Contact Lens & Anterior Eye最新文献_第3页

Anti-Demodex activity of castor oil confirmed in an ex vivo study 蓖麻油抗蠕形螨活性在离体研究中得到证实。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 DOI: 10.1016/j.clae.2025.102471

Catherine J. Jennings , Jordan M. Cooper , Kalika Bandamwar , Etty Bitton , Jennifer P. Craig

Purpose

Periocular castor oil application shows possible benefits in managing Demodex blepharitis based on visibly reduced cylindrical dandruff at the base of the eyelashes, but the antidemodectic mechanism remains unclear. This research sought to establish Demodex mite susceptibility to castor oil directly in a controlled, ex vivo study.

Methods

Motile Demodex mites from epilated eyelashes with visible cylindrical dandruff were exposed to 5 µL aliquots of one of four castor oil or tea tree oil-based preparations, or remained unexposed (negative control). Adult Demodex mite motility was confirmed by high magnification microscopy every 5 min for up to 480 min post-exposure and survival time recorded when movement ceased. Tested oils were 100% cold-pressed castor oil, a proprietary castor oil preparation containing identical castor oil combined with manuka and kanuka oils, and 100% and 50% tea tree oil as positive controls.

Results

Survival time in the negative control group exceeded 480 min. All tested oils exhibited shortened mite survival time relative to the negative control (p < 0.05 in all cases). Survival times for 59 mites from 12 participants were plotted for the 5 experimental groups. Undiluted and proprietary castor oil preparations exhibited median (interquartile range; IQR) survival times of 235 (200–285) and 325 (240–405) minutes, respectively, with no significant difference between groups (p > 0.05). A single mite from each castor oil group survived beyond 480 min. Positive controls exhibited median (IQR) survival times of 5 (5–10) mins for 100% tea tree oil and 20 (15–25) mins, for 50% tea tree oil.

Conclusions

Castor oil alone, or in proprietary form supplemented with manuka and kanuka oils, reduced Demodex survival over an 8-hour period. Outcomes suggest extended duration exposure to castor oil, such as in overnight application, has demodecidal activity that could contribute to Demodex blepharitis management.

目的：眼周蓖麻油应用显示在管理蠕形螨眼炎的基础上明显减少圆柱状头皮屑，但抗蠕形螨机制尚不清楚。本研究旨在建立蠕形螨对蓖麻油的敏感性直接控制，离体研究。方法：将有明显圆柱状头皮屑的脱毛睫毛中的蠕形螨暴露于5µL等份的蓖麻油或茶树油基制剂中，或不暴露（阴性对照）。暴露后480分钟内，每隔5分钟用高倍显微镜观察蠕形螨成虫的运动，并记录其停止运动时的存活时间。测试的油是100%冷榨蓖麻油，一种专有的蓖麻油制剂，含有相同的蓖麻油和麦卢卡和卡努卡油，以及100%和50%的茶树油作为阳性对照。结果：阴性对照组螨体存活时间均超过480 min，与阴性对照组相比，所有试验油的螨体存活时间均缩短（p < 0.05）。每个蓖麻油组都有一只螨存活超过480分钟。阳性对照显示，100%茶树油组的中位（IQR）存活时间为5（5-10）分钟，50%茶树油组的中位（IQR）存活时间为20（15-25）分钟。结论：单独使用蓖麻油，或添加麦卢卡油和卡努卡油的专有形式，可降低蠕形螨在8小时内的存活率。结果表明，长时间暴露于蓖麻油，如夜间应用，具有杀蠕形螨活性，可能有助于蠕形螨眼炎的管理。

{"title":"Anti-Demodex activity of castor oil confirmed in an ex vivo study","authors":"Catherine J. Jennings , Jordan M. Cooper , Kalika Bandamwar , Etty Bitton , Jennifer P. Craig","doi":"10.1016/j.clae.2025.102471","DOIUrl":"10.1016/j.clae.2025.102471","url":null,"abstract":"<div><h3>Purpose</h3><div>Periocular castor oil application shows possible benefits in managing <em>Demodex</em> blepharitis based on visibly reduced cylindrical dandruff at the base of the eyelashes, but the antidemodectic mechanism remains unclear. This research sought to establish <em>Demodex</em> mite susceptibility to castor oil directly in a controlled, <em>ex vivo</em> study.</div></div><div><h3>Methods</h3><div>Motile <em>Demodex</em> mites from epilated eyelashes with visible cylindrical dandruff were exposed to 5 µL aliquots of one of four castor oil or tea tree oil-based preparations, or remained unexposed (negative control). Adult <em>Demodex</em> mite motility was confirmed by high magnification microscopy every 5 min for up to 480 min post-exposure and survival time recorded when movement ceased. Tested oils were 100% cold-pressed castor oil, a proprietary castor oil preparation containing identical castor oil combined with manuka and kanuka oils, and 100% and 50% tea tree oil as positive controls.</div></div><div><h3>Results</h3><div>Survival time in the negative control group exceeded 480 min. All tested oils exhibited shortened mite survival time relative to the negative control (p < 0.05 in all cases). Survival times for 59 mites from 12 participants were plotted for the 5 experimental groups. Undiluted and proprietary castor oil preparations exhibited median (interquartile range; IQR) survival times of 235 (200–285) and 325 (240–405) minutes, respectively, with no significant difference between groups (p > 0.05). A single mite from each castor oil group survived beyond 480 min. Positive controls exhibited median (IQR) survival times of 5 (5–10) mins for 100% tea tree oil and 20 (15–25) mins, for 50% tea tree oil.</div></div><div><h3>Conclusions</h3><div>Castor oil alone, or in proprietary form supplemented with manuka and kanuka oils, reduced <em>Demodex</em> survival over an 8-hour period. Outcomes suggest extended duration exposure to castor oil, such as in overnight application, has demodecidal activity that could contribute to <em>Demodex</em> blepharitis management.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 6","pages":"Article 102471"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144568028","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}

引用次数: 0

Randomized contralateral eye study of myopia control between aspheric multifocal soft contact lens and orthokeratology in children 非球面多焦点软性接触镜与角膜塑形术对儿童近视控制的随机对侧眼研究。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 DOI: 10.1016/j.clae.2025.102508

Ruru Chen , Tianhui Chen , Weiwei Lu , Yue Li , Jiawei Li , Tiankun Li , Hengli Lian , Siping Chen , Colm McAlinden , Xiaoying Wang , Jinhai Huang

Background

This study aimed to compare myopia progression in children wearing an aspheric multifocal contact lens and an orthokeratology (OrthoK) lens.

