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Bolac R, Beyza Yıldız M, Alpogan O, Un Y, Mangan MS. The effect of extended periods of mini-scleral lens wear on the conjunctival/episcleral and scleral thickness. Cont Lens Anterior Eye 2024:102289. [PMID: 39217052 DOI: 10.1016/j.clae.2024.102289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/19/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE To evaluate the conjunctival/episcleral thickness (CET) and anterior scleral thickness (AST) in patients with keratoconus with an extended duration of mini-scleral contact lens wear by utilizing anterior segment optical coherence tomography (ASOCT). METHODS This study included 17 eyes of 17 patients with keratoconus with mini-scleral contact lens wear (Group 1), 20 eyes of 20 patients with keratoconus without any contact lens wear (Group 2), and 20 eyes of 20 healthy controls (Group 3). CET and AST were measured using AS-OCT (Triton, Topcon, Japan) at 1, 2, and 3 mm posterior to the scleral spur in the nasal, temporal, superior, and inferior quadrants. RESULTS The median age of the mini-scleral contact lens group was 26, and the number of male patients was 14 (82.4 %). The superior CET values at 1 mm, 2 mm, and 3 mm statistically differed between the groups, with Group 1 having significantly lower values than Group 3 and Group 2 having statistically similar values to the remaining two groups. The inferior CET at 2 mm was lower in Groups 1 and 2 than in Group 3. The inferior CET at 3 mm was lower in Group 1 compared to Groups 2 and 3. AST was similar between the groups at all measured quadrants and distances. The duration of lens wear had a strong, statistically significant, negative correlation with the superior CET at 2 mm (rho: -0.847, p < 0.001) and a moderate, statistically significant, negative correlation with the superior CET at 3 mm (rho: -0.506, p < 0.038). CONCLUSIONS In this study, it was found that mini-scleral contact lens usage causes thinning in the conjunctival-episcleral layer, especially in the superior and inferior quadrants, but does not affect scleral thickness. AS-OCT is a non-invasive and clinically applicable technique for assessing the impact of contact lens use on the conjunctiva/episclera and sclera.
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Affiliation(s)
- Ruveyde Bolac
- University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey.
| | - Merve Beyza Yıldız
- University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
| | - Oksan Alpogan
- University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
| | - Yasemin Un
- University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
| | - Mehmet Serhat Mangan
- University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
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Fogt JS, Schornack M, Nau C, Harthan J, Nau A, Shorter E. Image- and Impression-Based Technology in Scleral Lens Fitting for Keratoconus: Availability and Utilization. Eye Contact Lens 2024; 50:292-296. [PMID: 39078501 PMCID: PMC11296498 DOI: 10.1097/icl.0000000000001100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Indexed: 07/31/2024]
Abstract
OBJECTIVE Scleral lenses (SLs) can be customized using traditional diagnostic lens fitting or by using image- and/or impression-based technologies. This study describes the availability and usage of SL fitting technology in patients with keratoconus. METHODS An online survey queried practitioners on the mode of practice, country of residence, and estimated number of SL fits completed for keratoconus. Practitioners were asked whether they had access to image- and/or impression-based technology and to estimate the percentage of fits completed using diagnostic fitting, image-based technology, and impression-based technology. Access and usage of technology was compared between academic and community practices, United States and non-United States, and high-volume (≥60 SLs) and low-volume fitters. RESULTS 423 practitioners who fit SL for keratoconus participated. Image- and impression-based technologies were more frequently available in academic practices compared with community practices and high-volume compared with low-volume practitioners ( P <0.005). Practitioners with image-based technology used it for a median [interquartile range] 5 [25]% of SL fittings; those with impression-based technology used it for 8 [9]% of fittings, and those with both types of technology used image-based devices for 12 [23]% of fittings and impression-based for 5 [8]% of fittings. CONCLUSIONS In this study, most participants report using diagnostic lenses to fit SLs for patients with keratoconus.
