Contact Lens & Anterior Eye最新文献_第5页

Comprehensive assessment of tear film dynamics in pediatric vernal keratoconjunctivitis using a novel non-invasive device (MYAH) 一种新型无创装置（MYAH）对儿童春性角膜结膜炎泪膜动态的综合评估

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2026-02-01 Epub Date: 2025-12-26 DOI: 10.1016/j.clae.2025.102599

Ayşenur Gülcü, Sevil Karaman Erdur, Munise Altınbaş

Purpose

To objectively evaluate tear film parameters in children diagnosed with vernal keratoconjunctivitis (VKC) using the MYAH device, and to compare the findings with those of healthy controls.

Methods

This cross-sectional, case-control study included 45 children with clinically diagnosed VKC and 45 age- and sex-matched healthy controls. All participants underwent non-invasive ocular surface assessment using the MYAH system. The evaluated parameters included non-invasive tear break-up time (NI-TBUT), tear meniscus height (TMH), blink rate, and ocular protection index (OPI). Correlations between tear film parameters and VKC severity scores were analyzed using Spearman’s rank correlation coefficient.

Results

Compared to the control group, the VKC group showed significantly lower values in NI-TBUT (5.2 ± 2.1 s vs. 12.8 ± 3.6 s, p < 0.001), TMH (0.18 ± 0.07 mm vs. 0.28 ± 0.05 mm, p < 0.001), blink rate (11 ± 5 vs. 17 ± 4 blinks/min, p = 0.002), and OPI (2.1 ± 1.4 vs. 6.8 ± 2.0, p < 0.001). NI-TBUT and TMH demonstrated moderate negative correlations with clinical severity scores (r = –0.62, p < 0.001 and r = –0.58, p < 0.001, respectively).

Conclusion

Children with VKC exhibit significant alterations in tear film dynamics, even in the absence of visual acuity loss. The MYAH device offers a non-invasive, and pediatric-friendly approach for objectively assessing tear film stability and blink behavior. These parameters may serve as useful biomarkers for disease severity and monitoring in pediatric VKC.

目的应用MYAH仪客观评价春性角膜结膜炎（VKC）患儿的泪膜参数，并与健康对照组进行比较。方法本横断面病例对照研究包括45例临床诊断为VKC的儿童和45例年龄和性别匹配的健康对照。所有参与者使用MYAH系统进行无创眼表评估。评估参数包括无创撕裂时间（NI-TBUT）、撕裂半月板高度（TMH）、眨眼率和眼保护指数（OPI）。采用Spearman等级相关系数分析泪膜参数与VKC严重程度评分的相关性。结果与对照组相比，VKC组NI-TBUT（5.2±2.1 s vs. 12.8±3.6 s, p < 0.001）、TMH（0.18±0.07 mm vs. 0.28±0.05 mm, p < 0.001）、眨眼频率（11±5 vs. 17±4次/min， p = 0.002）、OPI（2.1±1.4 vs. 6.8±2.0,p < 0.001）均显著低于对照组。NI-TBUT和TMH与临床严重程度评分呈中度负相关（r = -0.62, p <； 0.001和r = -0.58, p < 0.001）。结论VKC患儿即使没有视力下降，泪膜动力学也有明显改变。MYAH设备为客观评估泪膜稳定性和眨眼行为提供了一种非侵入性和儿科友好的方法。这些参数可作为儿童VKC疾病严重程度和监测的有用生物标志物。

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引用次数: 0

The relationship between relative peripheral refraction and axial length elongation in myopic children wearing orthokeratology lenses using a novel wide-angle multispectral refraction topographer 应用新型广角多光谱屈光度地形仪研究近视儿童角膜塑形镜的相对外周屈光度与眼轴长度伸长的关系。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2026-02-01 Epub Date: 2025-10-13 DOI: 10.1016/j.clae.2025.102517

Mandantuoya, Mingxin Ao, Yu Zhang

Purpose

To investigate the peripheral retinal relative defocus in myopic children wearing orthokeratology (OK) lenses and evaluate its relationship with the efficacy of myopia control.

Methods

Wide-angle (150° field of view) relative peripheral refraction and axial length measurements were conducted in 48 children wearing OK lenses. Key peripheral refraction parameters included minimum defocus distance, defocus ring outer diameter, defocus ring inner diameter, defocus ring width, and retinal relative defocus values (RDVs). Pearson correlation analysis was used to evaluate the associations between axial elongation rate and these parameters. Multiple regression analysis was constructed to predict axial elongation, mainly based on the parameters of peripheral retinal defocus.