Methods

A total of 65 participants, aged 9.70 ± 1.31 years, were fitted with an OrthoK lens in one randomly assigned eye and a multifocal soft contact lens in the contralateral eye for the first 6 months (period 1). Following this, contact lens wear was discontinued in both eyes for 1 month, after which the two lens-wearing methods were swapped between eyes and continued for another 6 months (period 2). Axial length (AL), spherical equivalent refraction (SER), central corneal thickness (CCT), and central choroidal thickness (CChT) were measured at the 0-, 6-, 7-, 13-, and 14-month visits. AL and SER were the primary outcome measures.

Results

For the OrthoK and multifocal soft lens, AL elongation was 0.14 ± 0.11 mm and 0.23 ± 0.12 mm, respectively, after period 1. AL elongation for the OrthoK and multifocal lens was 0.12 ± 0.19 mm and 0.20 ± 0.13 mm, respectively, after period 2. The SER change for the OrthoK and multifocal lens was −0.20 ± 0.27 D and −0.33 ± 0.30 D after period 1 and −0.26 ± 0.40 D and −0.36 ± 0.46 D after period 2, respectively. No significant differences were observed between the two treatment groups (all P > 0.05).

Conclusions

During the 14-month observation period, no statistically significant differences in myopia progression were found between the aspheric multifocal contact lens and the OrthoK lens. Further longitudinal observation is necessary to characterize the disparities in long-term myopia-control efficacy between the two intervention strategies.

Trial registration

ChiCTR, ChiCTR2000041520. Registered 27 December 2020, https://www.chictr.org.cn/ChiCTR2000041520. Retrospectively registered.

背景：本研究旨在比较儿童配戴非球面多焦点隐形眼镜和角膜塑形镜（OrthoK）的近视进展。方法：65名参与者，年龄9.70±1.31岁，在前6个月（第一阶段）随机选择一只眼配戴OrthoK晶状体，对侧眼配戴多焦软性接触镜。在此之后，两只眼睛停止佩戴隐形眼镜一个月，之后在两只眼睛之间交换两种隐形眼镜佩戴方式，并继续佩戴6个月（第二阶段）。在第0、6、7、13和14个月随访时测量轴长（AL）、球面等效屈光度（SER）、角膜中央厚度（CCT）和脉络膜中央厚度（CChT）。AL和SER是主要结局指标。结果：对于OrthoK和多焦软性晶状体，第1期后AL伸长分别为0.14±0.11 mm和0.23±0.12 mm。第2期后，OrthoK和多焦晶状体的AL延伸率分别为0.12±0.19 mm和0.20±0.13 mm。OrthoK和多焦晶状体的SER变化在第1周期后分别为-0.20±0.27 D和-0.33±0.30 D，在第2周期后分别为-0.26±0.40 D和-0.36±0.46 D。两组间比较差异无统计学意义（P < 0.05）。结论：在14个月的观察期内，非球面多焦点隐形眼镜与OrthoK隐形眼镜的近视进展无统计学差异。进一步的纵向观察是必要的，以表征两种干预策略之间长期近视控制效果的差异。试验注册号：ChiCTR， ChiCTR2000041520。2020年12月27日注册，https://www.chictr.org.cn/ChiCTR2000041520。回顾注册。

{"title":"Randomized contralateral eye study of myopia control between aspheric multifocal soft contact lens and orthokeratology in children","authors":"Ruru Chen , Tianhui Chen , Weiwei Lu , Yue Li , Jiawei Li , Tiankun Li , Hengli Lian , Siping Chen , Colm McAlinden , Xiaoying Wang , Jinhai Huang","doi":"10.1016/j.clae.2025.102508","DOIUrl":"10.1016/j.clae.2025.102508","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to compare myopia progression in children wearing an aspheric multifocal contact lens and an orthokeratology (OrthoK) lens.</div></div><div><h3>Methods</h3><div>A total of 65 participants, aged 9.70 ± 1.31 years, were fitted with an OrthoK lens in one randomly assigned eye and a multifocal soft contact lens in the contralateral eye for the first 6 months (period 1). Following this, contact lens wear was discontinued in both eyes for 1 month, after which the two lens-wearing methods were swapped between eyes and continued for another 6 months (period 2). Axial length (AL), spherical equivalent refraction (SER), central corneal thickness (CCT), and central choroidal thickness (CChT) were measured at the 0-, 6-, 7-, 13-, and 14-month visits. AL and SER were the primary outcome measures.</div></div><div><h3>Results</h3><div>For the OrthoK and multifocal soft lens, AL elongation was 0.14 ± 0.11 mm and 0.23 ± 0.12 mm, respectively, after period 1. AL elongation for the OrthoK and multifocal lens was 0.12 ± 0.19 mm and 0.20 ± 0.13 mm, respectively, after period 2. The SER change for the OrthoK and multifocal lens was −0.20 ± 0.27 D and −0.33 ± 0.30 D after period 1 and −0.26 ± 0.40 D and −0.36 ± 0.46 D after period 2, respectively. No significant differences were observed between the two treatment groups (all <em>P</em> > 0.05).</div></div><div><h3>Conclusions</h3><div>During the 14-month observation period, no statistically significant differences in myopia progression were found between the aspheric multifocal contact lens and the OrthoK lens. Further longitudinal observation is necessary to characterize the disparities in long-term myopia-control efficacy between the two intervention strategies.</div></div><div><h3>Trial registration</h3><div>ChiCTR, ChiCTR2000041520. Registered 27 December 2020, <span><span>https://www.chictr.org.cn/ChiCTR2000041520</span><svg><path></path></svg></span>. Retrospectively registered.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 6","pages":"Article 102508"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082016","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}

引用次数: 0

Low-level light therapy alone versus combination therapy with intense pulsed light in the treatment of dry eye disease with meibomian gland dysfunction: A randomised paired-eye and mechanism of action trial 单独低强度光治疗与强脉冲光联合治疗伴有睑板腺功能障碍的干眼病：一项随机配对眼和作用机制试验

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 DOI: 10.1016/j.clae.2025.102456

Jeremy Chung Bo Chiang , Viktor Dremin , David A Semp , Hiu Yan Lam , Patrick WK Ting , Moonisah Ayaz , James S Wolffsohn

Purpose

To investigate ocular surface changes following intense pulsed light therapy (IPL) combined with low level light therapy (LLLT) versus LLLT alone for the treatment of meibomian gland dysfunction (MGD) in patients with dry eye disease (DED).

