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Mallada SO, Yebra DG, Zardoya NT, García JA. Using clinical optical coherence tomography to characterise contact lens edge shape and base curve radius. Clin Exp Optom 2024:1-9. [PMID: 38224567 DOI: 10.1080/08164622.2024.2302832] [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: 04/26/2023] [Accepted: 11/28/2023] [Indexed: 01/17/2024] Open
Abstract
CLINICAL RELEVANCE Clinical optical coherence tomography devices are widely used in optometry and ophthalmology and may be used to measure contact lens base curvature radius and visualise contact lens edge shape. BACKGROUND Knowledge of contact lens geometry facilitates fitting, while optical coherence tomography provides a powerful means of measuring geometrical form. This study evaluates the performance of a clinical optical coherence tomography device (3D OCT-1000) in characterising contact lens edge shape and measuring the back optic zone radius of rigid gas-permeable contact lenses in vitro. METHODS First, an opto-mechanical optical coherence tomography contact lens adaptor was designed and 3D-printed to facilitate a contact lens being imaged using a commercial optical coherence tomography device. Second, several image-processing algorithms and a simple calibration method were developed to measure the back optic zone radius in optical coherence tomography B-scans. Finally, based on the findings of two experiments, B-scan performance was evaluated in terms of 1) capacity to differentiate between contact lens edge geometries, and 2) capacity to obtain accurate and repeatable back optic zone radius measurements. Statistical and graphical analyses were performed to characterise reliability and reproducibility. RESULTS The 3D OCT-1000 and adaptor combination was capable of acquiring images of sufficient quality to discriminate between soft and rigid contact lens edge geometries. Additionally, statistical analysis of the rigid contact lens measurements demonstrated satisfactory back optic zone radius measurement accuracy and reproducibility. CONCLUSION This study demonstrates that a 3D OCT-1000 fitted with an opto-mechanical adaptor combination can be used to assess contact lens edges in vitro and that this clinical optical coherence tomography device, combined with image processing and linear calibration of the B-scans, is capable of obtaining back optic zone radius measurements of rigid gas-permeable contact lenses that are close to the ISO 18,369-2:2018 manufacturing tolerance range (±0.05 mm).
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Wolffsohn JS. 2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management. Optom Vis Sci 2024; 101:12-24. [PMID: 38350054 DOI: 10.1097/opx.0000000000002102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
ABSTRACT Detailed clinical assessment is critical to allow sensitive evaluation of the eye and its management. As technology advances, these assessment techniques can be adapted and refined to improve the detection of pathological changes of ocular tissue and their impact on visual function. Enhancements in optical medical devices including spectacle, contact, and intraocular lenses have allowed for a better understanding of the mechanism and amelioration of presbyopia and myopia control. Advancements in imaging technology have enabled improved quantification of the tear film and ocular surface, informing diagnosis and treatment strategies. Miniaturized electronics, large processing power, and in-built sensors in smartphones and tablets capacitate more portable assessment tools for clinicians, facilitate self-monitoring and treatment compliance, and aid communication with patients. This article gives an overview of how technology has been used in many areas of eye care to improve assessments and treatment and provides a snapshot of some of my studies validating and using technology to inform better evidence-based patient management.
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Ghorbani-Mojarrad N, Rountree L, Terry L, Bruce H, Hallam E, Jolly L, Retallic N, Evans K. Clinical Investigation of Flat Pack Toric Contact Lenses and Wearer Attitudes to Environmental Impact. Eye Contact Lens 2023; 49:475-482. [PMID: 37707468 PMCID: PMC10589431 DOI: 10.1097/icl.0000000000001031] [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] [Accepted: 07/27/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVES To investigate the performance of a novel flat pack toric daily disposable contact lens compared with traditionally packaged toric lenses in a randomized, crossover study. Environmental attitudes to contact lens wear were also explored. METHODS Habitual contact lens wearers were recruited to wear a hioxifilcon A (Miru 1 day Flat Pack Toric, Menicon, Nagoya, Japan) test lens and a control lens: either nelfilcon A (Dailies AquaComfort Plus, Alcon, Geneva, Switzerland) or etafilcon A (1-Day Acuvue Moist, Johnson & Johnson, New Brunswick, NJ). Objective lens performance was assessed at fitting, and participants wore lenses in a randomized order for three consecutive days. Subjective measures of lens performance (comfort, vision, and handling) were then assessed by a questionnaire, with further questions on overall lens preference and environmental perceptions. RESULTS Objective measures of lens fit were similar for the test and control lenses, except for distance VA which was better with the control lenses ( P <0.05; difference of two logMAR letters). End of day comfort was greater with the test lens, but this did not reach significance. Both lenses demonstrated similar scores for overall satisfaction. 87.5% of participants indicated the environmental impact of contact lenses to be important/extremely important to them, with 100% of participants identifying the flat pack packaging as having a smaller environmental impact. CONCLUSION Overall, the lenses used in the study performed to similar levels. Environmental credentials are important to contact lens wearers, which may contribute to overall lens preference.
