Specular microscopy of hard contact lens wearers.

Wide-field specular microscopy, slit-lamp examination, and pachometry were performed on 22 successful hard contact lens wearers and 22 controls matched for age, race, sex, and refractive error. A minimum of 600 cells per control and 1200 per contact lens wearer were manually digitized from the specular photomicrographs. Frequency distributions of cell areas were compared between the two groups using the parameters of mean, median, standard deviation, coefficient of variation, skewness and kurtosis. Slit-lamp examination was normal and there was no significant difference in corneal thickness between the patient group and the control group. Comparison of mean, median, and standard deviation also revealed no significant difference, but skewness (P less than .001), kurtosis (P less than .001) and coefficient of variation (P less than .004) were greater in the hard contact lens wear group. Hard contact lens wearing time correlated with increasing pleomorphism (P less than .05). Specular microscopy also revealed morphologic changes including deep stromal striae, intra- and extracellular "blackout" areas, and clustering of extremely small and large cells. The possible relationship between endothelial hypoxia and structural stromal changes are discussed.