The effects of long-term contact lens wear on corneal thickness, curvature, and surface regularity

PURPOSE: To evaluate the effect of long-term contact lens wear on corneal thickness, curvature, and surface regularity. DESIGN: A prospective, clinic-based, case-control study. PARTICIPANTS: A total of 40 eyes of 20 normal subjects and 64 eyes of 35 subjects wearing contact lenses for more than 5 years were evaluated. METHODS: The Orbscan Corneal Topography System was used to evaluate the entire corneal thickness and curvature, anterior curvature and the anterior and posterior elevation topographic patterns in normal eyes and subjects wearing contact lenses on a regular basis for more than 5 years. Indices of TMS-1 Corneal Topography System were used to determine corneal surface regularity in subjects wearing contact lenses and normal eyes. All topographic examinations were performed after contact lenses had been removed for at least 2 weeks. MAIN OUTCOME MEASURES: The entire corneal thickness, curvature, surface regularity index (SRI), surface asymmetry index (SAI), potential visual acuity (PVA) and topographic patterns were compared between normal eyes and subjects wearing contact lenses for more than 5 years. RESULTS: The 64 eyes of 35 subjects evaluated by the Orbscan instrument had an average of 13.45 +/- 6.42 years of contact lens wear. The mean corneal thickness in the center and in eight peripheral areas measured in contact lens wearing subjects was significantly reduced by about 30 to 50 microm compared to normal subjects (P < 0.001 for central and peripheral sites). No correlation was noted between central corneal thickness and degree of myopia in diopters (r = 0.15, 0.10 < P < 0.25). The corneal curvature, maximum keratometry (Max K) and minimum keratometry (Min K) readings, were significantly steeper in eyes wearing contact lenses than normal eyes (P < 0.01 for Max K and Min K measured by both instruments). No difference in the mean corneal astigmatism was noted between groups. The SRI and SAI, but not the PVA index, of the TMS-1 were significantly greater in contact lens wearers than in the control group (P < 0.01 for both SRI and SAI, P = 0.15 for PVA). The color-coded patterns of all curvature and elevation maps made with both instruments showed no significant difference between subjects wearing contact lenses and the control group. There was no significant difference between corneal curvature measurements taken with the Orbscan System or the TMS-1 System in both normal and contact lens groups. CONCLUSIONS: Long-term contact lens wear appears to decrease the entire corneal thickness and increase the corneal curvature and surface irregularity.