Methods

Twenty-four participants with MGD and DED were recruited into a double-masked, paired-eye clinical trial, with one eye randomised to being treated with combined therapy and the other eye with LLLT alone across 4 treatment sessions, each 2 to 3 weeks apart. Follow-up assessments were also conducted at 2 weeks and then 3 months after the final treatment. Outcome measures included change in DED signs, symptomatology and in-vivo confocal microscopy parameters at final follow-up from baseline. Mechanism of action was explored with laser doppler flowmetry and fluorescence measures of the central lower eyelid.

Results

Symptom frequency rated with the Symptom Assessment Questionnaire in Dry Eye improved from baseline to final follow-up with combined therapy (mean difference − 21.6; 95 % CI − 38.5, −4.8; p = 0.005) and LLLT alone (−20.5; 95 % CI − 37.9, −3.1; p = 0.01), while symptom severity improved only with combined therapy (−18.5; 95 % CI − 34.5, −2.6; p = 0.01). Both modalities improved meibum expressibility following 3 treatment sessions, although improvement remained at final follow-up only with LLLT alone (−0.5, 95 % CI − 0.8, −0.2; p < 0.001). Tissue flavin fluorescence decreased after the fifth visit only with combined therapy (−12.7; 95 % CI − 4.9, 20.6; p = 0.001).

Conclusions

Combined therapy may have further mechanistic changes in increasing cellular metabolism, in addition to improvements in symptoms and meibum expressibility compared to LLLT alone. LLLT alone could be considered an adjunctive therapy for MGD if IPL is contraindicated.

目的：探讨强脉冲光治疗（IPL）联合弱光治疗（LLLT）与单用弱光治疗（LLLT）治疗干眼病（DED）患者睑板腺功能障碍（MGD）后眼表的变化。方法：24名患有MGD和DED的参与者被招募到一项双盲、配对眼的临床试验中，其中一只眼睛随机分配接受联合治疗，另一只眼睛单独接受LLLT治疗，共4次治疗，每次治疗间隔2至3周。在最终治疗后2周和3个月分别进行随访评估。结果测量包括从基线到最终随访时DED体征、症状学和体内共聚焦显微镜参数的变化。采用激光多普勒血流法和荧光法对下眼睑中心部位的作用机制进行了探讨。结果：干眼症症状评估问卷评分的症状频次从基线到联合治疗的最终随访有所改善(平均差值- 21.6；95% ci - 38.5, -4.8；p = 0.005)和LLLT单独(-20.5；95% ci - 37.9, -3.1；P = 0.01)，而症状严重程度仅在联合治疗时改善(-18.5；95% ci - 34.5, -2.6；p = 0.01)。两种治疗方式在3次治疗后都改善了代谢因子的表达，尽管仅LLLT治疗在最后随访时仍有改善(-0.5,95% CI - 0.8, -0.2；结论：与单用LLLT相比，联合治疗除了改善症状和代谢表达外，还可能在增加细胞代谢方面有进一步的机制改变。如果IPL是禁忌症，单独的LLLT可以被认为是MGD的辅助治疗。

{"title":"Low-level light therapy alone versus combination therapy with intense pulsed light in the treatment of dry eye disease with meibomian gland dysfunction: A randomised paired-eye and mechanism of action trial","authors":"Jeremy Chung Bo Chiang , Viktor Dremin , David A Semp , Hiu Yan Lam , Patrick WK Ting , Moonisah Ayaz , James S Wolffsohn","doi":"10.1016/j.clae.2025.102456","DOIUrl":"10.1016/j.clae.2025.102456","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate ocular surface changes following intense pulsed light therapy (IPL) combined with low level light therapy (LLLT) versus LLLT alone for the treatment of meibomian gland dysfunction (MGD) in patients with dry eye disease (DED).</div></div><div><h3>Methods</h3><div>Twenty-four participants with MGD and DED were recruited into a double-masked, paired-eye clinical trial, with one eye randomised to being treated with combined therapy and the other eye with LLLT alone across 4 treatment sessions, each 2 to 3 weeks apart. Follow-up assessments were also conducted at 2 weeks and then 3 months after the final treatment. Outcome measures included change in DED signs, symptomatology and in-vivo confocal microscopy parameters at final follow-up from baseline. Mechanism of action was explored with laser doppler flowmetry and fluorescence measures of the central lower eyelid.</div></div><div><h3>Results</h3><div>Symptom frequency rated with the Symptom Assessment Questionnaire in Dry Eye improved from baseline to final follow-up with combined therapy (mean difference − 21.6; 95 % CI − 38.5, −4.8; p = 0.005) and LLLT alone (−20.5; 95 % CI − 37.9, −3.1; p = 0.01), while symptom severity improved only with combined therapy (−18.5; 95 % CI − 34.5, −2.6; p = 0.01). Both modalities improved meibum expressibility following 3 treatment sessions, although improvement remained at final follow-up only with LLLT alone (−0.5, 95 % CI − 0.8, −0.2; p < 0.001). Tissue flavin fluorescence decreased after the fifth visit only with combined therapy (−12.7; 95 % CI − 4.9, 20.6; p = 0.001).</div></div><div><h3>Conclusions</h3><div>Combined therapy may have further mechanistic changes in increasing cellular metabolism, in addition to improvements in symptoms and meibum expressibility compared to LLLT alone. LLLT alone could be considered an adjunctive therapy for MGD if IPL is contraindicated.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 6","pages":"Article 102456"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144267766","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}

引用次数: 0

Are scleral lenses underutilized? A call for greater awareness among healthcare professionals 巩膜晶状体是否未充分利用？呼吁医疗保健专业人员提高认识。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 DOI: 10.1016/j.clae.2025.102496

Maria K. Walker

引用次数: 0

Clinical efficacy of induced epiphora by punctal plugging on refractory dry eye disease with ocular surface Damage: Randomized sham-controlled trial 点状封堵诱导眼显治疗难治性干眼病伴眼表损伤的临床疗效：随机假对照试验。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 DOI: 10.1016/j.clae.2025.102588

Hyunmin Ahn , Jae Lim Chung , Ikhyun Jun , Tae-im Kim , Kyoung Yul Seo

Purpose

To evaluate the efficacy of induced epiphora by punctal plug on refractory dry eye disease (DED) with ocular surface damage.

