Pub Date : 2024-06-27DOI: 10.1016/j.clae.2024.102255
Purpose
Rigid contact lenses have an important role in contact lens practice. The purpose of this work is to update earlier surveys by describing global trends in rigid lens fitting between 2000-2023.
Method
An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023. Data relating to 342,500 fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of rigid lens fitting, defined as the fitting of any design of a contact lens manufactured in a rigid material.
Results
Overall, rigid lens prescribing increased slightly over time, from 14.2 % of lens fits in 2000 to 15.2 % in 2023 (p < 0.0001). However, post-hoc analysis shows that the change over time is best described as a decline between 2000 and 2012, followed by a steady increase subsequently. There were significant differences in rigid lens prescribing between countries (p < 0.0001). The difference between the percentage of males fitted with rigid lenses, as a proportion of all contact lenses (12.7 %), and females (12.0 %) is significant (p < 0.0001), although not clinically meaningful. Rigid lens wearers are older at fitting than soft lens wearers (38.7 vs 31.3 years, respectively) (p < 0.0001). Analysis of 5,994 rigid lens fits prescribed currently (2019–2023) were categorised as: corneal sphere – 30 %; scleral and corneo-scleral – 28 %; corneal myopia control/orthokeratology – 21 %; and corneal complex (including toric, multifocal and monovision) – 16 %.
Conclusion
There has been a slight increase in rigid lens fitting during the second decade of this century. This increase is apparently due to a ‘repurposing’ of rigid lenses, with the growth of scleral/corneo-scleral and myopia control/orthokeratology lens fits essentially replacing conventional spherical corneal lens fits.
{"title":"International trends in rigid contact lens prescribing (2000–2023): An update","authors":"","doi":"10.1016/j.clae.2024.102255","DOIUrl":"10.1016/j.clae.2024.102255","url":null,"abstract":"<div><h3>Purpose</h3><p>Rigid contact lenses have an important role in contact lens practice. The purpose of this work is to update earlier surveys by describing global trends in rigid lens fitting between 2000-2023.</p></div><div><h3>Method</h3><p>An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023. Data relating to 342,500 fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of rigid lens fitting, defined as the fitting of any design of a contact lens manufactured in a rigid material.</p></div><div><h3>Results</h3><p>Overall, rigid lens prescribing increased slightly over time, from 14.2 % of lens fits in 2000 to 15.2 % in 2023 (p < 0.0001). However, post-hoc analysis shows that the change over time is best described as a decline between 2000 and 2012, followed by a steady increase subsequently. There were significant differences in rigid lens prescribing between countries (p < 0.0001). The difference between the percentage of males fitted with rigid lenses, as a proportion of all contact lenses (12.7 %), and females (12.0 %) is significant (p < 0.0001), although not clinically meaningful. Rigid lens wearers are older at fitting than soft lens wearers (38.7 vs 31.3 years, respectively) (p < 0.0001). Analysis of 5,994 rigid lens fits prescribed currently (2019–2023) were categorised as: corneal sphere – 30 %; scleral and corneo-scleral – 28 %; corneal myopia control/orthokeratology – 21 %; and corneal complex (including toric, multifocal and monovision) – 16 %.</p></div><div><h3>Conclusion</h3><p>There has been a slight increase in rigid lens fitting during the second decade of this century. This increase is apparently due to a ‘repurposing’ of rigid lenses, with the growth of scleral/corneo-scleral and myopia control/orthokeratology lens fits essentially replacing conventional spherical corneal lens fits.</p></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1367048424001474/pdfft?md5=63e2cd10db2d6ed38442cb3d49aeb974&pid=1-s2.0-S1367048424001474-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-21DOI: 10.1016/j.clae.2024.102251
Purpose
To evaluate the efficacy of orthokeratology contact lens wear in slowing the axial elongation of the eye in myopic children.
Methods
Data from three prospective studies, which evaluated the use of orthokeratology for slowing myopia progression in children in comparison to a parallel control group of distance, single-vision spectacle lens wearers over a 2-year period, were pooled together for analysis.
Results
Collectively, data from 125 orthokeratology and 118 control subjects were analyzed in this study. Of these, 101 (81 %) and 88 (75 %) orthokeratology and control subjects completed the 2-year follow-up period, respectively. Statistically significant differences in the change in axial length from baseline were found over time, between groups and for the time*group interaction (all p < 0.001), indicating that the rate of increase in axial length over time was significantly lower in the orthokeratology versus the control group. The lower axial elongation of the orthokeratology versus the control group was statistically significant at all time points (all p < 0.001), with significant differences being also present between each of the different pairs of time points (all p < 0.001). The interactions of group with age, gender, mean spherical refractive error and ethnicity at baseline were not significant (p > 0.05). The change in axial length at the 2-year visit in comparison to baseline for the orthokeratology and control groups were 0.41 ± 0.25 and 0.65 ± 0.30 mm, respectively, thus providing a treatment effect following 2-years of lens wear of 0.24 mm (95 % confidence intervals: 0.15 to 0.34 mm). About 40 % and 25 % of the orthokeratology subjects experienced remarkably low and high levels of myopia progression, respectively (2-years axial elongation: ≤0.30 mm and >0.59 mm, respectively).
Conclusions
Orthokeratology lens wear slows the axial elongation of the eye in comparison to spectacle lens wear in myopic children. The use of these lenses for slowing myopia progression appears to be very effective and not effective at all in 40% and 25% of orthokeratology lens wearers, respectively.