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Affiliation(s)
- Neema Ghorbani-Mojarrad
- School of Optometry and Vision Sciences (K.E., L.T.), Cardiff University, Cardiff, United Kingdom; School of Optometry and Vision Science (H.B., E.H., L.J., L.R., N.G.-M.), University of Bradford, Bradford, United Kingdom; Menicon UK Ltd (N.R.), Northampton, United Kingdom; and Wolfson Centre for Applied Health Research (N.G.-M.), Bradford, United Kingdom
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Megat Abd Mana NA, Chee Chin L, Yazid H, Fook CY. Evaluation of Contact Lens Data Acquisition Approaches using Enhancement Techniques. 2022 4TH INTERNATIONAL CONFERENCE ON ARTIFICIAL INTELLIGENCE AND SPEECH TECHNOLOGY (AIST) 2022. [DOI: 10.1109/aist55798.2022.10065211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Affiliation(s)
| | - Lim Chee Chin
- Universiti Malaysia Perlis,Electronic Engineering Technology,Perlis,Malaysia
| | - Haniza Yazid
- Universiti Malaysia Perlis,Electronic Engineering Technology,Perlis,Malaysia
| | - Chong Yen Fook
- Universiti Malaysia Perlis,Sports Engineering Research Centre (SERC),Perlis,Malaysia
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Abdolalizadeh P, Karimi M, Latifi G, Nouri L, Hashemian MN, Hashemian H, Mehrpour M, Alipour F. Role of Different Types of Contact Lenses in Epithelial Thickness. Eye Contact Lens 2022; 48:210-216. [PMID: 35333790 DOI: 10.1097/icl.0000000000000878] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the potential role of different types of contact lenses, such as soft (SCL), hard (HCL), and mini scleral (SCCL), in corneal epithelial thickness with anterior segment optical coherence tomography (AS-OCT). METHODS In this cross-sectional study, patients who used contact lens at recent 6 months were recruited consecutively from September 2019 to October 2019, and the epithelial thicknesses of the cornea were obtained by AS-OCT and compared with control subjects who did not use contact lens. RESULTS In total, 184 eyes (115 subjects) were included; of them, 75 eyes were keratoconic (KCN) and 109 eyes were nonkeratoconic (non-KCN). Twenty eyes in KCN and 79 eyes of non-KCN group had no history of contact lens use and were included for comparison with KCN and non-KCN contact lens users, respectively. Mean duration of contact lens wearing was 75.63±50.42 months. The epithelial thickness of non-KCN SCL group was thinner than that of non-KCN control subjects all over the cornea, whereas the epithelium of non-KCN HCL was thinner at central site as well as nasal and temporal paracentral and midperipheral areas. Epithelial thickness of the KCN HCL group was not different from the KCN control subjects in all sectors. The KCN SCCL group had thinner epithelium at nearly all peripheral sectors as well as inferior, inferotemporal, inferonasal, and nasal midperipheral sectors compared with KCN control subjects. CONCLUSION The corneal epithelium was thinner at the peripheral zones in KCN SCCL users; at both peripheral and central zones in non-KCN SCL users and in central zones in non-KCN HCL users.
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Affiliation(s)
- Parya Abdolalizadeh
- Eye and Skull Base Research Centers (P.A.), The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran; and Eye Research Center (M.K., G.L., L.N., M.-N.H., H.H., M.M., F.A.), Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
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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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Kita M, Kanai K, Ono HK, Otaka Y, Okada D, Nagai N, Kudo R, Yamashita Y, Hino S, Matsunaga T, Tajima K. Retention, Bacterial Adhesion, and Biofilm Formation between Anionic and Zwitterionic Bandage Contact Lenses in Healthy Dogs: A Pilot Study. Vet Sci 2021; 8:vetsci8100238. [PMID: 34679069 PMCID: PMC8539595 DOI: 10.3390/vetsci8100238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 10/11/2021] [Accepted: 10/16/2021] [Indexed: 12/03/2022] Open
Abstract
This study aimed to compare the in vitro and in vivo retention, bacterial adhesion, and biofilm formation between anionic and zwitterionic bandage contact lenses (BCLs) in healthy canines. BCL retention and tolerance were evaluated in 10 healthy canines via a single-masked, crossover study for 7 days. To compare in vitro bacterial adhesion and biofilm formation, four Staphylococcus strains were incubated with the BCLs at 37 °C for 2 or 24 h, and the bacterial colony forming units (CFUs) adhering to the BCLs were counted. Next, to compare in vivo bacterial adhesion, the CFUs of bacteria adhering to the BCLs worn by canines for 24 h were counted. Anionic lenses significantly retained and reduced in vitro bacterial adhesion than in the zwitterionic lenses. However, the amount of in vitro biofilm formation was more likely to be higher on anionic lenses than on zwitterionic lenses. In vivo bacterial adhesion was not significantly different between the two types of BCLs. Nevertheless, both BCLs were well-tolerated by the canines; thus, their short-term use in dogs can be recommended as safe.
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Affiliation(s)
- Mizuki Kita
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 ban-cho, Towada, Aomori 034-8628, Japan; (M.K.); (Y.O.); (D.O.); (R.K.); (Y.Y.); (K.T.)
| | - Kazutaka Kanai
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 ban-cho, Towada, Aomori 034-8628, Japan; (M.K.); (Y.O.); (D.O.); (R.K.); (Y.Y.); (K.T.)
- Correspondence: ; Tel.: +81-176-23-4371
| | - Hisaya K. Ono
- Department of Zoonoses, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 ban-cho, Towada, Aomori 034-8628, Japan;
| | - Yuya Otaka
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 ban-cho, Towada, Aomori 034-8628, Japan; (M.K.); (Y.O.); (D.O.); (R.K.); (Y.Y.); (K.T.)
| | - Daiki Okada
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 ban-cho, Towada, Aomori 034-8628, Japan; (M.K.); (Y.O.); (D.O.); (R.K.); (Y.Y.); (K.T.)
| | - Noriaki Nagai
- Faculty of Pharmacy, Kindai University, 3-4-1 Kowakae, Higashi-Osaka, Osaka 577-8502, Japan;
| | - Rina Kudo
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 ban-cho, Towada, Aomori 034-8628, Japan; (M.K.); (Y.O.); (D.O.); (R.K.); (Y.Y.); (K.T.)
| | - Yohei Yamashita
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 ban-cho, Towada, Aomori 034-8628, Japan; (M.K.); (Y.O.); (D.O.); (R.K.); (Y.Y.); (K.T.)
| | - Shiori Hino
- SEED Co., Ltd., 2-40-2 Hongo, Bunkyo-ku, Tokyo 113-8402, Japan; (S.H.); (T.M.)
| | - Toru Matsunaga
- SEED Co., Ltd., 2-40-2 Hongo, Bunkyo-ku, Tokyo 113-8402, Japan; (S.H.); (T.M.)
| | - Kazuki Tajima
- Department of Small Animal Internal Medicine II, School of Veterinary Medicine, Kitasato University, 35-1 Higashi 23 ban-cho, Towada, Aomori 034-8628, Japan; (M.K.); (Y.O.); (D.O.); (R.K.); (Y.Y.); (K.T.)