Methods

A 24-week, patient-masked, randomized, sham-controlled trial was conducted. Participants (n = 66) with refractory DED were randomized into treatment and control groups. The treatment group received silicone punctal plugs in both upper and lower eyelids and induced an overflow of tears, while the control group underwent a sham procedure. Efficacy was assessed through changes in Ocular Surface Disease Index (OSDI), SICCA corneal staining score (CSS) over time. Repeated measures ANOVA was performed to test the significance.

Results

At baseline, the mean OSDI of the overall participants was 34.1 ± 11.7, the mean CSS were 1.5 ± 0.7. The treatment group showed significant improvement in OSDI scores and reduction in CSS compared to the control group, starting as early as 3 weeks and increasing over the study period (all p < 0.05). At the 12- and 24-week follow-ups, 70 % achieved mild or lower OSDI scores. Complications of the treatment included plug dislodgement (39.4 %) and skin irritation (33.3 %). Over 90 % of participants reported being satisfied with the induced epiphora.

Conclusion

Induced epiphora by punctal plugging showed improvement in both subjective and objective outcomes in patients with refractory DED with ocular surface damage. This approach may serve as a potential adjunctive option for patients unresponsive to standard treatments, warranting careful application and longer-term evaluation.

目的：评价点状眼塞诱导眼珠脱落治疗伴有眼表损伤的难治性干眼病（DED）的疗效。方法：采用为期24周的患者盲、随机、假对照试验。难治性DED患者（n = 66）随机分为治疗组和对照组。治疗组在上、下眼睑植入硅胶点塞，诱导泪液溢出，而对照组则进行假手术。通过眼表疾病指数（OSDI）、SICCA角膜染色评分（CSS）随时间的变化来评估疗效。采用重复测量方差分析检验显著性。结果：在基线时，所有参与者的平均OSDI为34.1±11.7，平均CSS为1.5±0.7。与对照组相比，治疗组在OSDI评分和CSS评分上均有显著改善，且早在治疗3周时就开始了，并随着研究时间的推移而增加（均p）。结论：点状封堵诱导显泪对伴有眼表损伤的难治性DED患者的主观和客观结局均有改善。这种方法可以作为对标准治疗无反应的患者的潜在辅助选择，需要谨慎应用和长期评估。

{"title":"Clinical efficacy of induced epiphora by punctal plugging on refractory dry eye disease with ocular surface Damage: Randomized sham-controlled trial","authors":"Hyunmin Ahn , Jae Lim Chung , Ikhyun Jun , Tae-im Kim , Kyoung Yul Seo","doi":"10.1016/j.clae.2025.102588","DOIUrl":"10.1016/j.clae.2025.102588","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the efficacy of induced epiphora by punctal plug on refractory dry eye disease (DED) with ocular surface damage.</div></div><div><h3>Methods</h3><div>A 24-week, patient-masked, randomized, sham-controlled trial was conducted. Participants (n = 66) with refractory DED were randomized into treatment and control groups. The treatment group received silicone punctal plugs in both upper and lower eyelids and induced an overflow of tears, while the control group underwent a sham procedure. Efficacy was assessed through changes in Ocular Surface Disease Index (OSDI), SICCA corneal staining score (CSS) over time. Repeated measures ANOVA was performed to test the significance.</div></div><div><h3>Results</h3><div>At baseline, the mean OSDI of the overall participants was 34.1 ± 11.7, the mean CSS were 1.5 ± 0.7. The treatment group showed significant improvement in OSDI scores and reduction in CSS compared to the control group, starting as early as 3 weeks and increasing over the study period (all <em>p</em> < 0.05). At the 12- and 24-week follow-ups, 70 % achieved mild or lower OSDI scores. Complications of the treatment included plug dislodgement (39.4 %) and skin irritation (33.3 %). Over 90 % of participants reported being satisfied with the induced epiphora.</div></div><div><h3>Conclusion</h3><div>Induced epiphora by punctal plugging showed improvement in both subjective and objective outcomes in patients with refractory DED with ocular surface damage. This approach may serve as a potential adjunctive option for patients unresponsive to standard treatments, warranting careful application and longer-term evaluation.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"49 1","pages":"Article 102588"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145662474","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}

引用次数: 0

Specific clinical phenotypes of dry eye disease can predict the presence of matrix metalloproteinase-9 in the ocular surface 干眼病的特定临床表型可以预测基质金属蛋白酶-9在眼表的存在。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 DOI: 10.1016/j.clae.2025.102475

Germán Mejía-Salgado , William Rojas-Carabali , Carlos Cifuentes-González , Luis Alejandro Diez-Bahamón , Valentina Kerguelén-Dumar , Juanita Téllez-Zambrano , Juan José García-Madero , Alejandro Guevara-Carvajal , Martha Lucía Moreno-Pardo , Juliana Tirado-Ángel , Guillermo Marroquín-Gómez , Anat Galor , Alejandra de-la-Torre

Objective

The InflammaDry test detects matrix metalloproteinase-9 (MMP-9) in tears, a biomarker associated with ocular surface inflammation. While a positive result may indicate the need for anti-inflammatory therapy, its cost and qualitative nature limit widespread use. This study aims to identify clinical phenotypes that predict positive InflammaDry results, facilitating targeted anti-inflammatory therapy without requiring MMP-9 testing.

Methods

This retrospective study analyzed 1,363 patients with Dry Eye Disease (DED) from a dry eye clinic. Diagnosis was based on symptoms and at least one tear dysfunction sign. All patients underwent InflammaDry testing. Bivariate analysis (Chi-square, Student’s t-test, Mann-Whitney-U) identified clinical factors associated with test positivity, which were further analyzed in a multivariable model. The proportion of InflammaDry-positive patients was compared across groups with increasing numbers of risk factors.

