Pub Date : 2019-11-08DOI: 10.1097/ICL.0000000000000676
Stephen J. Vincent, D. Alonso-Caneiro, M. Collins
OBJECTIVES To quantify regional variations in the postlens tear layer (PLTL) thickness during scleral lens wear. METHODS Fifteen healthy adults (22±3 years) with normal corneae were fitted with a 16.5-mm-diameter rotationally symmetric scleral lens in one eye. The PLTL thickness was measured across the central 5 mm at 0, 15, 30, 45, 60, 90, 120, 240, and 480 min after lens insertion using a 12 radial line scan optical coherence tomography imaging protocol. Regional analyses were conducted by dividing the PLTL into 8 equal 45° segments. RESULTS A tilted optic zone was observed immediately after lens insertion with the greatest PLTL asymmetry between nasal and temporal regions (156±22 μm more clearance temporally) and superior nasal and inferotemporal regions (124±12 μm more clearance inferotemporally). The magnitude of lens settling observed in each region was associated with the initial PLTL (r=0.59-0.77, P≤0.02). The superior nasal PLTL furthest from the pupil center stabilized after 90 min compared with other regions which stabilized after 4 hr. On average, after 8 hr of lens wear, the PLTL decreased by 29% and PLTL asymmetries between opposing regions decreased by 30%. CONCLUSIONS The PLTL was thickest temporally and thinnest nasally in healthy eyes fitted with rotationally symmetric scleral lenses, most likely because of regional differences in underlying scleral elevation, eyelid forces, and lens centration. Postlens tear layer asymmetries diminished with lens wear, and stabilization occurred more rapidly in regions with less corneal clearance immediately after lens insertion.
{"title":"Regional Variations in Postlens Tear Layer Thickness During Scleral Lens Wear.","authors":"Stephen J. Vincent, D. Alonso-Caneiro, M. Collins","doi":"10.1097/ICL.0000000000000676","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000676","url":null,"abstract":"OBJECTIVES\u0000To quantify regional variations in the postlens tear layer (PLTL) thickness during scleral lens wear.\u0000\u0000\u0000METHODS\u0000Fifteen healthy adults (22±3 years) with normal corneae were fitted with a 16.5-mm-diameter rotationally symmetric scleral lens in one eye. The PLTL thickness was measured across the central 5 mm at 0, 15, 30, 45, 60, 90, 120, 240, and 480 min after lens insertion using a 12 radial line scan optical coherence tomography imaging protocol. Regional analyses were conducted by dividing the PLTL into 8 equal 45° segments.\u0000\u0000\u0000RESULTS\u0000A tilted optic zone was observed immediately after lens insertion with the greatest PLTL asymmetry between nasal and temporal regions (156±22 μm more clearance temporally) and superior nasal and inferotemporal regions (124±12 μm more clearance inferotemporally). The magnitude of lens settling observed in each region was associated with the initial PLTL (r=0.59-0.77, P≤0.02). The superior nasal PLTL furthest from the pupil center stabilized after 90 min compared with other regions which stabilized after 4 hr. On average, after 8 hr of lens wear, the PLTL decreased by 29% and PLTL asymmetries between opposing regions decreased by 30%.\u0000\u0000\u0000CONCLUSIONS\u0000The PLTL was thickest temporally and thinnest nasally in healthy eyes fitted with rotationally symmetric scleral lenses, most likely because of regional differences in underlying scleral elevation, eyelid forces, and lens centration. Postlens tear layer asymmetries diminished with lens wear, and stabilization occurred more rapidly in regions with less corneal clearance immediately after lens insertion.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79241341","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 : 2019-11-01DOI: 10.1097/ICL.0000000000000620
E. Kilic-Toprak, I. Toprak, Sadettin Çalışkan, Y. Ozdemir, Onder Demirtas, Fatih Altıntaş, V. Kucukatay
OBJECTIVES To perform a systemic investigation on oxidative stress and DNA damage in patients with primary pterygium. METHODS This prospective cross-sectional study included 32 patients with primary pterygium (60.1±2.0 years of age) and 33 age- and sex-matched (58.8±2.2 years of age) control subjects (P>0.05). A commercial kit was used for measuring serum total oxidant status (TOS) and total antioxidant status (TAS). The comet assay was performed after lymphocyte isolation from venous blood to quantitate DNA damage. Tail length (TL), tail intensity (TI), and tail moment (TM) were used for statistical analysis as parameters of DNA damage. RESULTS In the pterygium group, TOS and TAS were significantly higher when compared with those of the control group (P=0.019 and P=0.005, respectively). In terms of DNA damage, patients with pterygium had higher TL, TI, and TM than in the control subjects (P<0.0001 for all). CONCLUSIONS Although current literature focuses on local factors in pterygium pathogenesis, patients with pterygium seem to have increased systemic oxidative status (and compensatory antioxidant response) and genotoxicity, which might create a predisposition for pterygium development.