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Affiliation(s)
- Jennifer Swingle Fogt
- The Ohio State University (J.S.F.), 338 West 10th Avenue, Columbus, OH, USA; Mayo Clinic, Rochester, 200 1 St SW, MN, USA; The Illinois College of Optometry, 3241 S Michigan Ave, Chicago, IL, USA; Korb and Associates, 400 Commonwealth Ave, Boston, MA, USA; and University of Illinois at Chicago, 1855 W Taylor St., Chicago IL, USA
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Martínez-Plaza E, López-de la Rosa A, Molina-Martín A, Piñero DP. Orthokeratology effect on the corneoscleral profile: Beyond the bull's eye. Ophthalmic Physiol Opt 2024; 44:757-768. [PMID: 38240175 DOI: 10.1111/opo.13279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/08/2024] [Accepted: 01/09/2024] [Indexed: 05/01/2024]
Abstract
PURPOSE To assess the impact of 3 months of orthokeratology (ortho-k) contact lenses (CLs) for myopia correction on the corneoscleral profile, as changes in scleral geometry could serve as indirect evidence of alteration in the corneal biomechanical properties. METHODS Twenty subjects (40 eyes) were recruited to wear ortho-k lenses overnight; however, after discontinuation (two CL fractures, one under-correction and two non-serious adverse events), 16 subjects (31 eyes) finished a 3-month follow-up. Corneoscleral topographies were acquired using the Eye Surface Profiler (ESP) system before and after 3 months of lens wear. Steep (SimKs) and flat (SimKf) simulated keratometry and scleral sagittal height measurements for 13-, 14- and 15-mm chord lengths were automatically calculated by the ESP software. Additionally, sagittal height and slope were calculated in polar format from 21 radii (0-10 mm from the corneal apex) at 12 angles (0-330°). Linear mixed models were fitted to determine the differences between visits. RESULTS SimKs and SimKf were increased significantly (p ≤ 0.02). The sagittal height in polar format increased significantly (p = 0.046) at a radius of 2.5 mm for 150°, 180°, 210° and 240° orientations and at a radius of 3.0 mm for 210°. Additionally, the slope in polar format significantly decreased (p ≤ 0.04) at radii ranges of 0.0-0.5, 0.5-1.0 and 1.0-1.5 mm for multiple angles and at a radii range of 5.0-5.5 mm for 90°. It also increased significantly (p ≤ 0.045) at a radii range of 1.5-2.0 mm for 30° and at radii ranges of 2.0-2.5, 2.5-3.0 and 3.0-3.5 mm for multiple angles. No significant changes were found for any parameter measured from the scleral area. CONCLUSIONS Three months of overnight ortho-k lens wear changed the central and mid-peripheral corneal geometry as expected, maintaining the peripheral cornea and the surrounding sclera stability.
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Affiliation(s)
- Elena Martínez-Plaza
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- University of Valladolid, Valladolid, Spain
| | - Alberto López-de la Rosa
- Department of Theoretical Physics, Atomic and Optics, University of Valladolid, Valladolid, Spain
- Instituto de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
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Martínez-Plaza E, Molina-Martín A, Piñero DP. Reliability and Agreement of Keratometry Measurements Obtained With Eye Surface Profilometry and Partial Coherence Interferometry. Cornea 2024; 43:343-348. [PMID: 37487176 DOI: 10.1097/ico.0000000000003348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 06/09/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE The aim of this study was to assess the repeatability of keratometry parameters obtained using the Eye Surface Profiler (ESP) system and their agreement with the IOL Master 500 device. METHODS Seventy-one eyes of 71 healthy participants were evaluated. Three repeated measurements were performed using the ESP system. Simulated keratometry in the flat (SimKf) and steep (SimKs) meridians, astigmatism, and axis were obtained. The same parameters were measured using the IOL Master 500 device. The J0 and J45 vector components of the astigmatism were calculated. The intrasession repeatability was analyzed using within-subject SD (Sw) and intraclass correlation coefficient (ICC). Agreement was assessed using paired statistical tests and the Bland-Altman method. RESULTS The Sw was 0.07 mm, 0.04 mm, 0.51 D, 0.33 D, and 0.22 D, and the ICC was 0.96, 0.98, 0.74, 0.61, and 0.55 for SimKf, SimKs, astigmatism, J0, and J45, respectively. The mean difference and limits of agreement when comparing the ESP system with the IOL Master 500 device were 0.37 mm (0.08/0.66) for SimKf ( P < 0.001), 0.18 mm (0.00/0.35) for SimKs ( P < 0.001), -0.93 D (-2.42/0.56) for astigmatism ( P < 0.001), 0.51 D (-0.22/1.24) for J0 ( P < 0.001), and 0.06 D (-0.48/0.60) for J45 ( P = 0.09). CONCLUSIONS The ESP system provides consistent values for simulated keratometry, showing moderate consistency for astigmatism parameters. Contact lens practitioners should be aware that the ESP system and IOL Master 500 device provide different simulated keratometry from a clinically viewpoint.
