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Contact lens wear decreases keratocyte density in keratoconus
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ROCHESTER, Minn. — Patients with keratoconus who wear contact lenses have lower keratocyte density than keratoconus patients who do not wear contact lenses, according to a study.
Jay Erie, MD, and colleagues at the Mayo Clinic evaluated 29 unscarred corneas of 19 patients with keratoconus and 29 corneas of normal controls using confocal microscopy. The groups were matched for age and contact lens wear. Confocal microscopy images were recorded from the full-thickness central cornea. Cell densities in anteroposterior stromal layers of keratoconus corneas were compared with densities in the corresponding layers of control corneas.
In patients with keratoconus with a mean age of 40, keratocyte density was 19% lower in those who wore contact lenses than in those who did not (P = .03). The control patient group (mean age 39) showed no statistically significant difference in keratocyte density between contact lens wearers and nonwearers.
Among patients who wore contact lenses, keratocyte density was 25% lower in corneas with keratoconus than in control corneas. Cell density was lower in the most anterior keratocyte layer and the layers between 0% and 10%, 67% and 90% and 91% and 100% of stromal thickness (P < .001 for all). Among contact lens nonwearers, there was no difference in cell density between the group with keratoconus and the control group.
“Our study demonstrates a decrease in keratocyte density in the anterior and posterior stroma of keratoconus patients who wear contact lenses. Investigation of the role of decreased keratocytes in the pathophysiology of this disease could lead to new therapeutic strategies to prevent progression of keratoconus once it is detected in its early stages,” the researchers report in the November issue of American Journal of Ophthalmology.