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

Objectives: This study aimed to investigate the clinical efficacy of MiSight 1 day soft contact lenses (MiSight CL) in Korean children with mild-to-moderate myopia. In addition, the study compared the effects of MiSight CL in children who had or had not previously used orthokeratology contact lenses (Ortho-K).

Methods: A total of 66 children aged 5 to 16 years, who were prescribed MiSight CL, were included in the study. Based on a myopia degree of -4 diopters (D), children were divided into mild and severe myopia groups to compare the effectiveness of myopia suppression. In addition, 55 eyes previously using Ortho-K were compared with 76 eyes using MiSight CL for the first time.

Results: The average follow-up period was 6.58±3.74 months. The average refractive value before using MiSight CL was 3.64±1.56 D, and there was no significant change in the final visit. Comparing myopia suppression between different degrees of myopia and previous use of Ortho-K lenses, there was no significant change in refractive error before and after using MiSight CL (unpaired t test, P >0.05). The main reason for Ortho-K failure was low visual acuity after correction. Regardless of Ortho-K history, children showed good visual acuity after wearing MiSight CL, and no other side effects were observed.

Conclusions: MiSight CL effectively inhibited the progression of myopia in Korean children with mild-to-moderate myopia. MiSight CL offer the advantage of easy application, making them a viable alternative when Ortho-K are not suitable.

Purpose: To determine the relationship between regional summed corneal refractive power changes (CRPCs) in myopic orthokeratology and axial elongation.

Design: This retrospective study included 70 eyes of 70 patients aged 8 years to 13 years who underwent orthokeratology lens (OK lens) treatment, and all patients underwent regular follow-ups at 1 week, 1 month, 6 months, and 12 months at Zhongshan Ophthalmic Center between January 2019 and May 2021.

Methods: Axial length (AL) was measured at baseline and 12 months by an IOLmaster 5.0. Refractive error power was measured using cycloplegia. Regional summed CRPCs were calculated by MATLAB software using difference tangential power maps at the sixth month acquired by corneal topography measurements (Medmont E300 Corneal Topographer; Medmont Pty, Victoria, Australia) and defined as changes in corneal refractive power at the sixth month from baseline. The regional summed CRPCs were then subdivided into 4-mm diameter circles, 4- to 5-mm diameter chords, and 5- to 6-mm diameter chords according to the distance from the central of the pupil and into negative, positive, and total according to the values. Pearson correlation, multiple linear regression analysis, and stepwise multiple linear regression analysis were performed to analyze the relationships among these parameters.

Results: Axial elongation had a negative relationship with positive regional summed corneal refractive power in the central 4-mm diameter circle and age (r=-0.282, P =0.018; r=-0.473, P <0.001, respectively) and a positive relationship with negative regional summed corneal refractive power in the 5- to 6-mm diameter chord (r=0.361, P =0.002). Stepwise multiple linear regression analysis identified age (standardized β =-0.434, P <0.001) and negative regional summed corneal refractive power in the 5- to 6-mm diameter chord (standardized β =0.305, P =0.004) as factors influencing AL elongation.

Conclusion: Negative regional summed corneal refractive power in a 5- to 6-mm diameter chord after OK lens treatment may be an important index for evaluating the control effects of axial elongation.

Objectives: To compare the control effectiveness and periretinal defocus between orthokeratology (OK) and highly aspherical lenslets (HAL) in adolescents with myopia.

Methods: In this prospective study, 211 children (211 right eyes) were enrolled in Beijing Ming Vision and Ophthalmology between October 2022 and February 2023. Based on the myopia correction method, participants were divided into three groups: OK, HAL, and single-vision spectacles (SVS). They were further divided into two subgroups according to the spherical equivalent (SE), namely, subgroup A with -1.0≤SE≤-2.0 D and subgroup B with -2.0

Results: Axial length growth in those with OK lenses and HAL was lower than what was observed for those with SVS after 6, 9, and 12 months. Comparison of the difference in AL change between OK and HAL was not statistically significant with -1.0≤SE≤-2.0 D. The myopic defocus of RDV270° to 300° in group HAL was higher than that in group OK, the difference was statistically significant ( P <0.05), and in other regions, the myopic defocus was higher in the group OK. Em, SRI (corneal regularity index), variation in cell area, and corneal thickness were significantly associated with shaping force.

Conclusions: Orthokeratology is one of the most effective optical treatments for controlling myopia, and the factors that affect the corneal shaping force under different corneal parameters are different. For mild myopia, HAL can achieve the same effectiveness as OK.

