Pub Date : 2017-01-01DOI: 10.1097/ICL.0000000000000318
F. Stapleton, Jacqueline Tan
Objective: To review the effect of contact lens (CL) material, design, and fitting characteristics on CL discomfort. Methods: A PubMed search identified publications describing subjective comfort and CL material, fitting, and design parameters. The review included clinical signs associated with discomfort that may be a consequence of these parameters. Results: Reduced lens movement or more CL tightness were associated with improved comfort. Increased lens-induced paralimbal conjunctival staining and indentation, considered as quasi-indicators of CL fitting or edge design, were also associated with better comfort. No recent studies have evaluated varying CL design parameters and subjective comfort. Silicone hydrogel CLs are no different in comfort compared with hydrogel CLs. Lower equilibrium water content is associated with improved comfort in hydrogel CL wear. Coefficient of friction shows promise as a material factor potentially associated with comfort. Lid wiper epitheliopathy and lid-parallel conjunctival folds have been linked with comfort in established wearers. Conclusions: Recent studies have confirmed the association between more mobile CLs and more discomfort, whereas closer conformity of the CL to the bulbar conjunctiva improved subjective comfort. There is no evidence to support the perceived comfort difference between silicone hydrogel and hydrogel CL. There has been limited progress in understanding the impact of varying specific CL design parameters. Although specific clinical signs may be predictive of discomfort, their role in the natural history of discomfort remains unclear. A better understanding of the relationship between coefficient of friction and comfort and strategies to improve lubricity may hold promise for limiting CL discomfort.
{"title":"Impact of Contact Lens Material, Design, and Fitting on Discomfort","authors":"F. Stapleton, Jacqueline Tan","doi":"10.1097/ICL.0000000000000318","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000318","url":null,"abstract":"Objective: To review the effect of contact lens (CL) material, design, and fitting characteristics on CL discomfort. Methods: A PubMed search identified publications describing subjective comfort and CL material, fitting, and design parameters. The review included clinical signs associated with discomfort that may be a consequence of these parameters. Results: Reduced lens movement or more CL tightness were associated with improved comfort. Increased lens-induced paralimbal conjunctival staining and indentation, considered as quasi-indicators of CL fitting or edge design, were also associated with better comfort. No recent studies have evaluated varying CL design parameters and subjective comfort. Silicone hydrogel CLs are no different in comfort compared with hydrogel CLs. Lower equilibrium water content is associated with improved comfort in hydrogel CL wear. Coefficient of friction shows promise as a material factor potentially associated with comfort. Lid wiper epitheliopathy and lid-parallel conjunctival folds have been linked with comfort in established wearers. Conclusions: Recent studies have confirmed the association between more mobile CLs and more discomfort, whereas closer conformity of the CL to the bulbar conjunctiva improved subjective comfort. There is no evidence to support the perceived comfort difference between silicone hydrogel and hydrogel CL. There has been limited progress in understanding the impact of varying specific CL design parameters. Although specific clinical signs may be predictive of discomfort, their role in the natural history of discomfort remains unclear. A better understanding of the relationship between coefficient of friction and comfort and strategies to improve lubricity may hold promise for limiting CL discomfort.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"64 1","pages":"32–39"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86166848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1097/ICL.0000000000000342
Stefanie M. Chan, T. Svitova, M. Lin
Abstract: Contact lens discomfort is a common problem that can lead to unsuccessful or limited contact lens wear. Although many factors may contribute to contact lens discomfort, limited research has explored the influence of ethnicity-related differences in the anatomy and physiology of the ocular surface. Therefore, we performed a search of the literature in PubMed using key words related to “ocular surface” paired with the terms “race” and “ethnicity.” The goal of this review was to determine potential areas of research regarding ethnicity differences, particularly between Asian and non-Asian eyes, in ocular surface integrity to advance our understanding of contact lens discomfort.
