A refined model on flow and oxygen consumption in the human cornea depending on the oxygen tension at the interface cornea/post lens tear film during contact lens wear

TFOS Lifestyle: Impact of contact lenses on the ocular surface

Several lifestyle choices made by contact lens wearers can have adverse consequences on ocular health. These include being non-adherent to contact lens care, sleeping in lenses, ill-advised purchasing options, not seeing an eyecare professional for regular aftercare visits, wearing lenses when feeling unwell, wearing lenses too soon after various forms of ophthalmic surgery, and wearing lenses when engaged in risky behaviors (e.g., when using tobacco, alcohol or recreational drugs). Those with a pre-existing compromised ocular surface may find that contact lens wear exacerbates ocular disease morbidity. Conversely, contact lenses may have various therapeutic benefits. The coronavirus disease-2019 (COVID-19) pandemic impinged upon the lifestyle of contact lens wearers, introducing challenges such as mask-associated dry eye, contact lens discomfort with increased use of digital devices, inadvertent exposure to hand sanitizers, and reduced use of lenses. Wearing contact lenses in challenging environments, such as in the presence of dust and noxious chemicals, or where there is the possibility of ocular trauma (e.g., sport or working with tools) can be problematic, although in some instances lenses can be protective. Contact lenses can be worn for sport, theatre, at high altitude, driving at night, in the military and in space, and special considerations are required when prescribing in such situations to ensure successful outcomes. A systematic review and meta-analysis, incorporated within the review, identified that the influence of lifestyle factors on soft contact lens dropout remains poorly understood, and is an area in need of further research. Overall, this report investigated lifestyle-related choices made by clinicians and contact lens wearers and discovered that when appropriate lifestyle choices are made, contact lens wear can enhance the quality of life of wearers.

Corneal optical density: Structural basis, measurements, influencing factors, and roles in refractive surgery

The cornea is the main refractive medium of the human eye, and its clarity is critical to visual acuity. Corneal optical density (COD) is an important index to describe corneal transparency. Intact corneal epithelial and endothelial cells, regular arrangement of collagen fibers in the stroma, and normal substance metabolism are all integral for the cornea to maintain its transparency. In the last two decades, the Pentacam Scheimpflug imaging system has emerged as a breakthrough for the measurement of COD (also called corneal densitometry). It has been found that a wide variety of factors such as age, refractive status, and corneal diseases can affect COD. Different corneal refractive surgery methods also change COD in different corneal regions and layers and affect visual acuity following the surgery. Thus, COD has gradually become a significant indicator to evaluate corneal health, one on which the attention of clinicians has been increasingly focused.

Metabolomics in Corneal Diseases: A Narrative Review from Clinical Aspects

Corneal pathologies may have subtle manifestations in the initial stages, delaying diagnosis and timely treatment. This can lead to irreversible visual loss. Metabolomics is a rapidly developing field that allows the study of metabolites in a system, providing a complementary tool in the early diagnosis and management of corneal diseases. Early identification of biomarkers is key to prevent disease progression. The advancement of nuclear magnetic resonance and mass spectrometry allows the identification of new biomarkers in the analysis of tear, cornea, and aqueous humor. Novel perspectives on disease mechanisms are identified, which provide vital information for potential targeted therapies in the future. Current treatments are analyzed at a molecular level to offer further information regarding their efficacy. In this article, we provide a comprehensive review of the metabolomic studies undertaken in the cornea and various pathologies such as dry eye disease, Sjogren’s syndrome, keratoconus, post-refractive surgery, contact lens wearers, and diabetic corneas. Lastly, we discuss the exciting future that metabolomics plays in cornea research.

A three-dimensional model to describe complete human corneal oxygenation during contact lens wear

We perform a novel 3D study to quantify the corneal oxygen consumption and diffusion in each part of the cornea with different contact lens materials. The oxygen profile is calculated as a function of oxygen tension at the cornea-tear interface and the oxygen transmissibility of the lens, with values used in previous studies. We aim to determine the influence of a detailed geometry of the cornea in their modeling compared to previous low dimensional models used in the literature. To this end, a 3-D study based on an axisymmetric volume element analysis model was applied to different contact lenses currently on the market. We have obtained that the model provides a valuable tool for understanding the flux and cornea oxygen profiles through the epithelium, stroma, and endothelium. The most important results are related to the dependence of the oxygen flux through the cornea-lens system on the contact lens thickness and geometry. Both parameters play an important role in the corneal flux and oxygen tension distribution. The decline in oxygen consumption experienced by the cornea takes place just inside the epithelium, where the oxygen tension falls to between 95 and 16 mmHg under open eye conditions, and 30 to 0.3 mmHg under closed eye conditions, depending on the contact lens worn. This helps to understand the physiological response of the corneal tissue under conditions of daily and overnight contact lens wear, and the importance of detailed geometry of the cornea in the modeling of diffusion for oxygen and other species.

Safe, Durable, and Sustainable Self-Powered Smart Contact Lenses

Smart contact lenses have the potential to serve as noninvasive healthcare devices or virtual displays. However, their implementation is limited by the lack of suitable power sources for microelectronic devices. This Article demonstrates smart contact lenses with fully embedded glucose fuel cells that are safe, flexible, and durable against deformations. These fuel cells produced stable power throughout the day or during intermittent use after storage for weeks. When the lenses were exposed to 0.05 mM glucose solution, a steady-state maximum power density of 4.4 μW/cm² was achieved by optimizing the chemistry and porous structure of the fuel cell components. Additionally, even after bending the lenses in half 100 times, the fuel cell performance was maintained without any mechanical failure. Lastly, when the fuel cells were connected to electroresponsive hydrogel capacitors, we could clearly distinguish between the tear glucose levels under normal and diabetic conditions through the naked eye.

Simulation of time-fractional oxygen diffusion in cornea coated by contact-lens

In this paper, the time-fractional oxygen diffusion has been simulated in a one-dimensional (1D) corneal-contact lens (CL) system. Different CLs have been employed as Balafilcon, thin- and thick-Polymacon. It is assumed that homogeneous and isotropic porous mediums of cornea and CL is saturated with compressible oxygen. The computations of the time-fractional derivations are done based on the Caputo method. The obtained results show that the fractional derivative order (FDO) severely affects pressure distribution in cornea and CL. Consequently, the magnitudes of post-lens-tear-film (PoLTF) pressure change due to diverse FDOs. Particularly, maximum changes have been observed in the results gained from the CLs with thicknesses more than 100 μm. The agreement of the results obtained from the time-fractional modeling with the experimental data compared to the standard diffusion modeling has been improved by more than 36%. Finally, it has been demonstrated that high-thickness CLs can cause exist anomalous diffusion process in cornea tissue.