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Affiliation(s)
- Elena Martínez-Plaza
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- University of Valladolid, Valladolid, Spain; and
| | - Ainhoa Molina-Martín
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain
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Consejo A, Roman DM, Roll V, Remon L. Relationship between corneal tissue and shape in short-term soft contact lens wear. Ophthalmic Physiol Opt 2023; 43:1372-1378. [PMID: 37551625 DOI: 10.1111/opo.13211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023]
Abstract
PURPOSE To investigate which morphometric and ocular surface tissue parameters are affected by short-term soft contact lens (CL) wear and to assess whether they carry related or independent information. METHODS Twenty-two healthy participants wore silicone hydrogel (SiHy; MyDay, CooperVision) soft CLs for 8 h in their left eye. Corneal tomography and corneoscleral topography were captured before and immediately after CL wear. Central corneal thickness (CCT), corneoscleral parameters (limbus position and corneoscleral junction [CSJ] angle) and corneal tissue parameters (corneal transparency and homogeneity) were evaluated. RESULTS Corneoscleral parameters (limbus position and CSJ angle) were independent of corneal tissue parameters (transparency and homogeneity) at baseline and after CL wear. CCT was independent of all the other parameters examined at baseline, but baseline values of corneal tissue parameters were moderately correlated with CCT change (transparency: r = -0.51; p = 0.007), homogeneity: r = -0.46; p = 0.02). CONCLUSIONS A complete characterisation of ocular surface changes following CL wear should consider corneoscleral topography and corneal densitometry simultaneously, since they carry complementary information.
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Affiliation(s)
- Alejandra Consejo
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
- Aragon Institute for Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Denisa M Roman
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
| | - Vanesa Roll
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
| | - Laura Remon
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
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Consejo A, Roll V, Roman DM, Remon L. The influence of soft contact lens material on the corneoscleral profile. Ophthalmic Physiol Opt 2023; 43:1364-1371. [PMID: 37376806 DOI: 10.1111/opo.13193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE To objectively quantify changes in corneoscleral profile, as evaluated by the limbus position and corneoscleral junction (CSJ) angle, as a consequence of wearing different soft contact lens (CL) materials. METHODS Twenty-two healthy participants wore silicone hydrogel (SiHy, MyDay, CooperVision) and hydrogel (Hy, Biomedics 1 day extra, CooperVision) soft CLs for 8 h per lens in their left eye. In each session, corneoscleral topography was captured before and immediately after CL removal with an Eye Surface Profiler. Previously validated automatic and objective algorithms for limbal position and CSJ angle calculation were applied to 360 semi-meridians to investigate the effect of short-term CL wear on corneoscleral topography, globally and by sectors, depending on the soft CL material worn. RESULTS Short-term soft CL wear significantly impacted limbal position (SiHy: 120 ± 97 μm, Hy: 128 ± 85 μm) and CSJ angle (SiHy: 0.57 ± 0.36°, Hy: 0.55 ± 0.40°); all p < 0.05. A statistically significant difference was found between the sectors with regard to limbus position and CSJ angle before CL wear that remained following lens wear (all pairwise comparisons, p < 0.001). Although individual differences were observed, there was no evidence that one material caused more substantial corneoscleral alterations. CONCLUSION Corneoscleral profile parameters were altered significantly following 8 h of soft CL wear. The observed changes in limbus position and CSJ angle support the importance of participant-material biocompatibility.