{"title":"Oxidative Stress and Genotoxicity in Pterygium: A Systemic Investigation.","authors":"E. Kilic-Toprak, I. Toprak, Sadettin Çalışkan, Y. Ozdemir, Onder Demirtas, Fatih Altıntaş, V. Kucukatay","doi":"10.1097/ICL.0000000000000620","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000620","url":null,"abstract":"OBJECTIVES\u0000To perform a systemic investigation on oxidative stress and DNA damage in patients with primary pterygium.\u0000\u0000\u0000METHODS\u0000This prospective cross-sectional study included 32 patients with primary pterygium (60.1±2.0 years of age) and 33 age- and sex-matched (58.8±2.2 years of age) control subjects (P>0.05). A commercial kit was used for measuring serum total oxidant status (TOS) and total antioxidant status (TAS). The comet assay was performed after lymphocyte isolation from venous blood to quantitate DNA damage. Tail length (TL), tail intensity (TI), and tail moment (TM) were used for statistical analysis as parameters of DNA damage.\u0000\u0000\u0000RESULTS\u0000In the pterygium group, TOS and TAS were significantly higher when compared with those of the control group (P=0.019 and P=0.005, respectively). In terms of DNA damage, patients with pterygium had higher TL, TI, and TM than in the control subjects (P<0.0001 for all).\u0000\u0000\u0000CONCLUSIONS\u0000Although current literature focuses on local factors in pterygium pathogenesis, patients with pterygium seem to have increased systemic oxidative status (and compensatory antioxidant response) and genotoxicity, which might create a predisposition for pterygium development.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87240297","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 : 2019-11-01DOI: 10.1097/ICL.0000000000000583
M. Ji, Seung-Jun Lee, S. Han, J. Hyon
PURPOSE To evaluate the efficacy and safety of conjunctival cystectomy using high-frequency radiowave electrosurgery. METHODS This retrospective study included 11 patients who underwent conjunctival cystectomy using high-frequency radiowave electrosurgery and had a follow-up of at least 6 months. Briefly, conjunctival opening with a diameter of 1 mm was made with using high-frequency radiowave electrosurgery (Ellman Surgitron; Ellman International, Inc., Hewlett, NY) in cut mode. The cyst was then extracted using a nontoothed forceps through the opening without rupture. Medical record of the patients was reviewed. RESULTS In all the 11 patients, conjunctival wound healed in 1 week without any complication. No recurrence was detected in any patients over the 6-month follow-up. CONCLUSIONS Conjunctival cystectomy with the adjunctive use of high-frequency radiowave electrosurgery was shown to be effective and safe.
{"title":"Efficacy and Safety of Conjunctival Cystectomy Using High-Frequency Radiowave Electrosurgery: A Preliminary Report.","authors":"M. Ji, Seung-Jun Lee, S. Han, J. Hyon","doi":"10.1097/ICL.0000000000000583","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000583","url":null,"abstract":"PURPOSE\u0000To evaluate the efficacy and safety of conjunctival cystectomy using high-frequency radiowave electrosurgery.\u0000\u0000\u0000METHODS\u0000This retrospective study included 11 patients who underwent conjunctival cystectomy using high-frequency radiowave electrosurgery and had a follow-up of at least 6 months. Briefly, conjunctival opening with a diameter of 1 mm was made with using high-frequency radiowave electrosurgery (Ellman Surgitron; Ellman International, Inc., Hewlett, NY) in cut mode. The cyst was then extracted using a nontoothed forceps through the opening without rupture. Medical record of the patients was reviewed.\u0000\u0000\u0000RESULTS\u0000In all the 11 patients, conjunctival wound healed in 1 week without any complication. No recurrence was detected in any patients over the 6-month follow-up.\u0000\u0000\u0000CONCLUSIONS\u0000Conjunctival cystectomy with the adjunctive use of high-frequency radiowave electrosurgery was shown to be effective and safe.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82637167","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 : 2019-11-01DOI: 10.1097/ICL.0000000000000580
