Critical Contact Lens Oxygen Transmissibility and Tear Lens Oxygen Tension to Preclude Corneal Neovascularization

Objective: The purpose of this study is to determine the peripheral oxygen transmissibility (pDk/t) and respective central oxygen transmissibility (cDk/t) in soft contact lenses (SCLs) which might preclude SCL-driven corneal neovascularization (NV) in healthy myopic SCL users. Methods: Twenty subjectively successful SCL-wearing patients who presented with asymptomatic but active peripheral corneal NV (not ghost vessels) were recruited as study patients. Twenty-one patients who did not have NV were similarly recruited as controls. Demographic data were collected. Corneal NV was documented and photographed. Current habitual SCLs were collected and thicknesses measured to allow for the calculation of both pDk/t and cDk/t and estimation of local tear oxygen tensions. Results: No statistical differences between study and control groups in patient age, refraction, or the numbers of years, days per week, or hours per day patients reported SCL wear were identified. Statistically significant differences were found between the two groups for both pDk/t (P=0.006) and cDk/t (P=0.004): mean (±SD) pDk/t was 38.0±23.5 and 19.2±17.7 Fatt units for control and study corneas, respectively. Mean cDk/t were 80.0±54.4 and 36.8±33.1 Fatt units for control and study corneas, respectively. Peripheral tear oxygen tension that “protected” corneas from vascular filling was over 84 mm Hg. Conclusion: Maintaining a pDk/t above 30 to 40 Fatt units with daily wear SCLs should protect most normal corneas from NV as a complication of SCL wear.

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