Results

Peripheral myopic defocus was observed in children wearing OK lenses. Axial elongation rate showed a negative correlation with defocus ring outer diameter (R = −0.388, P < 0.01) and defocus ring width (R = −0.503, P < 0.01), while it was positively correlated with minimum defocus distance (R = 0.383, P < 0.01) and defocus ring inner diameter (R = 0.309, P < 0.01). RDV-53, RDV-45, RDV-(30–45), RDV-(45–53), RDV-N, and RDV-I also showed significant positive correlations with axial elongation rate (P < 0.01). Age, baseline axial length, defocus ring width, minimum defocus distance, and RDV-(45–53) were five predictors in the multivariable prediction model.

Conclusion

Wearing OK lenses induced peripheral myopic defocus. Larger defocus ring width, closer defocus ring to the macular zone and greater relative peripheral myopic defocus were associated with less axial elongation. Peripheral defocus parameters combined with age and baseline axial length could predict axial elongation to some extent.

目的：探讨角膜塑形镜（orthokeratology， OK）配戴后近视儿童周围视网膜相对离焦情况，并评价其与近视控制效果的关系。方法：对48例配戴OK隐形眼镜的儿童进行广角（150°视场）相对外周屈光度和眼轴长度测量。关键外周折射参数包括最小离焦距离、离焦环外径、离焦环内径、离焦环宽度和视网膜相对离焦值（RDVs）。使用Pearson相关分析来评估轴向伸长率与这些参数之间的关系。以视网膜周围离焦参数为主要参数，构建多元回归分析预测轴向伸长。结果：儿童配戴OK隐形眼镜后出现外周性近视离焦。轴向伸长率与离焦环外径（R = -0.388, P < 0.01）和离焦环宽度（R = -0.503, P < 0.01）呈负相关，与最小离焦距离（R = 0.383, P < 0.01）和离焦环内径（R = 0.309, P < 0.01）呈正相关。RDV-53、RDV-45、RDV-(30-45)、RDV-(45-53)、RDV- n和RDV- i与轴向伸长率呈极显著正相关（P < 0.01）。年龄、基线轴长、离焦环宽度、最小离焦距离和RDV-(45-53)是多变量预测模型中的5个预测因子。结论：佩戴OK晶状体可引起周围性近视离焦。离焦环宽度越大、离黄斑区越近、相对外周近视离焦越大，轴向伸长越小。外周离焦参数结合年龄和基线轴长可以在一定程度上预测轴向伸长。

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引用次数: 0

Optimizing scleral lens prescriptions: a comparison of algorithmic and conventional refraction and over-refraction in irregular corneas 优化巩膜晶状体处方：不规则角膜屈光和过度屈光的比较。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2026-02-01 Epub Date: 2025-08-11 DOI: 10.1016/j.clae.2025.102485

Rafaela S. Alves-de-Carvalho, Rute J. Macedo-de-Araújo, José M. González-Méijome

Purpose

To compare the accuracy and consistency of subjective refraction using conventional methods versus an algorithm-based approach in patients with primary or secondary corneal irregularities, both with and without scleral lenses (SL).

Methods

Nineteen eyes of ten subjects with irregular corneas underwent non-cycloplegic refraction using (I) retinoscopy followed by conventional subjective refraction (Conventional Refraction) to achieve maximum visual acuity with the maximum positive prescription, and (II) a Hartmann-Shack wavefront aberrometer (WAM 800) followed by an algorithm-based semi-automatic phoropter (Vision-R 800). Refraction measurements were conducted with both techniques, without and with SLs. Outcomes included spherical equivalent (M) and astigmatic components (J0 and J45), and monocular high and low-contrast visual acuity (HCVA and LCVA).

Results

Without SLs, the mean difference in the spherical equivalent between methods was −0.80 ± 1.20 D (p = 0.001). With SLs, the mean difference was −1.04 ± 0.93 D (p = 0.001). Without SLs, monocular HCVA was 0.21 ± 0.20 LogMAR (range: −0.10 to 0.76) and 0.17 ± 0.14 LogMAR (range: −0.02 to 0.60) for Conventional Refraction and V-R 800 (p = 0.162), respectively. Monocular LCVA was 0.59 ± 0.22 LogMAR (range: 0.18 to 0.96) and 0.53 ± 0.20 LogMAR (range: 0.10 to 0.92) for Conventional Refraction and V-R 800, respectively (p = 0.060). With SLs, HCVA was 0.12 ± 0.16 LogMAR (range: −0.12 to 0.50) and 0.09 ± 0.11 LogMAR (range: −0.08 to 0.26) for Conventional Refraction and V-R 800 (p = 0.272), respectively. LCVA was 0.43 ± 0.20 LogMAR (range: 0.06 to 0.90) and 0.47 ± 0.15 LogMAR (range: 0.18 to 0.88), respectively (p = 0.287).

