone Hydrogel Contact Lens study wearing lotrafilcon A silicone hydrogel lenses for up to 30 days of continuous wear were used to determine risk factors for CLPC in this secondary analysis of the main cohort. The main covariates of interest included substantial lens-associated bacterial bioburden and topographically determined lens base curve-to-cornea fitting relationships. Additional covariates of interest included history of adverse events, time of year, race, education level, gender, and other subject demographics. Statistical analyses included univariate logistic regression to assess the impact of potential risk factors on the binary CLPC outcome and Cox proportional hazards regression to describe the impact of those factors on time-to-CLPC diagnosis. RESULTS: Across 12 months of follow-up, 52 subjects (25%) experienced CLPC. No associations were found between the CLPC development and the presence of bacterial bioburden, lens-to-cornea fitting relationships, history of adverse events, gender, or race. Contact lens-induced papillary conjunctivitis development followed the same seasonal trends as the local peaks in environmental allergens. CONCLUSIONS: Lens fit and biodeposits, in the form of lens-associated bacterial bioburden, were not associated with the development of CLPC during extended wear with lotrafilcon A silicone hydrogel lenses.

A multicenter study to map genes for Fuchs endothelial corneal dystrophy: baseline characteristics and heritability.

PURPOSE: To describe the methods for family and case-control recruitment for a multicenter genetic and associated heritability analyses of Fuchs endothelial corneal dystrophy (FECD). METHODS: Twenty-nine enrolling sites with 62 trained investigators and coordinators gathered individual and family information, graded the phenotype, and collected blood and/or saliva for genetic analysis on all individuals with and without FECD. The degree of FECD was assessed in a 0 to 6 semiquantitative scale using standardized clinical methods with pathological verification of FECD on at least 1 member of each family. Central corneal thickness was measured by ultrasonic pachymetry. RESULTS: Three hundred twenty-two families with 330 affected sibling pairs with FECD were enrolled and included a total of 650 sibling pairs of all disease grades. Using the entire 7-step FECD grading scale or a dichotomous definition of severe disease, heritability was assessed in families via sib-sib correlations. Both binary indicators of severe disease and semiquantitative measures of disease severity were significantly heritable, with heritability estimates of 30% for severe disease, 37% to 39% for FECD score, and 47% for central corneal thickness. CONCLUSIONS: Genetic risk factors have a strong role in the severity of the FECD phenotype and corneal thickness. Genotyping this cohort with high-density genetic markers followed by appropriate statistical analyses should lead to novel loci for disease susceptibility.