{"title":"Accounting for Ethnicity-Related Differences in Ocular Surface Integrity as a Step Toward Understanding Contact Lens Discomfort","authors":"Stefanie M. Chan, T. Svitova, M. Lin","doi":"10.1097/ICL.0000000000000342","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000342","url":null,"abstract":"Abstract: Contact lens discomfort is a common problem that can lead to unsuccessful or limited contact lens wear. Although many factors may contribute to contact lens discomfort, limited research has explored the influence of ethnicity-related differences in the anatomy and physiology of the ocular surface. Therefore, we performed a search of the literature in PubMed using key words related to “ocular surface” paired with the terms “race” and “ethnicity.” The goal of this review was to determine potential areas of research regarding ethnicity differences, particularly between Asian and non-Asian eyes, in ocular surface integrity to advance our understanding of contact lens discomfort.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"233 1","pages":"23–31"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75769490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1097/ICL.0000000000000237
Simin Masoudi, Zhenjun Zhao, F. Stapleton, M. Willcox
Purpose: Studies indicate that contact lens (CL) discontinuation mostly occurs because of dryness and discomfort symptoms. This study aimed to investigate relationships between changes in the concentration of tear inflammatory mediators with subjective comfort ratings with CL wear and no contact lens wear between morning and evening. Method: Forty-five subjects collected tears twice daily in the morning and in the evening with or without lenses. Comfort was rated subjectively on a scale from 1 to 100 (where 100 was extremely comfortable) just before each tear collection. Tear samples were assayed for complement components (C3 and C3a), leukotriene B4 (LTB4), secretory phospholipase A2 (sPLA2), secretory immunoglobulin A (sIgA), and bradykinin using commercially available immuno-based assay kits. Results: Comfort ratings showed a statistically significant decline from morning to evening both with CL (89.0±10.1 AM vs. 76.7±15.2 PM; P<0.001) and without CL (89.1±10.2 AM vs. 84.2±12.6 PM; P<0.005) wear. The decline was steeper with lens wear (P<0.001). Bradykinin and sPLA2 levels did not change between morning and evening or with CL wear (P>0.05). Leukotriene B4 levels were slightly higher in CL (CL 43.4±12.6 pg/ml vs. No CL 39.4±13.4 pg/mL; P=0.034), whereas the concentration of LTB4, C3, C3a, and sIgA dropped by the end of the day in the presence or absence of lens wear (P<0.001). For most mediators, tear levels were not correlated with comfort ratings in any of the conditions. Leukotriene B4 had a higher concentration in the evening, and when measured as a ratio to sIgA, there was a trend for increased concentration of this mediator during CL wear. Conclusion: Although specific mediators showed changes from morning to evening with and without lens wear, most of these were not correlated with subjective comfort ratings in lens wear. The only mediator that showed an increase in concentration during the day and during lens wear was LTB4, and further studies on this mediator are warranted.
目的:研究表明，隐形眼镜(CL)停戴主要是由于干燥和不适症状。本研究旨在探讨早晚佩戴CL和不佩戴隐形眼镜时泪液炎症介质浓度变化与主观舒适度之间的关系。方法:45例受试者每天早晚两次采集泪液，佩戴或不佩戴隐形眼镜。在每次收集眼泪之前，舒适度被主观地评定为从1到100的等级(其中100表示非常舒适)。泪液样品采用市售免疫检测试剂盒检测补体成分(C3和C3a)、白三烯B4 (LTB4)、分泌性磷脂酶A2 (sPLA2)、分泌性免疫球蛋白A (sIgA)和缓激肽。结果:舒适度评分从早上到晚上都有统计学上的显著下降(89.0±10.1 AM vs 76.7±15.2 PM;P0.05)。CL组白三烯B4水平略高(CL为43.4±12.6 pg/ml, CL为39.4±13.4 pg/ml;P=0.034)，而LTB4、C3、C3a和sIgA的浓度在有或没有镜片磨损的情况下在一天结束时下降(P<0.001)。对于大多数调解者来说，在任何条件下，眼泪水平都与舒适度评级无关。白三烯B4在晚上的浓度较高，当与sIgA的比值测量时，这种介质的浓度在CL磨损期间有增加的趋势。结论:虽然在佩戴和不佩戴隐形眼镜的情况下，特定的调节因子从早上到晚上都有变化，但大多数与佩戴隐形眼镜的主观舒适度评分无关。唯一在白天和镜片磨损期间显示浓度增加的介质是LTB4，对该介质的进一步研究是有必要的。
