Contact Lens & Anterior Eye最新文献

Purpose: To create a valid and reliable computer-adaptive testing (CAT) tool for assessing Multifocal Contact Lens (MCL) performance in presbyopic individuals, ensuring high precision. The self-administered tool will initially be accessible online in Spanish.

Methods: Five steps were followed for the correct development of the instruments: item bank development, item refinement phase, item response theory calibration of the refined item bank, CAT simulations and design, and an initial validation study. A total of 1163 presbyopic patients were involved in the over-all study. Convergent validity was assessed by comparing results to the CLDQ-8 questionnaire, and repeatability assessment was performed two weeks after the initial completion.

Results: The final item bank consisted of 108 items assessing various relevant domains for MCL performance evaluation. The calibration study showed a person separation index of 4.69 and a reliability of 0.96 along with a measurement precision of 0.27. The final CAT distinguished between 16 levels of MCL performance by presenting an average of 10.61  ± 1.00 items per patient, with an average completion time of 3:04 ± 1:24 min. Signs of convergent validity showed a correlation of 0.73 and repeatability was assessed showing an intraclass Correlation Coefficient of 0.881 with a 95% Confidence Interval 0,815-0,924, and Limits of Agreement of  ± 1.07.

Conclusion: The MCL-PRO-CAT is a groundbreaking tool for evaluating MCL performance in presbyopic individuals. With automated scoring and fewer items, it was feasible, valid, and precise, enhancing clinical practicality.

Background: Orthokeratology (OK) contact lenses are increasingly prescribed for myopia control but their impact on corneal epithelial immune cells (CEIC) is unclear. This study compares CEIC in OK wearers to soft contact lens (SCL) wearers and non-wearers.

Methods: In vivo confocal microscope images at the corneal central and mid-peripheral subbasal level were evaluated in 18 OK wearers, 18 SCL wearers and 18 non-wearers (mean age 27.6±8.0 years; 65% female). Corneal epithelial immune cell density was manually quantified and morphology was graded using a published system. Statistical significances (p<0.05) were examined using generalised estimating equations.

Results: Corneal epithelial immune cell density in OK wearers was lower than in SCL wearers (p=0.03) at the central cornea, but not at the mid-periphery. Compared to SCL wearers, OK wearers had smaller cell bodies, with fewer participants displaying CEIC with dendrites, long and thick dendrites at both corneal locations (p<0.001). Orthokeratology wearers also had smaller CEIC bodies (p=0.01) and fewer participants had CEIC with dendrites (p=0.01) than non-wearers at both locations. Contrarily, SCL wearers had larger CEIC bodies, with a greater proportion of SCL wearers displaying CEIC with dendrites, long and thick dendrites compared to non-wearers (p≤0.04) at both locations. Corneal epithelial immune cell density was higher at the central cornea than at mid-periphery in SCL wearers (p<0.001) and non-wearers (p=0.01), but not in OK wearers (p=0.26).

Conclusions: In long-term OK lens wear, immune cells observed in the corneal epithelium are fewer in number and are less likely to present with dendrites, suggesting a suppressed CEIC response in OK lens wear which should be investigated further.

Purpose: To evaluate the role of contact lenses (CLs) in visual rehabilitation following keratoplasty.

Methods: Four databases, including PubMed, Scopus, Web of Science, and Embase were systematically searched for studies published between January 2010 and July 2023. Visual outcomes, daily wearing duration, subjective comfort, rate and etiology of CL discontinuation, corneal endothelial cell density, central corneal thickness, and complications were extracted.

Results: This review included thirteen case series and two chart reviews, analyzing a total of 464 eyes, of which 97% underwent penetrating keratoplasty. Scleral CLs were the most frequently fitted lens (285 eyes, 61%). All studies reported a significant improvement in visual acuity with CL correction. Most post-keratoplasty patients could wear CLs comfortably for 8 to 12 h/day. The rate of CL dropout ranged from 0% to 39%, mainly due to CL intolerance, discomfort, and graft rejection. Corneal graft rejection (18 eyes), conjunctival hyperemia (8 eyes), corneal epithelial trauma (5 eyes), graft edema (4 eyes), and microbial keratitis (3 eyes) were the most frequently reported complications.

Conclusion: CLs are effective for improving visual acuity following keratoplasty, with minor complications depending on the type of CL.

Purpose: The objective of this investigation was to consolidate the extant data pertaining to interocular astigmatic symmetry, with a view to discerning any patterns that may emerge from the research.

