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Valencia-Nieto L, López-de la Rosa A, López-Miguel A, González-García MJ. Reliability of Tear Meniscus Height Measurements in Contact Lens Wearers and Its Relationship With Discomfort Symptoms. Eye Contact Lens 2024; 50:410-415. [PMID: 39024060 DOI: 10.1097/icl.0000000000001115] [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] [Accepted: 06/07/2024] [Indexed: 07/20/2024]
Abstract
OBJECTIVES To evaluate the reliability and agreement of tear meniscus height (TMH) measurements performed with a corneal analyzer and optical coherence tomography (OCT) technology in contact lens (CL) wearers and its correlation with contact lens discomfort symptoms. METHODS Asymptomatic and symptomatic CL wearers classified through the Contact Lens Dry Eye Questionnaire-8 were evaluated with the Corneal Analyzer (Topcon CA-800) and OCT technology (Topcon 3D OCT-2000). The repeatability and intraclass correlation coefficient (ICC) were calculated. The agreement between devices was calculated using the Bland-Altman method. The relationship between TMH measurements and the Contact Lens Dry Eye Questionnaire-8 and Contact Lens Discomfort Index scores was assessed through the Spearman correlation coefficient. RESULTS Seventy-nine asymptomatic and 42 symptomatic CL wearers aged 34.24±12.50 years were enrolled. The repeatability values obtained for the CA-800 were 0.07 mm in all cases, and the ICC was 0.93 for the whole sample. The CA-800 provided significantly ( P <0.01) higher TMH values than the OCT for the whole sample (0.22±0.08 vs. 0.17±0.06 mm). A weak indirect correlation (ρ=-0.22) between the OCT TMH measurement and Contact Lens Discomfort Index scores was found ( P ≤0.04). CONCLUSION The CA-800 provides reliable TMH measurements during CL wear; however, they might not be interchangeable with OCT ones. Tear meniscus height measurements might be useful as a complementary sign to detect CL discomfort, but it cannot be used alone as a diagnostic tool.
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Affiliation(s)
- Laura Valencia-Nieto
- Instituto de Oftalmobiología Aplicada (IOBA) (L.V.-N., A.L.-R., A.L.-M., M.J.G.-G.), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica (L.V.-N., A.L.-R., M.J.G.-G.), Atómica y Óptica, Facultad de Ciencias, Universidad de Valladolid, Valladolid, Spain; Departamento de Cirugía (A.L.-M.), Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain; and Biomedical Research Networking Center in Bioengineering (M.J.G.-G.), Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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Calderón-García AÁ, López-de la Rosa A, Valencia-Nieto L, García-Vázquez C, Arroyo-Del-Arroyo C, López-Miguel A, Blanco-Vázquez M, Novo-Diez A, Fernández I, Enríquez de Salamanca A, González-García MJ. Tear Cytokines as Predictive Biomarkers of Success in Contact Lens Discomfort Management. Ocul Immunol Inflamm 2024:1-9. [PMID: 38889385 DOI: 10.1080/09273948.2024.2361114] [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: 02/07/2024] [Accepted: 05/23/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE To analyze changes in tear levels of inflammatory mediators in symptomatic contact lens (CL) wearers after refitting with daily disposable CLs and to identify potential biomarkers of success in CL discomfort (CLD) management. METHODS Symptomatic CL wearers (CLDEQ-8 ≥ 12) were refitted (V1) with daily disposable CLs (Delefilcon A). After one month (V2), participants were classified into the post-fitting non-symptomatic (CLDEQ <12) and symptomatic (CLDEQ ≥12) groups. At each visit, the participants were clinically evaluated, tears were collected, and 20 inflammatory mediators and substance P (SP) were measured using multiplex immunobead analysis and ELISA, respectively. The detection rates and concentrations were compared between visits and groups, and logistic regression models were performed. RESULTS Forty-three subjects (32 women/11 men; mean age: 23.2 ± 4.9 years) were enrolled. The IL-1β and IL-9 detection rates were higher at V2 (p ≤ 0.044). The detection rates of IL-1β, IL-9, MIP-1α/CCL3, and MMP-9 at V1 (p ≤ 0.045) and IL-17A at V2 (p ≤ 0.014) were higher in the post-fitting symptomatic group. The tear IL-9 concentration was increased at V2 (p = 0.018). The tear concentrations of fractalkine/CX3CL1, IL-2, IL-6, IL-10, MCP-3/CCL7, MIP-1β, NGF, RANTES/CCL5, and TNF-α were higher in the post-fitting symptomatic group (p ≤ 0.044). Additionally, levels of fractalkine/CX3CL1, IL-2, IL-6, IL-10, RANTES/CCL5, and TNF-α at V1 were significantly associated with the post-fitting grouping (p ≤ 0.044). CONCLUSIONS Low tear concentrations of specific inflammatory mediators may be used as a predictive biomarker of success for refitting symptomatic CL wearers with daily disposable CLs. However, complementary treatments might be required for symptomatic CL wearers with higher levels of these inflammatory molecules.