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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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Efron N, Morgan PB, Nichols JJ, Walsh K, Willcox MD, Wolffsohn JS, Jones LW. All soft contact lenses are not created equal. Cont Lens Anterior Eye 2021; 45:101515. [PMID: 34583895 DOI: 10.1016/j.clae.2021.101515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/11/2021] [Accepted: 09/19/2021] [Indexed: 12/13/2022]
Abstract
Soft contact lenses that have been prescribed by eye care practitioners are sometimes substituted for alternative lenses by unqualified, unregulated and sometimes even fully regulated lens suppliers, in the mistaken belief that there is essentially no difference between different soft lens types. This review considers the implications of inappropriately substituting soft contact lens types in terms of (a) lens properties: surface treatment, internal wetting agents, material, total diameter, back optic zone radius, thickness, edge profile, back surface design, optical design, power, colour (tint) and ultraviolet protection; and (b) lens usage: wearing modality (daily versus overnight wear) and replacement frequency. Potential aspects of patient dissatisfaction and adverse events when prescribed soft lenses are substituted for lenses with different properties or intended usage are considered. Substitution of 15 of the 16 lens properties considered (i.e. except for back surface design) was found to be related to at least one - and as many as six - potential sources of patient dissatisfaction and adverse ocular events. Contact lens are medical devices which are prescribed and fitted; they should never be substituted for another lens type in the absence of a new prescription further to a full finalised fitting, for the simple reason that all soft contact lenses are not created equal. A substituted lens may have properties that results in undesirable consequences in respect of vision, ocular health, comfort and cosmetic appearance, and may be incompatible with the lifestyle of the patient.
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Affiliation(s)
- Nathan Efron
- School of Optometry and Vision Science, Queensland University of Technology, Kelvin Grove, Queensland, Australia.
| | - Phillip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, The University of Manchester, Manchester, UK
| | - Jason J Nichols
- School of Optometry, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen Walsh
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada
| | - Mark D Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - Lyndon W Jones
- Centre for Ocular Research & Education (CORE), School of Optometry and Vision Science, University of Waterloo, Waterloo, Ontario, Canada; Centre for Eye and Vision Research (CEVR), Hong Kong
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10
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Nguyen DCT, Dowling J, Ryan R, McLoughlin P, Fitzhenry L. Pharmaceutical-loaded contact lenses as an ocular drug delivery system: A review of critical lens characterization methodologies with reference to ISO standards. Cont Lens Anterior Eye 2021; 44:101487. [PMID: 34353748 DOI: 10.1016/j.clae.2021.101487] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/28/2021] [Accepted: 07/04/2021] [Indexed: 01/12/2023]
Abstract
Therapeutic contact lenses for ocular drug delivery have received considerable interest as they can potentially enhance ocular bioavailability, increase patient compliance, and reduce side effects. Along with the successful in vitro and in vivo studies on sustained drug delivery through contact lenses, lens critical properties such as water content, optical transparency and modulus have also been investigated. Aside from issues such as drug stability or burst release, the potential for the commercialization of pharmaceutical-loaded lenses can be limited by the alteration of lens physical and chemical properties upon the incorporation of therapeutic or non-therapeutic components. This review outlines advances in the use of pharmaceutical-loaded contact lenses and their relevant characterization methodologies as a potential ocular drug delivery system from 2010 to 2020, while summarizing current gaps and challenges in this field. A key reference point for this review is the relevant ISO standards on contact lenses, relating to the associated characterization methodologies. The content of this review is categorized based on the chemical, physical and mechanical properties of the loaded lens with the shortcomings of such analytical technologies examined.
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Affiliation(s)
- Dan Chau Thuy Nguyen
- Ocular Therapeutics Research Group (OTRG), Pharmaceutical & Molecular Biotechnology Research Centre (PMBRC), Waterford Institute of Technology, Waterford City, County Waterford X91 K0EK, Ireland.
| | - Joseph Dowling
- Research and Development Department, Bausch + Lomb Ireland Ltd., Waterford City, County Waterford X91 V383, Ireland
| | - Richie Ryan
- Ocular Therapeutics Research Group (OTRG), Pharmaceutical & Molecular Biotechnology Research Centre (PMBRC), Waterford Institute of Technology, Waterford City, County Waterford X91 K0EK, Ireland
| | - Peter McLoughlin
- Ocular Therapeutics Research Group (OTRG), Pharmaceutical & Molecular Biotechnology Research Centre (PMBRC), Waterford Institute of Technology, Waterford City, County Waterford X91 K0EK, Ireland
| | - Laurence Fitzhenry
- Ocular Therapeutics Research Group (OTRG), Pharmaceutical & Molecular Biotechnology Research Centre (PMBRC), Waterford Institute of Technology, Waterford City, County Waterford X91 K0EK, Ireland
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Fang M, Airen S, Jiang H, Wang J. Ocular surface microvascular response and its relation to contact lens fitting and ocular comfort: an update of recent research. Clin Exp Optom 2021; 104:661-671. [PMID: 33689669 DOI: 10.1080/08164622.2021.1878867] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
This review examines vascular responses in the ocular surface to contact lens wear and its relation to lens fitting characteristics and contact lens-related discomfort. A search of PubMed was performed to find original research in English, within the past 10 years, that studied the ocular surface, including lid-wiper vascular responses to the lens. The interaction between the lens and ocular surface triggers vascular responses, impacting the lens fitting and contact lens-related discomfort. Contact lens-related discomfort is a multifactorial event, which is affected by lens characteristics. Overall, contact lenses with low modulus and a relatively tight fit produce significant ocular comfort. If an appropriate lens fit is achieved, lens fitting characteristics may not play a critical role in contact lens-related discomfort. On the other hand, the pathogenic and vascular changes of lid-wiper vascular responses appear to play an essential role in developing contact lens-related discomfort, in concert with reactions of the cornea (compression and staining) and conjunctiva (indentation and staining). Robust evaluation of lid-wiper changes at the cellular and microvascular level may hold the key to better understanding the mechanism of contact lens-related discomfort and reveal strategies for eliminating lid wiper epitheliopathy and improving ocular comfort in contact lens wearers.