{"title":"Contact Lens–Induced Discomfort and Inflammatory Mediator Changes in Tears","authors":"Simin Masoudi, Zhenjun Zhao, F. Stapleton, M. Willcox","doi":"10.1097/ICL.0000000000000237","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000237","url":null,"abstract":"Purpose: Studies indicate that contact lens (CL) discontinuation mostly occurs because of dryness and discomfort symptoms. This study aimed to investigate relationships between changes in the concentration of tear inflammatory mediators with subjective comfort ratings with CL wear and no contact lens wear between morning and evening. Method: Forty-five subjects collected tears twice daily in the morning and in the evening with or without lenses. Comfort was rated subjectively on a scale from 1 to 100 (where 100 was extremely comfortable) just before each tear collection. Tear samples were assayed for complement components (C3 and C3a), leukotriene B4 (LTB4), secretory phospholipase A2 (sPLA2), secretory immunoglobulin A (sIgA), and bradykinin using commercially available immuno-based assay kits. Results: Comfort ratings showed a statistically significant decline from morning to evening both with CL (89.0±10.1 AM vs. 76.7±15.2 PM; P<0.001) and without CL (89.1±10.2 AM vs. 84.2±12.6 PM; P<0.005) wear. The decline was steeper with lens wear (P<0.001). Bradykinin and sPLA2 levels did not change between morning and evening or with CL wear (P>0.05). Leukotriene B4 levels were slightly higher in CL (CL 43.4±12.6 pg/ml vs. No CL 39.4±13.4 pg/mL; P=0.034), whereas the concentration of LTB4, C3, C3a, and sIgA dropped by the end of the day in the presence or absence of lens wear (P<0.001). For most mediators, tear levels were not correlated with comfort ratings in any of the conditions. Leukotriene B4 had a higher concentration in the evening, and when measured as a ratio to sIgA, there was a trend for increased concentration of this mediator during CL wear. Conclusion: Although specific mediators showed changes from morning to evening with and without lens wear, most of these were not correlated with subjective comfort ratings in lens wear. The only mediator that showed an increase in concentration during the day and during lens wear was LTB4, and further studies on this mediator are warranted.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"19 1","pages":"40–45"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74199242","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1097/ICL.0000000000000343
M. Willcox
Purpose: The aim of this study was to examine the literature with respect to inflammation of the ocular surface and the presence of inflammatory mediators in the tear film during contact lens wear. Methods: The literature on contact lens discomfort that relates to signs of inflammation was searched. Reference was paid to the cardinal signs of inflammation (pain, heat, redness, and swelling) as well as the appearance of inflammatory mediators in the tear film during contact lens wear. Results: Contact lens wear does induce discomfort, which is a mild form of pain, and wearing of lenses can induce increases in limbal and conjunctival redness. However, there is little evidence for a direct relationship between limbal or conjunctival redness and contact lens discomfort. Contact lenses may increase the temperature of the ocular surface by a small amount (⩽2.1°C). Corneal or conjunctival swelling has not been associated with contact lens discomfort. Complement or kinin breakdown products or histamine in tears are not associated with contact lens discomfort. Cytokines are generally not related to discomfort, although nerve growth factor levels were increased in tears of symptomatics in one report. The presence of degraded lipids, leukotriene B4 and peroxidation products, and the enzyme secretory phospholipase A2 in tears has been associated with contact lens discomfort, and this area is worthy of further research. Conclusions: There have been only a few studies that have investigated a role for inflammation in contact lens–induced discomfort, and the strongest associations have been found with lipid degradation processes.
