Inflammatory Cell Upregulation of the Lid Wiper in Contact Lens Dry Eye

Purpose. To determine if Langerhans cells in the lid wiper are upregulated in contact lens-induced dry eye (CLIDE). Methods. The lid wiper of one eye of 17 participants with CLIDE (assessed using the CLDEQ-8) and 29 without CLIDE (NO-CLIDE) was examined using a Heidelberg laser scanning confocal microscope after 6 months wear of daily disposable hydrogel contact lenses (Biomedics 1 day Extra). Twenty non-contact-lens-wearing controls were also examined. Langerhans cell density (LCD) in each participant was taken as the mean cell count calculated manually from six clear, randomly selected images of known dimensions. Results. There were significant overall differences in LCD in the lid wiper among the three groups (p < 0.001). LCD was significantly greater in the lid wiper in CLIDE (17 +/- 10 cells/mm(2)) compared to controls (8 +/- 4 cells/mm2) (p < 0.001); however, there was no difference in LCD between NO-CLIDE (10 +/- 5 cells/mm(2)) and controls (p = 0.489). LCD was significantly greater in CLIDE than NO-CLIDE (p = 0.002). Conclusions. Langerhans cells in the lid wiper are upregulated in CLIDE, suggesting an inflammatory component in the etiology of this condition.