Assessing neophyte response to daily disposable silicone hydrogel contact lenses: A randomised clinical trial investigation over one month

OBJECTIVE

This randomised clinical trial assessed the impact on symptoms, tear film dynamics and ocular surface integrity of daily disposable silicone-hydrogel contact lenses (CLs) over a month, paying special attention to lid wiper epitheliopathy (LWE) and its implications for CL discomfort.

METHODS

Neophyte CL wearers (n = 44, 21.09 ± 5.00 years old) were randomly assigned to either the experimental (n = 24) or control group (n = 20). Participants assigned to the experimental group were required to wear daily disposable CLs for 1 month for at least 8 h/day and 6 days/week. All participants were healthy subjects (no history of ocular surgery or active ocular disease) with spherical refractive errors between -8.00 and +5.00 D and cylindrical power <0.75 D. At the baseline and 1-month sessions, the Dry Eye Questionnaire 5 (DEQ-5) was completed, together with the measurement of tear film osmolarity with the TearLab osmometer, tear meniscus height (TMH) and lipid layer pattern (LLP) using a slit-lamp with Tearscope Plus attached, fluorescein break-up time (FBUT), maximum blink interval (MBI), corneal staining with fluorescein under cobalt blue light and LWE with lissamine green under slit lamp and halogen white light.

RESULTS

At the baseline session, LWE showed a negative correlation with DEQ-5 (r = -0.37, p = 0.02). Significant differences in FBUT and LWE (p = 0.04) and a positive correlation between LWE and DEQ-5 (r = 0.49, p = 0.007) were observed at 1 month. Intrasession analysis at 1 month showed significant differences between the experimental and control groups in DEQ-5, FBUT and LWE (all p ≤ 0.02). Intersession analysis in the experimental group showed variations in DEQ-5, FBUT and LWE (all p ≤ 0.02) but no significant variation in the control group (all p ≥ 0.11).

CONCLUSION

The presence of LWE was significantly correlated with higher symptom values in the DEQ-5. Also, participants in the experimental group presented higher values of LWE after 1 month of CL wear, in comparison with the control group.

Meibum Lipidomic Analysis in Evaporative Dry Eye Subjects

Meibomian Glands (MG) are sebaceous glands responsible for the production of meibum, the main component of the Tear Film Lipid Layer (TFLL). The TFLL facilitates the spread of the tear film over the ocular surface, provides stability and reduces tear evaporation. Alterations in meibum composition lead to different ocular alterations like Meibomian Gland Dysfunction (MGD) and subsequent Evaporative Dry Eye (EDE). The aim of the present study was to investigate the composition and abundance of meibum lipids and their relationship with eyelid margin abnormalities, lipid layer patterns and MG status. The study utilizes a lipidomic approach to identify and quantify lipids in meibum samples using an Elute UHPLC system. This system considered all four dimensions (mass/charge, retention time, ion mobility and intensity) to provide the accurate identification of lipid species. Samples were categorized as healthy or low/no signs of alteration (group 1) or severe signs of alteration or EDE/MGD (group 2). The current investigation found differences in Variable Importance in Projection lipid abundance between both groups for the MGD signs studied. Changes in meibum composition occur and are related to higher scores in eyelid margin hyperaemia, eyelid margin irregularity, MG orifice plugging, MG loss and lipid layer pattern.

A Comprehensive Study on Tear Meniscus Height Inter-Eye Differences in Aqueous Deficient Dry Eye Diagnosis

(1) Background: Dry eye disease (DED) is a chronic ocular surface condition that requires precise diagnostic tools. The present study aimed to investigate the diagnostic potential of the absolute inter-eye difference (|OD-OS|) in tear meniscus height (TMH) for the detection of the presence of aqueous deficient dry eye (ADDE). (2) Methods: A sample of 260 participants with dry eye complaints underwent ocular surface examinations thorough diagnostic assessments based on the Tear Film and Ocular Surface Society guidelines (TFOS DEWS II). Participants were subsequently categorized as No ADDE and ADDE based on TMH. Statistical analyses to determine the optimal TMH|OD-OS| cut-off value in a randomly selected study group (200 participants) were performed, while a separate validation analysis of the cut-off value obtained in a random cross-validation group (60 participants) was also performed. (3) Results: The significant diagnostic capability of TMH|OD-OS| (area under the curve = 0.719 ± 0.036, p < 0.001) was found. The identified cut-off value of 0.033 mm demonstrated reliable specificity (77.6%) and moderate sensitivity (59.1%). Cross-validation confirmed the cut-off value's association with the TFOS DEWS II diagnostic criterion (Cramer's V = 0.354, p = 0.006). (4) Conclusions: The present study provides evidence for the diagnostic potential of TMH|OD-OS| in identifying ADDE. The identified cut-off value enhances the specificity and offers moderate sensitivity, providing an objective tool for clinical decision making.

Intraocular pressure fluctuations assessment in professional wind instrument players

CLINICAL RELEVANCE

Due to the long-time that wind musicians spend playing their instruments, it is important to investigate if intraocular pressure could be affected by this activity.