{"title":"Is There a Role for Inflammation in Contact Lens Discomfort?","authors":"M. Willcox","doi":"10.1097/ICL.0000000000000343","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000343","url":null,"abstract":"Purpose: The aim of this study was to examine the literature with respect to inflammation of the ocular surface and the presence of inflammatory mediators in the tear film during contact lens wear. Methods: The literature on contact lens discomfort that relates to signs of inflammation was searched. Reference was paid to the cardinal signs of inflammation (pain, heat, redness, and swelling) as well as the appearance of inflammatory mediators in the tear film during contact lens wear. Results: Contact lens wear does induce discomfort, which is a mild form of pain, and wearing of lenses can induce increases in limbal and conjunctival redness. However, there is little evidence for a direct relationship between limbal or conjunctival redness and contact lens discomfort. Contact lenses may increase the temperature of the ocular surface by a small amount (⩽2.1°C). Corneal or conjunctival swelling has not been associated with contact lens discomfort. Complement or kinin breakdown products or histamine in tears are not associated with contact lens discomfort. Cytokines are generally not related to discomfort, although nerve growth factor levels were increased in tears of symptomatics in one report. The presence of degraded lipids, leukotriene B4 and peroxidation products, and the enzyme secretory phospholipase A2 in tears has been associated with contact lens discomfort, and this area is worthy of further research. Conclusions: There have been only a few studies that have investigated a role for inflammation in contact lens–induced discomfort, and the strongest associations have been found with lipid degradation processes.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"63 1","pages":"5–16"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74090343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1097/ICL.0000000000000233
Y. Matsumoto, Asako Kodama, E. Goto, T. Kawakita, M. Doğru, K. Tsubota
Purpose: To evaluate the relation between ocular surface irregularity and visual disturbance in early stage Acanthamoeba keratitis (AK). Methods: Fifteen patients with culture-proven AK underwent routine ophthalmic examinations, including best-corrected visual acuity (BCVA) measurement, slitlamp biomicroscope examination, and corneal fluorescein dye staining test, in both the eyes. We also evaluated the corneal sensitivity with Cochet-Bonnet esthesiometer, tear functions by Schirmer's test, and ocular surface irregularity by corneal topography and compared the results with the contralateral healthy eyes in this study. Results: The mean logarithm of the minimum angle of resolution BCVA (0.71±0.77) was significantly lower in the eyes with AK (P=0.002). Epithelial disorders were present in all eyes, and radial keratoneuritis in 14 eyes (93.3%). The mean corneal sensitivity (39.3±24.1 mm) was significantly lower in eyes with AK compared with the healthy eyes (P=0.005). The mean Schirmer's test value (22.5±12.0 mm) in eyes with AK was significantly higher compared with the healthy eyes (P=0.01). The ocular surface irregularity indices (the surface regularity index, 2.47±0.42; the surface asymmetry index, 3.24±1.31) were significantly higher in eyes with AK compared with contralateral healthy eyes (P<0.0001 and P<0.0001, respectively). Conclusions: The ocular surface disease in AK is associated with decrease in corneal sensitivity and increase in Schirmer's test value and ocular surface irregularity indices. The visual disturbance in AK may owe not only to corneal haze but also to ocular surface irregularity.
{"title":"The Relation of Ocular Surface Irregularity and Visual Disturbance in Early Stage Acanthamoeba Keratitis","authors":"Y. Matsumoto, Asako Kodama, E. Goto, T. Kawakita, M. Doğru, K. Tsubota","doi":"10.1097/ICL.0000000000000233","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000233","url":null,"abstract":"Purpose: To evaluate the relation between ocular surface irregularity and visual disturbance in early stage Acanthamoeba keratitis (AK). Methods: Fifteen patients with culture-proven AK underwent routine ophthalmic examinations, including best-corrected visual acuity (BCVA) measurement, slitlamp biomicroscope examination, and corneal fluorescein dye staining test, in both the eyes. We also evaluated the corneal sensitivity with Cochet-Bonnet esthesiometer, tear functions by Schirmer's test, and ocular surface irregularity by corneal topography and compared the results with the contralateral healthy eyes in this study. Results: The mean logarithm of the minimum angle of resolution BCVA (0.71±0.77) was significantly lower in the eyes with AK (P=0.002). Epithelial disorders were present in all eyes, and radial keratoneuritis in 14 eyes (93.3%). The mean corneal sensitivity (39.3±24.1 mm) was significantly lower in eyes with AK compared with the healthy eyes (P=0.005). The mean Schirmer's test value (22.5±12.0 mm) in eyes with AK was significantly higher compared with the healthy eyes (P=0.01). The ocular surface irregularity indices (the surface regularity index, 2.47±0.42; the surface asymmetry index, 3.24±1.31) were significantly higher in eyes with AK compared with contralateral healthy eyes (P<0.0001 and P<0.0001, respectively). Conclusions: The ocular surface disease in AK is associated with decrease in corneal sensitivity and increase in Schirmer's test value and ocular surface irregularity indices. The visual disturbance in AK may owe not only to corneal haze but also to ocular surface irregularity.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"1 1","pages":"51–56"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89465821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1097/ICL.0000000000000351
R. Arita, S. Fukuoka, N. Morishige
Abstract: Meibomian glands are located in the eyelids and secrete meibum, which gives rise to the lipid layer of the tear film. Changes to these glands can lead to the development of meibomian gland dysfunction (MGD), which is associated with various ocular symptoms such as fatigue, dryness, burning sensation, and heavy sensation. The diagnosis of MGD thus relies on evaluation of ocular symptoms, meibum condition, and lid margin abnormalities. The recent development of noninvasive meibography and tear interferometry has provided important insight into meibomian gland structure and function, respectively. Wearers of contact lenses complain of ocular symptoms that are thought to be attributable to a variety of causes, such as a diminished aqueous or mucin layer of the tear film, changes in tear protein concentration, and altered meibomian gland structure or function. Many studies have examined the relation between contact lens wear and meibomian gland changes. Such studies have found that lens wear is associated with adverse changes in meibomian gland morphology and in the condition of the lid margin and meibum, suggesting that contact lenses negatively affect meibomian glands. Meibomian gland dysfunction-like changes in meibomian glands induced by contact lens wear may thus be responsible for at least some of the ocular symptoms in lens wearers.
