Hydrogel contact lens-induced corneal warpage.

BACKGROUND: Although contact lens-induced corneal warpage is most frequently associated with PMMA lenses, approximately 27% of reported cases of corneal warpage have been attributed to hydrogel lens wear. The change in corneal contour may be the result of either mechanical deformation, chronic metabolic insult, or a combination of mechanical and metabolic challenges. Limited oxygen transmissibility through some hydrogel lenses may lead to chronic hypoxia and acidosis. These metabolic challenges can change corneal physiology sufficiently to cause clinically significant corneal warpage. CASE REPORTS: Three cases of hydrogel contact lens-induced corneal warpage are presented. In all three cases, cessation of lens wear led to restoration of the normal corneal contour and visual acuity. All patients were refit with more oxygen-permeable lenses, and have successfully resumed wearing contact lenses.
CONCLUSION: Certain individuals who wear hydrogel contact lenses can experience corneal warpage. Clinical signs of corneal warpage include changes in refractive error, decreased visual acuity with spectacle correction, and changes in corneal topography. Serial topography is useful to monitor the cornea to resolution of the condition. Contact lenses with higher oxygen transmissibility will frequently alleviate the relative hypoxia that may be associated with corneal warpage.