Results

The mean age of the population was 51.4 years; 84.1 % were female, and all were Hispanic. Multivariable analysis identified several significant predictors of positive InflammaDry results: the presence of any autoimmune or allergic disease (odds ratio, OR = 1.59), corneal staining (Oxford ≥3, OR = 2.41), conjunctival staining (Oxford ≥3, OR = 2.30), low tear film viscosity (OR = 1.55), and nasal (OR 1.80) or temporal (OR = 1.47) ocular redness (Jenvis score >2 by Oculus). The frequency of a positive InflammaDry increased from 69.9 % in the total population (n = 1,363) to 100 % in those with three identified risk factors (n = 9).

Conclusion

Specific systemic and ocular phenotypes can predict InflammaDry test results. Patients with specific characteristics may not require MMP-9 testing due to the high likelihood of having a positive result, potentially leading to more targeted and cost-effective management strategies.

目的：InflammaDry检测泪液中的基质金属蛋白酶-9 (MMP-9)，这是一种与眼表炎症相关的生物标志物。虽然阳性结果可能表明需要抗炎治疗，但其成本和定性性质限制了广泛使用。本研究旨在确定预测InflammaDry阳性结果的临床表型，从而在不需要检测MMP-9的情况下促进靶向抗炎治疗。方法：本回顾性研究分析了来自干眼诊所的1363例干眼病患者。诊断是基于症状和至少一个撕裂功能障碍体征。所有患者都进行了炎症检测。双变量分析（卡方检验、学生t检验、Mann-Whitney-U检验）确定了与检测阳性相关的临床因素，并在多变量模型中进一步分析。随着危险因素的增加，比较各组间炎症反应阳性患者的比例。结果：人口平均年龄为51.4岁；84.1%为女性，全部为西班牙裔。多变量分析确定了炎症阳性结果的几个重要预测因素：任何自身免疫性或过敏性疾病的存在（优势比，or = 1.59）、角膜染色（Oxford≥3,or = 2.41）、结膜染色（Oxford≥3,or = 2.30）、低泪膜粘度（or = 1.55）、鼻（or 1.80）或颞（or = 1.47）眼红肿（Oculus的Jenvis评分为bbbb2）。在具有三个确定的危险因素（n = 9）的人群中，InflammaDry阳性的频率从总人口的69.9% （n = 1363）增加到100%。结论：特异性的全身和眼部表型可以预测InflammaDry检测结果。具有特定特征的患者可能不需要检测MMP-9，因为阳性结果的可能性很高，这可能导致更有针对性和更具成本效益的管理策略。

{"title":"Specific clinical phenotypes of dry eye disease can predict the presence of matrix metalloproteinase-9 in the ocular surface","authors":"Germán Mejía-Salgado , William Rojas-Carabali , Carlos Cifuentes-González , Luis Alejandro Diez-Bahamón , Valentina Kerguelén-Dumar , Juanita Téllez-Zambrano , Juan José García-Madero , Alejandro Guevara-Carvajal , Martha Lucía Moreno-Pardo , Juliana Tirado-Ángel , Guillermo Marroquín-Gómez , Anat Galor , Alejandra de-la-Torre","doi":"10.1016/j.clae.2025.102475","DOIUrl":"10.1016/j.clae.2025.102475","url":null,"abstract":"<div><h3>Objective</h3><div>The InflammaDry test detects matrix metalloproteinase-9 (MMP-9) in tears, a biomarker associated with ocular surface inflammation. While a positive result may indicate the need for anti-inflammatory therapy, its cost and qualitative nature limit widespread use. This study aims to identify clinical phenotypes that predict positive InflammaDry results, facilitating targeted anti-inflammatory therapy without requiring MMP-9 testing.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed 1,363 patients with Dry Eye Disease (DED) from a dry eye clinic. Diagnosis was based on symptoms and at least one tear dysfunction sign. All patients underwent InflammaDry testing. Bivariate analysis (Chi-square, Student’s <em>t</em>-test, Mann-Whitney-U) identified clinical factors associated with test positivity, which were further analyzed in a multivariable model. The proportion of InflammaDry-positive patients was compared across groups with increasing numbers of risk factors.</div></div><div><h3>Results</h3><div>The mean age of the population was 51.4 years; 84.1 % were female, and all were Hispanic. Multivariable analysis identified several significant predictors of positive InflammaDry results: the presence of any autoimmune or allergic disease (odds ratio, OR = 1.59), corneal staining (Oxford ≥3, OR = 2.41), conjunctival staining (Oxford ≥3, OR = 2.30), low tear film viscosity (OR = 1.55), and nasal (OR 1.80) or temporal (OR = 1.47) ocular redness (Jenvis score >2 by Oculus). The frequency of a positive InflammaDry increased from 69.9 % in the total population (n = 1,363) to 100 % in those with three identified risk factors (n = 9).</div></div><div><h3>Conclusion</h3><div>Specific systemic and ocular phenotypes can predict InflammaDry test results. Patients with specific characteristics may not require MMP-9 testing due to the high likelihood of having a positive result, potentially leading to more targeted and cost-effective management strategies.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 6","pages":"Article 102475"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650967","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}

引用次数: 0

Therapeutic effect of intense pulsed light in ocular demodicosis: A systematic review and meta-analysis 强脉冲光治疗眼蠕虫病的疗效：系统回顾和荟萃分析。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 DOI: 10.1016/j.clae.2025.102477

Hsin-Ming Liu , Shannon Su , Cher-Ming Liou , Ann Yi-Chiun Chuang

Aims

To assess the effect of intense pulsed light (IPL) on reducing ocular demodicosis.

Methods

A systematic literature search was conducted up to March 8, 2025, using the PubMed, Embase, Google Scholar, and Cochrane Central Register of Controlled Trials databases. Randomized controlled trials (RCTs) or non-RCTs with Demodex measurements before and after IPL therapy were included.

Results

Six trials (five RCTs + one non-RCT) involving 329 adults were included. The overall risk of bias was assessed as low to moderate, and the certainty of evidence for all outcomes was considered low. IPL reduced Demodex mites per 100 eyelashes, with a mean difference (MD) of −7.80 (−16.36 to 0.76) with moderate heterogeneity (p = 0.11, I² = 47 %) when considering only RCTs. The risk ratio of Demodex eradication was 1.41 (1.18 to 1.69, I² = 0 %, p = 0.72) and was significant in both the IPL with meibomian gland expression (MGX) subgroup (1.49, 1.17–1.91) and IPL alone subgroup (1.32, 1.02–1.72). No major adverse events were reported.