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Affiliation(s)
- Alejandra Consejo
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
- Aragon Institute for Engineering Research (I3A), University of Zaragoza, Zaragoza, Spain
| | - Vanesa Roll
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
| | - Denisa M Roman
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
| | - Laura Remon
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
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Consejo A, Trillo-Moreno I, Remon L. Corneal tissue changes following short-term soft contact lens wear of different materials. Ophthalmic Physiol Opt 2023; 43:35-45. [PMID: 36408647 PMCID: PMC10099478 DOI: 10.1111/opo.13067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/11/2022] [Accepted: 10/24/2022] [Indexed: 11/22/2022]
Abstract
PURPOSE To study the effect of different soft contact lens (CL) materials during short-term wear on corneal tissue. METHODS Twenty-two healthy participants wore both silicone hydrogel (MyDay, CooperVision) and hydrogel soft CLs (Biomedics 1 day extra, CooperVision) for 8 h per lens. In each session, Scheimpflug images were captured before and immediately after CL removal. Images were analysed using the densitometry distribution analysis, a technique from which two parameters, α (corneal transparency) and β (corneal homogeneity), were estimated. In addition, the central corneal thickness changes after CL wear and the influence of the CL material on corneal transparency were evaluated. RESULTS The β parameter (homogeneity) increased by 5% after wearing both CL materials (paired t-test, p < 0.001). However, the α parameter (transparency) only increased in half of the participants. No material was found to be more determinant in causing the corneal densitometry changes. Statistically significant but not clinically relevant changes in corneal thickness were observed. CONCLUSIONS Biomarkers of corneal tissue integrity (α and β) were affected by short-term soft contact lens wear. The observed changes in corneal transparency and homogeneity were not clinically relevant but support the importance of participant-material biocompatibility.
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Affiliation(s)
- Alejandra Consejo
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
| | | | - Laura Remon
- Department of Applied Physics, University of Zaragoza, Zaragoza, Spain
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Deboutte I, Kreps EO, Rozema JJ, van Hoey M, Anthonissen L, Koppen C. Influence of Specialty Contact Lens Wear on Posterior Corneal Tomography in Keratoconus Subjects. Eye Contact Lens 2022; 48:497-502. [PMID: 36137997 DOI: 10.1097/icl.0000000000000941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 08/04/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To evaluate the effect of specialty contact lens (CL) wear on posterior corneal tomography in keratoconus subjects. METHODS Patients with keratoconus who were wearing specialty CL were included in this retrospective cohort study. Tomographic parameters were evaluated with Scheimpflug imaging (Pentacam HR) before lens fitting and immediately after removal of CLs worn habitually for a period of several months. Subjects were divided into groups, according to type of lens (corneal, scleral, and hybrid) and keratoconus severity based on Belin/Ambrosio D (BAD-D) score, for further analysis. RESULTS Thirty-four eyes of 34 subjects diagnosed with keratoconus were included. Mean duration of habitual CL wear was 7.0±0.3 months. For the entire cohort, a small increase in flat keratometric reading at the anterior corneal surface (K1F; P =0.032) and at the posterior surface (K1B; P =0.041) was found. In the corneal CL group (10 eyes; 29.4%), flattening of the anterior corneal curvature was detected (K max ; P =0.015). An increase in K1B value was seen in the scleral CL group (15 eyes; 44.1%) ( P =0.03). Combined topometric indices showed a small but significant difference in the entire cohort ( P <0.05) and in the subgroups of corneal CL wear and of moderate keratoconus (BAD-D score≥7). CONCLUSION Various types of specialty CLs exert a differential influence on corneal parameters. A small steepening of keratometry at the posterior surface (K1B) was observed in the scleral lens group. Although corneal lens wear flattens the anterior cornea (K max ), it does not significantly alter the posterior corneal surface.
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Affiliation(s)
- Isabel Deboutte
- Department of Ophthalmology (I.D., J.R., M.H., L.A., C.K.), Antwerp University Hospital, Edegem, Belgium ; Department of Ophthalmology (E.O.K.), Ghent University Hospital, Ghent, Belgium ; and Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences (J.R., C.K.), University of Antwerp, Antwerp, Belgium
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Valdes G, Romaguera M, Serramito M, Cerviño A, Gonzalo Carracedo G. OCT applications in contact lens fitting. Cont Lens Anterior Eye 2021; 45:101540. [PMID: 34799247 DOI: 10.1016/j.clae.2021.101540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 10/03/2021] [Accepted: 11/08/2021] [Indexed: 11/15/2022]
Abstract
Optical Coherence Tomography (OCT) is a noninvasive, high-speed, high-resolution imaging technology based in the Michaelson interferometry. A near-infrared light beam is used to register the intensity variations for the light backscattered on each sample layer. Due to the high repeatability on corneal measurements, spectral domain OCT (SD-OCT) is the gold standard when talking about in vivo, non-invasive anterior segment imaging. Changes in the morphology of various ocular surfaces such as the cornea, conjunctiva, limbus or tear film with soft (SCL), rigid, corneal or scleral lens (SL) wear can be described by OCT measurements. For instance, evaluation of the corneoscleral region is essential on SL fitting. For orthokeratology lenses central epithelial thinning and peripheral thickening and their regression could be quantified with OCT after Ortho-K lens wear. Blood vessel compression on the landing zone as well as vault thickness and fluid reservoir (FR) turbidity could be imaged with OCT. Tear film evaluation on contact lens wearers is essential because its use could lead to variations on the biochemical components in tears. Changes in tear meniscus dynamics and several parameters such as volume (TMV), tear meniscus height (HMT) and turbidity could be determined with OCT and positively correlated with the instillation of different ophthalmic solutions with Non-Invasive Break Up Time (NIBUT) and Schirmer test values. This manuscript shows the increasing applicability of OCT technology for the in vivo characterization of contact lens fitting and interaction with the ocular surface in a faster, safer and non-invasive way. Future research will still allow exploring OCT imaging to its full potential in contact lens practice, as there is still a significant amount of information contained in the images that are not yet easy to extract, analyze and give clinical value.