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Affiliation(s)
- Andrés Ángel Calderón-García
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
- Universidad Católica de Ávila, Ávlia, Spain
| | - Alberto López-de la Rosa
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
- Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Laura Valencia-Nieto
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
- Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Carmen García-Vázquez
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
| | | | - Alberto López-Miguel
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Marta Blanco-Vázquez
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
- Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Andrea Novo-Diez
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
- Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
| | - Itziar Fernández
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
- Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - Amalia Enríquez de Salamanca
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
- Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - María Jesús González-García
- Institute of Applied Ophthalmobiology (IOBA), Universidad de Valladolid, Valladolid, Spain
- Department of Theoretical Physics, Atomic and Optics, Universidad de Valladolid, Valladolid, Spain
- Networking Research Center on Bioengineering Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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Valencia-Nieto L, López-de la Rosa A, López-Miguel A, González-García MJ. Clinical characterisation of contact lens discomfort progression. Cont Lens Anterior Eye 2024; 47:102096. [PMID: 38097423 DOI: 10.1016/j.clae.2023.102096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 10/15/2023] [Accepted: 11/27/2023] [Indexed: 01/22/2024]
Abstract
PURPOSE This study aimed to assess the subjective and objective differences among the steps of the contact lens discomfort (CLD) progression classification established by the Tear Film & Ocular Surface Society (TFOS) using questionnaires and clinical signs, and to propose a simplified classification. METHODS Contact lens (CL) wearers were evaluated in a single visit. The Contact Lens Dry Eye Questionnaire (CLDEQ)-8, the Contact Lens Discomfort Index, and Visual Analog Scales for discomfort and dryness were administered. The non-invasive break-up time, the tear film lipid layer thickness, conjunctival hyperaemia and papillae, lid-parallel conjunctival folds, the fluorescein tear film break-up time, corneal and conjunctival staining, lid wiper epitheliopathy, and the Schirmer test were assessed. Sign and symptom scores were compared among TFOS CLD progression steps using analysis of variance or the Kruskal-Wallis H test. Steps 1 and 2 (reduced comfort), and steps 3 and 4 (reduced wearing time) of the TFOS classification were combined to obtain a simplified classification, and the same comparison was performed. A p-value ≤ 0.05 was considered statistically significant. RESULTS One hundred-fifty CL wearers (97 women and 53 men) aged 34.4 ± 12.6 years were included. In the TFOS classification, there were significant differences between step 0 (no CLD) and the rest of the severity steps for the scores obtained in all questionnaires (p ≤ 0.015). All steps were differentiated (p ≤ 0.032) based on the simplified classification for all questionnaires, except steps 1 and 2 for the CLDEQ-8 and dryness VAS (p = 0.089 and p = 0.051, respectively). There were no differences (all p ≥ 0.06) between the sign scores among the steps of either classification. CONCLUSION CLD management is encouraged from its first appearance. Simplifying the phases of CLD severity may allow a more accurate classification and a better awareness of the problem by clinicians and CL wearers by using more straightforward simple messages.
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Affiliation(s)
- Laura Valencia-Nieto
- Instituto de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Facultad de Ciencias, University of Valladolid, Valladolid, Spain
| | - Alberto López-de la Rosa
- Instituto de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Facultad de Ciencias, University of Valladolid, Valladolid, Spain
| | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain; Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Medicina, University of Valladolid, Valladolid, Spain.