Conclusion

IPL, either alone or in combination with MGX, demonstrates a trend toward reducing Demodex infestation with no major adverse events reported. However, its effect on mite count reduction has not reached statistical significance. Further studies are needed to establish an optimal IPL treatment protocol.

目的：探讨强脉冲光（IPL）治疗眼部蠕虫病的效果。方法：使用PubMed、Embase、谷歌Scholar和Cochrane Central Register of Controlled Trials数据库进行系统文献检索，检索时间截止到2025年3月8日。纳入IPL治疗前后Demodex测量的随机对照试验（rct）或非rct。结果：纳入6项试验（5项rct + 1项非rct），涉及329名成年人。总体偏倚风险被评估为低至中等，所有结果的证据确定性被认为较低。仅考虑随机对照试验时，IPL每100根睫毛减少蠕形螨，平均差异（MD）为-7.80(-16.36至0.76)，具有中等异质性（p = 0.11, I2 = 47%）。蠕形螨被根除的危险比为1.41 (1.18 ~ 1.69,I2 = 0%, p = 0.72)，在有眉板腺表达的IPL （MGX）亚组（1.49,1.17 ~ 1.91）和单独IPL亚组（1.32,1.02 ~ 1.72）中均有显著性差异。无重大不良事件报告。结论：IPL，无论是单独使用还是与MGX联合使用，都显示出减少蠕形螨感染的趋势，没有重大不良事件的报道。但其对螨数的减少效果尚未达到统计学意义。需要进一步的研究来建立一个最佳的IPL治疗方案。

{"title":"Therapeutic effect of intense pulsed light in ocular demodicosis: A systematic review and meta-analysis","authors":"Hsin-Ming Liu , Shannon Su , Cher-Ming Liou , Ann Yi-Chiun Chuang","doi":"10.1016/j.clae.2025.102477","DOIUrl":"10.1016/j.clae.2025.102477","url":null,"abstract":"<div><h3>Aims</h3><div>To assess the effect of intense pulsed light (IPL) on reducing ocular demodicosis.</div></div><div><h3>Methods</h3><div>A systematic literature search was conducted up to March 8, 2025, using the PubMed, Embase, Google Scholar, and Cochrane Central Register of Controlled Trials databases. Randomized controlled trials (RCTs) or non-RCTs with <em>Demodex</em> measurements before and after IPL therapy were included.</div></div><div><h3>Results</h3><div>Six trials (five RCTs + one non-RCT) involving 329 adults were included. The overall risk of bias was assessed as low to moderate, and the certainty of evidence for all outcomes was considered low. IPL reduced <em>Demodex</em> mites per 100 eyelashes, with a mean difference (MD) of −7.80 (−16.36 to 0.76) with moderate heterogeneity (<em>p</em> = 0.11, <em>I<sup>2</sup></em> = 47 %) when considering only RCTs. The risk ratio of <em>Demodex</em> eradication was 1.41 (1.18 to 1.69, <em>I<sup>2</sup></em> = 0 %, <em>p</em> = 0.72) and was significant in both the IPL with meibomian gland expression (MGX) subgroup (1.49, 1.17–1.91) and IPL alone subgroup (1.32, 1.02–1.72). No major adverse events were reported.</div></div><div><h3>Conclusion</h3><div>IPL, either alone or in combination with MGX, demonstrates a trend toward reducing <em>Demodex</em> infestation with no major adverse events reported. However, its effect on mite count reduction has not reached statistical significance. Further studies are needed to establish an optimal IPL treatment protocol.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 6","pages":"Article 102477"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676267","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}

引用次数: 0

Intraocular pressure following long-term scleral lens wear in Chinese eyes 中国人长期佩戴巩膜晶状体后的眼压。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 DOI: 10.1016/j.clae.2025.102476

Maoyuan Yang , Feifu Wang , Aiqin Xu , Qiaochu Yang , Ming Cao , Bichi Chen , Ruzhi Deng , Jun Jiang , Stephen J. Vincent

Purpose

Since the prevalence of glaucoma is greater in Asian populations, the purpose of this study was to investigate variations in intraocular pressure (IOP) following long-term scleral lens wear in Chinese eyes.

Methods

This prospective, observational clinical study included 60 Chinese participants with irregular corneas (irregular cornea group, ICG) and regular corneas (regular cornea group, RCG). Following a baseline examination and scleral lens fitting and dispensing, follow-up visits were conducted after 1 week, 1 month, and 3 months of scleral lens wear. IOP was measured without the lens on eye using rebound tonometry (ICG) or non-contact tonometry (RCG).

Results

In both the RCG and ICG, the mean IOP varied by < ± 0.3 mmHg across study visits (p > 0.05). A small number of participants (RCG n = 3, ICG n = 3, i.e. 10% of eyes) exhibited an IOP elevation of ≥ 2 mmHg from baseline across two consecutive study visits, including the final 3 month visit.

Conclusion

On average, IOP remained stable (mean changes < ± 0.3 mmHg) in Chinese participants with regular and irregular corneas following three months of scleral lens wear. Future long-term scleral lens studies examining changes in IOP with the lens in situ (e.g., using pneumotonometry), anterior chamber anatomy, or optic nerve parameters in Chinese populations are warranted given the higher prevalence of glaucoma in Asian eyes.

目的：由于亚洲人群青光眼的患病率较高，本研究的目的是调查中国人长期佩戴巩膜晶状体后眼压的变化。方法：本前瞻性、观察性临床研究纳入60名中国受试者，分别为不规则角膜组（不规则角膜组，ICG）和正常角膜组（正常角膜组，RCG）。在基线检查和巩膜镜片配戴和配药后，随访时间分别为巩膜镜片佩戴1周、1个月和3个月。眼内眼压在无晶状体的情况下用反弹眼压仪（ICG）或非接触眼压仪（RCG）测量。结果：在RCG和ICG中，在研究访问期间，平均眼压变化<±0.3 mmHg （p < 0.05）。少数参与者（RCG n = 3, ICG n = 3，即10%的眼睛）在连续两次研究访问中，包括最后3个月的访问，IOP比基线升高≥2 mmHg。结论：中国正常和不规则角膜患者在巩膜晶状体配戴3个月后，IOP保持稳定（平均变化<±0.3 mmHg）。考虑到亚洲人青光眼的发病率较高，未来的长期巩膜晶状体研究有必要在中国人群中检测原位晶状体（例如，使用气压计）、前房解剖或视神经参数的IOP变化。