{"title":"Meibomian Gland Dysfunction and Contact Lens Discomfort","authors":"R. Arita, S. Fukuoka, N. Morishige","doi":"10.1097/ICL.0000000000000351","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000351","url":null,"abstract":"Abstract: Meibomian glands are located in the eyelids and secrete meibum, which gives rise to the lipid layer of the tear film. Changes to these glands can lead to the development of meibomian gland dysfunction (MGD), which is associated with various ocular symptoms such as fatigue, dryness, burning sensation, and heavy sensation. The diagnosis of MGD thus relies on evaluation of ocular symptoms, meibum condition, and lid margin abnormalities. The recent development of noninvasive meibography and tear interferometry has provided important insight into meibomian gland structure and function, respectively. Wearers of contact lenses complain of ocular symptoms that are thought to be attributable to a variety of causes, such as a diminished aqueous or mucin layer of the tear film, changes in tear protein concentration, and altered meibomian gland structure or function. Many studies have examined the relation between contact lens wear and meibomian gland changes. Such studies have found that lens wear is associated with adverse changes in meibomian gland morphology and in the condition of the lid margin and meibum, suggesting that contact lenses negatively affect meibomian glands. Meibomian gland dysfunction-like changes in meibomian glands induced by contact lens wear may thus be responsible for at least some of the ocular symptoms in lens wearers.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"8 1","pages":"17–22"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82965793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1097/ICL.0000000000000231
Esteban Porcar, E. España, J. C. Montalt, J. Benlloch-Fornés, C. Peris-Martínez
Objective: To evaluate the visual quality results of fitting a corneoscleral contact lens with multiaspheric geometry design (MAGD CScL) in subjects with irregular corneas after laser-assisted in situ keratomileusis (LASIK) surgery. Methods: From a database of patients evaluated for scleral contact lenses, we identified those with irregular corneas and visual problems after they underwent LASIK surgery for correcting myopia. They manifested unsatisfactory visual quality with their current contact lenses or glasses. Therefore, a MAGD CScL was fitted and monitored according to standardized fitting methodology. A diagnostic trial set was used in the fitting process. Visual acuity (VA), subjective visual quality (SVQ), and ocular aberrations were evaluated. A new re-evaluation of these parameters was performed after 1 year wearing MAGD CScL. Results: Eighteen eyes of 18 patients (10 male and 8 female) with irregular cornea after LASIK surgery participated in this study; their ages ranged from 27 to 39 years (mean±SD, 32.6±3.8 years). All patients showed good fitting characteristics: optimal values were seen for lens position and lens movement. Statistically significant differences were found between before and after fitting MAGD CScL in the VA (mean±SD, 0.14±0.03 logMAR and 0.01±0.06 logMAR, respectively; P<0.001); ocular aberrations of second-order, coma, spherical; and the total higher-order aberrations (HOAs) (all P<0.001). The total HOAs decreased by approximately 78% to normal levels after fitting MAGD CScL. In addition, SVQ was also significantly improved after fitting MAGD CScL (16 eyes were favorable or very favorable). After 1 year wearing MAGD CScL, no statistically significant differences were found in the total HOAs and VA in regard to the initial fitting. Conclusions: Corneoscleral contact lens with multiaspheric geometry design is proposed as an effective procedure, providing a good VA and an optimal visual quality on irregular corneas after LASIK surgery in myopic subjects.