Tianpu Gu, Boteng Gong, D. Lu, Weiping Lin, Na Li, Qing He, R. Wei
OBJECTIVE To investigate the lens decentration (LD) of orthokeratology (ortho-k) and the association between pretreatment corneal topographic parameters and LD of the ortho-k. METHODS Fifty right eyes of 50 myopes wearing ortho-k lenses were included in the prospective study. Corneal topography was conducted pretreatment to get topographic corneal parameters, including flat-K (K1); steep-K (K2); corneal astigmatism (CA), CA at 0 to 3 mm (3 mm-CA), 3 to 5 mm (5 mm-CA), 5 to 7 mm (7 mm-CA); surface asymmetry index (SAI); surface regularity index; the curvature of best-fit sphere; the diameter of cornea (DC); the distance from the corneal center to the corneal vertex (CCCV); flat eccentricity (E1), steep eccentricity (E2), and E1/E2 (E ratio); and the corneal curvature differences between the nasal and temporal quadrants at 0 to 3 mm (3 mm-Knt), and the corneal curvature differences between the superior and inferior quadrants at 0 to 3 mm (3 mm-Ksi), 5 mm-Knt (at 3-5 mm), 5 mm-Ksi (at 3-5 mm), 7 mm-Knt (at 5-7 mm), and 7 mm-Ksi (at 5-7 mm). The relationship between these cornea topographic parameters and LD of the ortho-k was tested using stepwise multiple linear regression models. RESULTS The mean magnitude of LD was 0.51±0.23 mm (0.06-1.03 mm). According to the stepwise analysis, 4 factors were associated with the overall LD (P<0.01): SAI (β=0.252), CCCV (β=0.539), 5 mm-CA (β=-0.268), and 3 mm-Ksi (β=-0.374); 5 factors were associated with the horizontal LD (P<0.01): DC (β=0.205), CCCV (β=0.881), 3 mm-CA (β=-0.217), 5 mm-Knt (β=0.15), and 3 mm-Ksi (β=-0.18); and 3 factors were associated with the vertical LD (P<0.01): SAI (β=0.542), 5 mm-CA (β=-0.188), and 3 mm-Ksi (β=-0.213). CONCLUSION Lens decentration is most common, but in most cases, the amount of LD is moderate and acceptable. The magnitude of LD can be predetermined by topographic corneal parameters. Surface asymmetry index, CCCV, 5 mm-Knt, and 3 mm-Ksi may be more preferable parameters in terms of the assessment of LD of ortho-k.
{"title":"Influence of Corneal Topographic Parameters in the Decentration of Orthokeratology.","authors":"Tianpu Gu, Boteng Gong, D. Lu, Weiping Lin, Na Li, Qing He, R. Wei","doi":"10.1097/ICL.0000000000000580","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000580","url":null,"abstract":"OBJECTIVE\u0000To investigate the lens decentration (LD) of orthokeratology (ortho-k) and the association between pretreatment corneal topographic parameters and LD of the ortho-k.\u0000\u0000\u0000METHODS\u0000Fifty right eyes of 50 myopes wearing ortho-k lenses were included in the prospective study. Corneal topography was conducted pretreatment to get topographic corneal parameters, including flat-K (K1); steep-K (K2); corneal astigmatism (CA), CA at 0 to 3 mm (3 mm-CA), 3 to 5 mm (5 mm-CA), 5 to 7 mm (7 mm-CA); surface asymmetry index (SAI); surface regularity index; the curvature of best-fit sphere; the diameter of cornea (DC); the distance from the corneal center to the corneal vertex (CCCV); flat eccentricity (E1), steep eccentricity (E2), and E1/E2 (E ratio); and the corneal curvature differences between the nasal and temporal quadrants at 0 to 3 mm (3 mm-Knt), and the corneal curvature differences between the superior and inferior quadrants at 0 to 3 mm (3 mm-Ksi), 5 mm-Knt (at 3-5 mm), 5 mm-Ksi (at 3-5 mm), 7 mm-Knt (at 5-7 mm), and 7 mm-Ksi (at 5-7 mm). The relationship between these cornea topographic parameters and LD of the ortho-k was tested using stepwise multiple linear regression models.