BACKGROUND

To assess the intraocular pressure fluctuations and fluctuations affecting factors in professional wind musicians while playing different tones.

METHODS

Thirty professional wind musicians (23.0 ± 3.20 years) were recruited from the Professional Music College of A Coruña. A questionnaire about environmental/demographic factors was given to participants. Intraocular pressure was measured four times by ICare IC100 tonometer: before, during low and high-pitched tones, and immediately after stopping playing the wind instrument.

RESULTS

Pairwise comparison revealed statistical differences between measurement points (Sidak, all p ≤ 0.019), except between before playing and while playing low-pitched tones (Sidak, p = 1.000). Intraocular pressure increases during high pitch playing and decreases after stopping playing. No significant differences in intraocular pressure fluctuation were reported between physically active (>2 days/week) and non-physically active participants (Unpaired t-test, p = 0.680). All intraocular pressure values were positively correlated (Pearson's correlation, all r ≥ 0.505, p ≤ 0.004). Intraocular pressure fluctuations were negatively correlated with musical playing years (Pearson's correlation, r = - 0.396, p = 0.030). There were no significant correlations among intraocular pressure fluctuation and gender, age, weight, height, or daily time playing (Pearson's correlation, all p ≥ 0.058).

CONCLUSION

Professional wind musicians suffer intraocular pressure peaks while playing high-pitched tones; therefore, ocular fundus evaluation and visual campimetry should be performed as routine tests in the visual exam of this population.

Lenstar LS900 vs EchoScan US-800: comparison between optical and ultrasound biometry with and without contact lenses and its relationship with other biometric parameters

BACKGROUND

Due to the increasing use of contact lenses (CL) and the interest in ocular and body size relationships, this study aimed to compare measurements from two biometers (contact ultrasonic EchoScan US-800 and non-contact optical Lenstar LS900) with and without CL and to explore the relationship between ocular and body biometric parameters.

DESIGN AND METHODS

This cross-sectional study measured ocular biometry using two biometers along with their body height and right foot length in 50 participants. Differences between biometry data from the two devices were compared and correlations between ocular and body biometric values were analyzed.

RESULTS

All parameters showed interbiometric differences (p ≤ 0.030), except crystalline lens thickness during CL wear (p = 0.159). Comparing measurements with and without CL, differences were observed in axial length (p < 0.001), vitreous length measured by optical biometer (p = 0.016), and anterior chamber depth by ultrasonic biometer (p < 0.016). Lens thickness remained unaffected (p ≥ 0.190). Body height and foot length were correlated with anterior chamber depth, vitreous length, and axial length (p ≤ 0.019, r ≥ 0.330). Most biometric parameters were correlated among them using both devices (p ≤ 0.037, r ≥ 0.296).

CONCLUSIONS

These biometers are not interchangeable and CL affects measurements. Body height and foot length correlate with ocular dimensions, and most ocular biometric values correlate positively.

Meibomian gland secretion quality association with ocular parameters in university students during COVID- 19 restrictions

PURPOSE

To determine if the Meibomian Gland (MG) secretion quality is associated with symptoms of ocular discomfort, hours of Video Display Terminals (VDT) use, eyelid margin abnormalities, conjunctival hyperemia, and Meibomian Gland Loss Area (MGLA) in a sample of university students.

METHODS

An online survey that included an Ocular Surface Disease Index (OSDI) questionnaire and an extra question about hours of VDT use recruited an initial sample of 183 participants. Only 120 participants that fulfilled the inclusion criteria were scheduled for a battery of ocular surface and MG specific exam. The tests include: 1) meibometry, 2) slit lamp exploration of eyelid margin abnormalities (irregularity, hyperemia and MG orifices plugging), MG secretion quality and conjunctival hyperemia, and 3) Meibography.

RESULTS

Significant positive correlations between the MG secretion quality and eyelid margin hyperemia, MG orifices plugging, MGLA, nasal conjunctival hyperemia, and temporal conjunctival hyperemia (Spearman Rho; all r>0.186, p<0.042) were found. Multivariate regression found association between OSDI with hours of VDT use (B=0.316, p=0.007), and eyelid hyperemia (B=0.434, p≤ 0.001). A statistical association between MG secretion quality and eyelid margin hyperemia, MG orifices plugging, MGLA and conjunctival hyperemia (Fisher's exact; all p<0.039) were found. Multivariate regression found association between MG secretion quality with MG orifices plugging (B=0.295, p=0.004) and meibometry (B=-0.001, p=0.029).

CONCLUSION

Participants with higher values in MG secretion quality have higher values in eyelid margin hyperemia, MG plugging, MGLA, and conjunctival hyperemia. No direct relationship between MG secretion quality and hours of VDT use or OSDI were found.

Changes of symptomatology, tear film and ocular surface integrity one week during Somofilcon-A and Omafilcon-A lens wear

PURPOSE

Clinicians play a key role in prescribing contact lenses that best suited for fitting which materials had an impact on ocular surface parameters. The present study aimed to evaluate the impact on symptomatology, tear film dynamics and ocular surface integrity of a silicone-hydrogel (Somofilcon-A) and a hydrogel (Omafilcon-A) lens before and after wearing for one week in contact lens neophyte participants.