{"title":"A new look at the myopia control efficacy of orthokeratology","authors":"","doi":"10.1016/j.clae.2024.102251","DOIUrl":"10.1016/j.clae.2024.102251","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the efficacy of orthokeratology contact lens wear in slowing the axial elongation of the eye in myopic children.</p></div><div><h3>Methods</h3><p>Data from three prospective studies, which evaluated the use of orthokeratology for slowing myopia progression in children in comparison to a parallel control group of distance, single-vision spectacle lens wearers over a 2-year period, were pooled together for analysis.</p></div><div><h3>Results</h3><p>Collectively, data from 125 orthokeratology and 118 control subjects were analyzed in this study. Of these, 101 (81 %) and 88 (75 %) orthokeratology and control subjects completed the 2-year follow-up period, respectively. Statistically significant differences in the change in axial length from baseline were found over time, between groups and for the time*group interaction (all p < 0.001), indicating that the rate of increase in axial length over time was significantly lower in the orthokeratology versus the control group. The lower axial elongation of the orthokeratology versus the control group was statistically significant at all time points (all p < 0.001), with significant differences being also present between each of the different pairs of time points (all p < 0.001). The interactions of group with age, gender, mean spherical refractive error and ethnicity at baseline were not significant (p > 0.05). The change in axial length at the 2-year visit in comparison to baseline for the orthokeratology and control groups were 0.41 ± 0.25 and 0.65 ± 0.30 mm, respectively, thus providing a treatment effect following 2-years of lens wear of 0.24 mm (95 % confidence intervals: 0.15 to 0.34 mm). About 40 % and 25 % of the orthokeratology subjects experienced remarkably low and high levels of myopia progression, respectively (2-years axial elongation: ≤0.30 mm and >0.59 mm, respectively).</p></div><div><h3>Conclusions</h3><p>Orthokeratology lens wear slows the axial elongation of the eye in comparison to spectacle lens wear in myopic children. The use of these lenses for slowing myopia progression appears to be very effective and not effective at all in 40% and 25% of orthokeratology lens wearers, respectively.</p></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1367048424001437/pdfft?md5=2a3f1804c2044e39e739a9b9ec9241bd&pid=1-s2.0-S1367048424001437-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-18DOI: 10.1016/j.clae.2024.102250
Rute J Macedo-de-Araújo, Ana Amorim-de-Sousa, José M González-Méijome
Purpose: To investigate whether the midday removal and re-application of scleral lenses (SL) influences fluid reservoir (FR) thickness, pre-lens tear film quality and visual acuity.
Methods: Two clinical experiments were conducted. A total of 49 keratoconic eyes were evaluated for Part1(tear film and visual acuity analysis) and 12 keratoconic eyes for Part2 (FR thickness analysis). All subjects were wearing 16.4 mm SL for more than 12-months. Tear Film Surface Quality (TFSQ) was evaluated with Medmont E300 at more than 120 min of SL wear, 10 min after SL removal (pre-corneal TFSQ) and 5 min after re-apply the same SL. High and Low Contrast Visual Acuity (HCVA and LCVA) were also assessed with the SL on eye (before and after re-application). For Part2, Anterior OCT (MOptim MOcean4000, China) measurements were taken with and without the SL (at the same time points of Part1) and three outcomes were evaluated: FR thickness, SL thickness (control measurement) and corneal thickness.
Results: Removing and re-applying a SL had a statistically significant positive impact on TFSQ, with an improvement from 0.26 ± 011 to 0.16 ± 0.08 (p = 0.001). This was accompanied by a statistically significant improvement in LogMAR HCVA (from 0.10 ± 0.09 to 0.08 ± 0.08, p < 0.001) and LCVA (from 0.39 ± 0.13 to 0.36 ± 0.13, p < 0.001). Regarding Part2 of the study, a statistically significant increase in FR thickness was observed after SL re-application (from 223.64 ± 48.08 µm to 267.81 ± 80.03 µm, p = 0.007). No changes in corneal thickness were observed.
Conclusions: Midday removal and re-application of a scleral lens positively impacted pre-lens tear film surface quality, although the observed improvement in visual acuity does not constitute a clinically significant change. Clinicians should consider that removing and reapplying a scleral lens may result in an overestimation of the fluid reservoir thickness, which could affect clinical assessments and treatment decisions.
{"title":"Influence of midday removal and re-application of a scleral lens on fluid reservoir thickness, pre-lens tear film quality and visual acuity.","authors":"Rute J Macedo-de-Araújo, Ana Amorim-de-Sousa, José M González-Méijome","doi":"10.1016/j.clae.2024.102250","DOIUrl":"https://doi.org/10.1016/j.clae.2024.102250","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate whether the midday removal and re-application of scleral lenses (SL) influences fluid reservoir (FR) thickness, pre-lens tear film quality and visual acuity.</p><p><strong>Methods: </strong>Two clinical experiments were conducted. A total of 49 keratoconic eyes were evaluated for Part1(tear film and visual acuity analysis) and 12 keratoconic eyes for Part2 (FR thickness analysis). All subjects were wearing 16.4 mm SL for more than 12-months. Tear Film Surface Quality (TFSQ) was evaluated with Medmont E300 at more than 120 min of SL wear, 10 min after SL removal (pre-corneal TFSQ) and 5 min after re-apply the same SL. High and Low Contrast Visual Acuity (HCVA and LCVA) were also assessed with the SL on eye (before and after re-application). For Part2, Anterior OCT (MOptim MOcean4000, China) measurements were taken with and without the SL (at the same time points of Part1) and three outcomes were evaluated: FR thickness, SL thickness (control measurement) and corneal thickness.</p><p><strong>Results: </strong>Removing and re-applying a SL had a statistically significant positive impact on TFSQ, with an improvement from 0.26 ± 011 to 0.16 ± 0.08 (p = 0.001). This was accompanied by a statistically significant improvement in LogMAR HCVA (from 0.10 ± 0.09 to 0.08 ± 0.08, p < 0.001) and LCVA (from 0.39 ± 0.13 to 0.36 ± 0.13, p < 0.001). Regarding Part2 of the study, a statistically significant increase in FR thickness was observed after SL re-application (from 223.64 ± 48.08 µm to 267.81 ± 80.03 µm, p = 0.007). No changes in corneal thickness were observed.</p><p><strong>Conclusions: </strong>Midday removal and re-application of a scleral lens positively impacted pre-lens tear film surface quality, although the observed improvement in visual acuity does not constitute a clinically significant change. Clinicians should consider that removing and reapplying a scleral lens may result in an overestimation of the fluid reservoir thickness, which could affect clinical assessments and treatment decisions.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141428072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-17DOI: 10.1016/j.clae.2024.102252
Purpose
This study sought to assess contact lens solutions care practices, and their microbial contamination among contact lens wearers in Ghana and to profile their antibiotic susceptibility pattern.