Objective: We conducted a retrospective evaluation of the long-term prognosis associated with anterior blepharitis subsequent to topical antibiotic intervention.

Methods: Inclusion criteria encompassed 92 eyes of 92 patients who exhibited clinical manifestations of anterior blepharitis and undergone a regimen of topical azithromycin. The follow-up duration extended to a minimum of one year within our medical facility. The diagnostic framework for anterior blepharitis, along with the evaluation of both objective and subjective manifestations, adhered to the Blepharitis Preferred Practice Pattern as promulgated by the American Academy of Ophthalmology. Relapse denoted the resurgence of blepharitis symptoms subsequent to the primary treatment, necessitating the instigation of either topical or oral therapeutic measures.

Results: Of 92 cases of anterior blepharitis, 48 showed recurrence, with a recurrence rate of 52.2%. During the follow-up period, 2 patients experienced 5 relapses, 2 patients experienced 4 relapses, 5 patients experienced 3 relapses, 13 patients experienced 2 relapses, and 26 patients experienced 1 relapse. When the patients were divided into three groups: multiple recurrence group (22 patients), single recurrence group (26 patients), and no recurrence group (44 patients), there were no significant differences in the blepharitis finding score before and after the initial treatment among three groups. However, significantly fewer patients in the no recurrence group required further treatment after initial treatment, and the percentage of patients with residual blepharitis during follow-up was significantly lower in the no recurrence group.

Conclusions: Our data suggest that patients with residual findings after blepharitis treatment are at a risk of recurrence.

Objectives: To investigate the level of compliance with contact lens (CL) care habits among CL wearers of different age and occupation groups.

Methods: This survey study included 205 CL wearers followed in the tertiary reference center between 2016 and 2022. The survey was employed to probe each user's demographic data and noncompliant behaviors. To this end, the study compared CL compliance levels of patients in different age and occupation groups.

Results: There were 85 (41.5%) patients in the good compliant group, 72 (35.1%) in the average compliant group, and 48 (23.4%) in the poor compliant group. The most common noncompliant behavior was disruption of aftercare visits. Except for two noncompliant behaviors (storage of fresh lens solution and exceeding the recommended lens case replacement time), other noncompliant behaviors were found more frequently in the ≤25 age group. The differences between the age groups were significant in hand washing and water activities ( P =0.004 and P =0.023, respectively). Exceeding lens replacement time and sleeping with lenses criteria were found to be significantly noncompliant in health care workers compared to non-health care workers ( P =0.006 and P =0.001, respectively). The level of compliance was found to be lower in users with 6 to 7 days of CL use per week than in those with fewer days ( P =0.006).

Conclusion: We found that the compliance rate was lower in younger patients and health care workers. We also observed that long-term use of CL reduces the level of compliance. Therefore, it might be necessary to focus on modifiable risk factors in these patient groups.

Background: Diagnosis of keratoconus (KC) involves the identification of corneal signs, refraction, and corneal imaging. The prevalence of KC ranges between 0.4 per 100,000 and 4,790, depending on geographical location and ethnicity. Diagnosis of KC should occur early for appropriate management with relatively affordable, accessible options to prevent visual impairment in low-income settings.

Method: Written consent and assent were obtained from subjects before a questionnaire was administered to collate demographics, general and ocular history of subjects, and keratoconus risk factors. A novel scoring system was applied to identify subjects at a higher risk of developing KC and document KC risk factors prevalent in Harare using an informed risk score calculation.

Results: Thousand one hundred fifty-three subjects aged between 6 and 12 years were seen. The prevalence of KC was found to be 626/100,000 in primary school children resident in Harare. Reduced visual acuity, vernal keratoconjunctivitis, itchy eyes, eye rubbing, and atopy are the most prevalent KC risk factors identified in this community. Informed risk score calculation proved valuable in the screening for KC.

Conclusion: The prevalence of KC in primary school children in Harare is 626/100,000, which is relatively high. School-aged children stand to benefit from the early screening for KC based on evidence-based practices in the absence of advanced clinical instrumentation.

Objectives: To evaluate the reliability and agreement of tear meniscus height (TMH) measurements performed with a corneal analyzer and optical coherence tomography (OCT) technology in contact lens (CL) wearers and its correlation with contact lens discomfort symptoms.