Conclusions

Algorithm-based refraction method provided a more positive spherical equivalent than conventional methods, and both techniques resulted in comparable HCVA and LCVA. Algorithm-based refraction may offer an alternative for over-refraction in patients with irregular corneas during SLs.

目的：比较使用常规方法和基于算法的方法对有或无巩膜晶状体（SL）的原发性或继发性角膜不规则患者主观屈光的准确性和一致性。方法：对10例角膜不规则患者19只眼进行非睫状体麻痹性屈光检查，采用(I)视网膜镜检查+常规主观屈光检查（conventional refraction），以最大正处方获得最大视力；（II）哈特曼-沙克波前像差仪(WAM 800) +基于算法的半自动屈光仪（Vision-R 800）。使用两种技术进行了折射测量，包括不使用SLs和使用SLs。结果包括球面等效(M)和散光分量（J0和J45），以及单眼高对比度和低对比度视力（HCVA和LCVA）。结果：在无SLs的情况下，两种方法的球等效平均差值为-0.80±1.20 D （p = 0.001）。SLs组的平均差异为-1.04±0.93 D （p = 0.001）。无SLs时，单眼HCVA常规折射和V-R 800分别为0.21±0.20 LogMAR（范围：-0.10至0.76）和0.17±0.14 LogMAR（范围：-0.02至0.60）（p = 0.162）。常规屈光和V-R 800的单眼LCVA分别为0.59±0.22 LogMAR（范围：0.18至0.96）和0.53±0.20 LogMAR（范围：0.10至0.92）（p = 0.060）。对于SLs，常规折射和V-R 800的HCVA分别为0.12±0.16 LogMAR（范围：-0.12至0.50）和0.09±0.11 LogMAR（范围：-0.08至0.26）（p = 0.272）。LCVA分别为0.43±0.20 LogMAR（范围：0.06 ~ 0.90）和0.47±0.15 LogMAR（范围：0.18 ~ 0.88）（p = 0.287）。结论：基于算法的折射法比传统方法提供了更正的球面等效，两种技术的HCVA和LCVA相当。基于算法的屈光可能为SLs期间角膜不规则患者的过度屈光提供另一种选择。

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引用次数: 0

Tendency to obtain written informed consent in clinical applications of contact lenses 在隐形眼镜临床应用中获得书面知情同意的倾向。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2026-02-01 Epub Date: 2025-12-10 DOI: 10.1016/j.clae.2025.102593

Onur Furundaoturan , Ilayda Korkmaz , Ozlem Barut Selver

Aim

Notwithstanding contact lenses extensive clinical application, complications particularly in the absence of adequate hygiene and education remain a concern. The objective of this study was to evaluate physicians’ propensity to obtain written informed consent prior to the prescription of contact lenses, and to investigate the factors associated with this practice.

Methods

A cross-sectional survey was distributed to physicians authorized to prescribe contact lenses. The questionnaire collected data on demographics, prescription habits, patient education practices, and consent behaviors of clinicians. Associations between demographic factors and consent behaviors were analyzed using chi-square tests. A power analysis determined a minimum sample size of 370 participants. The survey was created using the Google Forms Platform. The results were recorded anonymously and stored securely using a password-protected system.

Results

A total of 390 physicians participated in the study(mean age:33.7 years;54.1 % female). The majority of these professionals were employed in university or tertiary hospitals(76.4 %), and most of their prescriptions were for contact lenses for refractive(97.4 %) and therapeutic(65.1 %) reasons. Pre-usage education was provided by 88.7 % of physicians, and 95.7 % of these informed patients about potential complications. However, only 4.3 % of participants obtained written informed consent, 12.2 % obtained verbal consent, and 36.5 % obtained no consent. Among the remaining respondents, 41.8 % were unaware of the necessity for informed consent, while 5.2 % believed it was unnecessary. A statistically significant variation in consent practices was observed according to professional rank(p < 0.05). The highest rates of written consent were recorded among professors (11.1 %).

Conclusion

This study underscores a critical paucity of awareness and consistency in obtaining informed consent prior to contact lens utilization, a particular concern among early-career physicians. Although patient education was commonly provided, formal documentation of consent was rare. Establishing standardized consent guidelines will reduce variability in obtaining written informed consent, enhance medicolegal safety, and guide future clinical practice in contact lens prescription.