| | - María J González-García
- Instituto de Oftalmobiología Aplicada (IOBA), University of Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Facultad de Ciencias, University of Valladolid, Valladolid, Spain; Biomedical Research Networking Center in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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Valencia-Nieto L, López-de la Rosa A, González-García MJ, López-Miguel A. Reliability and agreement of subjective and objective non-invasive break-up time measurements in contact lens wearers. Ophthalmic Physiol Opt 2024; 44:124-130. [PMID: 37974449 DOI: 10.1111/opo.13243] [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: 05/05/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/19/2023]
Abstract
PURPOSE To assess the reliability and agreement of non-invasive break-up time (NIBUT) in symptomatic and asymptomatic contact lens (CL) wearers using automatic objective and conventional subjective techniques. METHODS In this prospective cross-sectional study, soft CL wearers, classified into symptomatic and asymptomatic based on the Contact Lens Dry Eye Questionnaire-8, underwent NIBUT assessment with the CL in situ. The CA-800 Corneal Analyzer and the EasyTear® VIEW+ Tearscope were used for objective and subjective evaluation, respectively. The within-subject repeatability and intraclass correlation coefficient (ICC) were calculated. The agreement between the devices was compared using the Bland-Altman method. RESULTS A total of 141 CL wearers (51 male and 90 female) with a mean age of 33.6 (SD = 12.2) years were included. The repeatability and ICC values obtained with the CA-800 device when measuring NIBUT were 5.4 s and 58.6% across the whole sample, 4.2 s and 48.8% for the asymptomatic group and 7.1 s and 68.4% for the symptomatic group. When using the subjective method (EasyTear®), the respective repeatability and ICC values were 7.3 s and 32.7% for the whole sample, 6.5 s and 30.4% for the asymptomatic group and 8.6 s and 35.9% for the symptomatic group. The CA-800 device provided significantly (p < 0.001) shorter NIBUT values compared with EasyTear® for the whole sample (3.3 [2.9] vs. 8.1 [3.4] s), the asymptomatic (3.3 [3.0] vs. 7.7 [3.6] s) and the symptomatic (3.8 [2.9] vs. 8.6 [3.0] s) groups. CONCLUSION Objective (CA-800) NIBUT assessment provides more reliable measurements than the conventional subjective technique using the EasyTear® device. However, CL practitioners should also be aware that the objective method indicates shorter NIBUT values. Symptomatic CL wearers may also need a higher number of NIBUT measurements to obtain reliable estimations.
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Affiliation(s)
- Laura Valencia-Nieto
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, Facultad de Ciencias, Universidad de Valladolid, Valladolid, Spain
| | - Alberto López-de la Rosa
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, Facultad de Ciencias, Universidad de Valladolid, Valladolid, Spain
| | - María J González-García
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, Facultad de Ciencias, Universidad de Valladolid, Valladolid, Spain
- Biomedical Research Networking Centre in Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - Alberto López-Miguel
- Instituto de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
- Departamento de Cirugía, Oftalmología, Otorrinolaringología y Fisioterapia, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
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Baghban R, Talebnejad MR, Meshksar A, Heydari M, Khalili MR. Recent advancements in nanomaterial-laden contact lenses for diagnosis and treatment of glaucoma, review and update. J Nanobiotechnology 2023; 21:402. [PMID: 37919748 PMCID: PMC10621182 DOI: 10.1186/s12951-023-02166-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023] Open
Abstract
Despite the existence of numerous eye drops in the market, most of them are not sufficiently effective because of quick clearance and the barriers within the eye. To increase the delivery of the drugs to the eye, various new formulations have been explored in recent decades. These formulations aim to enhance drug retention and penetration, while enabling sustained drug release over extended periods. One such innovative approach is the utilization of contact lenses, which were originally designed for cosmetic purposes and vision correction. Contact lenses have appeared as a promising formulation for ocular drug delivery, as they can increase the bioavailability of drugs in the eye and diminish unwanted side effects. They are specifically appropriate for treating chronic eye conditions, making them an area of interest for researchers in the field of ophthalmology. This review outlines the promising potential of nanomaterial-laden contact lenses for diagnosis and treatment of glaucoma. It classifies therapeutic approaches based on nanomaterial type, summarizes diagnostic advances, discusses improvement of contact lenses properties, covers marketing perspectives, and acknowledges the challenges of these innovative contact lenses for glaucoma management.