Methods
The study employed a biphasic approach which involved a cross-sectional design that investigated participants’ habits related to care for the solutions with a two-part questionnaire and a microbiological analysis of samples of contact lens care solutions of the participants for microbial contamination. A snowball sampling method provided access to 32 different contact lens wearers in four care facilities in Ghana. In most cases, the participants had no pre-existing familial relationship with each other or with the care facilities.
Results
Out of 32 samples of contact lens solutions, 30 were tested for microbial contamination. A total of 23 (76.67 %) samples of contact lens solution were found to be contaminated with Enterobacter sp. (34.80 %), Pseudomonas sp. (21.70 %), Bacilli sp. (21.70 %), Klebsiella sp. (17.20 %), and Escherichia coli (4.60 %). The duration of solution storage in the open bottle and nonadherence to manufacturer instructions for solution storage showed a statistically significant association with microbial contamination (p ≤ 0.05).
Conclusion
Contact lens care solutions have been found to harbour multiple antibiotic-resistant bacteria that are potentially pathogenic to the corneal surface. The contamination is associated with some unhealthy solution-care practices among wearers.
{"title":"Care practices of contact lens solutions and microbial contamination among wearers in Ghana","authors":"","doi":"10.1016/j.clae.2024.102252","DOIUrl":"10.1016/j.clae.2024.102252","url":null,"abstract":"<div><h3>Purpose</h3><p>This study sought to assess contact lens solutions<span> care practices, and their microbial contamination among contact lens wearers in Ghana and to profile their antibiotic susceptibility pattern.</span></p></div><div><h3>Methods</h3><p>The study employed a biphasic approach which involved a cross-sectional design that investigated participants’ habits related to care for the solutions with a two-part questionnaire and a microbiological analysis of samples of contact lens care solutions of the participants for microbial contamination. A snowball sampling method provided access to 32 different contact lens wearers in four care facilities in Ghana. In most cases, the participants had no pre-existing familial relationship with each other or with the care facilities.</p></div><div><h3>Results</h3><p><span>Out of 32 samples of contact lens solutions, 30 were tested for microbial contamination. A total of 23 (76.67 %) samples of contact lens solution were found to be contaminated with </span><span><em>Enterobacter</em></span> sp. (34.80 %), <span><em>Pseudomonas</em></span> sp. (21.70 %), <span><em>Bacilli</em></span> sp. (21.70 %), <span><em>Klebsiella</em></span> sp. (17.20 %), and <em>Escherichia coli</em> (4.60 %). The duration of solution storage in the open bottle and nonadherence to manufacturer instructions for solution storage showed a statistically significant association with microbial contamination (<em>p</em> ≤ 0.05).</p></div><div><h3>Conclusion</h3><p>Contact lens care solutions have been found to harbour multiple antibiotic-resistant bacteria that are potentially pathogenic to the corneal surface. The contamination is associated with some unhealthy solution-care practices among wearers.</p></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-08DOI: 10.1016/j.clae.2024.102159
<div><h3>Objective</h3><p><span><span>To explore the changes in microcirculation<span> and microvasculature of the </span></span>bulbar conjunctiva during the short-term wearing of the </span>scleral lenses (ScCL). And investigate the factors affecting the microcirculation and microvasculature of the bulbar conjunctiva.</p></div><div><h3>Methods</h3><p><span><span>In this prospective cross-sectional study, functional slit lamp biomicroscopy (FSLB) was used to image the </span>ocular surface<span> microcirculation and microvascular images at two different sites (under the area of ScCL and outside of the area of ScCL) before (baseline) and during the wearing of ScCL at 0 h, 1 h, 2 h and 3 h. Anterior segment optical coherence tomography (AS-OCT) (RTVue, Optovue Inc, USA) was also used to image central post-lens tear film (PoLTF) and the morphology changes of the conjunctiva under the landing zone at the same time period. The semi-automatic quantification of microcirculation and microvasculature including vessel density (D</span></span><sub>box</sub><span>), vessel diameter<span> (D), axial blood flow velocity (Va) and blood flow volume (Q). And the morphological changes of conjunctiva and PoLTF fogging grading were evaluated manually. The changes in the microcirculation and microvasculature of the ocular surface, PoLTF fogging grade and conjunctival morphology were compared before and during the ScCL wearing at different time periods, and the relationship between them was analyzed.</span></span></p></div><div><h3>Results</h3><p>Nineteen eyes (11 right eyes, 8 left eyes) were analyzed in this study. Outside of the area of ScCL, the D<sub>box</sub> before wearing lenses was less than that at 0 h (P = 0.041). The Q at baseline was greater than that after 1 h ScCL wearing (P = 0.026). Under the area of the ScCL, the Q at 1 h was less than that at baseline and 3 h. During the ScCL wearing, statistically significant conjunctival morphology changes were found among different time stages (baseline (0 μm), 0 h (113.18 μm), 2 h (138.97 μm), 3 h (143.83 μm) (all P ＜0.05). Outside the area of the ScCL, the morphology changes of the conjunctiva were negatively correlated with the changes of Va (P＜0.001,r = -0.471) and Q (P = 0.003,r = -0.348),but positively correlated with the D<sub>box</sub> (P = 0.001,r = 0.386). Under the area of ScCL, the morphology changes of the conjunctiva were negatively correlated with the Q (P = 0.012, r = -0.291). The fogging grade was positively correlated with the Q under the area of the ScCL (P = 0.005, r = 0.331).</p></div><div><h3>Conclusions</h3><p>The microcirculation and microvasculature of the ocular surface and conjunctival morphology were changed after wearing ScCL in wearers, which indicated that the microvascular responses happened in the ScCL wearers and the severity of microvascular responses of the ocular surface related to the morphology changes of the conjunctiva. The quantification methods and findings in this stud