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Affiliation(s)
- Min Fang
- Shenzhen Key Laboratory of Ophthalmology, Shenzhen Eye Hospital, Jinan University, Shenzhen, Guangdong, China.,School of Medicine, Bascom Palmer Eye Institute, University of Miami Miller, Miami, FL, USA
| | - Shriya Airen
- School of Medicine, University of Miami Miller, Miami, FL, USA
| | - Hong Jiang
- School of Medicine, Bascom Palmer Eye Institute, University of Miami Miller, Miami, FL, USA.,Department of Neurology, School of Medicine, University of Miami Miller, Miami, FL, USA
| | - Jianhua Wang
- School of Medicine, Bascom Palmer Eye Institute, University of Miami Miller, Miami, FL, USA
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12
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Stachura J, Mlyniuk P, Bloch W, Jimenez-Villar A, Grulkowski I, Kaluzny BJ. Shape of the anterior surface of the cornea after extended wear of silicone hydrogel soft contact lenses. Ophthalmic Physiol Opt 2021; 41:683-690. [PMID: 33945648 DOI: 10.1111/opo.12830] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 03/02/2021] [Accepted: 03/03/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To measure geometrical changes in the anterior surface of the cornea after wearing silicon hydrogel (SiH) soft contact lenses continuously for 1 week. METHODS Forty-three eyes with 3.0D of myopia and 22 eyes with 3.0D of hyperopia were enrolled in the prospective, interventional study. All subjects underwent a general eye examination, corneal tomography with wavefront aberration analysis, corneal thickness measurements and epithelial thickness mapping before and after wearing SiH lenses (Acuvue Oasys) for 7 days. RESULTS No significant changes in average keratometry were observed in either refractive group. In the myopic group, keratometry findings for the flat meridian (K1) and central corneal thickness decreased significantly. After +3.0 D lens wear in the hyperopic group, a significant decrease in epithelial thickness up to 3.19 µm was observed in the central and paracentral cornea, (p < 0.001). In both refractive groups, the largest epithelial thickness increase was seen in the periphery. A decrease in spherical aberration was noted in myopic eyes, while an increase of both higher order corneal aberrations and coma was found in hyperopic subjects. CONCLUSION Extended wear of SiH lenses results in a significant change in epithelial thickness leading to alteration in the geometry of the anterior surface of the cornea, particularly in hyperopic patients. These epithelial thickness variations lead to changes in the higher order aberrations of the cornea.
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Affiliation(s)
- 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
| | - Waldemar Bloch
- 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
| | - Ireneusz Grulkowski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, Toruń, Poland
| | - Bartlomiej J Kaluzny
- Division of Ophthalmology and Optometry, Department of Ophthalmology, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
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13
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Downie LE, Lindsay RG. Contact lens management of keratoconus. Clin Exp Optom 2021; 98:299-311. [DOI: 10.1111/cxo.12300] [Citation(s) in RCA: 96] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Revised: 03/30/2015] [Accepted: 04/04/2015] [Indexed: 11/29/2022] Open
Affiliation(s)
- Laura E Downie
- Department of Optometry and Vision Sciences, The University of Melbourne, Parkville, Victoria, Australia
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Wolffsohn JS, Dumbleton K, Huntjens B, Kandel H, Koh S, Kunnen CME, Nagra M, Pult H, Sulley AL, Vianya-Estopa M, Walsh K, Wong S, Stapleton F. CLEAR - Evidence-based contact lens practice. Cont Lens Anterior Eye 2021; 44:368-397. [PMID: 33775383 DOI: 10.1016/j.clae.2021.02.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/01/2021] [Indexed: 12/15/2022]
Abstract
Evidence-based contact lens -->practice involves finding, appraising and applying research findings as the basis for patient management decisions. These decisions should be informed by the strength of the research study designs that address the question, as well as by the experience of the practitioner and the preferences and environment of the patient. This reports reviews and summarises the published research evidence that is available to inform soft and rigid contact lens history and symptoms taking, anterior eye health examination (including the optimised use of ophthalmic dyes, grading scales, imaging techniques and lid eversion), considerations for contact lens selection (including the ocular surface measurements required to select the most appropriate lens parameter, lens modality and material selection), evaluation of lens fit, prescribing (teaching self-application and removal, adaptation, care regimen and cleaning instructions, as well as -->minimising risks of lens wear through encouraging compliance) and an aftercare routine.
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Affiliation(s)
| | - Kathy Dumbleton
- School of Optometry, University of California, Berkeley, CA, USA
| | - Byki Huntjens
- Division of Optometry and Visual Sciences at City, University of London, London, UK
| | - Himal Kandel
- Save Sight Institute, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Shizuka Koh
- Department of Innovative Visual Science, Osaka University Graduate School of Medicine, Japan
| | | | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Cambridge, UK
| | - Heiko Pult
- Optometry and Vision Research, Weinheim, Germany
| | | | - Marta Vianya-Estopa
- Department of Vision and Hearing Sciences Research Centre, Anglia Ruskin University, Cambridge, UK
| | - Karen Walsh
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Stephanie Wong
- Centre for Ocular Research & Education, School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Australia
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Morgan PB, Murphy PJ, Gifford KL, Gifford P, Golebiowski B, Johnson L, Makrynioti D, Moezzi AM, Moody K, Navascues-Cornago M, Schweizer H, Swiderska K, Young G, Willcox M. CLEAR - Effect of contact lens materials and designs on the anatomy and physiology of the eye. Cont Lens Anterior Eye 2021; 44:192-219. [PMID: 33775377 DOI: 10.1016/j.clae.2021.02.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/01/2021] [Indexed: 12/19/2022]
Abstract
This paper outlines changes to the ocular surface caused by contact lenses and their degree of clinical significance. Substantial research and development to improve oxygen permeability of rigid and soft contact lenses has meant that in many countries the issues caused by hypoxia to the ocular surface have largely been negated. The ability of contact lenses to change the axial growth characteristics of the globe is being utilised to help reduce the myopia pandemic and several studies and meta-analyses have shown that wearing orthokeratology lenses or soft multifocal contact lenses can reduce axial length growth (and hence myopia). However, effects on blinking, ptosis, the function of Meibomian glands, fluorescein and lissamine green staining of the conjunctiva and cornea, production of lid-parallel conjunctival folds and lid wiper epitheliopathy have received less research attention. Contact lens wear produces a subclinical inflammatory response manifested by increases in the number of dendritiform cells in the conjunctiva, cornea and limbus. Papillary conjunctivitis is also a complication of all types of contact lenses. Changes to wear schedule (daily disposable from overnight wear) or lens materials (hydrogel from SiHy) can reduce papillary conjunctivitis, but the effect of such changes on dendritic cell migration needs further study. These changes may be associated with decreased comfort but confirmatory studies are needed. Contact lenses can affect the sensitivity of the ocular surface to mechanical stimulation, but whether these changes affect comfort requires further investigation. In conclusion, there have been changes to lens materials, design and wear schedules over the past 20+ years that have improved their safety and seen the development of lenses that can reduce the myopia development. However, several changes to the ocular surface still occur and warrant further research effort in order to optimise the lens wearing experience.