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Affiliation(s)
- Roghayyeh Baghban
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Talebnejad
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Aidin Meshksar
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojtaba Heydari
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Khalili
- Poostchi Ophthalmology Research Center, Department of Ophthalmology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
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Xiao K, Song H, Chen Z, Long Q. Conjunctival microbiome changes in soft contact lens users and contact lens discomfort patients. Biomarkers 2023; 28:531-537. [PMID: 37352111 DOI: 10.1080/1354750x.2023.2229532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/17/2023] [Indexed: 06/25/2023]
Abstract
INTRODUCTION Contact lens discomfort (CLD) acts as a challenging problem, and the associated conjunctival microbiome changes were unclear. MATERIAL AND METHODS Conjunctival sac swab samples were collected from 12 eyes of nonwearers (NW), 12 eyes of asymptomatic contact lens (ACL) wearers, and 11 eyes of CLD. The V3-V4 region of the 16S rRNA gene sequencing was used to investigate differences among three groups. RESULTS No differences in alpha diversity were observed among the three groups. The beta diversity showed a distinct microbiome composition between ACL and CLD group (P = 0.018) with principal coordinate analysis. The relative abundance of Firmicutes was significantly higher in CLD (48.18%) than in ACL (13.21%) group (P = 0.018). The abundance of Bacillus in patients with ACL (0.05%) or with CLD (0.02%) were significantly lower than that in the NW (1.27%) group (P = 0.024, 0.028, respectively). Moreover, the abundance of Firmicutes was positively correlated with the OSDI scores in CLD patients (r = 0.817, P < 0. 01, Spearman). DISCUSSIONS Patients with CLD have various degrees of bacterial microbiota imbalance in the conjunctival sac, compared with NW and ACL groups. CONCLUSION Firmicutes may serve as a potential biomarker for the CLD patients.
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Affiliation(s)
- Kang Xiao
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hang Song
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zhengyu Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qin Long
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Is contact lens discomfort related to meibomian gland morphology? Cont Lens Anterior Eye 2022; 45:101743. [PMID: 36028427 DOI: 10.1016/j.clae.2022.101743] [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: 02/09/2022] [Revised: 07/20/2022] [Accepted: 08/04/2022] [Indexed: 11/24/2022]
Abstract
PURPOSE To examine the relationship between contact lens (CL) discomfort and meibomian gland (MG) morphology assessed by a semi-objective software in subjects without an alteration of MG function (meibum quality and expressibility). METHODS Nineteen symptomatic (CLDEQ-8 ≥ 12) CL wearers, 19 asymptomatic (CLDEQ-8 < 12) wearers, and 22 non-wearers were recruited. Upper and lower eyelid meibography images were taken and the following parameters were analysed using a semi-objective software in the central 2/3 of each eyelid: number of MG, number of partial MG, percentage of MG loss and percentage of tortuosity. One-way ANOVA or Kruskal-Wallis H test were used for comparisons among groups. The relationships between CLDEQ-8 and MG morphology parameters were analysed using the Spearman correlation coefficient and multivariable linear regression models. RESULTS No significant differences were found among groups in the MG morphology of the upper or lower eyelids. In all CL wearers, a significant correlation with CLDEQ-8 was found in the upper eyelid for the number of MG (rho = 0.47, p = 0.003). In symptomatic wearers, significant correlations with CLDEQ-8 were found in the lower eyelid for the number of partial MG (rho = 0.49, p = 0.03) and the percentage of partial MG (rho = 0.61, p = 0.005). In all CL wearers, multivariable models were fitted to explain CLDEQ-8 score including the number of MG, the number of partial MG and the percentage of MG loss from the lower eyelid (R2 = 0.19; p = 0.007), and the number of MG from the upper eyelid (R2 = 0.19; p = 0.001). In symptomatic wearers, a model was fitted including the percentage of MG loss from the lower eyelid (R2 = 0.30; p = 0.016). CONCLUSIONS Alterations of MG morphology, without clinically apparent alteration of MG function, can be involved in causing CL discomfort and influence the degree of symptoms. The differences in findings between eyelids indicate the need to monitor both eyelids, especially the lower one, in CL wearers.
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Osae EA, Jones L, Nichols JJ. The impact of contact lenses on meibomian gland morphology. Ocul Surf 2022; 24:148-155. [PMID: 35395385 DOI: 10.1016/j.jtos.2022.04.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 02/22/2022] [Accepted: 04/02/2022] [Indexed: 11/28/2022]
Abstract
Despite years of experience with contact lenses, controversy remains as to whether contact lenses adversely impact the meibomian glands (MG). This review summarizes the present body of evidence, showing that contact lens wear is associated with alterations in MG morphology (up to 80% higher gland atrophy compared to non-wearers) and qualitative changes in MG secretion. Key factors such as duration of contact lens wear, contact lens type (e.g., soft vs. rigid), edge design, and material modulus of elasticity are discussed in relation to the extent of MG morphological changes, the quality of MG secretion and other ocular surface parameters. Longitudinal studies of sufficient statistical power are needed to better understand how contact lens wear affects the MG, risk factors, and the clinical sequelae of these changes.
