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To determine the density of corneal stromal cells in wearers of soft contact lenses (SCLs) and rigid gas-permeable (RGP) contact lenses (CLs).The keratocyte density (KD) was measured at different depths of the stroma by confocal microscopy. In study 1, 32 wearers of rigid gas-permeable (RGP) lenses and 30 wearers of SCLs were studied. Forty volunteers with no history of CL wear were studied as controls. In study 2, 16 volunteers with no history of CL wear were divided into 2 groups; 7 subjects wore RGP lenses (oxygen transmissibility, Dk/L, 35) and 9 subjects wore SCLs (Dk/L, 34). All subjects were asked to wear the CLs daily for 6 months.In study 1, the KDs in the anterior stroma (AST) and the posterior stroma (PST) of the cornea were significantly lower in the RGP lens group than in the control group. The KD in the SCL group was significantly lower at all depths of the cornea than that of the control group. In study 2, the KD in the AST of the RGP lens group was significantly lower after 1 month of CL wear. The KD in the AST and PST of the SCL group was decreased significantly at 1 month, and all layers were decreased by 10% to 20% 6 months after wearing CLs. At 5 weeks after discontinuation of SCL wear, the KD in all layers was not significantly different from that at the baseline.The change in the KD was greater in CL wearers than in volunteers with no history of CL wear and also greater in SCL wearers than in RGP lens wearers. Analysis of the KD by confocal microscopy may be a useful method for evaluating the effect of CL wear.