{"title":"Changes in bulbar conjunctival microcirculation and microvasculature during short-term scleral lens wearing and their associated factors","authors":"","doi":"10.1016/j.clae.2024.102159","DOIUrl":"10.1016/j.clae.2024.102159","url":null,"abstract":"<div><h3>Objective</h3><p><span><span>To explore the changes in microcirculation<span> and microvasculature of the </span></span>bulbar conjunctiva during the short-term wearing of the </span>scleral lenses (ScCL). And investigate the factors affecting the microcirculation and microvasculature of the bulbar conjunctiva.</p></div><div><h3>Methods</h3><p><span><span>In this prospective cross-sectional study, functional slit lamp biomicroscopy (FSLB) was used to image the </span>ocular surface<span> microcirculation and microvascular images at two different sites (under the area of ScCL and outside of the area of ScCL) before (baseline) and during the wearing of ScCL at 0 h, 1 h, 2 h and 3 h. Anterior segment optical coherence tomography (AS-OCT) (RTVue, Optovue Inc, USA) was also used to image central post-lens tear film (PoLTF) and the morphology changes of the conjunctiva under the landing zone at the same time period. The semi-automatic quantification of microcirculation and microvasculature including vessel density (D</span></span><sub>box</sub><span>), vessel diameter<span> (D), axial blood flow velocity (Va) and blood flow volume (Q). And the morphological changes of conjunctiva and PoLTF fogging grading were evaluated manually. The changes in the microcirculation and microvasculature of the ocular surface, PoLTF fogging grade and conjunctival morphology were compared before and during the ScCL wearing at different time periods, and the relationship between them was analyzed.</span></span></p></div><div><h3>Results</h3><p>Nineteen eyes (11 right eyes, 8 left eyes) were analyzed in this study. Outside of the area of ScCL, the D<sub>box</sub> before wearing lenses was less than that at 0 h (P = 0.041). The Q at baseline was greater than that after 1 h ScCL wearing (P = 0.026). Under the area of the ScCL, the Q at 1 h was less than that at baseline and 3 h. During the ScCL wearing, statistically significant conjunctival morphology changes were found among different time stages (baseline (0 μm), 0 h (113.18 μm), 2 h (138.97 μm), 3 h (143.83 μm) (all P ＜0.05). Outside the area of the ScCL, the morphology changes of the conjunctiva were negatively correlated with the changes of Va (P＜0.001,r = -0.471) and Q (P = 0.003,r = -0.348),but positively correlated with the D<sub>box</sub> (P = 0.001,r = 0.386). Under the area of ScCL, the morphology changes of the conjunctiva were negatively correlated with the Q (P = 0.012, r = -0.291). The fogging grade was positively correlated with the Q under the area of the ScCL (P = 0.005, r = 0.331).</p></div><div><h3>Conclusions</h3><p>The microcirculation and microvasculature of the ocular surface and conjunctival morphology were changed after wearing ScCL in wearers, which indicated that the microvascular responses happened in the ScCL wearers and the severity of microvascular responses of the ocular surface related to the morphology changes of the conjunctiva. The quantification methods and findings in this stud","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-08DOI: 10.1016/j.clae.2024.102246
Purpose
Myopia (short-sightedness) is a growing vision problem worldwide. Currently atropine eye drops are used to control the progression of myopia but these suffer from potential lack of bioavailability and low ocular residence time. Commercially available myopia control contact lenses are also used to limit myopia progression, but neither atropine nor contact lenses individually completely stop progression. Development of myopia control contact lenses which could deliver therapeutic doses of atropine is thus desirable and may provide increased efficacy. This study was designed to explore the feasibility of attaching atropine to etafilcon A contact lenses through an esterification reaction.
Methods
Carboxylic acid groups on etafilcon A contact lenses were quantified using Toluidine Blue O. The carboxylic acid groups in etafilcon A contact lenses were activated using 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC-HCl) and N-hydroxysuccinimide (NHS) crosslinkers after which atropine was added to undergo potential binding via esterification. Atropine was released from lenses by alkaline hydrolysis. Reverse phase high performance liquid chromatography (HPLC) was used to detect and quantify the released atropine and its degradation products in solution. Contact lenses that had not been activated by EDC-NHS (controls) were also examined to determine the amount of atropine that could be absorbed rather than chemically bound to lenses.
Results
Each etafilcon A contact lens contained 741.1 ± 5.5 µg carboxylic acid groups which may be available for esterification. HPLC had a limit of detection for atropine of 0.38 µg/mL and for tropic acid, an atropine degradation product, of 0.80 µg/mL. The limits of quantification were 1.16 µg/mL for atropine and 2.41 µg/mL for tropic acid in NH4HCO3. The etafilcon A lenses adsorbed up to 7.69 μg atropine when incubated in a 5 mg/mL atropine solution for 24 h. However, there was no evidence that atropine could be chemically linked to the lenses, as washing in a high concentration of NaCl removed all the atropine from the contact lenses with no atropine being subsequently released from the lenses after incubating in 0.01 N NH4HCO3.
