Giant papillary conjunctivitis in frequent replacement contact lens wearers: a retrospective study

We conducted a retrospective study of 47 patients who wore frequent replacement contact lenses on a daily-wear basis to determine the incidence of giant papillary conjunctivitis (GPC) and to assess the potential risk factors that may predispose frequent replacement contact lens wearers to develop GPC.

We reviewed the records of patients with no prior contact lens experience who were fit with frequent replacement contact lenses from September 1993 to February 1997.

Forty-seven of 260 patients met the requirements for inclusion in the study. Ten (21.27%) patients had developed GPC. The incidence varied with the frequency of contact lens replacement. The contact lens replacement schedule ranged from 1 day to 12 weeks. In those patients replacing their contact lenses every 4 weeks or at a longer interval, the incidence of GPC was 36%, while for patients who replaced their lenses more frequently, the incidence was 4.5%. Coated contact lenses were also more common among patients who replaced their lenses at 4 weeks or longer (P = 0.23). A significantly greater number of patients in the GPC group incorporated enzymatic cleaning into their contact lens care system (P = .0004). A history of allergy was more prevalent in patients who developed GPC and was statistically significant (P = .012). There was no significant difference found between the groups for age, gender, average daily wearing time, FDA classification of contact lens material, time in contact lenses from fitting to diagnosis or last follow-up period, or the parameters and fitting characteristics of the contact lenses.

The frequency at which patients replace their contact lenses appears to be an important variable in developing GPC. Although frequent replacement contact lenses do not eliminate GPC, patients on a 1-day to 3-week replacement cycle had a significantly lower risk of developing GPC than patients who replaced their lenses at longer intervals. Lens coating was present less often on contact lenses replaced daily and up to 3 weeks. For patients who are at high risk for GPC, replacing lenses at intervals ranging of one day to two weeks appears to offer a better strategy for avoiding GPC than incorporating enzymatic cleaning into their lens care system.