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Affiliation(s)
- Gonzalo Valdes
- Ocupharm Research Group, Faculty of Optic and Optometry, Universidad Complutense de Madrid, Madrid, Spain.
| | - Maria Romaguera
- Ocupharm Research Group, Faculty of Optic and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Maria Serramito
- Ocupharm Research Group, Faculty of Optic and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Alejandro Cerviño
- Optometry Research Group, Department of Optics, Optometry and Vision Sciences, Universidad de Valencia, Valencia, Spain
| | - G Gonzalo Carracedo
- Ocupharm Research Group, Faculty of Optic and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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Niyazmand H, Read SA, Atchison DA. Repeatability of Anterior Eye Surface Topography Parameters from an Anterior Eye Surface Profilometer. Optom Vis Sci 2021; 98:1203-1209. [PMID: 34620781 DOI: 10.1097/opx.0000000000001789] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Anterior eye shape measurements are important for clinical contact lens fitting. The detailed assessment of measurement repeatability using the Eye Surface Profiler (ESP; Eaglet Eye B.V., AP Houten, the Netherlands) allows for more reliable interpretation of eye surface topography measurements. PURPOSE This study aimed to determine the repeatability of the ESP for anterior central corneal power and anterior eye surface height measurements. METHODS A Badal optometer was mounted on the ESP to provide an external fixation target with appropriate accommodation control and refractive correction. Forty-five healthy young adults underwent two sessions of anterior eye measurements, separated by 20 minutes, using the ESP. In each session, three consecutive scans were captured. Sagittal height data were obtained from 8-mm central cornea and from 8- to 14-mm diameter (encompassing the corneal periphery and anterior sclera). Anterior corneal powers were determined from the central cornea. Intersessional and intrasessional repeatability values were determined as coefficients of repeatability and root mean square error differences. RESULTS Sagittal height intersessional coefficients of repeatability for central nasal (5 μm) and central temporal (7 μm) were better than peripheral nasal (24 μm) and peripheral temporal (21 μm) regions. Sagittal height intrasessional coefficients of repeatability were 9, 8, 28, and 31 μm for central nasal, central temporal, peripheral nasal, and peripheral temporal regions, respectively. Intersessional coefficients of repeatability of mean sphere, 90/180° (J0) astigmatism, and oblique (J45) astigmatism were 0.67, 0.22, and 0.13 D, respectively, with corresponding intrasessional coefficients of repeatability of 1.27, 0.21, and 0.27 D. CONCLUSIONS The modified measuring procedure for the ESP used in this study provides highly repeatable sagittal height measurements in the central cornea but is less repeatable in the corneal periphery and scleral region. Results of the current study can be considered when using ESP in the interpretation of anterior eye surface shape measurements and in contact lens fitting and design.