Conclusions
Etafilcon A contact lenses contain free carboxylic acids which may be an appropriate option for attaching drugs such as atropine. Etafilcon A lenses adsorbed up to 7.69 μg atropine, which would be more than enough to deliver atropine to eyes to control myopia. However, atropine could not be chemically bound to the carboxylic acids of the etafilcon A lenses using this methodology.
目的：近视（近视眼）是全世界日益严重的视力问题。目前，人们使用阿托品滴眼液来控制近视度数的加深，但这种滴眼液可能存在生物利用度不足和眼球停留时间短的问题。市面上销售的近视控制隐形眼镜也可用于限制近视的发展，但无论是阿托品还是隐形眼镜都不能单独完全阻止近视的发展。因此，开发可输送治疗剂量阿托品的近视控制隐形眼镜是可取的，并可提高疗效。本研究旨在探索通过酯化反应将阿托品附着在依他菲康 A 隐形眼镜上的可行性：使用 1-乙基-3-（3-二甲氨基丙基）碳二亚胺（EDC-HCl）和 N-羟基琥珀酰亚胺（NHS）交联剂激活依他菲康 A 隐形眼镜上的羧酸基团，然后加入阿托品，通过酯化反应进行潜在结合。阿托品通过碱性水解作用从透镜中释放出来。反相高效液相色谱法 (HPLC) 用于检测和定量溶液中释放的阿托品及其降解产物。此外，还对未被 EDC-NHS 激活的隐形眼镜（对照组）进行了检测，以确定可被吸收而非化学结合在镜片上的阿托品含量：每个依他菲康 A 隐形眼镜含有 741.1 ± 5.5 µg 羧酸基团，可用于酯化。高效液相色谱法的阿托品检测限为 0.38 微克/毫升，阿托品降解产物托品酸的检测限为 0.80 微克/毫升。在 NH4HCO3 中，阿托品的定量限为 1.16 微克/毫升，托品酸的定量限为 2.41 微克/毫升。在 5 毫克/毫升的阿托品溶液中培养 24 小时后，Etafilcon A 镜片吸附了多达 7.69 微克的阿托品。然而，没有证据表明阿托品会与镜片发生化学反应，因为在高浓度的氯化钠中清洗后，隐形眼镜上的阿托品全部被清除，在 0.01 NH4HCO3 中培养后，镜片也没有释放出阿托品：Etafilcon A 隐形眼镜含有游离羧酸，可作为吸附阿托品等药物的合适选择。Etafilcon A 镜片最多可吸附 7.69 μg 阿托品，这足以将阿托品输送到眼睛以控制近视。但是，使用这种方法无法将阿托品与依他菲尔康 A 镜片的羧酸进行化学结合。
{"title":"Absorption and attachment of atropine to etafilcon A contact lenses","authors":"","doi":"10.1016/j.clae.2024.102246","DOIUrl":"10.1016/j.clae.2024.102246","url":null,"abstract":"<div><h3>Purpose</h3><p>Myopia (short-sightedness) is a growing vision problem worldwide. Currently atropine eye drops are used to control the progression of myopia but these suffer from potential lack of bioavailability and low ocular residence time. Commercially available myopia control contact lenses are also used to limit myopia progression, but neither atropine nor contact lenses individually completely stop progression. Development of myopia control contact lenses which could deliver therapeutic doses of atropine is thus desirable and may provide increased efficacy. This study was designed to explore the feasibility of attaching atropine to etafilcon A contact lenses through an esterification reaction.</p></div><div><h3>Methods</h3><p>Carboxylic acid groups on etafilcon A contact lenses were quantified using Toluidine Blue O. The carboxylic acid groups in etafilcon A contact lenses were activated using 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide (EDC-HCl) and N-hydroxysuccinimide (NHS) crosslinkers after which atropine was added to undergo potential binding via esterification. Atropine was released from lenses by alkaline hydrolysis. Reverse phase high performance liquid chromatography (HPLC) was used to detect and quantify the released atropine and its degradation products in solution. Contact lenses that had not been activated by EDC-NHS (controls) were also examined to determine the amount of atropine that could be absorbed rather than chemically bound to lenses.</p></div><div><h3>Results</h3><p>Each etafilcon A contact lens contained 741.1 ± 5.5 µg carboxylic acid groups which may be available for esterification. HPLC had a limit of detection for atropine of 0.38 µg/mL and for tropic acid, an atropine degradation product, of 0.80 µg/mL. The limits of quantification were 1.16 µg/mL for atropine and 2.41 µg/mL for tropic acid in NH<sub>4</sub>HCO<sub>3</sub>. The etafilcon A lenses adsorbed up to 7.69 μg atropine when incubated in a 5 mg/mL atropine solution for 24 h. However, there was no evidence that atropine could be chemically linked to the lenses, as washing in a high concentration of NaCl removed all the atropine from the contact lenses with no atropine being subsequently released from the lenses after incubating in 0.01 N NH<sub>4</sub>HCO<sub>3</sub>.</p></div><div><h3>Conclusions</h3><p>Etafilcon A contact lenses contain free carboxylic acids which may be an appropriate option for attaching drugs such as atropine. Etafilcon A lenses adsorbed up to 7.69 μg atropine, which would be more than enough to deliver atropine to eyes to control myopia. However, atropine could not be chemically bound to the carboxylic acids of the etafilcon A lenses using this methodology.</p></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1367048424001383/pdfft?md5=26abd8cfb208cd043814bc7ffd9bfdef&pid=1-s2.0-S1367048424001383-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-07DOI: 10.1016/j.clae.2024.102248
M Hoffmann, S Farrell, L H Colorado, K Edwards
Purpose: To evaluate the relative contributions of objective and subjective indicators of dry eye disease (DED) in individuals with chronic pain conditions compared with controls.