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Affiliation(s)
- Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, UK.
| | - Paul J Murphy
- University of Waterloo, School of Optometry and Vision Science, Waterloo, Canada
| | - Kate L Gifford
- School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Australia
| | - Paul Gifford
- School of Optometry and Vision Science, UNSW Sydney, Australia
| | | | - Leah Johnson
- CooperVision Specialty EyeCare, Gilbert, AZ, United States
| | - Dimitra Makrynioti
- School of Health Rehabilitation Sciences, University of Patras (Aigio), Greece
| | - Amir M Moezzi
- Centre for Ocular Research and Education, University of Waterloo, Canada
| | - Kurt Moody
- Johnson & Johnson Vision Care, Jacksonville, FL, United States
| | | | | | - Kasandra Swiderska
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, UK
| | | | - Mark Willcox
- School of Optometry and Vision Science, UNSW Sydney, Australia
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Jandl A, Ruland T, Schwarz D, Wolffsohn JS, Pult H, Bandlitz S. Clinical significance of contact lens related changes of ocular surface tissue observed on optical coherence images. Cont Lens Anterior Eye 2020; 44:101388. [PMID: 33293225 DOI: 10.1016/j.clae.2020.11.008] [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: 09/15/2020] [Revised: 11/12/2020] [Accepted: 11/15/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the relationship between the real contact lens imprint into the conjunctival tissue, observed by optical coherence tomography (OCT) and conjunctival staining and contact lens wearing comfort. METHODS 17 participants (mean age = 26.6 SD ± 3.6 years; 7 females) were fitted with three different contact lenses base curves of the same silicone hydrogel custom lens type (Visell 50; Hecht Contactlinsen, Au, Germany) in a randomised order. One lens was optimally fitted according to the manufacturer's recommendation, one fitted 0.4 mm flatter and one fitted 0.4 mm steeper. After 4 h of lens wear the contact lens edge in the area of the conjunctiva was imaged nasally and temporally using OCT (Optovue iVue SD-OCT). To correct the artefact due to optical distortion with OCT, the imprint of all worn lenses was measured on a glass plate afterwards. Conjunctival staining in the limbal region after 4 h of lens wear was classified using the CCLRU Grading Scale. Comfort scoring was based on visual analog scales from 0 (very poor) to 100 (excellent). RESULTS The mean conjunctival imprint of all contact lens edges was 32.0 ± 8.1 μm before and 7.3 ± 6.5 μm after distortion correction of the OCT images. The distortion corrected conjunctival imprint with the 0.4 mm steeper lens (11.5 ± 6.2 μm) was statistically significantly greater compared to the optimally fitted lens (6.5 ± 5.9 μm) (One-way ANOVA followed Tukey-test; p = 0.017) and greater compared to the 0.4 mm flatter lens (3.9 ± 5.3 μm) (p < 0.001). There was no statistically significant difference between the optimally fitted lens and the 0.4 mm flatter lens (p = 0.209). The nasally measured imprint (11.4 ± 9.0 μm) was significantly greater than the temporally measured (3.3 ± 7.6 μm) (p < 0.001). There was no statistically significant correlation between the amount of conjunctival imprint and the graded conjunctival staining (p = 0.346) or the wearer's comfort (p = 0.735). CONCLUSIONS Contact lens edges imaged by OCT exhibited displacement artefacts. The observed conjunctival imprints are a combination of real conjunctival compression and artefacts. A deeper imprint of the contact lens into the conjunctiva caused by a steeper base curve was not related to clinically significant staining or changes in comfort after 4 h of lens wear. The observed differences between nasal and temporal imprint are likely to be caused by variations of conjunctival thickness and the shape of the underlying sclera.
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Affiliation(s)
- Alexandra Jandl
- Höhere Fachschule für Augenoptik Köln, Cologne School of Optometry, Cologne, Germany
| | - Thomas Ruland
- Höhere Fachschule für Augenoptik Köln, Cologne School of Optometry, Cologne, Germany
| | - David Schwarz
- Höhere Fachschule für Augenoptik Köln, Cologne School of Optometry, Cologne, Germany
| | - James S Wolffsohn
- Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom
| | - Heiko Pult
- Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom; Dr Heiko Pult - Optometry and Vision Research, Weinheim, Germany; School of Biomedical & Life Sciences, Cardiff University, Cardiff, United Kingdom
| | - Stefan Bandlitz
- Höhere Fachschule für Augenoptik Köln, Cologne School of Optometry, Cologne, Germany; Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom.