\u0000\u0000\u0000RESULTS\u0000The mean magnitude of LD was 0.51±0.23 mm (0.06-1.03 mm). According to the stepwise analysis, 4 factors were associated with the overall LD (P<0.01): SAI (β=0.252), CCCV (β=0.539), 5 mm-CA (β=-0.268), and 3 mm-Ksi (β=-0.374); 5 factors were associated with the horizontal LD (P<0.01): DC (β=0.205), CCCV (β=0.881), 3 mm-CA (β=-0.217), 5 mm-Knt (β=0.15), and 3 mm-Ksi (β=-0.18); and 3 factors were associated with the vertical LD (P<0.01): SAI (β=0.542), 5 mm-CA (β=-0.188), and 3 mm-Ksi (β=-0.213).\u0000\u0000\u0000CONCLUSION\u0000Lens decentration is most common, but in most cases, the amount of LD is moderate and acceptable. The magnitude of LD can be predetermined by topographic corneal parameters. Surface asymmetry index, CCCV, 5 mm-Knt, and 3 mm-Ksi may be more preferable parameters in terms of the assessment of LD of ortho-k.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"52 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81019968","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 : 2019-11-01DOI: 10.1097/ICL.0000000000000593
Binbin Zhu, Yunfang Liu, Lin Lin, Xiaodan Huang, Yue Zhang, Jiao Zheng, Xiuming Jin
OBJECTIVE The aim of this study was to determine the characteristics of infectious keratitis in patients wearing bandage contact lenses (BCLs). METHODS The BCL-related infectious keratitis cases were reviewed at the eye center of the Second Affiliated Hospital at the Zhejiang University School of Medicine from January 2015 to August 2018. Detailed information about the patients with infectious keratitis was collected, including the age, gender, clinical characteristics, culture results, and other measures. All the data analyses were performed using IBM SPSS Statistics for Windows version 24.0. RESULTS From January 2015 until August 2018, 6,385 eyes of 6,188 patients, including 3,410 males and 2,778 females, received BCLs at our hospital. The mean age of these patients was 48.10±20.81 years (range=15-78 years). The mean BCL wearing time was 18.98±23.72 days (range=1-58 days). Eight patients (0.13%) with infectious keratitis were identified, and the mean age of these patients was 54.33±28.14 years (range=16-75 years). Seven of the infectious keratitis patients were older than 50 years, and one patient was 16 years old. The infectious keratitis incidence rate of the older patients (≥50 years) was significantly higher than that of the young patients (<50 years) (χ=9.647, P=0.002). There was a higher postkeratoplasty risk of BCL-related infectious keratitis than that in the corneal epithelial defect (χ=21.371, P=0.000) and pterygium surgery (χ=16.037, P=0.000) cases, but not in the corneal collagen cross-linking cases (χ=1.792, P=0.181). The mean onset time of BCL-related infectious keratitis was 22.63±18.72 days (range=3-58 days) after wearing the BCLs. Among these 8 infected patients, 3 were noncompliant with their eye drop use and 2 extended their BCL wearing time past 30 days. CONCLUSION Bandage CL-related infectious keratitis is more likely to occur in older patients. The most common risk factor for BCL-related infectious keratitis was postkeratoplasty use. Overall, appropriate indications, good compliance, and close follow-up attention are required for BCL wearers.
目的研究绷带隐形眼镜(bcl)患者感染性角膜炎的特点。方法回顾性分析2015年1月至2018年8月浙江大学医学院附属第二医院眼科中心收治的bcl相关感染性角膜炎病例。收集感染性角膜炎患者的详细资料，包括年龄、性别、临床特征、培养结果等。所有数据分析均使用IBM SPSS Statistics for Windows version 24.0进行。结果2015年1月至2018年8月，6188例患者6385眼接受bcl治疗，其中男性3410例，女性2778例。患者平均年龄为48.10±20.81岁(15 ~ 78岁)。BCL的平均佩戴时间为18.98±23.72天(1 ~ 58天)。感染性角膜炎8例(0.13%)，平均年龄54.33±28.14岁(范围16 ~ 75岁)。感染性角膜炎患者年龄≥50岁7例，16岁1例。老年患者(≥50岁)感染性角膜炎发病率显著高于年轻患者(<50岁)(χ=9.647, P=0.002)。角膜移植术后bcl相关性感染性角膜炎的发生风险高于角膜上皮缺损组(χ=21.371, P=0.000)和翼状胬肉手术组(χ=16.037, P=0.000)，而角膜胶原交联组(χ=1.792, P=0.181)。bcl相关性感染性角膜炎的平均发病时间为佩戴bcl后22.63±18.72天(范围为3 ~ 58天)。8例感染患者中，3例滴眼液使用不合规，2例BCL配戴时间超过30天。结论绷带cl相关性感染性角膜炎易发生于老年患者。bcl相关性感染性角膜炎最常见的危险因素是角膜移植术后的使用。总的来说，BCL佩戴者需要适当的适应症，良好的依从性和密切的随访注意。
