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Risk Factors for Contact Lens–Induced Papillary Conjunctivitis Associated With Silicone Hydrogel Contact Lens Wear

Tagliaferri, Angela M.S.; Love, Thomas E. Ph.D.; Szczotka-Flynn, Loretta B. O.D., M.S., Ph.D.

Eye & Contact Lens: Science & Clinical Practice: May 2014 - Volume 40 - Issue 3 - p 117–122
doi: 10.1097/ICL.0000000000000019

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.

Department of Ophthalmology and Visual Sciences (A.T., L.B.S.-F.), Case Western Reserve University, Cleveland, OH; Center for Health Care Research and Policy (T.E.L.), Case Western Reserve University at MetroHealth Medical Center, Cleveland, OH; Department of Medicine (T.E.L.), Case Western Reserve University, Cleveland, OH; and Department of Epidemiology and Biostatistics (T.E.L., L.B.S.-F.), Case Western Reserve University, Cleveland, OH.

Address correspondence to Loretta B. Szczotka-Flynn, O.D., M.S., Ph.D., University Hospitals Eye Institute, 11100 Euclid Avenue, Lakeside 4126C, Cleveland, OH 44106; e-mail:

Supported by NEI: K23 EY015270 with indirect support for laboratories and coordination from the Ohio Lions Eye Research Foundation and Research to Prevent Blindness. The identifier is NCT00727402. L. B. Szczotka-Flynn has received research funding from Alcon Laboratories and Johnson & Johnson Vision Care.

The authors have no other funding or conflicts of interest to disclose.

Accepted December 16, 2013

© 2014 Contact Lens Association of Ophthalmologists, Inc.