目的：尽管隐形眼镜广泛的临床应用，并发症，特别是缺乏适当的卫生和教育仍然是一个问题。本研究的目的是评估医生在处方隐形眼镜前获得书面知情同意的倾向，并调查与这种做法相关的因素。方法：对授权开具隐形眼镜处方的医生进行横断面调查。问卷收集了人口统计学、处方习惯、患者教育实践和临床医生同意行为的数据。采用卡方检验分析人口统计学因素与同意行为之间的关系。功效分析确定了最小样本量为370名参与者。该调查是使用谷歌表单平台创建的。结果是匿名记录的，并使用密码保护系统安全地存储。结果：共有390名医生参与了这项研究（平均年龄：33.7岁，女性占54.1%）。这些专业人员中的大多数在大学或三级医院工作（76.4%），他们的处方主要是出于屈光原因（97.4%）和治疗原因（65.1%）使用隐形眼镜。88.7%的医生提供了使用前教育，95.7%的医生告知患者潜在的并发症。然而，只有4.3%的参与者获得了书面知情同意，12.2%的参与者获得了口头同意，36.5%的参与者没有获得同意。在剩下的受访者中，41.8%的人不知道知情同意的必要性，而5.2%的人认为这是不必要的。结论：这项研究强调了在使用隐形眼镜之前获得知情同意的意识和一致性的严重缺乏，这是早期职业医生特别关注的问题。虽然通常提供患者教育，但很少有正式的同意文件。建立标准化的同意指南将减少获得书面知情同意的可变性，提高医学法律安全性，并指导未来隐形眼镜处方的临床实践。

{"title":"Tendency to obtain written informed consent in clinical applications of contact lenses","authors":"Onur Furundaoturan , Ilayda Korkmaz , Ozlem Barut Selver","doi":"10.1016/j.clae.2025.102593","DOIUrl":"10.1016/j.clae.2025.102593","url":null,"abstract":"<div><h3>Aim</h3><div>Notwithstanding contact lenses extensive clinical application, complications particularly in the absence of adequate hygiene and education remain a concern. The objective of this study was to evaluate physicians’ propensity to obtain written informed consent prior to the prescription of contact lenses, and to investigate the factors associated with this practice.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was distributed to physicians authorized to prescribe contact lenses. The questionnaire collected data on demographics, prescription habits, patient education practices, and consent behaviors of clinicians. Associations between demographic factors and consent behaviors were analyzed using chi-square tests. A power analysis determined a minimum sample size of 370 participants. The survey was created using the Google Forms Platform. The results were recorded anonymously and stored securely using a password-protected system.</div></div><div><h3>Results</h3><div>A total of 390 physicians participated in the study(mean age:33.7 years;54.1 % female). The majority of these professionals were employed in university or tertiary hospitals(76.4 %), and most of their prescriptions were for contact lenses for refractive(97.4 %) and therapeutic(65.1 %) reasons. Pre-usage education was provided by 88.7 % of physicians, and 95.7 % of these informed patients about potential complications. However, only 4.3 % of participants obtained written informed consent, 12.2 % obtained verbal consent, and 36.5 % obtained no consent. Among the remaining respondents, 41.8 % were unaware of the necessity for informed consent, while 5.2 % believed it was unnecessary. A statistically significant variation in consent practices was observed according to professional rank(p < 0.05). The highest rates of written consent were recorded among professors (11.1 %).</div></div><div><h3>Conclusion</h3><div>This study underscores a critical paucity of awareness and consistency in obtaining informed consent prior to contact lens utilization, a particular concern among early-career physicians. Although patient education was commonly provided, formal documentation of consent was rare. Establishing standardized consent guidelines will reduce variability in obtaining written informed consent, enhance medicolegal safety, and guide future clinical practice in contact lens prescription.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"49 1","pages":"Article 102593"},"PeriodicalIF":3.7,"publicationDate":"2026-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745620","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

An in vivo study of cigarette smoke induced meibomian gland deterioration in a murine model 香烟烟雾诱导小鼠睑板腺退化的体内研究。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 Epub Date: 2025-06-03 DOI: 10.1016/j.clae.2025.102452

Yuting Jiang , Ling Zhang , Jingru Wang , Runhua Lyu , Yingying Gao

Objective

To investigate the effects of cigarette smoke (CS) exposure on the histopathological structure of the meibomian gland in a murine model, including the presence of inflammatory mediators and sebocyte apoptosis, and to provide a new experimental basis and theoretical support to further explore the relationship between CS and dry eye.