{"title":"Characteristics of Infectious Keratitis in Bandage Contact Lens Wear Patients.","authors":"Binbin Zhu, Yunfang Liu, Lin Lin, Xiaodan Huang, Yue Zhang, Jiao Zheng, Xiuming Jin","doi":"10.1097/ICL.0000000000000593","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000593","url":null,"abstract":"OBJECTIVE\u0000The aim of this study was to determine the characteristics of infectious keratitis in patients wearing bandage contact lenses (BCLs).\u0000\u0000\u0000METHODS\u0000The BCL-related infectious keratitis cases were reviewed at the eye center of the Second Affiliated Hospital at the Zhejiang University School of Medicine from January 2015 to August 2018. Detailed information about the patients with infectious keratitis was collected, including the age, gender, clinical characteristics, culture results, and other measures. All the data analyses were performed using IBM SPSS Statistics for Windows version 24.0.\u0000\u0000\u0000RESULTS\u0000From January 2015 until August 2018, 6,385 eyes of 6,188 patients, including 3,410 males and 2,778 females, received BCLs at our hospital. The mean age of these patients was 48.10±20.81 years (range=15-78 years). The mean BCL wearing time was 18.98±23.72 days (range=1-58 days). Eight patients (0.13%) with infectious keratitis were identified, and the mean age of these patients was 54.33±28.14 years (range=16-75 years). Seven of the infectious keratitis patients were older than 50 years, and one patient was 16 years old. The infectious keratitis incidence rate of the older patients (≥50 years) was significantly higher than that of the young patients (<50 years) (χ=9.647, P=0.002). There was a higher postkeratoplasty risk of BCL-related infectious keratitis than that in the corneal epithelial defect (χ=21.371, P=0.000) and pterygium surgery (χ=16.037, P=0.000) cases, but not in the corneal collagen cross-linking cases (χ=1.792, P=0.181). The mean onset time of BCL-related infectious keratitis was 22.63±18.72 days (range=3-58 days) after wearing the BCLs. Among these 8 infected patients, 3 were noncompliant with their eye drop use and 2 extended their BCL wearing time past 30 days.\u0000\u0000\u0000CONCLUSION\u0000Bandage CL-related infectious keratitis is more likely to occur in older patients. The most common risk factor for BCL-related infectious keratitis was postkeratoplasty use. Overall, appropriate indications, good compliance, and close follow-up attention are required for BCL wearers.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88450977","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 : 2019-09-10DOI: 10.1097/ICL.0000000000000662
Tomoko Kaida, Chie Yukawa, S. Higashi, K. Minami, K. Miyata
OBJECTIVES To investigate the effectiveness of presbyopia correction using multifocal soft contact lenses (MF SCLs) for pseudophakic subjects with monofocal intraocular lenses (IOLs). METHODS In 11 subjects, after monofocal IOL implantation, disposable MF SCLs (Dailies Total 1 Multifocal, Alcon) were daily used for 3 months. Binocular visual acuity between 0.3 and 5 m was measured using an all-distance vision tester (AS-15, Kowa) at 1 and 3 months and compared before and during MF SCL wear. Binocular contrast sensitivity testing was conducted under mesopic and photopic illuminations at 1 month. RESULTS The mean manifest refraction spherical equivalent before MF SCL wear was -0.36 D. The add powers of used MF SCLs were +1.25, +2.00, and +2.50 D in 1, 16, and 5 eyes, respectively. The mean binocular visual acuities during MF SCL wear were 20/20 or better between 0.5 and 5 m and significantly improved at 0.7 m or less (P<0.025). There was no change in the mesopic contrast sensitivity, whereas the photopic contrast sensitivity at 18 cycles per degree was degraded during MF SCL wear. CONCLUSIONS The use of MF SCL was effective for presbyopia correction in pseudophakic subjects with monofocal IOL, and favorable binocular vision would be obtained in a range from distance to intermediate.