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Affiliation(s)
| | - Scott A Read
- Contact Lens and Visual Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland University of Technology, Queensland, Australia
| | - David A Atchison
- Visual and Ophthalmic Optics Laboratory, Centre for Vision and Eye Research, School of Optometry and Vision Science, Kelvin Grove, Queensland University of Technology, Queensland, Australia
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Bataille L, Molina-Martin A, Piñero DP. Intrasession repeatability of corneal, limbal and scleral measurements obtained with a fourier transform profilometer. Cont Lens Anterior Eye 2020; 44:101382. [PMID: 33243586 DOI: 10.1016/j.clae.2020.11.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/08/2020] [Accepted: 11/10/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE To evaluate the intrasession repeatability of corneal, limbal and scleral measurements obtained by an experienced operator with a Fourier transform profilometer in healthy eyes. METHODS Prospective, single-center study including 35 eyes of 35 participants with ages ranging from 13 to 52 years. All patients underwent three consecutive corneoscleral topographic evaluations with the Eye Surface Profiler (ESP) system (Eaglet Eye b.v.). Intrasession repeatability was analyzed for different geometric and sagittal height variables using the following parameters: the within-subject standard deviation (Sw) of the three consecutive measurements, intrasubject precision (1.96 × Sw), coefficient of variation (CV) and the intraclass correlation coefficient (ICC). RESULTS Inner best fit sphere (BFS) showed good repeatability, with ICC of 0.844. Higher variability was observed for the repeated measurements of limbus and outer BFS, with ICCs of 0.636 and 0.739, respectively. For mean corneal and scleral radius, ICCs were 0.933 and 0.888, respectively. The repeatability of all sagittal height data was good for all chords evaluated (11-15 mm), with Sw values from 0.02 to 0.11 mm, and ICCs from 0.568 to 0.909. A significant positive correlation was found between the magnitude of temporal-nasal sagittal height difference for all measured chords and its Sw associated. CONCLUSION The ESP system can provide consistent measurements of sagittal height data for different chord diameters as well as for mean corneal and scleral radius in healthy eyes. Best fit approaches for limbal and scleral areas were less repeatable, although within a clinically acceptable range.
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Affiliation(s)
- Laurent Bataille
- Group of Optics and Visual Perception. Department of Optics, Pharmacology and Anatomy, University of Alicante, Spain
| | - Ainhoa Molina-Martin
- Group of Optics and Visual Perception. Department of Optics, Pharmacology and Anatomy, University of Alicante, Spain
| | - David P Piñero
- Group of Optics and Visual Perception. Department of Optics, Pharmacology and Anatomy, University of Alicante, Spain; Department of Ophthalmology, Vithas Medimar International Hospital, Alicante, Spain.
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Kaluzny BJ, Stachura J, Mlyniuk P, Jimenez-Villar A, Wietlicka-Piszcz M, Grulkowski I. Change in the geometry of positive- and negative-powered soft contact lenses during wear. PLoS One 2020; 15:e0242095. [PMID: 33166364 PMCID: PMC7652269 DOI: 10.1371/journal.pone.0242095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 10/27/2020] [Indexed: 11/21/2022] Open
Abstract
Contact lens wear causes mutual interactions between the ocular surface and the lens, which may affect comfort as well as vision. The aim of this study was to examine deformations in modern positive- and negative-powered silicone hydrogel soft contact lenses (SiH SCLs) after 7 days of continuous wear. This pre-post interventional study included 64 eyes: 42 eyes with myopia of -3.00 D and 22 eyes with hyperopia of +3.00 D. All patients underwent general ophthalmic examination, corneal topography/tomography, total corneal and epithelial thickness mapping, and specular microscopy before and after the wearing period. SiH SCLs made of senofilcon A were worn continuously for 7 days on all eligible eyes. The geometry of the new and used lenses was measured 3 to 6 minutes after removal in two perpendicular planes using a custom-made swept source optical coherence tomography (SS-OCT) system for in vitro measurements. The anterior and posterior radii of curvature decreased in -3.00 D lenses in two perpendicular planes. This effect correlated significantly with average keratometry of the cornea. Sagittal lens height was lower in +3.00 D lens after wear, which correlated moderately with the corneal sagittal height. A significant decrease in central corneal epithelial thickness was observed after wearing +3.0 D lenses. In conclusion, SiH SCLs made of senofilcon A undergo minor deformations after 7-day continuous wear. Geometry modifications are different for -3.00 D and +3.00 D lenses, and they imitate the shape of the anterior eye surface. These geometric changes are accompanied by a decrease in the central thickness of corneal epithelium after +3.00 D lens wear.