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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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18
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Saeki K, Huyan D, Sawada M, Sun Y, Nakamura A, Kimura M, Kubota S, Uno K, Ohnuma K, Shiina T. Measurement algorithm for real front and back curved surfaces of contact lenses. APPLIED OPTICS 2020; 59:9051-9059. [PMID: 33104595 DOI: 10.1364/ao.399190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 09/05/2020] [Indexed: 06/11/2023]
Abstract
The optical measurement algorithm for the real front and back surfaces of contact lenses from their center to periphery accurately and simultaneously is proposed. It is an algorithm that makes light incident vertically along the curved surfaces of contact lenses under the condition that the difference of curvature radii between the front and back surfaces is small enough within the NA of the optical probe. For this purpose, we adopted time-domain optical coherence tomography (OCT) with translation and rotation mechanisms. The shape, thickness distribution, and curvature radii of both surfaces were estimated with OCT signal analysis and circular approximation. The measured results were compared with the designed values and the measured data from a conventional shape measurement device. The curved shape of both surfaces and thickness were well matched with the designed values from lens center to periphery. In a curvature radius of the front surface, there was a proportional bias with a limit of agreement of -0.77% to -2.09%, and the correlation coefficient was 0.57. On the back surface, there was no systematic bias, and minimal detectable change was 0.178 mm, in a range of 95% confidential interval. The proposed algorithm well visualized the real shape and optical characteristics of the contact lens with enough accuracy to the design.
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A 12-month Prospective Study of Tear Osmolarity in Contact Lens Wearers Refitted with Daily Disposable Soft Contact Lenses. Optom Vis Sci 2020; 97:178-185. [PMID: 32168240 DOI: 10.1097/opx.0000000000001488] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
SIGNIFICANCE Tear osmolarity has been reported as one of the best diagnostic tests for dry eye disease and its management. Contact lens wear is thought to influence tear homeostasis. Understanding how regular wear of contact lenses and their type affect tear osmolarity is important. PURPOSE The purpose of this study was to assess changes in tear osmolarity and ocular symptoms over a period of 12 months following refitting contact lens wearers with daily disposable contact lenses. METHODS Fifty subjects aged (mean ± SD) 26 ± 4 years were refitted with either silicone-hydrogel (delefilcon A, SiHy, n = 34) or hydrogel (omafilcon A, Hy, n = 16) daily disposable soft contact lenses. Study included seven visits: baseline measurements without contact lenses; two visits for contact lens fit and selection; follow-up measurements after 3, 6, and 12 months of contact lens wear; and a post-study visit without contact lenses. Lens type selection was based on a set of objective measurements. Subjects were instructed to follow strict wearing rules. Impedance-based osmometer was used to collect samples from the lower tear meniscuses. The Ocular Surface Disease Index (OSDI) and the eight-item Contact Lens Dry Eye Questionnaire were used to assess subject-reported ocular symptoms and contact lens discomfort, respectively. RESULTS Downward trend of tear osmolarity was noted over the time course of study. Statistically significant differences were noted in tear osmolarity (Friedman test, χ = 21.91 [P < .001], and χ = 13.89 [P = .003]) for the right and left eyes, respectively. A statistically significant decrease in tear osmolarity was apparent only for initially symptomatic subjects (for OSDI ≥13: χ = 26.25, P < .001; for OSDI <13: χ = 5.65, P = .13). Statistically significant differences were not noted in OSDI and the eight-item Contact Lens Dry Eye Questionnaire between the baseline and 12-month visit (χ = 5.92 [P = .12] and R = 0.015 [P = .87], respectively). There was a difference between baseline and post-study visits (P = .002) in OSDI, showing lower score at the latter visit. CONCLUSIONS Refitting with daily disposable contact lenses was demonstrated to lower tear osmolarity.
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Sorbara L, Maram J, Simpson T, Hutchings N. Corneal, Conjunctival effects and blood flow changes related to silicone hydrogel lens wear and their correlations with end of day comfort. Cont Lens Anterior Eye 2018; 41:193-200. [DOI: 10.1016/j.clae.2017.12.010] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 11/30/2017] [Accepted: 12/01/2017] [Indexed: 11/28/2022]
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Abstract
PURPOSE To assess the edge shape of soft contact lenses using Gabor-Domain Optical Coherence Microscopy (GD-OCM) with a 2-μm imaging resolution in three dimensions and to generate edge-thickness profiles at different distances from the edge tip of soft contact lenses. METHODS A high-speed custom-designed GD-OCM system was used to produce 3D images of the edge of an experimental soft contact lens (Bausch + Lomb, Rochester, NY) in four different configurations: in air, submerged into water, submerged into saline with contrast agent, and placed onto the cornea of a porcine eyeball. An algorithm to compute the edge-thickness was developed and applied to cross-sectional images. The proposed algorithm includes the accurate detection of the interfaces between the lens and the environment, and the correction of the refraction error. RESULTS The sharply defined edge tip of a soft contact lens was visualized in 3D. Results showed precise thickness measurement of the contact lens edge profile. Fifty cross-sectional image frames for each configuration were used to test the robustness of the algorithm in evaluating the edge-thickness at any distance from the edge tip. The precision of the measurements was less than 0.2 μm. CONCLUSIONS The results confirmed the ability of GD-OCM to provide high-definition images of soft contact lens edges. As a nondestructive, precise, and fast metrology tool for soft contact lens measurement, the integration of GD-OCM in the design and manufacturing of contact lenses will be beneficial for further improvement in edge design and quality control. In the clinical perspective, the in vivo evaluation of the lens fitted onto the cornea will advance our understanding of how the edge interacts with the ocular surface. The latter will provide insights into the impact of long-term use of contact lenses on the visual performance.
