Transient decrease of secretory IgA in tears during rigid gas permeable contact lens wear

Decreased humoral defense mechanisms may be involved in the occurrence of keratic ulcerations after contact lens wear. To investigate the effect of contact lens wear on tear protein composition a prospective study was performed whereby tears were collected with Schirmer papers from 42 healthy individuals, before and at varying times after contact lens wear. Tear proteins were quantitated using HPLC analysis. Analysis of tear fluid by HPLC is a rapid and simple technique to detect the major tear proteins. Four separate peaks containing respectively IgA, lactoferrin, TSPA and lysozyme can easily be identified. The results show that the mean relative level of secretory IgA in the collected tear samples decreased significantly after the first months of contact lens wear but was not significantly altered after one year. The decrease in IgA was accompanied by a significant increase in the relative amount of lysozyme, whereas the levels of lactoferrin and TSPA remained the same. Certain individuals showed a marked decrease in their tear secretory IgA levels after wearing the lenses for more than one year. Future studies will clarify whether such individuals are at higher risk to develop corneal complications.