Methods

Forty-eight female C57BL/6 mice aged 6–8 weeks were randomly divided into a normal control group (12 weeks, 24 weeks) and a CS exposure group (12 weeks, 24 weeks). The normal control group received no treatment while the CS exposure group were exposed to CS 2 cigarettes/hour, 3 h/day and 6 days/week for either 12 or 24 weeks. Corneal changes were monitored regularly. Following CS exposure, meibomian gland tissues of mice were processed for H&E staining, CD45 immunohistochemical staining, and immunofluorescence staining for IL-6 and Ki67. The expression of IL-6, Ki67, P63, MMP-3 in meibomian glands were evaluated by RT-PCR. Sebocyte apoptosis was assessed through TUNEL staining.

Results

Compared with the normal control group, H&E staining in the CS12 group showed no significant change, while meibomian gland orifices were blocked in the CS24 group. TUNEL staining demonstrated a significant increase in cellular apoptosis in both smoke-exposed groups compared to the normal control group. IL-6 and MMP-3 were significantly up-regulated in meibomian gland tissues after 12 weeks of CS exposure and the expression of cell proliferation-related gene Ki67 and P63 decreased.

Conclusion

CS exposure induces meibomian gland inflammation, promotes sebocyte apoptosis, and inhibits sebocyte proliferation in mice.

目的：探讨香烟烟雾（CS）暴露对小鼠睑板腺组织病理结构的影响，包括炎症介质的存在和脂质细胞凋亡，为进一步探讨CS与干眼症的关系提供新的实验依据和理论支持。方法：将48只6 ~ 8周龄雌性C57BL/6小鼠随机分为正常对照组（12周、24周）和CS暴露组（12周、24周）。正常对照组不接受任何治疗，而CS暴露组分别暴露于CS 2支/小时、3小时/天、6天/周，持续12周或24周。定期监测角膜变化。CS暴露后，对小鼠黑脂腺组织进行H&E染色、CD45免疫组化染色、IL-6和Ki67免疫荧光染色。采用RT-PCR法检测小鼠睑板腺组织中IL-6、Ki67、P63、MMP-3的表达。TUNEL染色检测脂质细胞凋亡。结果：与正常对照组比较，CS12组H&E染色无明显变化，CS24组睑板腺孔道堵塞。TUNEL染色显示，与正常对照组相比，两个烟雾暴露组的细胞凋亡明显增加。CS暴露12周后，小鼠睑板腺组织中IL-6、MMP-3表达显著上调，细胞增殖相关基因Ki67、P63表达降低。结论：CS暴露可诱导小鼠睑板腺炎症，促进皮脂细胞凋亡，抑制皮脂细胞增殖。

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引用次数: 0

Proteomic analysis of tear fluid: Comparative short-term effects of scleral lenses and rigid corneal lenses wear in ametropic healthy adults 泪液的蛋白质组学分析：在屈光健康成人中，巩膜镜片和硬性角膜镜片配戴的短期效果比较。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 Epub Date: 2025-09-11 DOI: 10.1016/j.clae.2025.102507

Zhe Zhang , Li Zeng , Qihua Le , Yanze Yu , Jiaqi Zhou , Feng Xue , Xingtao Zhou , Jiaxu Hong , Zhi Chen

Purpose

The aim of this study was to evaluate the effect of scleral lenses (SLs) on the ocular surface of healthy individuals and explore potential molecular changes in the tear fluid reservoir associated with this form of contact lens.

Methods

Forty-one healthy Chinese subjects were enrolled in the prospective study and assigned to wear SLs or rigid corneal lenses (RCL), and their ocular surface was evaluated at various time points over one month period. Hyperemia, tear film stability, and molecular changes in tear fluid were assessed. Tandem mass tagging proteomics analysis was used to identify differentially expressed proteins in tears after wearing different lenses.

Results

There were no statistically significant differences observed in in the hyperemia index of the nasal and temporal ciliary vessel areas, as well as the nasal and temporal conjunctival vessel areas between groups. The difference in tear film stability between the two groups was not statistically significant. However, proteomic analysis of tear samples revealed 397 differentially expressed proteins in the SLs group, including pro-inflammatory markers such as interleukins. Pathway analysis identified upregulation of inflammation-related pathways.

Conclusions

SLs wear does not significantly impact hyperemia and tear film stability compared to RCL. Nevertheless, at the molecular level, there is evidence showing an underlying inflammatory response. These findings require continued research to elucidate the clinical implications of these molecular changes and to guide SLs fitting.