{"title":"Presbyopia Correction Using Multifocal Soft Contact Lenses in Patients With Monofocal Intraocular Lenses.","authors":"Tomoko Kaida, Chie Yukawa, S. Higashi, K. Minami, K. Miyata","doi":"10.1097/ICL.0000000000000662","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000662","url":null,"abstract":"OBJECTIVES\u0000To investigate the effectiveness of presbyopia correction using multifocal soft contact lenses (MF SCLs) for pseudophakic subjects with monofocal intraocular lenses (IOLs).\u0000\u0000\u0000METHODS\u0000In 11 subjects, after monofocal IOL implantation, disposable MF SCLs (Dailies Total 1 Multifocal, Alcon) were daily used for 3 months. Binocular visual acuity between 0.3 and 5 m was measured using an all-distance vision tester (AS-15, Kowa) at 1 and 3 months and compared before and during MF SCL wear. Binocular contrast sensitivity testing was conducted under mesopic and photopic illuminations at 1 month.\u0000\u0000\u0000RESULTS\u0000The mean manifest refraction spherical equivalent before MF SCL wear was -0.36 D. The add powers of used MF SCLs were +1.25, +2.00, and +2.50 D in 1, 16, and 5 eyes, respectively. The mean binocular visual acuities during MF SCL wear were 20/20 or better between 0.5 and 5 m and significantly improved at 0.7 m or less (P<0.025). There was no change in the mesopic contrast sensitivity, whereas the photopic contrast sensitivity at 18 cycles per degree was degraded during MF SCL wear.\u0000\u0000\u0000CONCLUSIONS\u0000The use of MF SCL was effective for presbyopia correction in pseudophakic subjects with monofocal IOL, and favorable binocular vision would be obtained in a range from distance to intermediate.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72949920","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 : 2019-09-10DOI: 10.1097/ICL.0000000000000661
Karen Molina, A. Graham, Thao N Yeh, Mariel Lerma, Wing Li, Vivien Tse, M. Lin
OBJECTIVES To compare subjective and clinical outcomes in three study groups: (1) asymptomatic contact lens (CL) wearers (ASYM); (2) symptomatic CL wearers who become asymptomatic on lens removal; and (3) symptomatic CL wearers who do not resolve on lens removal. METHODS Ninety-two subjects completed the Berkeley Dry Eye Flow Chart with and without lenses, ocular surface examinations, and a battery of questionnaires. RESULTS Thirty-seven subjects (40%) were ASYM, 30 (33%) had contact lens-induced dry eye (CLIDE), and 25 (27%) had underlying physiological DE. Visual Analog Scale ratings, OSDI score, and SPEED score were significantly better for the ASYM group (P<0.001) but did not distinguish CLIDE from DE. The DE group was significantly worse than CLIDE and ASYM, which were similar, in precorneal noninvasive tear breakup time (8.2 sec DE vs. 12.3 sec CLIDE and 14.3 sec ASYM; P=0.002), anterior displacement of the Line of Marx (P=0.017), and superior conjunctival staining (P=0.001). CONCLUSIONS Many CL wearers presenting with dryness symptoms have an underlying DE condition and will not respond to treatments aimed at changing lenses or solutions. Contradictory results from research studies of DE in CL wearers could be due in part to a failure to distinguish subjects with symptoms due specifically to CL wear from those whose symptoms have underlying causes unrelated to CL wear.
{"title":"Not All Dry Eye in Contact Lens Wear Is Contact Lens-Induced.","authors":"Karen Molina, A. Graham, Thao N Yeh, Mariel Lerma, Wing Li, Vivien Tse, M. Lin","doi":"10.1097/ICL.0000000000000661","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000661","url":null,"abstract":"OBJECTIVES\u0000To compare subjective and clinical outcomes in three study groups: (1) asymptomatic contact lens (CL) wearers (ASYM); (2) symptomatic CL wearers who become asymptomatic on lens removal; and (3) symptomatic CL wearers who do not resolve on lens removal.\u0000\u0000\u0000METHODS\u0000Ninety-two subjects completed the Berkeley Dry Eye Flow Chart with and without lenses, ocular surface examinations, and a battery of questionnaires.\u0000\u0000\u0000RESULTS\u0000Thirty-seven subjects (40%) were ASYM, 30 (33%) had contact lens-induced dry eye (CLIDE), and 25 (27%) had underlying physiological DE. Visual Analog Scale ratings, OSDI score, and SPEED score were significantly better for the ASYM group (P<0.001) but did not distinguish CLIDE from DE. The DE group was significantly worse than CLIDE and ASYM, which were similar, in precorneal noninvasive tear breakup time (8.2 sec DE vs. 12.3 sec CLIDE and 14.3 sec ASYM; P=0.002), anterior displacement of the Line of Marx (P=0.017), and superior conjunctival staining (P=0.001).\u0000\u0000\u0000CONCLUSIONS\u0000Many CL wearers presenting with dryness symptoms have an underlying DE condition and will not respond to treatments aimed at changing lenses or solutions. Contradictory results from research studies of DE in CL wearers could be due in part to a failure to distinguish subjects with symptoms due specifically to CL wear from those whose symptoms have underlying causes unrelated to CL wear.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90458278","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 : 2019-09-01DOI: 10.1097/ICL.0000000000000569
Ang Li, Jack Shao, R. Gans, J. Bena, J. Goshe
PURPOSE To compare the rate of endophthalmitis of intracameral versus topical antibiotic prophylaxis for patients undergoing phacoemulsification at a single-centered, multispecialty ophthalmological institute. METHODS A retrospective analysis of the rate of endophthalmitis by coding search within 90 days of cataract surgery in periods before (May 15, 2012-May 15, 2014) and after (April 30, 2015-April 30, 2017) intracameral antibiotics became the institution's preferred practice pattern for phacoemulsification. Clinical data were collected for each endophthalmitis case, including timing of onset, presenting symptoms and signs, culture results, treatment performed, and visual acuity outcome. RESULTS The rate of postphacoemulsification endophthalmitis decreased from 0.18% (29 eyes among 16,201 cataract surgeries) to 0.07% (11 eyes among 16,325 surgeries) when the preferred method was changed from topical to intracameral antibiotics (P=0.004) with an odds ratio of 0.32. Endophthalmitis cases in the 2 groups had comparable visual acuity at initial presentation and at 3 months (P=0.86). The most commonly isolated organism in culture-proven cases of endophthalmitis in both groups was coagulase-negative staphylococcus. The rate of gram-positive endophthalmitis decreased from 0.08% to 0.02% with an odds ratio of 0.23 (P=0.012) while the rate of gram-negative cases remained similar. CONCLUSIONS The use of intracameral antibiotics during cataract surgery was associated with a statistically significant reduction of postoperative endophthalmitis.