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Affiliation(s)
- Bartlomiej J. Kaluzny
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
- * E-mail:
| | - Joanna Stachura
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Patryk Mlyniuk
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Alfonso Jimenez-Villar
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
| | - Magdalena Wietlicka-Piszcz
- Department of Theoretical Foundations of Biomedical Sciences and Medical Information Technology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
| | - Ireneusz Grulkowski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
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Consejo A, Wu R, Abass A. Anterior Scleral Regional Variation between Asian and Caucasian Populations. J Clin Med 2020; 9:jcm9113419. [PMID: 33113864 PMCID: PMC7692638 DOI: 10.3390/jcm9113419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/13/2020] [Accepted: 10/21/2020] [Indexed: 02/06/2023] Open
Abstract
Purpose: To evaluate the anterior scleral shape regional differences between Asian and Caucasian populations. Methods: The study included 250 Asian eyes and 235 Caucasian eyes from participants aged 22 to 67 years (38.5 ± 7.6). Three-dimensional (3D) corneo-scleral maps were acquired using a corneo-scleral topographer (Eye Surface Profiler, Eaglet Eye BV) and used to calculate sagittal height. For each 3D map, the sclera (maximum diameter of 18 mm) and cornea were separated at the limbus using an automated technique. Advanced data processing steps were applied to ensure levelled artefact-free datasets to build an average scleral shape map for each population. Results: Statistically, Asian and Caucasian sclerae are significantly different from each other in sagittal height (overall sclera, p = 0.001). The largest difference in sagittal height between groups was found in the inferior-temporal region (271 ± 203 µm, p = 0.03), whereas the smallest difference was found in the superior-temporal region (84 ± 105 µm, p = 0.17). The difference in sagittal height between Caucasian and Asian sclera increases with the distance from the limbus. Conclusions: Asian anterior sclera was found to be less elevated than Caucasian anterior sclera. However, the nasal area of the sclera is less elevated than the temporal area, independently of race. Gaining knowledge in race-related scleral topography differences could assist contact lens manufacturers in the process of lens design and practitioners during the process of contact lens fitting.
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Affiliation(s)
- Alejandra Consejo
- Institute of Physical Chemistry, Polish Academy of Sciences, 01-224 Warsaw, Poland;
- Department of Applied Physics, University of Zaragoza, 50009 Zaragoza, Spain
| | - Richard Wu
- Department of Optometry, Central Taiwan University of Science and Technology, Taichung City 40601, Taiwan;
- College of Optometry, Pacific University, Forest Grove, OR 97116, USA
| | - Ahmed Abass
- School of Engineering, University of Liverpool, Liverpool L69 3GH, UK
- Correspondence:
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Walker MK, Schornack MM, Vincent SJ. Anatomical and physiological considerations in scleral lens wear: Conjunctiva and sclera. Cont Lens Anterior Eye 2020; 43:517-528. [PMID: 32624363 DOI: 10.1016/j.clae.2020.06.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/17/2020] [Accepted: 06/18/2020] [Indexed: 12/20/2022]
Abstract
While scleral lenses have been fitted using diagnostic lenses or impression moulding techniques for over a century, recent advances in anterior segment imaging such as optical coherence tomography and corneo-scleral profilometry have significantly improved the current understanding of the anatomy of the anterior eye including the morphometry of the conjunctiva, sclera, and corneo-scleral junction, as well as the ocular surface shape and elevation. These technological advances in ocular imaging along with continual improvements and innovations in scleral lens design and manufacturing have led to a global increase in scleral lens prescribing. This review provides a comprehensive overview of the conjunctiva and sclera in the context of modern scleral lens practice, including anatomical variations in healthy and diseased eyes, the physiological impact of scleral lens wear, potential fitting challenges, and current approaches to lens modifications in order to minimise lens-induced complications and adverse ocular effects. Specific topics requiring further research are also discussed.
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Affiliation(s)
- Maria K Walker
- University of Houston College of Optometry, The Ocular Surface Institute, Houston, USA
| | | | - Stephen J Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Contact Lens and Visual Optics Laboratory, Institute of Health and Biomedical Innovation, Queensland, Australia.