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Affiliation(s)
| | - Lyndon Jones
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Ontario, Canada; Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Jason J Nichols
- The University of Alabama at Birmingham, School of Optometry, Birmingham, AL, 35233, USA.
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Koh S, Chalmers R, Yamasaki K, Kawasaki R, Nishida K. Factors influencing the 8-item contact lens dry eye questionnaire score and comparison of translations in Japanese soft contact lens wearers. Cont Lens Anterior Eye 2021; 45:101519. [PMID: 34620551 DOI: 10.1016/j.clae.2021.101519] [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: 06/03/2021] [Revised: 08/21/2021] [Accepted: 09/27/2021] [Indexed: 11/03/2022]
Abstract
PURPOSE To determine (1) the factors associated with a high degree of self-reported symptoms with Japanese translations of the 8-Item Contact Lens Dry Eye Questionnaire (J-CLDEQ-8) in a cross-section of soft contact lens (SCL) wearers in Japan and (2) whether the difference in translation of the CLDEQ-8 affects the scores between validated and non-validated versions of the Japanese translation. METHODS Habitual SCL wearers completed the validated J-CLDEQ-8 and a previous non-validated version. Demographics and SCL history questions were queried when they presented for routine eye care in nine geographically distinct clinics across Japan. The following risk factors for high J-CLDEQ-8 scores (≥11) were tested: sex, age, SCL replacement (daily disposable vs. bi-weekly and monthly reusable), years of SCL wear, and self-reported use of rewetting drops. The scores of the validated and non-validated questionnaires were compared. RESULTS Significant patient-related risk factors for high J-CLDEQ-8 scores were female sex, use of reusable SCLs, longer years of SCL wear, and use of rewetting drops. Scores for six out of eight questions in the validated J-CLDEQ-8 were significantly higher than those of the non-validated version, resulting in a significant difference in the average total score between the two questionnaires (validated J-CLDEQ-8: 10.5 ± 5.9 vs non-validated J-CLDEQ-8: 9.5 ± 5.8, P < 0.001). CONCLUSIONS Female sex, use of reusable SCLs, longer years of SCL wear, and use of rewetting drops were significant risk factors for high J-CLDEQ-8 scores in a cross-sectional clinical population of Japanese SCL wearers. Symptoms with SCL are not predicted by age and must therefore be queried at follow-up visits for all SCL wearers. Differences in the two translations affected the ability of the questionnaire to identify individuals with high symptoms associated with SCL wear.
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Affiliation(s)
- Shizuka Koh
- Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
| | | | | | - Ryo Kawasaki
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan; Department of Vision Informatics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan
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Novo-Diez A, Arroyo-Del Arroyo C, Blanco-Vázquez M, Fernández I, López-Miguel A, González-García MJ. Usefulness of a global rating change scale for contact lens discomfort evaluation. Cont Lens Anterior Eye 2021; 44:101467. [PMID: 34006459 DOI: 10.1016/j.clae.2021.101467] [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: 09/09/2020] [Revised: 05/05/2021] [Accepted: 05/08/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVES To evaluate the usefulness of a global rate of change scale (GRCS) to detect variations in contact lens discomfort (CLD). METHODS Symptomatic contact lens (CL) wearers were recruited according to the 'Contact Lens Dry Eye Questionnaire-8' (CLDEQ-8). At the baseline visit, subjects scored their comfort following insertion of their habitual CL using a 0-100 visual analogue scale (VAS). After 4-10 h of CL wear, comfort was again self-evaluated with the VAS and with a GRCS (range, -50 to +50). Then, a daily disposable CL (DDCL) was fitted. After one month of DDCL wear, a follow-up visit was conducted where the same evaluations as the baseline visit were performed. Changes in comfort were estimated using a Student's t-test for normal variables and the Friedman test for multiple comparisons of non-parametric variables. Internal responsiveness was measured by calculating the standardised response mean. Agreement between scales was estimated by the intraclass correlation coefficient (ICC). RESULTS Twenty-nine (22 females and 7 males) CL wearers with a mean age of 23.4 ± 5.4 years participated in the study. There was a significant decrease in comfort at both visits detected by the GRCS (baseline = -13.58 ± 17.48, p < 0.001; follow up = -6.86 ± 12.69, p = 0.007). However, the VAS did not detect that change, either at baseline (insertion = 64.28 ± 18.72 vs removal = 52.89 ± 17.64, p = 1.000) or follow-up visit (insertion = 81.97 ± 12.91 vs removal = 76.48 ± 16.02, p = 1.000). Comfort at insertion and removal times was significantly higher with the DDCL (p = 0.008 at insertion and p = 0.004 at removal). The standardised response mean was greater with the GRCS than the VAS at baseline (0.78 vs 0.63) and follow-up (0.54 vs 0.37) visits. Agreement between both scales was moderate and significant (p < 0.001) for both visits, ICC: 0.674 (95 % confidence interval (CI):0.411-0.833) (baseline) and 0.652 (95 % CI:0.377-0.821) (follow-up visit). CONCLUSIONS The GRCS can detect slight changes in CL wear comfort and shows higher responsiveness than the VAS. This subjective scale can allow detection of changes in comfort in a simple and quick way.
