Eye & Contact Lens-Science and Clinical Practice最新文献

Objectives: The purpose of this study was to analyze the size of the effective optical zone (EOZ) and its related influencing factors in small incision lenticule extraction.

Methods: Calculation of the horizontal EOZ (Y1: H-EOZ), vertical EOZ (Y2: V-EOZ), and average EOZ (Y3: A-EOZ) using corneal topographic difference maps. Multivariate linear regression analysis was used to establish a multivariate linear equation for the dependent variable EOZ. Receiver operating characteristic (ROC) curves were constructed based on the experimental cohort and were validated in the validation cohort.

Results: The EOZ was smaller than the programmed optical zone (POZ) (p<0.001), and the spherical (Sp) and astigmatism (As) were positively correlated with H-EOZ (p Sp <0.001, p As <0.001), whereas average K-value (Km) and horizontal corneal diameter (WTW) were negatively correlated with H-EOZ (p Km <0.001, p WTW <0.002). The corresponding multivariate linear regression equation was Y1=5.246+0.168X1-0.278X2+0.027X3-0.131X4. Spherical, As, the asphericity of cornea (Q-value), and POZ were positively correlated with V-EOZ (p As <0.000, p Q <0.001, and p POZ <0.05, respectively) and Y2=3.032+0.102X1+0.175X2+0.642X5+0.415X6. Spherical, astigmatism, and POZ were positively correlated with A-EOZ (p Sp <0.000, p As <0.05, p POZ <0.05, respectively), whereas WTW was negatively correlated with A-EOZ (p WTW <0.004) as follows: Y3=4.384+0.132X1+0.023X3-0.117X4+0.294X6. The H-EOZ model had the largest area under the ROC curve, 0.853 (95% confidence interval: 0.807-0.767).

Conclusions: The preoperative intended correction of spherical lesions may be the main factor affecting the size of the postoperative EOZ, and this study has strong predictability for the horizontal EOZ.

Background: Orthokeratology (OK) lenses are used to control myopia progression in children. Few studies have described the changes in stereoacuity scores and fusion ranges in OK-treated children.

Objectives: This study sought to investigate the effects of short-term OK lens wearing on binocular visual function, including fusion and stereoacuity, in children successfully fit with OK lenses.

Methods: This prospective study included 36 children with ideal lens fitting (treatment zone decentration <1 mm) and was conducted between September 2020 and December 2021. Thirty-six patients were assessed before treatment, after 3 months of follow-up, and after 6 months of follow-up for contrast sensitivity (CS), fusion function, and stereopsis and calculation of the accommodative convergence/accommodation (AC/A) ratio.

Results: Compared with those at baseline, the stereoacuity score and convergence amplitude were significantly improved after 3 months of OK lens wear ( P <0.05) but did not further increase after 6 months of lens wear. By contrast, the CS and AC/A ratio did not significantly change from baseline to either follow-up date ( P >0.05).

Conclusions: The CS and AC/A ratio remained unchanged after OK lens wear, while the stereoacuity score and fusion range improved in the pediatric population. These findings suggest that OK lens wearing improves or maintains binocular vision function in myopic children who achieve good visual performance with OK lenses (ChiCTR2000038600, registered September 24, 2020).September 24, 2020).

Abstract: Dry eye disease (DED) is a complex condition characterized by the loss of tear film homeostasis, resulting in ocular symptoms, inflammation, and damage. Managing DED involves a diverse range of therapies aimed at alleviating symptoms and addressing underlying causes. This review provides a comprehensive update on current DED treatments, focusing on medications approved by the United States (US) Food and Drug Administration and notable treatments available outside the United States. Differences in treatment approaches between Asian and Western countries have been explored, highlighting the need for a nuanced understanding of regional variations. The Asia Dry Eye Society offers a new perspective on dry eye, further elucidating these regional distinctions. This review emphasizes the importance of staying informed about evolving treatment guidelines and advancements in DED therapeutics. As the field progresses with new and innovative therapies, there is increased potential for improved patient management and enhanced quality of life for individuals affected by DED.

Objectives: Topical insulin (TI) at 25 IU/mL effectively normalizes healing of corneal epithelium and dry eye in diabetic patients. We aim to determine physicochemical stability and sterility of TI in sodium hyaluronate 0.18% (TI-artificial tears [AT]) in an eye drop formulation.

Methods: The physicochemical stability of TI-AT at 5°C±3°C and 30°C±2°C in sterile low-density polyethylene bottles was studied. Samples were put in conditions of simulated use and analyzed weekly for stability parameters (visual inspection, turbidity, ultraviolet spectral absorption, osmolality, and pH) and culture growth. Insulin was quantified using the stability-indicating high-performance liquid chromatographic method with diode-array detection with RP-C18 column, o -nitrophenol as an internal standard, and ultraviolet detection at 214 nm. Stability was set according to British Pharmacopoeia with 90% to 110% of initial concentration (with 95% confidence interval) considered acceptable.

Results: All tested physicochemical and sterility parameters remained stable for 1 month in both temperature conditions with stable TI concentrations.

Conclusion: Topical insulin-artificial tears is stable in both room temperature and refrigeration. Topical insulin-artificial tears can be prescribed with a 1-month shelf life.

Objective: To assess the clinical safety and efficacy of orthokeratology (OK) lenses with toric peripheral curves (TPCs), based on a review of published literature.

Methods: A literature search on OK lenses with TPCs using 11 relevant search term combinations was conducted. Databases included PubMed, Cochrane Online Library, Prospero International Prospective Register of Systematic Reviews, and Embase. The period covered was January 1, 2012, to May 1, 2024.