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Bandlitz S, Bäumer J, Conrad U, Wolffsohn J. Scleral topography analysed by optical coherence tomography. Cont Lens Anterior Eye 2017; 40:242-247. [DOI: 10.1016/j.clae.2017.04.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 11/28/2022]
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Corneo-scleral limbal changes following short-term soft contact lens wear. Cont Lens Anterior Eye 2017; 40:293-300. [PMID: 28550975 DOI: 10.1016/j.clae.2017.04.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 04/28/2017] [Accepted: 04/28/2017] [Indexed: 12/25/2022]
Abstract
PURPOSE To assess whether short-term soft contact lens wear alters the anterior eye surface. METHODS Twenty-two neophyte subjects wore soft contact lenses for a period of five hours. Topography based corneo-scleral limbal radius estimates were derived from height measurements acquired with a corneo-scleral profilometer. Additionally, central corneal thickness (CCT), anterior chamber depth (ACD), corneal curvature radius (R) and white-to-white (WTW) diameter were acquired with an OCT-assisted biometer. Measurements were obtained without lens wear (baseline), immediately after lens removal following five hours of wear and three hours after lens removal. RESULTS Short-term soft contact lens wear significantly modifies corneo-scleral limbal radius (mean±SD: 130±74μm, p << 0.001) and the changes are repeatable. In contrast, the WTW diameter and R were not modified. ACD and CCT were significantly affected but no significant correlations were found between the increment of the limbal radius and the decrease in ACD and CCT. Limbal radius increment was reversed three hours after lens removal for 68% of the subjects but the time course of this reversal was not uniform. CONCLUSIONS It is possible to accurately quantify limbal radius changes as a consequence of soft contact lens wear. The increment in the limbal diameter could reach over 0.5mm but that alteration does not correspond to changes in WTW diameter and it was not observable to the examiner using a slit lamp. Assessing topographical limbus after contact lens wear could be a tool to optimize the selection of the contact lens, from the perspective of anterior eye surface changes.
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Ersan I, Arikan S, Kara S, Gencer B, Koklu A, Tufan HA. Non-invasive assessment of corneal and conjunctival deterioration in soft contact lens users using anterior segment optical coherence tomography. Clin Exp Optom 2016; 99:564-567. [PMID: 27029024 DOI: 10.1111/cxo.12363] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Accepted: 09/24/2015] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aim was to evaluate the corneal and bulbar conjunctival thicknesses of soft contact lens (SCL) wearers using anterior segment optical coherence tomography (AS-OCT). METHODS The epithelial and overall thicknesses of both the central cornea and the infero-temporal bulbar conjunctiva of SCL wearers (30 subjects) were obtained by Cirrus HD-OCT and compared with those of refraction-matched controls (30 subjects) and patients with emmetropia (30 subjects). RESULTS The mean corneal epithelial thicknesses in SCL wearing, spectacle-wearing and emmetropic groups were 48.97 ± 5.45, 52.18 ± 4.84 and 53.18 ± 5.05 µm, respectively. The corneal epithelium of members of the SCL group was significantly thinner than in both the spectacles and emmetropic groups (p = 0.044 and 0.006, respectively), whereas the central corneal thickness did not differ between groups (p = 0.210). The mean conjunctival epithelial thicknesses in SCL, spectacles and emmetropic groups were 41.50 ± 7.75, 54.33 ± 8.39 and 49.10 ± 7.11 µm, respectively. Conjunctival epithelium in the SCL group was significantly thinner than in both spectacle-wearing and emmetropic groups (p < 0.001 and p = 0.001, respectively). The conjunctiva was significantly thinner in the SCL group compared to the spectacles group (p = 0.001) but not the emmetropic group. CONCLUSIONS Contact lens wear is related to thinning of both corneal and conjunctival layers. AS-OCT is a non-invasive and clinically applicable technique for assessing the involvement of the cornea and conjunctiva in contact lens wearers.
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Affiliation(s)
- Ismail Ersan
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey.
| | - Sedat Arikan
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Selcuk Kara
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Baran Gencer
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Asiye Koklu
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
| | - Hasan Ali Tufan
- Department of Ophthalmology, Canakkale Onsekiz Mart University School of Medicine, Canakkale, Turkey
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Carracedo G, Crooke A, Guzman-Aranguez A, Pérez de Lara MJ, Martin-Gil A, Pintor J. The role of dinucleoside polyphosphates on the ocular surface and other eye structures. Prog Retin Eye Res 2016; 55:182-205. [PMID: 27421962 DOI: 10.1016/j.preteyeres.2016.07.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 06/30/2016] [Accepted: 07/05/2016] [Indexed: 11/17/2022]
Abstract
Dinucleoside polyphosphates comprises a group of dinucleotides formed by two nucleosides linked by a variable number of phosphates, abbreviated NpnN (where n represents the number of phosphates). These compounds are naturally occurring substances present in tears, aqueous humour and in the retina. As the consequence of their presence, these dinucleotides contribute to many ocular physiological processes. On the ocular surface, dinucleoside polyphosphates can stimulate tear secretion, mucin release from goblet cells and they help epithelial wound healing by accelerating cell migration rate. These dinucleotides can also stimulate the presence of proteins known to protect the ocular surface against microorganisms, such as lysozyme and lactoferrin. One of the latest discoveries is the ability of some dinucleotides to facilitate the paracellular way on the cornea, therefore allowing the delivery of compounds, such as antiglaucomatous ones, more easily within the eye. The compound Ap4A has been described being abnormally elevated in patient's tears suffering of dry eye, Sjogren syndrome, congenital aniridia, or after refractive surgery, suggesting this molecule as biomarker for dry eye condition. At the intraocular level, some diadenosine polyphosphates are abnormally elevated in glaucoma patients, and this can be related to the stimulation of a P2Y2 receptor that increases the chloride efflux and water movement in the ciliary epithelium. In the retina, the dinucleotide dCp4U, has been proven to be useful to help in the recovery of retinal detachments. Altogether, dinucleoside polyphosphates are a group of compounds which present relevant physiological actions but which also can perform promising therapeutic benefits.
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Affiliation(s)
- Gonzalo Carracedo
- Department of Optics II (Optometry and Vision), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Almudena Crooke
- Department of Biochemistry and Molecular Biology IV, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana Guzman-Aranguez
- Department of Biochemistry and Molecular Biology IV, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Maria J Pérez de Lara
- Department of Biochemistry and Molecular Biology IV, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Alba Martin-Gil
- Department of Biochemistry and Molecular Biology IV, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Jesús Pintor
- Department of Biochemistry and Molecular Biology IV, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain.