Methods: A systematic review and meta-analysis was conducted of studies that reported the signs and symptoms of DED and/or their prevalence in individuals with chronic pain compared with controls. International Association for the Study of Pain (IASP) International Classification of Diseases (ICD)-11 codes for chronic pain conditions were applied, and outcomes defined as DED signs and symptoms. A search strategy utilised the EMBASE, Web of Science, Cochrane Library and MEDLINE databases. Risk of bias assessment was performed with the Newcastle-Ottawa scale. Random effects meta-analysis calculated mean differences (MD) and odds ratios (OR), while subgroup analysis of different chronic pain conditions explored their relative association with the signs and symptoms of DED. Evidence certainty was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE).
Results: Fourteen observational studies comprising 3,281,882 individuals were included. Meta-analysis found high quality evidence that individuals with chronic pain were more likely to experience symptoms of DED than controls (OR = 3.51 [95 %CI: 3.45,3.57]). These symptoms were more severe (MD = 18.53 [95 %CI: 11.90, 25.15]) than controls with a clinically meaningful effect size. Individuals with chronic pain had more rapid tear film disruption (MD = -2.45 [95 %CI: -4.20, -0.70]) and reduced tear production (MD = -5.57 [95 %CI: -9.56, -1.57]) compared with controls (with moderate evidence quality). High quality evidence revealed individuals with chronic pain had lower basal tear production (anaesthetised) than controls (MD = -2.59 [95 %CI: -3.60, -1.58]). Tear film osmolarity showed no significant differences between the chronic pain and pain-free groups. Group differences for DED signs were not considered clinically meaningful.
Conclusion: More severe, clinically meaningful symptoms of DED were reported in individuals with chronic pain than controls, however group differences for the signs of DED were typically of limited or questionable clinical relevance. This ocular phenotype where DED is felt more than it is seen in chronic pain may reflect underlying sensory hypersensitivity, shared by both conditions and contributing to their frequent comorbidity. Advancing understanding of this potential pathophysiological mechanism may guide clinical management.
{"title":"Discordant dry eye disease and chronic pain: A systematic review and meta-analysis.","authors":"M Hoffmann, S Farrell, L H Colorado, K Edwards","doi":"10.1016/j.clae.2024.102248","DOIUrl":"https://doi.org/10.1016/j.clae.2024.102248","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the relative contributions of objective and subjective indicators of dry eye disease (DED) in individuals with chronic pain conditions compared with controls.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted of studies that reported the signs and symptoms of DED and/or their prevalence in individuals with chronic pain compared with controls. International Association for the Study of Pain (IASP) International Classification of Diseases (ICD)-11 codes for chronic pain conditions were applied, and outcomes defined as DED signs and symptoms. A search strategy utilised the EMBASE, Web of Science, Cochrane Library and MEDLINE databases. Risk of bias assessment was performed with the Newcastle-Ottawa scale. Random effects meta-analysis calculated mean differences (MD) and odds ratios (OR), while subgroup analysis of different chronic pain conditions explored their relative association with the signs and symptoms of DED. Evidence certainty was evaluated using Grades of Recommendation, Assessment, Development, and Evaluation (GRADE).</p><p><strong>Results: </strong>Fourteen observational studies comprising 3,281,882 individuals were included. Meta-analysis found high quality evidence that individuals with chronic pain were more likely to experience symptoms of DED than controls (OR = 3.51 [95 %CI: 3.45,3.57]). These symptoms were more severe (MD = 18.53 [95 %CI: 11.90, 25.15]) than controls with a clinically meaningful effect size. Individuals with chronic pain had more rapid tear film disruption (MD = -2.45 [95 %CI: -4.20, -0.70]) and reduced tear production (MD = -5.57 [95 %CI: -9.56, -1.57]) compared with controls (with moderate evidence quality). High quality evidence revealed individuals with chronic pain had lower basal tear production (anaesthetised) than controls (MD = -2.59 [95 %CI: -3.60, -1.58]). Tear film osmolarity showed no significant differences between the chronic pain and pain-free groups. Group differences for DED signs were not considered clinically meaningful.</p><p><strong>Conclusion: </strong>More severe, clinically meaningful symptoms of DED were reported in individuals with chronic pain than controls, however group differences for the signs of DED were typically of limited or questionable clinical relevance. This ocular phenotype where DED is felt more than it is seen in chronic pain may reflect underlying sensory hypersensitivity, shared by both conditions and contributing to their frequent comorbidity. Advancing understanding of this potential pathophysiological mechanism may guide clinical management.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-05DOI: 10.1016/j.clae.2024.102249
Purpose
Contact lenses can be contaminated with various microorganisms, including pathogenic yeasts of the genus Candida, which are known for their ability to adhere to abiotic surfaces, including plastic materials used for various medical purposes. Microbial contamination of the lenses can lead to infection of the wearer’s eyes. The purpose of this study was to simulate the contamination of contact lenses with C. albicans and C. parapsilosis, analyze the interaction of the microorganisms with the lens material, and optimize the protocol for PCR-based analysis of the microbial agents responsible for lens contamination.
Methods
Hilafilcon lenses were exposed to C. albicans and C. parapsilosis cultures, washed, and examined for their ability to further spread the contamination. Scanning electron microscopy was used to analyze the attachment of yeast cells to the lenses. Infrared spectroscopy was used to examine the potential changes in the lens material due to Candida contamination. The protocol for DNA isolation from contaminated lenses was established to enable PCR analysis of microbes attached to the lenses.
Results
Hilafilcon lenses contaminated with Candida were able to spread the contamination even after washing with saline or with a commercial cleaning solution. In the present experimental settings, the yeasts did not grow into the lenses but began to form biofilms on the surface. However, the ability of the lenses to retain water was altered. The PCR-based protocol could be used to help identify the type of contamination of contact lenses.
Conclusion
Once contaminated with Candida albicans or Candida parapsilosis, Hilafilcon contact lenses are difficult to clean. Yeasts began to form biofilms on lens surfaces.