Results: In total, 600 publications were identified in the search databases using the search criteria. Based on titles and abstracts, 52 distinct articles were identified for further review; of these, 16 were determined related to clinical evaluation of OK lenses with TPCs. The published studies involved five different lens models from five different manufacturers: Menicon Z Night Toric (Menicon Co, Ltd, Nagoya, Japan), Euclid Emerald Toric (Euclid Systems Corporation, Herndon, VA), Lucid Night Ortho-K Toric (Lucid Korea, Seoul, Korea), Dual Axis Corneal Refractive Therapy (Paragon Vision Sciences, Gilbert, AZ), and Eyebright Base Curve Aspheric Ortho-K (Eyebright Medical Technology Co, Ltd, Beijing, China).

Conclusions: Published literature suggests that OK lenses with TPCs are effective in treating patients with both myopia and astigmatism, with favorable safety profiles.

Objectives: To assess the quality of life in Japanese patients with Fuchs endothelial corneal dystrophy (FECD) using The National Eye Institute Visual Function Questionnaire.

Methods: Here, 34 patients with FECD (FECD group) and 13 healthy individuals (control group) completed the National Eye Institute Visual Function Questionnaire Japanese version by interview format. The association between dominant eye corrected distance visual acuity and composite score (component 11) or subscales in the FECD group was evaluated using Spearman rank correlation coefficient.

Results: The average age was 65.8±11.9 and 60.1±7.9 years in the FECD and control groups, respectively. Corrected distance visual acuity was significantly lower in the FECD group (0.021±0.21 logarithm of the minimum angle of resolution) than in the control group (-0.61±0.055 logarithm of the minimum angle of resolution) ( P <0.0001). Composite scores were significantly lower in the FECD group (77.6±11.0) than in the control group (89.2±7.0) ( P =0.0006). All subscale scores were lower in the FECD group, particularly for distance vision and mental health (81.4±13.1 and 84.0±15.6, respectively) than in the control group (90.7±12.0 and 95.7±5.7) ( P =0.022 and P =0.0046, respectively). Corrected distance visual acuity in the dominant eye did not significantly correlate with composite scores or subscales in the FECD group.

Conclusions: Quality of life is lower in patients with FECD than in healthy individuals, particularly regarding distance vision and mental health.

Abstract: Stevens-Johnson syndrome often results in a significant reduction in vision, dryness, and photophobia based on severity. Scleral lenses are well-considered visual interventions that enhance vision and comfort, resulting in an increased quality of life for patients. This case report describes the enhancement of comfort, cosmesis, and reduction of photophobia using a piggyback system (scleral contact lenses over a prosthetic contact lens), whereas the other modalities were unsatisfactory.

Objectives: Large language models (LLMs) are increasingly being used today and are becoming increasingly important for providing accurate clinical information to patients and physicians. This study aimed to evaluate the effectiveness of generative pre-trained transforme-4.0 (ChatGPT-4.0), Google Gemini, and Microsoft Copilot LLMs in responding to patient questions regarding keratoconus.

Methods: The LLMs' responses to the 25 most common questions about keratoconus asked by real-life patients were blindly rated by two ophthalmologists using a 5-point Likert scale. In addition, the DISCERN scale was used to evaluate the responses of the language models in terms of reliability, and the Flesch reading ease and Flesch-Kincaid grade level indices were used to determine readability.

Results: ChatGPT-4.0 provided more detailed and accurate answers to patients' questions about keratoconus than Google Gemini and Microsoft Copilot, with 92% of the answers belonging to the "agree" or "strongly agree" categories. Significant differences were observed between all three LLMs on the Likert scale ( P <0.001).

Conclusions: Although the answers of ChatGPT-4.0 to questions about keratoconus were more complex for patients than those of other language programs, the information provided was reliable and accurate.

Purpose: To investigate the impact on distance and near contrast sensitivity (CS) after fitting multifocal contact lenses (MFCLs) for presbyopia correction according to the scientific evidence already published.

Methods: Three bibliographic search was conducted on PubMed, Web of Sciences, and Scopus. Inclusion criteria were articles written in English evaluating distance and/or near CS in presbyopic patients using MFCLs, controlled clinical trials, and articles published from 2000 to 2024. After reading and analyzing carefully the articles that were finally included, the Critical Appraisal Skills Programme (CASP) tool for clinical trials was used to evaluate the quality of the research.

Results: A total of eight articles were considered. One study did not find significant changes in binocular contrast sensitivity function (CSF) after fitting center-distance MFCL (CD) in the dominant eye and a center-near (CN) in the nondominant eye. Another research did not detect significant differences comparing CN MFCLs with monovision. However, another study found significant differences when comparing CN MFCL with spectacles. Half of studies only reported the comparison in CSF among different MFCL designs, with two studies confirming worse visual performance with MFCLs compared to pinhole contact lenses. Concerning the CASP analysis, some level of variability in the quality scores was found, with 5/13 in three studies, 6/13 in three studies, 7/13 in one study, and 8/13 in one study.

Conclusions: The limited evidence on the impact on CS of using MFCLs does not allow to extract consistent generalizable conclusions, with only three studies suggesting a variable impact and no evidence of the real clinical benefit of using this metric for the evaluation and optimization of MFCL fitting. More research is needed on this topic.

Abstract: The increased usage of nonrefractive cosmetic contact lenses in Asia and a trend toward increased online purchasing of both refractive and cosmetic contact lenses poses unique challenges in the management of contact lens-related complications. However, regulations have lagged behind this increased uptake in the community. This paper reviews regulations surrounding the manufacturing, import, and distribution of contact lenses in the Asia Pacific region and compares them with international regulations from the European Union and United States. It found a need for more specific regulations and closer surveillance targeted at new trends in contact lens purchasing and usage. This paper also found a need for more effective enforcement of current regulations.