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

Objective: l -cysteine graphene oxide (CysGO) was synthesized and deposited onto the hydrogel and silicone hydrogel contact lenses (CLs) to study the surface characterization.

Methods: A cysteine graphene oxide composite was synthesized, characterized, and deposited on commercially available soft CLs. Characterization techniques such as FESEM, Fourier Transform Infrared, Raman spectroscopy, X-ray photoelectron spectroscopy (XPS), and Ultraviolet-Visible spectroscopy were employed to analyze CysGO deposited lens surface characterisation. Swelling and transmission percentages were calculated.

Results: Raman spectra revealed an increased I d /I g ratio of 2.5 for CysGO compared with GO (2.25), indicating reduced layer stacking due to cysteine interaction. IR spectra confirmed the presence of amide groups, and XPS spectra exhibited a distinct s2p peak at 164eV and N2 spectrum at 399 eV exclusively in CysGO, confirming its deposition on the lens substrate. The deposited CLs showed a uniform coating of CysGO, an increase in the swelling percentage ( P <0.001), and no difference in transmittance percentage when compared with the control.

Conclusion: This study presents the inaugural investigation of CysGO deposition applied to CL, revealing its advantageous properties, including uniformity and enhanced wettability. The potential of this coating extends beyond these characteristics, prompting further exploration of its diverse properties and applications in subsequent studies.

Objectives: To evaluate the impact of using a high-viscosity hyaluronate solution in the fluid reservoir (FR) on post-lens fluid turbidity and the settling of scleral lenses (SLs).

Methods: Forty-four eyes of 22 keratoconus patients were fitted SLs. SLs applied to the right eye were filled with preservative-free sodium hyaluronate solution, whereas those applied to the left eye were filled with preservative-free saline. After SL fitting, high- and low-contrast visual acuities (VAs) were measured at 0, 4, and 8 hr. The optical density of the post-lens fluid was calculated using Scheimpflug tomography and graded from anterior-segment optical coherence (AS-OCT) images. Central corneal clearance and lens settling were measured with AS-OCT.

Results: High-contrast VA showed no significant change over time in either group. Low-contrast VA remained stable during 8 hr of SL wear in the right eyes, but low-contrast VA decreased at 4th and 8th hours in the left eyes. AS-OCT-based turbidity grading and the optical density increased over time, with no difference between the two solutions. The rate and amount of settling did not differ between the groups.

Conclusions: High-viscosity sodium hyaluronate may sustain improved low-contrast vision in keratoconus patients compared with saline, without adversely affecting post-lens fluid turbidity or lens settling.

Objective: To investigate and compare the effects of bifocal soft contact lenses, single-focus soft contact lenses, and orthokeratology lenses (OK lenses) on patients with small-angle intermittent exotropia (IXT) accompanied by myopia, providing a basis for reducing secondary surgeries in clinical practice.

Methods: A prospective, randomized, controlled study was conducted on 142 patients with small-angle IXT who had undergone IXT surgery and had concomitant myopia. Patients were randomly assigned to three groups using a computer-generated random number sequence with allocation concealment: the bifocal soft contact lens group (group A), the single-focus soft contact lens group (group B), and the OK lens group (group C). During the one-year treatment period, multiple visual function parameters were measured, including best-corrected visual acuity (BCVA), contrast sensitivity, accommodative function, eye position control ability, strabismus angle, and axial length (AL).

Results: There were no significant differences in BCVA among the three groups, indicating similar basic visual acuity correction effects. Compared with the other two lens types, defocus soft contact lenses led to reduced contrast sensitivity at high spatial frequencies. Orthokeratology lenses resulted in decreased accommodative amplitude, increased accommodative lag, and reduced accommodative facility compared with the other lenses. The strabismus angle decreased in all patients, with improved positive fusional convergence. Groups A and B showed better improvements in eye position control and strabismus angle reduction than group C. Defocus soft contact lenses and OK lenses were comparable in controlling AL growth. The strabismus angle positively correlated with near stereopsis acuity and eye position control scores and negatively correlated with near horizontal positive fusional convergence.