{"title":"Contact lenses as a potential vehicle of Candida transmission","authors":"","doi":"10.1016/j.clae.2024.102249","DOIUrl":"10.1016/j.clae.2024.102249","url":null,"abstract":"<div><h3>Purpose</h3><p>Contact lenses can be contaminated with various microorganisms, including pathogenic yeasts of the genus <em>Candida</em><span>, which are known for their ability to adhere to abiotic surfaces<span>, including plastic materials used for various medical purposes. Microbial contamination of the lenses can lead to infection of the wearer’s eyes. The purpose of this study was to simulate the contamination of contact lenses with </span></span><span><span>C. albicans</span></span> and <em>C. parapsilosis</em>, analyze the interaction of the microorganisms with the lens material, and optimize the protocol for PCR-based analysis of the microbial agents responsible for lens contamination.</p></div><div><h3>Methods</h3><p>Hilafilcon lenses were exposed to <span><em>C. albicans</em></span> and <em>C. parapsilosis</em><span><span><span> cultures, washed, and examined for their ability to further spread the contamination. Scanning electron microscopy was used to analyze the attachment of </span>yeast cells to the lenses. </span>Infrared spectroscopy was used to examine the potential changes in the lens material due to </span><em>Candida</em><span> contamination. The protocol for DNA isolation from contaminated lenses was established to enable PCR analysis of microbes attached to the lenses.</span></p></div><div><h3>Results</h3><p>Hilafilcon lenses contaminated with <em>Candida</em> were able to spread the contamination even after washing with saline or with a commercial cleaning solution. In the present experimental settings, the yeasts did not grow into the lenses but began to form biofilms on the surface. However, the ability of the lenses to retain water was altered. The PCR-based protocol could be used to help identify the type of contamination of contact lenses.</p></div><div><h3>Conclusion</h3><p>Once contaminated with <span><em>Candida albicans</em></span> or <span><span>Candida parapsilosis</span></span>, Hilafilcon contact lenses are difficult to clean. Yeasts began to form biofilms on lens surfaces.</p></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141263174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-03DOI: 10.1016/j.clae.2024.102247
İbrahim Özlük, Bora Yüksel, Tuncay Küsbeci
Purpose: To compare the efficacy of topical autologous serum and platelet-rich plasma (PRP) in patients with severe dry eye and persistent epithelial defects.
Methods: Sixty-seven eyes of 42 patients including 12 Sjogren, 11 meibomian gland dysfunction, 8 post penetrating keratoplasty, 5 acne rosacea, 5 chemical burn and 3 neurotophic keratopathy were analyzed. Best corrected visual acuity, Schirmer, Ocular Surface Disease Index (OSDI), tear break-up time, Oxford staining scores were measured before the treatment and 1 month. One month scores of two groups were compared.
Results: Thirty three eyes received autologous serum and 34 received PRP. There was no statistically significant differences between two groups in ocular surface parameters at baseline. Statistically significant improvements were achieved in both groups in all parameters at 1 month (p < 0.05). Schirmer score improved from 7.9 ± 7.6 to 10.6 ± 8.4 mm in autologous serum (p < 0.001) and from 10.9 ± 9.5 to 13.3 ± 10.1 in PRP (p < 0.001); BUT from 4.3 ± 2.7 to 6.7 ± 3.4 s (p < 0.001) and 4.5 ± 3.0 to 6.0 ± 3.6 (p < 0.001); OSDI from 47.7 ± 14.7 to 25.7 ± 11.0 (p < 0.001) and from 54.1 ± 17.3 to 26.8 ± 11.0 (p < 0.001); Oxford score from 4.0 ± 1.0 to 1.3 ± 1.1 in (p < 0.001) and 3.9 ± 0.9 to 1.6 ± 1.3 (p < 0.001) respectively. Significant visual improvement was achieved with PRP from 0.81 ± 0.73 LogMAR to 0.72 ± 0.63 (p = 0.025), whereas insignificant with serum from 0.60 ± 0.65 to 0.57 ± 0.67 (p = 0.147). Mean epithelial healing time was 6.7 ± 4.7 (2-14) days in serum and 3.6 ± 1.9 (2-7) in PRP (p = 0.195).
Conclusions: Both treatments are equally effective in severe dry eye and persistent epithelial defects. Although, visual gain is higher in PRP, autologous serum may be preferable due to low cost.
{"title":"Comparison of autologous serum and platelet-rich plasma in the treatment of severe dry eye and persistent epithelial defects.","authors":"İbrahim Özlük, Bora Yüksel, Tuncay Küsbeci","doi":"10.1016/j.clae.2024.102247","DOIUrl":"https://doi.org/10.1016/j.clae.2024.102247","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficacy of topical autologous serum and platelet-rich plasma (PRP) in patients with severe dry eye and persistent epithelial defects.</p><p><strong>Methods: </strong>Sixty-seven eyes of 42 patients including 12 Sjogren, 11 meibomian gland dysfunction, 8 post penetrating keratoplasty, 5 acne rosacea, 5 chemical burn and 3 neurotophic keratopathy were analyzed. Best corrected visual acuity, Schirmer, Ocular Surface Disease Index (OSDI), tear break-up time, Oxford staining scores were measured before the treatment and 1 month. One month scores of two groups were compared.</p><p><strong>Results: </strong>Thirty three eyes received autologous serum and 34 received PRP. There was no statistically significant differences between two groups in ocular surface parameters at baseline. Statistically significant improvements were achieved in both groups in all parameters at 1 month (p < 0.05). Schirmer score improved from 7.9 ± 7.6 to 10.6 ± 8.4 mm in autologous serum (p < 0.001) and from 10.9 ± 9.5 to 13.3 ± 10.1 in PRP (p < 0.001); BUT from 4.3 ± 2.7 to 6.7 ± 3.4 s (p < 0.001) and 4.5 ± 3.0 to 6.0 ± 3.6 (p < 0.001); OSDI from 47.7 ± 14.7 to 25.7 ± 11.0 (p < 0.001) and from 54.1 ± 17.3 to 26.8 ± 11.0 (p < 0.001); Oxford score from 4.0 ± 1.0 to 1.3 ± 1.1 in (p < 0.001) and 3.9 ± 0.9 to 1.6 ± 1.3 (p < 0.001) respectively. Significant visual improvement was achieved with PRP from 0.81 ± 0.73 LogMAR to 0.72 ± 0.63 (p = 0.025), whereas insignificant with serum from 0.60 ± 0.65 to 0.57 ± 0.67 (p = 0.147). Mean epithelial healing time was 6.7 ± 4.7 (2-14) days in serum and 3.6 ± 1.9 (2-7) in PRP (p = 0.195).</p><p><strong>Conclusions: </strong>Both treatments are equally effective in severe dry eye and persistent epithelial defects. Although, visual gain is higher in PRP, autologous serum may be preferable due to low cost.</p>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":null,"pages":null},"PeriodicalIF":3.2,"publicationDate":"2024-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141248857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-05-28DOI: 10.1016/j.clae.2024.102192
Purpose
To investigate bilateral axial length (AL) growth patterns and interactions of myopic eyes in anisometropic children during unilateral orthokeratology (OK) treatment in their singularly myopic eyes (Eyes1), followed by bilateral treatment when their second eyes (Eyes2) developed myopia.