目的：本研究的目的是评估巩膜隐形眼镜（SLs）对健康个体眼表的影响，并探讨与这种形式的隐形眼镜相关的泪液储层的潜在分子变化。方法：41名健康的中国受试者被纳入前瞻性研究，并被分配佩戴SLs或刚性角膜镜片（RCL），并在一个月内的不同时间点对其眼表进行评估。充血、泪膜稳定性和泪液分子变化进行了评估。串联质量标记蛋白质组学分析用于鉴定佩戴不同镜片后泪液中差异表达的蛋白质。结果：两组患者鼻、颞睫血管区充血指数、鼻、颞结膜血管区充血指数比较，差异均无统计学意义。两组泪膜稳定性差异无统计学意义。然而，泪液样本的蛋白质组学分析显示，在SLs组中有397种差异表达蛋白，包括促炎标志物，如白细胞介素。通路分析确定了炎症相关通路的上调。结论：与RCL相比，SLs磨损对充血和泪膜稳定性没有显著影响。然而，在分子水平上，有证据表明存在潜在的炎症反应。这些发现需要继续研究，以阐明这些分子变化的临床意义，并指导SLs的匹配。

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引用次数: 0

Reply to letter RE “Improved control efficacy of a novel aspherical orthokeratology lens compared with the traditional three-zone spherical lens in a single-blind randomized clinical trial” 给编辑的信。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 Epub Date: 2025-10-21 DOI: 10.1016/j.clae.2025.102518

引用次数: 0

Predicting contact lens discomfort from meibomian gland morphology and function 从睑板腺形态和功能预测隐形眼镜不适。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 Epub Date: 2025-07-31 DOI: 10.1016/j.clae.2025.102480

Fatima Iqbal , Eric B Papas , Fiona Stapleton , Waleed M. Alghamdi , Amy Ruan , Karuna Darvesh , Lucy Nguyen , Jacqueline Tan

Purpose

To develop and validate a model to predict contact lens discomfort (CLD) using features of the meibomian glands (MG).

Methods

This study consisted of three parts: (i) 50 meibography images from contact lens wearers and non-wearers were assessed to distinguish features of interest between the groups to develop an automated algorithm which was tested on 154 images from CLD participants (ii) A multivariable model was constructed with a separate population of 84 lens wearers using imaging features and ocular surface signs to predict Contact Lens Dry Eye Questionnaire-8 (CLDEQ-8) score (iii) The model was validated on two independent sets of images using Bland-Altman comparisons between actual and predicted CLDEQ-8 scores.

Results

Part I: Intergland distance and width of the gland at the lid margin, centre and distal end were identified as features distinguishing between lens wearers and non-wearers. Part II: In univariate analysis, CLDEQ-8 scores were negatively associated with gland width at the lid margin (r = −0.52, p = 0.01) and lipid layer thickness (r = −0.40, p < 0.05) and positively associated with tear break-up time (r = 0.51, p < 0.001), MG expressibility (r = 0.35, p = 0.01), and intergland distance at the lid margin (r = 0.73, p = 0.02). The multivariable regression model accounted for 68 % (R² = 0.68, p < 0.05) of the variance in CLDEQ-8 scores. Part III: The mean difference (bias) between the predicted and actual CLDEQ-8 score was −0.1 with limits of agreement of ± 2.8 units.

Conclusion

Morphometric features of MG can predict CLDEQ-8 score in lens wearers with reasonable accuracy. This approach may be a suitable screening tool in early detection and to understand the natural history of CLD.

目的：建立并验证一种利用睑板腺（MG）特征预测隐形眼镜不适（CLD）的模型。方法：本研究由三部分组成：(i)评估了来自隐形眼镜佩戴者和非佩戴者的50张meibography图像，以区分组间感兴趣的特征，并开发了一种自动算法，该算法对来自CLD参与者的154张图像进行了测试。（ii）构建了一个多变量模型，包括84名隐形眼镜佩戴者，使用成像特征和眼表体征来预测隐形眼镜干眼症问卷-8 （CLDEQ-8）得分Bland-Altman比较实际和预测的CLDEQ-8分数。结果：第一部分：眼睑边缘、中心和远端腺体间距离和宽度被确定为区分配戴者和非配戴者的特征。第二部分：在单变量分析中，CLDEQ-8评分与眼睑边缘腺体宽度（r = -0.52, p = 0.01）和脂质层厚度（r = -0.40, p 2 = 0.68, p）呈负相关。结论：MG形态计量学特征可以合理准确地预测晶状体佩戴者的CLDEQ-8评分。这种方法可能是早期发现和了解CLD自然历史的一种合适的筛选工具。

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引用次数: 0

Effectiveness of DIMS combined with atropine and orthokeratology in a real-world setting in China DIMS联合阿托品和角膜塑形术在中国的实际应用效果。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 Epub Date: 2025-07-05 DOI: 10.1016/j.clae.2025.102473

Desheng Song , Yanxu Chen , Jiaqi Yao, Juan Chen

Background and objectives

Myopia cases have markedly increased worldwide, particularly in younger individuals. This study evaluates the effect of defocus incorporated multiple segments (DIMS) lens combined with atropine (DIMSA) in the control of myopia progression versus orthokeratology (ortho-k) lenses.

