From Corneal Epithelium to Endothelium: Long-Term Corneal Changes in Myopic Children Wearing Daily Disposable Hydrogel Soft Contact Lenses

Purpose This study aims to investigate the long-term impact of soft contact lens (SCL) wear on the cornea in children. Methods Twenty-one participants who had worn daily disposable hydrogel SCLs for over 10 years (≥10 h/day, 6 days/week) since ages 8–12 years were recruited, together with age-matched controls without contact lens wear. Corneal epithelial (CET) and stromal thickness (CST) were measured using anterior segment optical coherence tomography in central (2 mm), mid-peripheral (2–5 mm) and peripheral (5–6 mm) annular regions. Corneal endothelium was imaged with a non-contact specular microscope to calculate corneal endothelial cell density (ECD), coefficients of variation of cell size (polymegethism, CV,%) and percentage of hexagonal cells (pleomorphism, HEX,%) in the central and six peripheral regions. Results Participants’ mean age was 21.3 ± 1.2 years in the control group (12 females) and 21.6 ± 1.5 years in the SCL group (10 females). Mean central 2-mm CET and CST were similar between groups (CET: Control vs SCL: 52.4 ± 3.4 vs 52.2 ± 2.5 μm, CST: 478.3 ± 30.8 vs 487.6 ± 23.4, both p > 0.20), with no significant differences in peripheral regions ( p > 0.10). Neither central ECD (3064 ± 249 vs 3076 ± 203 cells/mm 2 ), HEX (67.3 ± 6.8 vs 65.9 ± 7.4%) nor CV (28.0 ± 3.8 vs 29.8 ± 3.8%) differed significantly between groups ( p > 0.10). The SCL group showed significantly higher CV in the superior and superonasal regions only ( p = 0.01), while peripheral ECD and HEX were similar between groups (all p > 0.10). Conclusion Long-term wear of daily disposable hydrogel SCLs in children did not alter CET and CST significantly over a minimum 10-year period. Corneal endothelial integrity and pleomorphism were maintained, with higher polymegethism observed only in two peripheral regions. These findings support daily disposable hydrogel SCLs as a safe and suitable choice for children over a typical myopia control treatment period.