Methods
This study enrolled 94 eyes from 47 anisometropes (20 males). All patients had undergone monocular OK treatment for > 1 year followed by binocular treatment for > 1 year. Axial growth of Eyes1 and Eyes2 during the first year of monocular treatment (Stage 1), average annual axial elongation during the monocular treatment period, and axial elongation during the first year of binocular treatment (Stage 2) were respectively termed: S1E1 and S1E2, Annual E1 and Annual E2, and S2E1 and S2E2. Associations between AL growth and age, sex, interval time, and ocular parameters were analysed using correlation and generalised estimating equation (GEE) analysis.
Results
During the monocular period, Eyes1 showed less AL growth (S1E1: 0.05 ± 0.18 mm; Annual E1: 0.05 ± 0.21 mm) than Eyes2 (S1E2: 0.51 ± 0.24 mm; Annual E2: 0.52 ± 0.25 mm) (all p < 0.001). During the binocular period, there was no significant difference between S2E1 and S2E2(0.21 ± 0.14 mm v. 0.19 ± 0.17 mm, p = 0.951). Between monocular and binocular periods, Eyes1 had significantly higher S2E1 compared to S1E1 and Annual E1 (both p < 0.001), and Eyes2 had significantly lower S2E2 than S1E2 and Annual E2 (both p < 0.001). In the GEE model, spherical equivalent refraction (SER) and between periods interval time showed independently significant associations with AL growth after adjusting for age and sex.
Conclusion
Orthokeratology can significantly control AL growth in unilateral myopia. AL growth of the initial myopic OK-treated eyes accelerated relative to the monocular period when contralateral eyes developed myopia and assumed OK treatment. During the binocular treatment phase, OK lenses showed moderate and comparable effects on AL retardation across both eyes.
{"title":"Bilateral axial length growth patterns of myopic anisometropes undergoing sequential monocular to binocular orthokeratology treatment","authors":"","doi":"10.1016/j.clae.2024.102192","DOIUrl":"10.1016/j.clae.2024.102192","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate bilateral axial length (AL) growth patterns and interactions of myopic eyes in anisometropic children during unilateral orthokeratology (OK) treatment in their singularly myopic eyes (Eyes1), followed by bilateral treatment when their second eyes (Eyes2) developed myopia.</p></div><div><h3>Methods</h3><p>This study enrolled 94 eyes from 47 anisometropes (20 males). All patients had undergone monocular OK treatment for > 1 year followed by binocular treatment for > 1 year. Axial growth of Eyes1 and Eyes2 during the first year of monocular treatment (Stage 1), average annual axial elongation during the monocular treatment period, and axial elongation during the first year of binocular treatment (Stage 2) were respectively termed: S1E1 and S1E2, Annual E1 and Annual E2, and S2E1 and S2E2. Associations between AL growth and age, sex, interval time, and ocular parameters were analysed using correlation and generalised estimating equation (GEE) analysis.</p></div><div><h3>Results</h3><p>During the monocular period, Eyes1 showed less AL growth (S1E1: 0.05 ± 0.18 mm; Annual E1: 0.05 ± 0.21 mm) than Eyes2 (S1E2: 0.51 ± 0.24 mm; Annual E2: 0.52 ± 0.25 mm) (all p < 0.001). During the binocular period, there was no significant difference between S2E1 and S2E2(0.21 ± 0.14 mm v. 0.19 ± 0.17 mm, p = 0.951). Between monocular and binocular periods, Eyes1 had significantly higher S2E1 compared to S1E1 and Annual E1 (both p < 0.001), and Eyes2 had significantly lower S2E2 than S1E2 and Annual E2 (both p < 0.001). In the GEE model, spherical equivalent refraction (SER) and between periods interval time showed independently significant associations with AL growth after adjusting for age and sex.</p></div><div><h3>Conclusion</h3><p>Orthokeratology can significantly control AL growth in unilateral myopia. AL growth of the initial myopic OK-treated eyes accelerated relative to the monocular period when contralateral eyes developed myopia and assumed OK treatment. During the binocular treatment phase, OK lenses showed moderate and comparable effects on AL retardation across both eyes.</p></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":null,"pages":null},"PeriodicalIF":4.1,"publicationDate":"2024-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1367048424000845/pdfft?md5=1197c474c25e39b6b98c9208044e6d39&pid=1-s2.0-S1367048424000845-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141160268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号