Conclusion: After the initial IXT surgery, patients wearing defocus soft contact lenses with a concentric bifocal design can effectively control AL growth, enhance eye position control ability, improve visual function, and achieve good subjective visual outcomes.

Objectives: To determine the factors that may affect pediatric epithelial remodeling after accelerated epi-off cross-linking (A-CXL) by examining the changes in epithelial thickness (ET) maps in pediatric keratoconus patients at the 1-year follow-up.

Methods: Seventy-one eyes of 53 patients (mean age 14.89±1.89 years) were included. Before A-CXL, the MS-39 anterior segment optical coherence tomography images were examined 3, 6, and 12 months after corneal cross-linking (CXL).

Results: Significant flattening was observed in Kmax and Ksteep values at 6 and 12 months after A-CXL ( P <0.05). No significant change was noted in mean ET, except for the 6 to 8 mm inferonasal area ( P >0.05). When max-min ET differences were examined in each region of the corneal ET map, significant improvement was detected in the central 6 mm area, in the 2 to 4 mm inferior-temporal (IT) zone, and in the 4 to 6 mm area in the IT and inferior (I) zones ( P <0.05). The change in max-min ET differences in the central 6 mm area before A-CXL and at 12 months after CXL was significantly correlated with the change in corrected distance visual acuity values, corneal keratometry, corneal astigmatism, and stromal thickness parameters ( P <0.05).

Conclusions: A-CXL is an effective treatment for preventing the progression of pediatric keratoconus and for normalizing ET changes by promoting epithelial remodeling. Epithelial remodeling may have an impact on the improvement in visual acuity after A-CXL by providing a smooth optical surface.

Abstract: This case series reports two cases of scleral lens (SL)-associated suture erosion of polytetrafluoroethylene CV-8 (Gore-Tex, Newark, DE) in scleral-sutured CZ70BD (Alcon, Fort Worth, TX) posterior chamber intraocular lens (SS-PCIOL). Suture erosion after SS-PCIOL has been reported in two of the patients who were fitted with SL for visual acuity improvement. Erosion was corrected in both cases with suture repositioning and corneal patch graft, with one patient requiring the exchange of the intraocular lens. The other patient was able to transition to an SL of a different size parameter. Scleral lens fitting should consider the position of haptic placement in relation to the suture site and be monitored for suture erosion postoperatively. A scleral flap or corneal tissue patch graft may be needed for patients who have scleral thinning from prior surgery.

Abstract: A 36-year-old man presented with a vascularized corneal epithelial hypertrophy after a persistent epithelial defect (PED) in the left eye, 1 year after undergoing retinal detachment surgery. Despite multiple interventions such as bandage contact lens, punctal occlusion, topical steroids and lubricants, tarsorrhaphy, amniotic membrane transplantation, and insulin drops, the defect progressed to a hypertrophic, elevated, and vascularized corneal lesion obstructing visual axis. A customized scleral lens (SL) was prescribed to support ocular surface healing, improve comfort, and enhance visual acuity. Over 18 months of daily SL wear, the patient experienced a marked reduction in the size, elevation, and vascularization of the epithelial hypertrophy, with gradual visual improvement from 6/36 to 6/12. The fitting complications, including lens removal difficulty and nasal quadrant impingement, were resolved through edge modification. Follow-up revealed improved ocular surface appearance, a stable fluid reservoir, and better surface wettability. This case highlights the therapeutic potential of SLs not only in promoting epithelial healing but also in remodeling chronic corneal pathologic condition such as epithelial hypertrophy and neovascularization post-PED. Scleral lens therapy, when appropriately customized and monitored, offers a safe, nonsurgical alternative for patients with complex ocular surface disorders unresponsive to conventional treatments.

