Inflammatory Response of Presbyopes Neophyte Contact Lens Wearers during 6 Months of Multifocal Lens Wear

Abstract

Purpose: To investigate the macroscopic (clinical) and molecular (subclinical) inflammatory responses of presbyopic neophyte contact lens (CL) wearers after 6 months of multifocal hydrogel (Hy) CL wear.

Methods: A prospective, longitudinal, single-arm clinical study was conducted on 12 presbyopic neophytes after 1-, 3- and 6-month wear of monthly replacement Hy Polymacon CLs. Clinical impact was assessed by the tear film stability (first non-invasive tear film breakup time (NIKBUT), average NIKBUT and tear breakup time (TBUT)), tear volume (Schirmer test), ocular surface staining (bulbar redness and corneal and conjunctival staining), meibomian gland expression and the lid-parallel conjunctival folds (LIPCOF). Subclinical impact was analysed by isolation of conjunctival total RNA, retrotranscription and quantitative polymerase chain reaction amplification with specific primers for NLRP3, MUC16 and CD73 inflammation-related genes.

Results: No significant differences were found in any clinical signs, except for a significant increase in corneal staining after 3 and 6 months (p = 0.03 for both). NLRP3 and MUC16 transcript levels remained stable throughout the visits. In contrast, CD73 mRNA expression significantly decreased at 3 and 6 months (p = 0.008 and p = 0.03, respectively).

Conclusions: Monthly Polymacon CLs induced relevant changes in corneal staining and conjunctival levels of the inflammatory transcript CD73 of neophyte presbyopes after 3 months. Wearing monthly Hy CLs for at least 6 months seemed to exacerbate ocular surface inflammation in neophyte presbyopic CL-wearing individuals. Further research is needed to investigate the potential link between these findings and CL-related discomfort experienced by presbyopes, a key factor for CL dropout.