Methods

In this non-randomized controlled clinical study, 180 eyes in 180 myopic children treated at the Nanjing Children’s Hospital between January 2022 and February 2023 were included. According to the preferences of patients and their guardians, the participants were divided into the DIMSA and ortho-k groups, with 90 cases (90 eyes) each. Totally 161 patients in both groups met the inclusion and exclusion criteria, including 88 and 73 in the DIMSA and ortho-k groups, respectively. Right eye parameters were analyzed. Both groups were compared in terms of change in axial length (AL), AL negative growth rate and AL elongation rate after a one-year visit.

Results

No significant differences were found in baseline features other than age between the DIMSA and ortho-k groups. After a one-year treatment, no statistically significant difference was found in axial elongation (AE) between the two groups. After adjustment for baseline age, axial elongations in the DIMSA and ortho-k groups were 0.14 ± 0.18 mm and 0.20 ± 0.18 mm (P = 0.025), respectively. Baseline age was the only factor impacting the axial control efficacy of DIMSA and ortho-k lenses, with a negative association between AE and age in both groups and a positive association between spherical equivalent refraction (SER) increase and baseline age in the DIMSA group. The DIMSA group exhibited higher AL negative growth and AL slow growth (≤0.15 mm) rates after one year compared with the ortho-k lens group (P = 0.008 and P = 0.004, respectively).

Conclusions

DIMSA demonstrated marginally superior myopia control efficacy compared to ortho-k lenses in children with mild to moderate myopia in a real-world setting in China.

背景和目的：近视病例在世界范围内显著增加，特别是在年轻人中。本研究评估了离焦合并多节段（DIMS）晶状体联合阿托品（DIMSA）与角膜塑形（orthokeratology）镜片在控制近视进展中的效果。方法：在这项非随机对照临床研究中，纳入2022年1月至2023年2月在南京儿童医院就诊的180名近视儿童的180只眼。根据患者及其监护人的喜好，将参与者分为DIMSA组和ortho-k组，每组90例（90只眼）。两组共161例患者符合纳入和排除标准，其中DIMSA组88例，ortho-k组73例。分析右眼参数。两组在随访一年后比较轴向长度（AL）、AL负生长率和AL伸长率的变化。结果：除年龄外，DIMSA组和ortho-k组的基线特征无显著差异。治疗一年后，两组间的轴向伸长（AE）无统计学差异。调整基线年龄后，DIMSA组和ortho-k组的轴向伸长分别为0.14±0.18 mm和0.20±0.18 mm （P = 0.025）。基线年龄是影响DIMSA和orthok透镜轴向控制效果的唯一因素，两组的AE与年龄呈负相关，而DIMSA组的球面等效折射（SER）增加与基线年龄呈正相关。与orthok lens组相比，DIMSA组在1年后AL负增长和AL慢增长（≤0.15 mm）率更高（P = 0.008和P = 0.004）。结论：在中国的现实环境中，DIMSA在轻度至中度近视儿童中的控制效果略优于orthok镜片。

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引用次数: 0

A survey of attitudes and clinical behaviour of UK eyecare practitioners towards fitting contact lenses for children and young people 一项调查的态度和临床行为的英国眼科医生对适合儿童和年轻人的隐形眼镜。

IF 3.7 3区医学 Q1 OPHTHALMOLOGY

Contact Lens & Anterior Eye

Pub Date : 2025-12-01 Epub Date: 2025-07-09 DOI: 10.1016/j.clae.2025.102470

Sophie Coverdale , Edward Mallen , Matthew Cufflin , Michael Bowen , Teresa Lewandowski , Neema Ghorbani-Mojarrad

Purpose

This study explored the attitudes and prescribing behaviours of UK eyecare practitioners (ECPs) toward fitting contact lenses (CLs) for patients under 18, and whether these have been influenced by the growing availability of myopia control options.

Methods

An online survey was conducted in 2023 with UK-based optometrists and contact lens opticians (CLOs). It examined minimum fitting ages for different CL types, key decision-making factors when prescribing for paediatrics, and changes in practitioners’ willingness to fit CLs for children. Comparisons were made to a prior iteration of the survey in 2014.

