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Abstract
1.1 Purpose
The purpose of this study is to prescribe follicular-like conjunctivitis associated with Siliconhydrogels
(FoCoSi) in silicone hydrogel contact lens wearers as a novel subtype of
the well prescribed contact lens induced papillary conjunctivitis (CLPC).
1.2 Methods
1211 patients who wore silicon hydrogels were included in this prospective, nonrandomised,
single center study. Subjective symptoms and clinical signs were evaluated
for daily wear (DW) and continuous wear (CW) populations for several (Lotrafilcon A,
Lotrafilcon B, Senofilcon A, Galyfilcon A) silicon hydrogel lens types. CCLRU and other
specifically developed grading scale were utilized for evaluation. Grading of 2 and above
was rated as clinically significant. Statistical evaluation was performed for eyes rather
than subjects.
1.3 Results
The clinical presentation of FoCoSi could be confirmed and showed an incidence of
3.8%. Lotrafilcon A followed by Senofilcon A on a CW modality presented, with a risk
ratio of 2.49 and 1.53 respectively, the highest affinity for developing FoCoSi. Fluorescein
positive spots showed the closest correlation with subjective symptoms reported
by patients and divided FoCoSi into an active and dormant form. Besides Protein, Lipid
deposition on the contact lens surface and air pollution like Ozone or fine and ultrafine
particles seems to be important factors in developing FoCoSi, whereas mechanical irritation
played a minor role.
1.4 Conclusion
FoCoSi is a novel and relevant subtype of CLPC. Further studies should be performed
to validate these findings and clear up several questions about the aetiology of FoCoSi
and CLPC.
Keywords: Giant papillary conjunctivitis (GPC), contact lens-induced papillary conjunctivitis
(CLPC), follicular-like conjunctivitis associated with siliconhydrogels (FoCoSi)