METHODS

A Somofilcon-A and Omafilcon-A were randomly fitted to one or other the eye on an initial group of 28 participants. Subjects were scheduled for three sessions: basal session previous fitting, second session after 4-wear hours, and final session after 7-wear days for up to 10 h. In each session, CLDEQ-8, tear meniscus height and hyperemia with and without lenses, as well as lipid layer thickness and corneal/conjunctival staining without lenses were assessed. Values were compared between lenses and sessions.

RESULTS

In intrasession comparison, there were no differences in any parameter between materials on any session with or without lenses (all p≥0.176), except on the conjunctival staining where values obtained during Somofilcon-A wear (all p ≤ 0.006). In intersession analysis, CLDEQ-8 score, tear meniscus height and lipid layer thickness showed a statistical difference during both materials wear (all p ≤ 0.009), while conjunctival hyperemia does not (p  =  0.237); corneal staining showed differences during Omafilcon-A wear (p  =  0.037), contrary to conjunctival staining which showed differences only during Somofilcon-A wear (p < 0.001).

CONCLUSION

Contact lenses wear had an impact on ocular parameters that have some specific influences of the material on which lenses were manufactured.

Analysis of the Differences in Ocular Surface Damage and Inflammatory Signs between Healthy and Evaporative Dry Eye Participants

OBJECTIVE

Distinguish between EDE severity levels by analysing the MGLA, conjunctival hyperemia and corneal staining.

METHODS

One hundred participants were recruited based on OSDI, TO, TFBUT, TMH, and LLP to be categorised as healthy (Group 1) or EDE (Group 2). Group 2 was divided into Group 2A (mild symptoms), 2B (moderate), and 2C (severe). MGLA, conjunctival hyperemia, and corneal staining were measured.

RESULTS

 Positive correlation between MGLA, conjunctival hyperemia, and corneal staining were found (all r ≥ 0.221, p ≤ 0.027). Significant differences were found: MGLA between Group 1 vs. 2C and 2C vs. 2A or 2B; conjunctival hyperemia between Group 1 vs. 2A, 2B or 2C; corneal staining between Group 1 vs. 2B or 2C and 2A vs. 2B or 2C (all p ≤ 0.049).

CONCLUSION

Severe EDE participants have higher MGLA, conjunctival hyperemia, and corneal staining values than healthy, mild, or moderate EDE participants.

Interobserver variability of an open-source software for tear meniscus height measurement

PURPOSE

Different values of the lower tear meniscus height (TMH) can be obtained depending on the method and technique of measurement employed. The aim of this study was to analyse the interobserver variability of a method for measuring TMH by using an open source software.

MATERIAL AND METHODS

On a group of 176 subjects, two videos of the central lower tear meniscus, first under slit-lamp illumination and ten minutes later under Tearscope illumination, were generated by a digital camera attached to a slit-lamp. Images were extracted from each video by a masked observer. Two further observers measured in a masked and randomized order the TMH in each illumination method by using an open source software based on Java (NIH ImageJ). TMH was measured from the lower lid to the upper limit of the tear meniscus for both slit-lamp (TMH-SL) and Tearscope (TMH-Tc) illumination methods. Subsequently, in different order, observers assigned a four-grading and a healthy/abnormal subjective classification to each central meniscus.

RESULTS

No significant differences were found between the TMH measurements obtained by both investigators in slit-lamp or Tearscope image datasets (t-test; both p≥0.136). When comparing TMH measurements stratified by grade, only interobserver significant differences were observed for grades 3 and 4 with silt-lamp (t-test; both p≤0.009). Significant differences on TMH results between subjective subgroups were observed for both illumination techniques (ANOVA, all p≤0.045).

CONCLUSION

This study showed a useful tool to objectively measure TMH by photography.

Accuracy and Precision of EyeSys and Orbscan Systems on Calibrated Spherical Test Surfaces

BACKGROUND

It is important to know how well the surface topography can be measured with current devices for corneal topographic analysis. There are several applications that need an accurate and precise method to measure corneal shape and variations, such as the effect of contact lens wear and the different refractive surgery techniques.

PURPOSE

The aim of this study is to compare the accuracy and reproducibility of the measurement of the central curvature on calibrated steel balls using the EyeSys videokeratoscope and the Orbscan corneal topography system.

METHODS

The videokeratoscope (EyeSys Corneal Analysis System 2000, version 3.1) and the Orbscan corneal topography system (Orbscan II version 3.0) were used by four trained investigators to measure a series of five uniform and calibrated test surfaces with known radius of curvature ranging from 6.13 to 9.00 mm.

RESULT

No statistically significant difference was found between the videokeratoscope and Orbscan systems in relation to accuracy or precision. The 95% confidence limits showed a close agreement between both instruments. The mean bias was less than +/-0.05 mm for both devices. The precision of the instruments was found to be similar.

CONCLUSION

The EyeSys seems to measure more accurately, but the accuracy of the Orbscan was also acceptable, suggesting that both instruments are accurate and precise enough for research and clinical purposes. However, further studies of accuracy and repeatability of topographical measurements on human eyes generated by different topographers are necessary.