Effect of soft contact lens wear on corneal endothelial cell characteristics

To evaluate the impact of soft contact lens (SCL) wear on corneal endothelial morphology, particularly endothelial cell density (ECD), coefficient of variation (COV), and hexagonality (HEX), comparing SCL wearers with non-wearers in a young adult population in Iraq.

A cross-sectional study was conducted involving 394 participants, aged 18-30 years, comprising 207 SCL wearers and 187 non-wearers. Corneal endothelial characteristics were assessed using non-contact specular microscopy to measure ECD, COV, and HEX. The spherical equivalent (SE) was measured using an autorefractometer. Statistical analyses were performed using one-way and two-way ANOVA tests to compare between groups.

A total of 394 subjects participated in the study, including 207 CL wearers (108 silicone hydrogel and 99 traditional hydrogel) and 187 non-CL wearers (control group), with 149 males and 245 females. The mean age was 23.90 ± 3.07 years, and the mean spherical equivalent (SE) was -3.07 ± 1.36 diopters. The duration of CL wear ranged from 2 to 12 years, with an average of 6.37 ± 3.25 years. Participants were divided into two groups: Group 1 (2-6 years) and Group 2 (7-12 years). Statistical analysis revealed significant changes in endothelial cell density (ECD), coefficient of variation (COV), and hexagonality (HEX) in CL wearers (p < 0.001), with more pronounced alterations in Group 2, particularly among traditional hydrogel lens wearers.

Prolonged soft contact lens wear is associated with significant changes in corneal endothelial morphology, including decreased ECD, increased COV, and reduced HEX, which worsen with extended use. These findings underscore the importance of monitoring corneal health in long-term SCL users and suggest the need for regular ophthalmic evaluations to mitigate potential risks.