Evaluation of tear protein deposits on contact lenses from patients with and without giant papillary conjunctivitis.

Giant papillary conjunctivitis (GPC) associated with contact lens wear is believed to result from an irritative or allergic response to accumulated lens surface deposits. In a masked study, contact lenses worn short-term (2 weeks or less) or long-term (2-12 months), and obtained from patients with and without active GPC, were examined for deposited proteins: IgA, IgE, IgG, IgM, lactoferrin, and lysozyme. Using immunohistochemical methods lenses were separately graded on a 4+ scale for extent of protein coverage. All lenses showed substantial deposits (averaging 50-75% lens coverage) of the normal tear proteins, with the exception of IgE which averaged less than 25% lens coverage; maximum protein deposition was apparent on lenses worn for only 3 days. Both symptomatic and asymptomatic persons deposited similar amounts of the common tear proteins on their contact lenses, with the exception of IgM. A statistically significant increase in IgM deposition was found when the short-term GPC lenses were compared to short-term asymptomatic lenses. Our data suggest that the development of GPC does not depend on amount of deposition of the normal tear proteins IgA, IgG, IgE, lactoferrin or lysozyme. Differences observed in IgM deposition may reflect an immune response in GPC.