{"title":"Post-LASIK Visual Quality With a Corneoscleral Contact Lens to Treat Irregular Corneas","authors":"Esteban Porcar, E. España, J. C. Montalt, J. Benlloch-Fornés, C. Peris-Martínez","doi":"10.1097/ICL.0000000000000231","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000231","url":null,"abstract":"Objective: To evaluate the visual quality results of fitting a corneoscleral contact lens with multiaspheric geometry design (MAGD CScL) in subjects with irregular corneas after laser-assisted in situ keratomileusis (LASIK) surgery. Methods: From a database of patients evaluated for scleral contact lenses, we identified those with irregular corneas and visual problems after they underwent LASIK surgery for correcting myopia. They manifested unsatisfactory visual quality with their current contact lenses or glasses. Therefore, a MAGD CScL was fitted and monitored according to standardized fitting methodology. A diagnostic trial set was used in the fitting process. Visual acuity (VA), subjective visual quality (SVQ), and ocular aberrations were evaluated. A new re-evaluation of these parameters was performed after 1 year wearing MAGD CScL. Results: Eighteen eyes of 18 patients (10 male and 8 female) with irregular cornea after LASIK surgery participated in this study; their ages ranged from 27 to 39 years (mean±SD, 32.6±3.8 years). All patients showed good fitting characteristics: optimal values were seen for lens position and lens movement. Statistically significant differences were found between before and after fitting MAGD CScL in the VA (mean±SD, 0.14±0.03 logMAR and 0.01±0.06 logMAR, respectively; P<0.001); ocular aberrations of second-order, coma, spherical; and the total higher-order aberrations (HOAs) (all P<0.001). The total HOAs decreased by approximately 78% to normal levels after fitting MAGD CScL. In addition, SVQ was also significantly improved after fitting MAGD CScL (16 eyes were favorable or very favorable). After 1 year wearing MAGD CScL, no statistically significant differences were found in the total HOAs and VA in regard to the initial fitting. Conclusions: Corneoscleral contact lens with multiaspheric geometry design is proposed as an effective procedure, providing a good VA and an optimal visual quality on irregular corneas after LASIK surgery in myopic subjects.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"28 1","pages":"46–50"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88000484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1097/ICL.0000000000000234
Naciye Kabataş, Aysun Sanal Dogan, E. U. Kabataş, M. Acar, Tolga Bicer, C. Gürdal
Objective: This study aimed to determine the frequency of Demodex infestation of eyelashes in patients with and without blepharitis and to determine the effects of Demodex infestation on blepharitis and the ocular symptoms. Methods: The study included patients with chronic mixed (anterior + posterior) blepharitis who presented to our clinic. Patients with refractive error and no ocular disease were enrolled as the control group. From each participant, a total of 4 eyelashes were removed and were then examined under a light microscope for Demodex infestation. Symptoms, fluorescein tear breakup time, and ocular surface staining pattern were recorded. Results: The prevalence of Demodex infection in the blepharitis group was 67.2%, versus 54.9% in the control group (P=0.18). The incidence of itching in the blepharitis group was significantly higher in the Demodex (+) patients than in the Demodex (−) patients (P<0.001). Fluorescein tear breakup time in the Demodex (+) patients was significantly shorter than in the Demodex (−) patients (P<0.001). There was not a significant difference in the fluorescein staining pattern between the 2 groups (P=0.57). The incidence of advanced stage blepharitis was significantly higher among the Demodex (+) patients (P=0.007). The incidence of cylindrical eyelash dandruff in the blepharitis group was significantly higher in the Demodex (+) patients (P<0.001). There was a significant difference in meibomian gland dysfunction between the 2 groups (P=0.039). Conclusion: Demodex infestation must be investigated in patients with advanced stage blepharitis, itching, and shorter than normal fluorescein tear breakup time.