Methods: A systematic literature review was conducted in accordance with the PICO framework. The search, conducted through September 2024, included three databases (PubMed, Web of Science, and Scopus) and the reference list of the selected articles, which were identified from inception. The articles were selected based on the inclusion criteria of population-based studies with data on interocular astigmatic symmetry.

Results: A total of 65 articles were retrieved, of which 13 met the inclusion criteria. The thirteen studies included a total of 329,747 subjects from ten different countries. The prevalence of interocular astigmatic symmetry according to axis orientation was isorule in most of the articles (i.e., both eyes having the same pattern: with-the-rule astigmatism, against-the-rule astigmatism, or oblique astigmatism), except for those pertaining to the geriatric population. Regarding the classification according to axis orientation, mirror symmetry was demonstrated to be the most prevalent pattern in interocular astigmatism. Genetic and individual factors, such as age, sex, and refractive error, did not exhibit a discernible influence on interocular astigmatic symmetry.

Conclusion: The findings of this study indicated a clear trend through the isorule pattern and mirror symmetry in a population.

Purpose: To compare the two-year efficacy of spectacle lenses with highly aspherical lenslets (HAL) and orthokeratology (OK) lenses in managing myopia in children.

Methods: This retrospective study examined medical records from the Affiliated Eye Hospital of Wenzhou Medical University, involving 1683 HAL users and 1192 OK users. Participants were children aged 8-13 with a refractive error of -0.50 to -6.00 D. They were divided by age into younger (8-10 years) and older (11-13 years) groups and further divided into low myopia (-0.50 to -3.00 D) and moderate myopia (<-3.00 to -6.00 D) subgroups. The participants were included in either the 1-year or 2-year follow-up group based on the length of their follow-up records. The change in axial length (AL) was compared between the HAL and OK groups using t-tests and multiple linear regression analysis.

Results: In the younger group, HALs yielded significantly slower AL elongation than did the OK lenses at both the 1-year (HAL: 0.16 ± 0.19 mm; OK: 0.22 ± 0.17 mm; p < 0.001) and 2-year follow-ups (HAL: 0.32 ± 0.27 mm; OK: 0.37 ± 0.24 mm; p = 0.009). In the older group, the AL changes did not significantly differ by lens at the 1-year (p = 0.782) or 2-year (p = 0.239) follow-up. Among the low myopia subgroup, the HAL users consistently exhibited smaller AL changes than did the OK users across all follow-ups (p < 0.05), except at the 2-year follow-up in the olders (p = 0.414). For the moderate myopia subgroup, the OK lenses yielded significantly slower AL changes at the 2-year follow-up (younger: p = 0.013; older: p = 0.01), although no significant differences were found at the 1-year follow-up (younger: p = 0.635; older: adjusted: p = 0.143).

Conclusions: HALs are significantly more effective than OK lenses in controlling AL elongation in younger children with low myopia, while both treatments show similar effectiveness in older children. For moderate myopia, OK lenses are preferred for superior long-term control.

Purpose: To investigate the prognostic ability of blink rate and the proportion of incomplete blinking to predict dry eye disease diagnosis, as defined by the TFOS DEWS II criteria.

Methods: A total of 453 community residents (282 females, 171 males; mean ± SD age, 37 ± 19 years) were recruited in an investigator-masked, prospective registry-based, cross-sectional, prognostic study. Dry eye symptomology, tear film quality, and ocular surface characteristics were assessed in a single clinical session, and blink parameters evaluated by an independent masked observer.

Results: Overall, 214 (47 %) participants fulfilled the TFOS DEWS II criteria for dry eye disease. Multivariate regression analysis demonstrated that an increased proportion of incomplete blinking was associated with a higher odds of dry eye disease (odds ratio, 1.12 per 10 % increase; 95 % CI, 1.05-1.19; p < 0.001), with the Youden-optimal prognostic threshold proportion being ≥ 40 % incomplete blinking. Higher levels of incomplete blinking were also associated with poorer dry eye symptomology, tear film stability, corneal and lid margin staining, lipid layer thickness, meibography, and meibum quality (all p ≤ 0.03). No significant associations were detected between blink rate and ocular surface parameters (all p > 0.10).

Conclusions: The degree of incomplete blinking is a significant predictor of dry eye disease, and the utility of incorporating blink assessment into diagnostic workup algorithms warrants further investigation. The association with meibomian gland dropout, expressed meibum quality, and lipid layer thickness would suggest that incomplete blinking may predispose towards the development of meibomian gland dysfunction.