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15
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Consejo A, Rozema JJ. In vivo anterior scleral morphometry, axial length and myopia. Cont Lens Anterior Eye 2020; 43:21-25. [DOI: 10.1016/j.clae.2018.10.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 10/26/2018] [Accepted: 10/26/2018] [Indexed: 12/01/2022]
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16
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Macedo-de-Araújo RJ, van der Worp E, González-Méijome JM. In vivo assessment of the anterior scleral contour assisted by automatic profilometry and changes in conjunctival shape after miniscleral contact lens fitting. JOURNAL OF OPTOMETRY 2019; 12:131-140. [PMID: 30393001 PMCID: PMC6449784 DOI: 10.1016/j.optom.2018.10.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 09/17/2018] [Accepted: 10/01/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE To compare the shape of the anterior sclera of candidates to scleral lens (ScCL) fitting with regular and irregular corneas and analyze the changes induced in the shape of the sclero-conjunctiva after ScCL wear. METHODS Thirty-five eyes of 18 subjects (19 eyes with irregular corneas and 16 with regular corneas) were consecutively recruited. Three measures of sclero-conjunctival shape were taken with Eye Surface Profiler (ESP, Eaglet Eye, Houten, The Netherlands). Tangent angles and ocular sagittal heights (OC-SAG) were analyzed at different chords from 13 to 17mm in the nasal, temporal, superior and inferior regions. The 19 eyes with irregular cornea were selected to wear ScCL and the changes in their sclero-conjunctival surface parameters were compared before and after 3h of lens wear. RESULTS Irregular corneas showed higher OC-SAG values than regular corneas in all the chords analyzed, with statistical significant differences in the temporal region. Regarding tangent angles, regular corneas showed lower values (flatter surface), with statistical significant differences at 8 and 8.50mm on the nasal and 8.50mm on the temporal region. Some changes were seen in sclero-conjuctival shape after short-term ScCL wear. There was an augment in OC-SAG after 3h of scleral lens wear and a reduction on tangent angles, namely on the nasal region at 7.5mm and 8.00mm chord lengths, which is coincidental with the landing zone of ScCL. CONCLUSIONS ESP shows mild differences in scleral shape between eyes with regular and irregular corneas. ESP might be valuable in quantifying the mechanical impact of the ScCL on the anterior eye surface.
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Affiliation(s)
| | - Eef van der Worp
- Eye-Contact-Lens Research & Education, Amsterdam, The Netherlands
| | - José Manuel González-Méijome
- Clinical & Experimental Optometry Research Lab (CEORLab), Center of Physics, University of Minho, Braga, Portugal
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17
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Anterior eye surface changes following miniscleral contact lens wear. Cont Lens Anterior Eye 2019; 42:70-74. [DOI: 10.1016/j.clae.2018.06.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 12/16/2022]
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Affiliation(s)
- Alejandra Consejo
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
- Department of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
- Department of Biomedical Engineering, Wroclaw University of Science and Technology, Wroclaw, Poland
- Institute of Physical Chemistry, Polish Academy of Sciences, Warsaw, Poland
| | - Tomasz Melcer
- Department of Biomedical Engineering, Wroclaw University of Science and Technology, Wroclaw, Poland
| | - Jos J. Rozema
- Department of Ophthalmology, Antwerp University Hospital, Edegem, Belgium
- Department of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Consejo A, Behaegel J, Van Hoey M, Iskander DR, Rozema JJ. Scleral asymmetry as a potential predictor for scleral lens compression. Ophthalmic Physiol Opt 2018; 38:609-616. [DOI: 10.1111/opo.12587] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 10/16/2018] [Indexed: 12/26/2022]
Affiliation(s)
- Alejandra Consejo
- Department of Ophthalmology; Antwerp University Hospital; Edegem Belgium
- Department of Medicine and Health Sciences; University of Antwerp; Antwerp Belgium
- Department of Biomedical Engineering; Wroclaw University of Science and Technology; Wroclaw Poland
| | - Joséphine Behaegel
- Department of Medicine and Health Sciences; University of Antwerp; Antwerp Belgium
- Department of Ophthalmology; Brussels University Hospital; Jette Belgium
| | - Maarten Van Hoey
- Department of Ophthalmology; Antwerp University Hospital; Edegem Belgium
| | - D Robert Iskander
- Department of Biomedical Engineering; Wroclaw University of Science and Technology; Wroclaw Poland
| | - Jos J Rozema
- Department of Ophthalmology; Antwerp University Hospital; Edegem Belgium
- Department of Medicine and Health Sciences; University of Antwerp; Antwerp Belgium
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Ang M, Baskaran M, Werkmeister RM, Chua J, Schmidl D, Aranha dos Santos V, Garhöfer G, Mehta JS, Schmetterer L. Anterior segment optical coherence tomography. Prog Retin Eye Res 2018; 66:132-156. [DOI: 10.1016/j.preteyeres.2018.04.002] [Citation(s) in RCA: 216] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 02/20/2018] [Accepted: 04/04/2018] [Indexed: 02/03/2023]
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