{"title":"Intraocular pressure following long-term scleral lens wear in Chinese eyes","authors":"Maoyuan Yang , Feifu Wang , Aiqin Xu , Qiaochu Yang , Ming Cao , Bichi Chen , Ruzhi Deng , Jun Jiang , Stephen J. Vincent","doi":"10.1016/j.clae.2025.102476","DOIUrl":"10.1016/j.clae.2025.102476","url":null,"abstract":"<div><h3>Purpose</h3><div>Since the prevalence of glaucoma is greater in Asian populations, the purpose of this study was to investigate variations in intraocular pressure (IOP) following long-term scleral lens wear in Chinese eyes.</div></div><div><h3>Methods</h3><div>This prospective, observational clinical study included 60 Chinese participants with irregular corneas (irregular cornea group, ICG) and regular corneas (regular cornea group, RCG). Following a baseline examination and scleral lens fitting and dispensing, follow-up visits were conducted after 1 week, 1 month, and 3 months of scleral lens wear. IOP was measured without the lens on eye using rebound tonometry (ICG) or non-contact tonometry (RCG).</div></div><div><h3>Results</h3><div>In both the RCG and ICG, the mean IOP varied by < ± 0.3 mmHg across study visits (p > 0.05). A small number of participants (RCG n = 3, ICG n = 3, i.e. 10% of eyes) exhibited an IOP elevation of ≥ 2 mmHg from baseline across two consecutive study visits, including the final 3 month visit.</div></div><div><h3>Conclusion</h3><div>On average, IOP remained stable (mean changes < ± 0.3 mmHg) in Chinese participants with regular and irregular corneas following three months of scleral lens wear. Future long-term scleral lens studies examining changes in IOP with the lens in situ (e.g., using pneumotonometry), anterior chamber anatomy, or optic nerve parameters in Chinese populations are warranted given the higher prevalence of glaucoma in Asian eyes.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 6","pages":"Article 102476"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660870","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}

引用次数: 0

Machine learning techniques in the diagnosis of meibomian glands related alterations from clinical indicators 从临床指标诊断睑板腺相关改变的机器学习技术。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 DOI: 10.1016/j.clae.2025.102479

Elena Fernández-Jiménez , Elena Diz-Arias , Jose A. Gomez-Pedrero , Assumpta Peral

Purpose

There is no “Gold Standard” test that allows the diagnosis and classification of alterations and pathologies related to Meibomian glands (MG). A global evaluation of objective and subjective tests is necessary to determine the final diagnosis.

In recent years, Artificial Intelligence (AI) and Machine Learning (ML) techniques have experienced great progress in the field of health sciences, as promising techniques for predicting pathologies from data and images.

The main objective of this study has been to train ML classifiers for the classification of three groups of participants with and without MG alterations. The secondary objective was to study the precision, specificity and sensitivity of the ML classifiers.

Methods

A retrospective comparative study was carried out on a total of 135 participants (control, contact lens wearers and MG pathology). Symptomatology and clinical tests were performed to evaluate the ocular surface and adnexa. The numerical data obtained from these tests were used to train ML classifiers and the top 5 were subsequently verified.

Results

Accuracies greater than 76 % were obtained for the training group and greater than 79 % for the verification group, for five classifiers previously described in Matlab. Subspace KNN was the classifier with the highest accuracies, specificities and sensitivities, these being moderate-high (greater than 79 %).

Conclusions

ML algorithms can be useful for classifying groups of participants with various meibomian gland disorders using clinical data. A large number of participants is needed for reliable diagnostic accuracy.

目的：睑板腺（MG）病变的诊断和分类尚无“金标准”检验。需要对客观和主观检查进行全面评估，以确定最终诊断。近年来，人工智能（AI）和机器学习（ML）技术在健康科学领域取得了巨大进展，作为从数据和图像中预测病理的有前途的技术。本研究的主要目的是训练ML分类器对三组有或没有MG改变的参与者进行分类。次要目的是研究ML分类器的精确性、特异性和敏感性。方法：对135名参与者（对照组、配戴隐形眼镜者和MG患者）进行回顾性比较研究。通过症状学和临床检查来评估眼表和附件。从这些测试中获得的数值数据用于训练ML分类器，并随后验证前5个分类器。结果：对于先前在Matlab中描述的五个分类器，训练组的准确率大于76%，验证组的准确率大于79%。子空间KNN分类器具有最高的准确性、特异性和灵敏度，这些为中高（大于79%）。结论：ML算法可用于根据临床数据对不同睑板腺疾病的参与者进行分组。可靠的诊断准确性需要大量的参与者。

{"title":"Machine learning techniques in the diagnosis of meibomian glands related alterations from clinical indicators","authors":"Elena Fernández-Jiménez , Elena Diz-Arias , Jose A. Gomez-Pedrero , Assumpta Peral","doi":"10.1016/j.clae.2025.102479","DOIUrl":"10.1016/j.clae.2025.102479","url":null,"abstract":"<div><h3>Purpose</h3><div>There is no “Gold Standard” test that allows the diagnosis and classification of alterations and pathologies related to Meibomian glands (MG). A global evaluation of objective and subjective tests is necessary to determine the final diagnosis.</div><div>In recent years, Artificial Intelligence (AI) and Machine Learning (ML) techniques have experienced great progress in the field of health sciences, as promising techniques for predicting pathologies from data and images.</div><div>The main objective of this study has been to train ML classifiers for the classification of three groups of participants with and without MG alterations. The secondary objective was to study the precision, specificity and sensitivity of the ML classifiers.</div></div><div><h3>Methods</h3><div>A retrospective comparative study was carried out on a total of 135 participants (control, contact lens wearers and MG pathology). Symptomatology and clinical tests were performed to evaluate the ocular surface and adnexa. The numerical data obtained from these tests were used to train ML classifiers and the top 5 were subsequently verified.</div></div><div><h3>Results</h3><div>Accuracies greater than 76 % were obtained for the training group and greater than 79 % for the verification group, for five classifiers previously described in Matlab. Subspace KNN was the classifier with the highest accuracies, specificities and sensitivities, these being moderate-high (greater than 79 %).</div></div><div><h3>Conclusions</h3><div>ML algorithms can be useful for classifying groups of participants with various meibomian gland disorders using clinical data. A large number of participants is needed for reliable diagnostic accuracy.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 6","pages":"Article 102479"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692110","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}

引用次数: 0

Effect of selective topical anaesthesia on the initial comfort of rigid contact lenses 选择性局部麻醉对硬性隐形眼镜初始舒适度的影响。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 DOI: 10.1016/j.clae.2025.102474

Maria Navascues-Cornago, Carole Maldonado-Codina, Michael L. Read, Philip B. Morgan

Purpose:

The primary sensory location of contact lens discomfort remains unclear. This study utilised selective topical anaesthesia of the ocular surface to investigate if the relative contribution of different tissues to lens-related discomfort could be determined.