Results

A total of 316 ECPs (248 optometrists, 68 CLOs) completed the survey, with a median of 16 years of experience. Patients under age 18 comprised an estimated 37.2 % of respondents’ CL patients, dropping to 6.2 % for those under age 10. All respondents considered soft CLs suitable for under-18 s, with a median starting age of 8–9 years; rigid corneal lenses were deemed suitable from a significantly higher age of 10–12 years (p < 0.001). CLOs were more willing than optometrists to fit both lens types at earlier ages (p < 0.05) and rated a child’s age as less influential in decision-making (4.9/10 vs. 6.2/10 respectively, p < 0.001). In general, the child’s motivation was the most important factor (9.1/10), while sex was the least (1.8/10). Myopia control was a key consideration (8.4/10), and 38.6 % of ECPs said they had greater willingness to fit CLs for children due to increased access to myopia control options. The proportion of optometrists willing to fit a child under age 8 increased from 12.7 % in 2014 to 39.1 % in 2023.

Conclusions

UK ECPs are generally supportive of CL wear in under-18 s, with myopia control increasingly influencing prescribing. CLOs appear more proactive in paediatric fittings, suggesting a need to enhance optometrists’ training to improve confidence in prescribing for younger patients.

目的：本研究探讨了英国眼科医生（ECPs）对18岁以下患者配戴隐形眼镜（CLs）的态度和处方行为，以及这些态度和行为是否受到越来越多的近视控制选择的影响。方法：于2023年对英国验光师和隐形眼镜验光师（CLOs）进行在线调查。它检查了不同CL类型的最低适合年龄，儿科处方时的关键决策因素，以及从业人员适合儿童CL的意愿的变化。与2014年的调查结果进行了比较。结果：共有316名ECPs（248名验光师，68名clo）完成了调查，平均经验为16年。18岁以下的患者估计占应答者CL患者的37.2%，而10岁以下的患者则降至6.2%。所有受访者都认为软CLs适合18岁以下的人，中位数起始年龄为8-9岁；结论：英国ECPs普遍支持18岁以下儿童配戴晶状体眼镜，近视控制对处方的影响越来越大。CLOs在儿科配光方面显得更加主动，这表明需要加强验光师的培训，以提高为年轻患者开处方的信心。

{"title":"A survey of attitudes and clinical behaviour of UK eyecare practitioners towards fitting contact lenses for children and young people","authors":"Sophie Coverdale , Edward Mallen , Matthew Cufflin , Michael Bowen , Teresa Lewandowski , Neema Ghorbani-Mojarrad","doi":"10.1016/j.clae.2025.102470","DOIUrl":"10.1016/j.clae.2025.102470","url":null,"abstract":"<div><h3>Purpose</h3><div>This study explored the attitudes and prescribing behaviours of UK eyecare practitioners (ECPs) toward fitting contact lenses (CLs) for patients under 18, and whether these have been influenced by the growing availability of myopia control options.</div></div><div><h3>Methods</h3><div>An online survey was conducted in 2023 with UK-based optometrists and contact lens opticians (CLOs). It examined minimum fitting ages for different CL types, key decision-making factors when prescribing for paediatrics, and changes in practitioners’ willingness to fit CLs for children. Comparisons were made to a prior iteration of the survey in 2014.</div></div><div><h3>Results</h3><div>A total of 316 ECPs (248 optometrists, 68 CLOs) completed the survey, with a median of 16 years of experience. Patients under age 18 comprised an estimated 37.2 % of respondents’ CL patients, dropping to 6.2 % for those under age 10. All respondents considered soft CLs suitable for under-18 s, with a median starting age of 8–9 years; rigid corneal lenses were deemed suitable from a significantly higher age of 10–12 years (p < 0.001). CLOs were more willing than optometrists to fit both lens types at earlier ages (p < 0.05) and rated a child’s age as less influential in decision-making (4.9/10 vs. 6.2/10 respectively, p < 0.001). In general, the child’s motivation was the most important factor (9.1/10), while sex was the least (1.8/10). Myopia control was a key consideration (8.4/10), and 38.6 % of ECPs said they had greater willingness to fit CLs for children due to increased access to myopia control options. The proportion of optometrists willing to fit a child under age 8 increased from 12.7 % in 2014 to 39.1 % in 2023.</div></div><div><h3>Conclusions</h3><div>UK ECPs are generally supportive of CL wear in under-18 s, with myopia control increasingly influencing prescribing. CLOs appear more proactive in paediatric fittings, suggesting a need to enhance optometrists’ training to improve confidence in prescribing for younger patients.</div></div>","PeriodicalId":49087,"journal":{"name":"Contact Lens & Anterior Eye","volume":"48 6","pages":"Article 102470"},"PeriodicalIF":3.7,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144601988","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