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Boychev N, Laughton DS, Bharwani G, Ghuman H, Wolffsohn JS. How should initial fit inform soft contact lens prescribing. Cont Lens Anterior Eye 2016; 39:227-33. [DOI: 10.1016/j.clae.2015.11.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/07/2015] [Accepted: 11/01/2015] [Indexed: 10/22/2022]
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27
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Morphological changes in the conjunctiva, episclera and sclera following short-term miniscleral contact lens wear in rigid lens neophytes. Cont Lens Anterior Eye 2016; 39:53-61. [DOI: 10.1016/j.clae.2015.06.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Revised: 06/28/2015] [Accepted: 06/30/2015] [Indexed: 11/20/2022]
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28
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Coldrick BJ, Richards C, Sugden K, Wolffsohn JS, Drew TE. Developments in contact lens measurement: A comparative study of industry standard geometric inspection and optical coherence tomography. Cont Lens Anterior Eye 2016; 39:270-6. [PMID: 26818615 DOI: 10.1016/j.clae.2016.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 12/11/2015] [Accepted: 01/08/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study was to compare a developmental optical coherence tomography (OCT) based contact lens inspection instrument to a widely used geometric inspection instrument (Optimec JCF), to establish the capability of a market focused OCT system. METHODS Measurements of 27 soft spherical contact lenses were made using the Optimec JCF and a new OCT based instrument, the Optimec is830. Twelve of the lenses analysed were specially commissioned from a traditional hydrogel (Contamac GM Advance 49%) and 12 from a silicone hydrogel (Contamac Definitive 65), each set with a range of back optic zone radius (BOZR) and centre thickness (CT) values. Three commercial lenses were also measured; CooperVision MyDay (Stenfilcon A) in -10D, -3D and +6D powers. Two measurements of BOZR, CT and total diameter were made for each lens in temperature controlled saline on both instruments. RESULTS The results showed that the is830 and JCF measurements were comparable, but that the is830 had a better repeatability coefficient for BOZR (0.065mm compared to 0.151mm) and CT (0.008mm compared to 0.027mm). Both instruments had similar results for total diameter (0.041mm compared to 0.044mm). CONCLUSIONS The OCT based instrument assessed in this study is able to match and improve on the JCF instrument for the measurement of total diameter, back optic zone radius and centre thickness for soft contact lenses in temperature controlled saline.
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Affiliation(s)
- Benjamin J Coldrick
- Aston University, Life and Health Sciences, Biomedical Engineering, Birmingham, United Kingdom; Optimec Limited, Malvern, United Kingdom.
| | | | - Kate Sugden
- Aston University, Engineering and Applied Sciences, AIPT, Birmingham, United Kingdom
| | - James S Wolffsohn
- Aston University, Life and Health Sciences, Biomedical Engineering, Birmingham, United Kingdom
| | - Thomas E Drew
- Aston University, Life and Health Sciences, Biomedical Engineering, Birmingham, United Kingdom
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Del Águila-Carrasco AJ, Ferrer-Blasco T, García-Lázaro S, Esteve-Taboada JJ, Montés-Micó R. Assessment of corneal thickness and tear meniscus during contact-lens wear. Cont Lens Anterior Eye 2015; 38:185-93. [DOI: 10.1016/j.clae.2015.01.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 12/10/2014] [Accepted: 01/26/2015] [Indexed: 11/15/2022]
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Turhan SA, Toker E. Optical coherence tomography to evaluate the interaction of different edge designs of four different silicone hydrogel lenses with the ocular surface. Clin Ophthalmol 2015; 9:935-42. [PMID: 26045658 PMCID: PMC4448929 DOI: 10.2147/opth.s83798] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the lens edge interaction with the ocular surface with different edge designs using optical coherence tomography and to examine the effect of lens power on the lens edge interactions. Methods Four types of silicone hydrogel lenses with different edge designs (round-, semi-round-, chisel-, and knife-edged) at six different powers (+5.0, +3.0, +1.0, −1.0, −3.0, and −5.0 diopters) were fitted to both eyes of 20 healthy volunteers. Optical coherence tomography images were taken at the corneal center and at the limbus within 15–30 minutes after insertion. The images were evaluated with respect to two parameters: conjunctival indentation exerted by the lens edge; and the tear film gaps between the posterior surface of the lens and the ocular surface. The amount of conjunctival indentation was measured with the distortion angle of the conjunctiva at the lens edge. Results The degree of conjunctival indentation was highest with the chisel-edged design followed by the semi-round design (P<0.0001). Knife- and round-edged lenses exerted similar levels of conjunctival indentation that was significantly lower compared to chisel-edged lens (P<0.001). For each one of the tested lens edge designs, no significant difference was observed in the conjunctival indentation with respect to lens power. The chisel-edged lens produced the highest amount of conjunctival indentation for each one of the six lens powers (P<0.0001). Post-lens tear film gaps at the limbus were observed at most in the round-edge design (P=0.001). Conclusion The fitting properties of contact lenses may be influenced by their edge design but not by their lens power.
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Affiliation(s)
- Semra Akkaya Turhan
- Department of Ophthalmology, School of Medicine, University of Marmara, Istanbul, Turkey
| | - Ebru Toker
- Department of Ophthalmology, School of Medicine, University of Marmara, Istanbul, Turkey
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Sorbara L, Simpson TL, Maram J, Song ES, Bizheva K, Hutchings N. Optical edge effects create conjunctival indentation thickness artefacts. Ophthalmic Physiol Opt 2015; 35:283-92. [DOI: 10.1111/opo.12196] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 12/08/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Luigina Sorbara
- School of Optometry & Vision Science; University of Waterloo; Waterloo Canada
- Centre for Contact Lens Research; University of Waterloo; Waterloo Canada
| | - Trefford L. Simpson
- School of Optometry & Vision Science; University of Waterloo; Waterloo Canada
| | - Jyotsna Maram
- School of Optometry & Vision Science; University of Waterloo; Waterloo Canada
- Centre for Contact Lens Research; University of Waterloo; Waterloo Canada
| | - Eun Sun Song
- Department of Physics & Astronomy; University of Waterloo; Waterloo Canada
| | - Kostadinka Bizheva
- School of Optometry & Vision Science; University of Waterloo; Waterloo Canada
- Department of Physics & Astronomy; University of Waterloo; Waterloo Canada
| | - Natalie Hutchings
- School of Optometry & Vision Science; University of Waterloo; Waterloo Canada
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