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Affiliation(s)
- Andrea Novo-Diez
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain
| | - Cristina Arroyo-Del Arroyo
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain
| | - Marta Blanco-Vázquez
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Itziar Fernández
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - Alberto López-Miguel
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Redes temáticas de investigación cooperativa en salud (Oftared), Instituto de Salud Carlos III, Madrid, Spain.
| | - María Jesús González-García
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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Arroyo-Del Arroyo C, Novo-Diez A, Blanco-Vázquez M, Fernández I, López-Miguel A, González-García MJ. Does placebo effect exist in contact lens discomfort management? Cont Lens Anterior Eye 2020; 44:101370. [PMID: 33071184 DOI: 10.1016/j.clae.2020.09.003] [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: 05/21/2020] [Revised: 09/18/2020] [Accepted: 09/28/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To study the effect of daily disposable contact lens (DDCL) refitting in monthly contact lens (CL) wearers suffering from contact lens discomfort (CLD), and to assess if there is a placebo effect associated with this CLD intervention. METHODS Symptomatic CL wearers, according to the Contact Lens Dry Eye Questionnaire 8 (CLDEQ-8 ≥ 12 points), were divided into two groups. The study group was provided with DDCLs (delefilcon A) and the control group with a masked pair of their habitual monthly CLs (placebo effect) and were assessed after one month. Then, the control group was provided with the same DDCLs and evaluated one month later. The symptoms were recorded with the CLDEQ-8 and global rating of change scale (GRCS). Non-invasive tear break-up time (NITBUT), conjunctival hyperaemia, fluorescein staining, and lid wiper epitheliopathy (LWE) were evaluated. Changes between visits, groups, and the effect of each intervention were analysed. RESULTS Thirty-one participants (mean age: 23.2 ± 5.3 years) were recruited. The study group (n = 14) showed an improvement of -39.6 ± 25.8 % (p < 0.001) in CLDEQ-8 and 31.3 ± 14.6 points in GRCS (p < 0.001) after one month of DDCL use, while no changes in clinical tests were found. In the control group (n = 17), symptoms improved significantly after wearing the masked monthly CL (CLDEQ-8: -26.1 ± 31.0 %, p = 0.03; GRCS: 14.9 ± 17.0, p = 0.002), however a worsening in bulbar (26.5 ± 40.0 %; p = 0.02) and limbal hyperaemia (21.6 ± 34.7 %, p = 0.02) and an improvement of -19.1 ± 37.0 % (p = 0.049) in LWE was found. When the control group was fitted with the DDCL, improvements in GRCS (20.5 ± 25.5, p = 0.02), NITBUT (37.9 ± 42.3 %, p = 0.002), and conjunctival staining (-47.1 ± 59.9 %, p = 0.005) were noted. CONCLUSIONS Refitting symptomatic monthly CL wearers with Delefilcon A DDCL is effective in reducing symptoms related to CLD. However, clinicians and researchers must be aware of the existence of a placebo effect when assessing the effectiveness of any CL refitting.
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Affiliation(s)
- Cristina Arroyo-Del Arroyo
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain
| | - Andrea Novo-Diez
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain
| | - Marta Blanco-Vázquez
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain
| | - Itziar Fernández
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
| | - Alberto López-Miguel
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Redes temáticas de investigación cooperativa en salud (Oftared), Instituto de Salud Carlos III, Madrid, Spain.
| | - María Jesús González-García
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Valladolid, Spain; Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Valladolid, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN), Valladolid, Spain
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