{"title":"Postoperative Endophthalmitis Before and After Preferred Utilization of Prophylactic Intracameral Antibiotics for Phacoemulsification Cataract Surgeries at Cole Eye Institute.","authors":"Ang Li, Jack Shao, R. Gans, J. Bena, J. Goshe","doi":"10.1097/ICL.0000000000000569","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000569","url":null,"abstract":"PURPOSE\u0000To compare the rate of endophthalmitis of intracameral versus topical antibiotic prophylaxis for patients undergoing phacoemulsification at a single-centered, multispecialty ophthalmological institute.\u0000\u0000\u0000METHODS\u0000A retrospective analysis of the rate of endophthalmitis by coding search within 90 days of cataract surgery in periods before (May 15, 2012-May 15, 2014) and after (April 30, 2015-April 30, 2017) intracameral antibiotics became the institution's preferred practice pattern for phacoemulsification. Clinical data were collected for each endophthalmitis case, including timing of onset, presenting symptoms and signs, culture results, treatment performed, and visual acuity outcome.\u0000\u0000\u0000RESULTS\u0000The rate of postphacoemulsification endophthalmitis decreased from 0.18% (29 eyes among 16,201 cataract surgeries) to 0.07% (11 eyes among 16,325 surgeries) when the preferred method was changed from topical to intracameral antibiotics (P=0.004) with an odds ratio of 0.32. Endophthalmitis cases in the 2 groups had comparable visual acuity at initial presentation and at 3 months (P=0.86). The most commonly isolated organism in culture-proven cases of endophthalmitis in both groups was coagulase-negative staphylococcus. The rate of gram-positive endophthalmitis decreased from 0.08% to 0.02% with an odds ratio of 0.23 (P=0.012) while the rate of gram-negative cases remained similar.\u0000\u0000\u0000CONCLUSIONS\u0000The use of intracameral antibiotics during cataract surgery was associated with a statistically significant reduction of postoperative endophthalmitis.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89444738","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 : 2019-09-01DOI: 10.1097/ICL.0000000000000568
Lisa Bennett, Hugo Y Hsu, Shannon Tai, Benjamin J. Ernst, E. Schmidt, Rohit Parihar, Chelsea Horwood, S. Edelstein
PURPOSE To compare the infectious contact lens-related corneal ulcer (CLRU) and non-CLRU cases at Saint Louis University. METHODS Retrospective review of corneal ulcer cases identified by search of the ophthalmology and microbiology department databases between 1999 and 2016. RESULTS Six hundred seventy-seven cases of corneal ulcers were identified, of which 46% were CLRU. CLRU cases were seen more commonly in younger patients (P<0.001) and women (P=0.03) than non-CLRU cases. Many of the infections were vision-threatening as defined by central/paracentral location (73% CLRU and 71% non-CLRU [P=0.60]) and large size of ulcer >2 mm in 36% CLRU and 51% non-CLRU (P=0.002). Causative pathogen in cultured CLRU was predominately Pseudomonas species (44%, P<0.001 vs. the non-CLRU group), other gram-negative (6%), gram-positive (33%), fungi (13%), and Acanthamoeba (5%). Comparatively, cultured non-CLRU was predominately gram-positive (64%, P<0.001 vs. the CLRU group), gram-negative (26%), and fungi (11%). The combined oxacillin-resistant Staphylococcus aureus and coagulase-negative Staphylococcus isolates were 35% and 34%, respectively. Despite the progressive increase in the number of corneal ulcers seen, the annual trend for any one particular organism for either CLRU cases or non-CLRU cases did not change significantly. CONCLUSIONS Most of the cases were non-CLRU. CLRU was disproportionately associated with Pseudomonas species and non-CLRU with Staphylococcal species. Fungal infections were predominately caused by filamentous organisms in both groups. Acanthamoeba keratitis was exclusively associated with CL use.
