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Neovascularization, Corneal, CL-related

Background

The normal cornea is transparent and maintains itself as an immune privileged site, in part because it is avascular. Ocular insult and ocular hypoxia due to infectious keratitis, immunological conditions, corneal trauma, alkali injury, and contact lens (CL) wear
can encourage new blood vessels to grow from the limbus and, hence, neovascularization (NV).
NV is generally accompanied with an inflammatory response and always represents a state of disease.

With CL wear, superficial NV is more common than deep stromal vessels. It is speculated that deep stromal NV may reflect a more profound insult (hypoxia) compared to that which generates only superficial NV. Both superficial and deep stromal NV are reported with the use of hydrogel, hard (polymethyl methacrylate [PMMA]), rigid gas permeable CLs, and scleral lenses, especially with a history of aphakia, extended wear, poor compliance, low oxygen permeable CLs, long-term CL wear (many years), and poor follow-up care.
Deep stromal NV is serious, possibly leading to loss of optical transparency of the tissue through stromal hemorrhage, scarring, and lipid deposition.

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