Objectives: This study aimed to compare temporal changes in tear meniscus height (TMH) and noninvasive tear film break-up time after the instillation of four dry eye treatments: artificial tears (AT), 3% diquafosol sodium long-acting (DQL), 3% diquafosol sodium (DQS), and rebamipide (RB).

Methods: Sixty healthy eyes were randomly divided into four treatment groups. The TMH and noninvasive tear film break-up time were measured using a noninvasive tear film analysis device at baseline and 1, 5, 15, 30, 60, 120, and 180 min after instillation.

Results: TMH and noninvasive tear film break-up time did not show significant differences among the groups. In the AT and RB groups, TMH increased significantly 1 min after instillation compared with baseline. In the DQS group, TMH remained elevated for up to 60 min, whereas the DQL group showed a more prolonged increase, lasting up to 120 min. For the noninvasive tear film break-up time, significant prolongation was observed only at 5 and 15 min after instillation in the DQL group.

Conclusions: Topical instillation of 3% diquafosol ophthalmic solution effectively increased tear volume on the ocular surface, with the long-acting DQL formulation demonstrating a more sustained effect in healthy eyes.

Purpose: This study compared the myopia control effects of corneal high-order aberrations (CHOA) from two orthokeratology (OK) lenses based on their relative corneal refractive power shifts.

Methods: In this prospective cohort study, 101 school children with low to moderate myopia were divided into three groups: group A (N=35) used 3-curve design lenses, group B (N=31) used 4-curve design lenses, and group C (N=35) wore regular spectacles. Cycloplegic refraction, visual acuity, and axial length (AL) were measured at baseline and after one year. Keratometry and CHOA were assessed before and after 3 months of lens wear. Relative corneal refractive power shifts and summed corneal power change (SCPC) were calculated. One-way ANOVA and planned comparison analyzed group differences.

Results: Group B showed significantly slower AL elongation than group A ( P =0.017) after OK treatment. Group B's SCPC was significantly higher than group A's ( P ≤0.005). Group B had a significant increase in horizontal coma ( P =0.004). Increased SCPC led to more coma aberration with four-curve lens wear ( P <0.01).

Conclusions: The four-curve lens design was more effective in slowing AL elongation for OK treatment. It also caused significantly higher horizontal coma aberration than the three-curve design.

Objectives: This study aimed to quantify the differences in the anterior and posterior segment parameters between both eyes of individuals with nonamblyopic myopic anisometropia of ≥2 diopters (D).

Methods: This study enrolled 141 adults (mean age: 24.3±6.0 years; 48.3% men) with myopic anisometropia (binocular refractive difference of ≥2.0 D in spherical power). Bilateral measurements included refractive error (spherical equivalent, SE), mean keratometry, intraocular pressure, axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), anterior chamber volume (ACV), peripapillary retinal nerve fiber layer (RNFL) thickness, optic nerve head (ONH) parameters, and macular thickness in Early Treatment Diabetic Retinopathy Study (ETDRS)-defined regions. Linear associations between variables and interocular differences in ocular parameters were statistically evaluated.

Results: The right eyes of the 68 men and 73 women enrolled in this study had significantly high myopia ( P <0.05). The mean interocular difference in the SE was 2.72±0.93 D. The AL, ACD, and ACV were significantly greater for the more myopic eyes than for the contralateral eyes (all P <0.05). The CCT, ETDRS thickness, and ONH parameters (excluding average RNFL thickness) were lower for the more myopic eyes than for the contralateral eyes (all P <0.05). The superior quadrant RNFL thickness decreased with age ( P <0.05). The refractive difference was significantly correlated with interocular differences in AL (r=0.735, P <0.001).

Conclusions: Interocular differences in anterior chamber parameters, macular thickness, and ONH structures were identified in adult patients with nonamblyopic myopic anisometropia. The more myopic eyes had thinner CCT, greater corneal curvatures, and specific ONH and macular layer alterations.