{"title":"Contact Lens Versus Non-Contact Lens-Related Corneal Ulcers at an Academic Center.","authors":"Lisa Bennett, Hugo Y Hsu, Shannon Tai, Benjamin J. Ernst, E. Schmidt, Rohit Parihar, Chelsea Horwood, S. Edelstein","doi":"10.1097/ICL.0000000000000568","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000568","url":null,"abstract":"PURPOSE\u0000To compare the infectious contact lens-related corneal ulcer (CLRU) and non-CLRU cases at Saint Louis University.\u0000\u0000\u0000METHODS\u0000Retrospective review of corneal ulcer cases identified by search of the ophthalmology and microbiology department databases between 1999 and 2016.\u0000\u0000\u0000RESULTS\u0000Six hundred seventy-seven cases of corneal ulcers were identified, of which 46% were CLRU. CLRU cases were seen more commonly in younger patients (P<0.001) and women (P=0.03) than non-CLRU cases. Many of the infections were vision-threatening as defined by central/paracentral location (73% CLRU and 71% non-CLRU [P=0.60]) and large size of ulcer >2 mm in 36% CLRU and 51% non-CLRU (P=0.002). Causative pathogen in cultured CLRU was predominately Pseudomonas species (44%, P<0.001 vs. the non-CLRU group), other gram-negative (6%), gram-positive (33%), fungi (13%), and Acanthamoeba (5%). Comparatively, cultured non-CLRU was predominately gram-positive (64%, P<0.001 vs. the CLRU group), gram-negative (26%), and fungi (11%). The combined oxacillin-resistant Staphylococcus aureus and coagulase-negative Staphylococcus isolates were 35% and 34%, respectively. Despite the progressive increase in the number of corneal ulcers seen, the annual trend for any one particular organism for either CLRU cases or non-CLRU cases did not change significantly.\u0000\u0000\u0000CONCLUSIONS\u0000Most of the cases were non-CLRU. CLRU was disproportionately associated with Pseudomonas species and non-CLRU with Staphylococcal species. Fungal infections were predominately caused by filamentous organisms in both groups. Acanthamoeba keratitis was exclusively associated with CL use.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"161 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80149099","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 : 2019-08-30DOI: 10.1097/ICL.0000000000000654
Gemini A. Singh, M. Magone
We describe a case of a 37-year-old veteran with recurrent conjunctival hyperemia 5 years after an eye-whitening conjunctivectomy procedure with mitomycin C who desired to have a repeat procedure by the original surgeon. Instead, the patient was counseled and successfully fitted with white sclera painted contact lenses to mask the regrowth of his conjunctival vasculature with excellent cosmetic results and comfort. Further eye-whitening surgery was, therefore, avoided. We conclude that hand-painted white sclera contact lenses with regular ocular surface health monitoring can be offered as a cosmetic, safer, and economical alternative to patients in order to avoid eye-whitening procedures known to induce ocular ischemia.
{"title":"White Sclera Painted Contact Lens for Masking of Conjunctival Neovascularization and Hyperemia Following Cosmetic Eye Whitening Procedure.","authors":"Gemini A. Singh, M. Magone","doi":"10.1097/ICL.0000000000000654","DOIUrl":"https://doi.org/10.1097/ICL.0000000000000654","url":null,"abstract":"We describe a case of a 37-year-old veteran with recurrent conjunctival hyperemia 5 years after an eye-whitening conjunctivectomy procedure with mitomycin C who desired to have a repeat procedure by the original surgeon. Instead, the patient was counseled and successfully fitted with white sclera painted contact lenses to mask the regrowth of his conjunctival vasculature with excellent cosmetic results and comfort. Further eye-whitening surgery was, therefore, avoided. We conclude that hand-painted white sclera contact lenses with regular ocular surface health monitoring can be offered as a cosmetic, safer, and economical alternative to patients in order to avoid eye-whitening procedures known to induce ocular ischemia.","PeriodicalId":12216,"journal":{"name":"Eye & Contact Lens: Science & Clinical Practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74050523","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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