Methods:

This was a randomised, subject-masked, contralateral eye pilot study involving 10 participants. Mechanical sensitivity was measured at three locations on the ocular surface (cornea, upper and lower eyelid marginal conjunctiva) using a Cochet–Bonnet aesthesiometer. Following sensitivity measurements, proxymetacaine hydrochloride 0.5% was topically applied to one of the three locations in one eye whilst 0.9% saline was applied to the corresponding location in the fellow eye as a placebo. Sensitivity measurements were then repeated. A pair of rigid contact lenses was subsequently applied and comfort scores were recorded after 5 min using a 0-100 visual analogue scale.

Results:

The sensitivity of the location anesthetised decreased significantly (all Bonferroni-adjusted p

<

0.006), whilst the sensitivity of the unanaesthetised remaining two locations showed no significant change (all p

>

0.05). There was no significant change in sensitivity following the application of saline (all p

>

0.05). There was no significant difference in comfort following lens application between the anaesthetic and saline for the cornea and lower lid marginal conjunctiva [LSM difference (95% CI): −3.0 (−11.3, 5.3) and 2.0 (−6.3, 10.3), respectively]. However, comfort was significantly better when the upper lid marginal conjunctiva was anaesthetised compared to saline application [12.3 (4.0, 20.6)].

Conclusion:

This work has demonstrated a novel technique which can successfully selectively anaesthetise specific regions of the ocular surface. The initial comfort of rigid lenses was better when the upper lid marginal conjunctiva was anaesthetised, which supports the hypothesis that initial comfort of rigid lenses may be driven by the interaction between the lens and the upper eyelid. This work may also have significant utility for investigating discomfort in soft contact lenses.

目的：隐形眼镜不适的主要感觉部位尚不清楚。本研究利用眼表选择性局部麻醉来研究不同组织对晶状体相关不适的相对影响是否可以确定。方法：这是一项随机、受试者隐藏、对侧眼先导研究，涉及10名参与者。采用Cochet-Bonnet美感计测量眼表三个位置（角膜、上、下眼睑边缘结膜）的机械灵敏度。敏感度测量后，将0.5%盐酸丙美他卡因局部涂抹在一只眼睛的三个位置之一，同时将0.9%生理盐水涂抹在另一只眼睛的相应位置作为安慰剂。然后重复灵敏度测量。随后使用一副硬性隐形眼镜，并在5分钟后使用0-100视觉模拟量表记录舒适度评分。结果：麻醉部位敏感性明显降低（经bonferroni校正p0.05）。应用生理盐水后，敏感性无显著变化（p < 0.05）。麻醉和生理盐水对角膜和下眼睑边缘结膜的舒适度无显著差异[LSM差异（95% CI）分别为-3.0（-11.3,5.3）和2.0(-6.3,10.3)]。然而，与生理盐水应用相比，上眼睑边缘结膜麻醉的舒适度明显更好[12.3(4.0,20.6)]。结论：这项工作证明了一种新的技术，可以成功地选择性麻醉特定区域的眼表。在上眼睑边缘结膜麻醉时，刚性晶状体的初始舒适度较好，支持了晶状体与上眼睑相互作用驱动刚性晶状体初始舒适度的假设。这项工作对于研究软性隐形眼镜的不适也有重要的实用价值。

{"title":"Effect of selective topical anaesthesia on the initial comfort of rigid contact lenses","authors":"Maria Navascues-Cornago, Carole Maldonado-Codina, Michael L. Read, Philip B. Morgan","doi":"10.1016/j.clae.2025.102474","DOIUrl":"10.1016/j.clae.2025.102474","url":null,"abstract":"<div><h3>Purpose:</h3><div>The primary sensory location of contact lens discomfort remains unclear. This study utilised selective topical anaesthesia of the ocular surface to investigate if the relative contribution of different tissues to lens-related discomfort could be determined.</div></div><div><h3>Methods:</h3><div>This was a randomised, subject-masked, contralateral eye pilot study involving 10 participants. Mechanical sensitivity was measured at three locations on the ocular surface (cornea, upper and lower eyelid marginal conjunctiva) using a Cochet–Bonnet aesthesiometer. Following sensitivity measurements, proxymetacaine hydrochloride 0.5% was topically applied to one of the three locations in one eye whilst 0.9% saline was applied to the corresponding location in the fellow eye as a placebo. Sensitivity measurements were then repeated. A pair of rigid contact lenses was subsequently applied and comfort scores were recorded after 5 min using a 0-100 visual analogue scale.</div></div><div><h3>Results:</h3><div>The sensitivity of the location anesthetised decreased significantly (all Bonferroni-adjusted p<span><math><mo><</mo></math></span>0.006), whilst the sensitivity of the unanaesthetised remaining two locations showed no significant change (all p<span><math><mo>></mo></math></span>0.05). There was no significant change in sensitivity following the application of saline (all p<span><math><mo>></mo></math></span>0.05). There was no significant difference in comfort following lens application between the anaesthetic and saline for the cornea and lower lid marginal conjunctiva [LSM difference (95% CI): −3.0 (−11.3, 5.3) and 2.0 (−6.3, 10.3), respectively]. However, comfort was significantly better when the upper lid marginal conjunctiva was anaesthetised compared to saline application [12.3 (4.0, 20.6)].</div></div><div><h3>Conclusion:</h3><div>This work has demonstrated a novel technique which can successfully selectively anaesthetise specific regions of the ocular surface. The initial comfort of rigid lenses was better when the upper lid marginal conjunctiva was anaesthetised, which supports the hypothesis that initial comfort of rigid lenses may be driven by the interaction between the lens and the upper eyelid. This work may also have significant utility for investigating discomfort in soft contact lenses.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 6","pages":"Article 102474"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144800718","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}

引用次数: 0