{"title":"The Effect of Demodex Infestation on Blepharitis and the Ocular Symptoms","authors":"Naciye Kabataş, Aysun Sanal Dogan, E. U. Kabataş, M. Acar, Tolga Bicer, C. Gürdal","doi":"10.1097/ICL.0000000000000234","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000234","url":null,"abstract":"Objective: This study aimed to determine the frequency of Demodex infestation of eyelashes in patients with and without blepharitis and to determine the effects of Demodex infestation on blepharitis and the ocular symptoms. Methods: The study included patients with chronic mixed (anterior + posterior) blepharitis who presented to our clinic. Patients with refractive error and no ocular disease were enrolled as the control group. From each participant, a total of 4 eyelashes were removed and were then examined under a light microscope for Demodex infestation. Symptoms, fluorescein tear breakup time, and ocular surface staining pattern were recorded. Results: The prevalence of Demodex infection in the blepharitis group was 67.2%, versus 54.9% in the control group (P=0.18). The incidence of itching in the blepharitis group was significantly higher in the Demodex (+) patients than in the Demodex (−) patients (P<0.001). Fluorescein tear breakup time in the Demodex (+) patients was significantly shorter than in the Demodex (−) patients (P<0.001). There was not a significant difference in the fluorescein staining pattern between the 2 groups (P=0.57). The incidence of advanced stage blepharitis was significantly higher among the Demodex (+) patients (P=0.007). The incidence of cylindrical eyelash dandruff in the blepharitis group was significantly higher in the Demodex (+) patients (P<0.001). There was a significant difference in meibomian gland dysfunction between the 2 groups (P=0.039). Conclusion: Demodex infestation must be investigated in patients with advanced stage blepharitis, itching, and shorter than normal fluorescein tear breakup time.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"21 1","pages":"64–67"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73488073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-01-01DOI: 10.1097/ICL.0000000000000235
K. Mittal, Shikha Gupta, S. Khokhar, M. Vanathi, N. Sharma, T. Agarwal, R. Vajpayee
Purpose: To compare graft outcomes following pterygium excision and conjunctival autograft fixation using patient's in situ autologous blood or standard fibrin glue-assisted conjunctival autograft adhesion. Methods: Outcomes of 23 consecutive eyes which underwent pterygium excision and conjunctival autograft with autologous in situ blood coagulum (group I) were compared with historical case controls (20 eyes) that had undergone fibrin glue-assisted conjunctival autograft (group II). Primary outcome measure was graft stability. Secondary outcome measure was severity of graft inflammation at day 1, day 7, 3 months, and 6 months. Results: The two groups were similar regarding age, gender, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refractive error, tear function tests, and pterygium size. Mean surgical time was similar for the two groups (14.2±2.74 min, group I; 12.25±1.88 min, group II; P=0.1); with the mean difference in operative time being 1.95 min (95% CI, 0.48–3.42 min). Postoperatively, there was a statistically significant reduction in astigmatism and improvement in UCVA, BCVA, and spherical equivalent in all eyes. No difference was found in mean epithelial defect healing time, UCVA, BCVA, astigmatism, tear film break-up time, and Schirmer I and II at 6 months between the two groups. Initial graft stability was better for group II at 1 month (P=0.001) but was similar for both groups at 6 months. Median score of graft inflammation was significantly more for group II during the first week (P<0.05; Wilcoxon rank-sum test). Conclusion: Autologous blood may be used as an effective alternative with lesser postoperative inflammation in comparison to glue-assisted autograft fixation.
{"title":"Evaluation of Autograft Characteristics After Pterygium Excision Surgery: Autologous Blood Coagulum Versus Fibrin Glue","authors":"K. Mittal, Shikha Gupta, S. Khokhar, M. Vanathi, N. Sharma, T. Agarwal, R. Vajpayee","doi":"10.1097/ICL.0000000000000235","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000235","url":null,"abstract":"Purpose: To compare graft outcomes following pterygium excision and conjunctival autograft fixation using patient's in situ autologous blood or standard fibrin glue-assisted conjunctival autograft adhesion. Methods: Outcomes of 23 consecutive eyes which underwent pterygium excision and conjunctival autograft with autologous in situ blood coagulum (group I) were compared with historical case controls (20 eyes) that had undergone fibrin glue-assisted conjunctival autograft (group II). Primary outcome measure was graft stability. Secondary outcome measure was severity of graft inflammation at day 1, day 7, 3 months, and 6 months. Results: The two groups were similar regarding age, gender, uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), refractive error, tear function tests, and pterygium size. Mean surgical time was similar for the two groups (14.2±2.74 min, group I; 12.25±1.88 min, group II; P=0.1); with the mean difference in operative time being 1.95 min (95% CI, 0.48–3.42 min). Postoperatively, there was a statistically significant reduction in astigmatism and improvement in UCVA, BCVA, and spherical equivalent in all eyes. No difference was found in mean epithelial defect healing time, UCVA, BCVA, astigmatism, tear film break-up time, and Schirmer I and II at 6 months between the two groups. Initial graft stability was better for group II at 1 month (P=0.001) but was similar for both groups at 6 months. Median score of graft inflammation was significantly more for group II during the first week (P<0.05; Wilcoxon rank-sum test). Conclusion: Autologous blood may be used as an effective alternative with lesser postoperative inflammation in comparison to glue-assisted autograft fixation.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"114 1","pages":"68–72"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87595392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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