Methods: Asymptomatic and symptomatic CL wearers classified through the Contact Lens Dry Eye Questionnaire-8 were evaluated with the Corneal Analyzer (Topcon CA-800) and OCT technology (Topcon 3D OCT-2000). The repeatability and intraclass correlation coefficient (ICC) were calculated. The agreement between devices was calculated using the Bland-Altman method. The relationship between TMH measurements and the Contact Lens Dry Eye Questionnaire-8 and Contact Lens Discomfort Index scores was assessed through the Spearman correlation coefficient.

Results: Seventy-nine asymptomatic and 42 symptomatic CL wearers aged 34.24±12.50 years were enrolled. The repeatability values obtained for the CA-800 were 0.07 mm in all cases, and the ICC was 0.93 for the whole sample. The CA-800 provided significantly ( P <0.01) higher TMH values than the OCT for the whole sample (0.22±0.08 vs. 0.17±0.06 mm). A weak indirect correlation (ρ=-0.22) between the OCT TMH measurement and Contact Lens Discomfort Index scores was found ( P ≤0.04).

Conclusion: The CA-800 provides reliable TMH measurements during CL wear; however, they might not be interchangeable with OCT ones. Tear meniscus height measurements might be useful as a complementary sign to detect CL discomfort, but it cannot be used alone as a diagnostic tool.

Objectives: To compare astigmatism correction after photorefractive keratectomy (PRK) using three excimer laser devices, Alcon Wavelight EX500, Schwind Amaris 1,050, and Technolas Teneo317 M2.

Methods: This retrospective study included 414 eyes from 414 subjects with a history of PRK performed using Alcon Wavelight (n=172), Schwind Amaris (n=122), and Technolas (n=120). Uncorrected & corrected distance visual acuity (UDVA & CDVA), and refractive status (spherical equivalent (SE) and vector analysis (J0 and J45)) were postoperatively recorded at the 6-month and 12-month examinations.

Results: The mean CDVA and J45 at 6-month and 12-month showed no statistically significant difference among the three different excimer lasers ( P >0.05). There was a statistically significant difference in mean UDVA and J0 at 6-month and 12-month after PRK among the three groups, with no statistically significant difference between Alcon Wavelight and Schwind Amaris lasers, while both of the prior lasers showed a significant difference with the Technolas laser. The highest and lowest changes in the magnitude of J0 in 6-month and 12-month follow-ups were seen for the Alcon Wavelight and Technolas groups, respectively. Both Schwind Amaris and Technolas had a small hyperopic SE while the Alcon Wavelight's SE was minimally myopic. This difference in SE between Alcon Wavelight and both Schwind Amaris and Technolas reached statistical significance.

Conclusion: While all three lasers performed well in reducing preoperative astigmatism; however, the Alcon Wavelight and Schwind Amaris were more effective in correcting astigmatism than the Technolas. The difference between the Alcon Wavelight and Schwind Amaris did not reach statistical significance.

Objective: To describe a patient diagnosed with Exophiala jeanselmei keratitis.

Methods: We report a case of a patient who developed infectious keratitis following laser in situ keratomileusis and chronic topical steroid use for approximately six months in both eyes. An atypical infiltrate containing dark pigmentation was noted in the left eye on the initial presentation. During treatment, the infiltrates of the right eye began to exhibit a similar pigmentation.

Results: Early treatment with topical antifungals was initiated in the left eye and later in the right eye once culture results returned. Both eyes recovered with good vision after approximately one month.

Conclusions: Patients treated with postoperative topical corticosteroids should be cautioned of potential adverse effects of chronic use and have close follow-up. If infectious keratitis develops, particularly after two weeks, then atypical organisms, such as fungi, should be considered. In addition, our case highlights the significance of recognizing and associating dark-pigmentation with fungal etiologies.

Purpose: This study aimed to evaluate the efficacy, safety, and participant compliance of orthokeratology treatment for the correction of myopic refractive errors over a six-month prospective study and to define the potential reasons for early treatment discontinuation.

Methods: A total of 32 participants with low-to-moderate myopia were fitted with the spherical model of corneal refractive therapy (CRT) orthokeratology lenses (Paragon Vision Sciences) and followed over six months, with specific attention to alterations in refractive error, corneal topography, and epithelial thickness. Concurrently, participant feedback and reasons for any treatment discontinuation were documented.

Results: Significant changes in refractive error and in corneal topography were observed, with approximately 50% of the refractive error being corrected on the first night of use and 100% by the first two weeks ( P <0.001). Central epithelial thickness experienced substantial thinning, reducing to 15.65±4.49 μm (67.38%) ( P <0.001) after 6 months of lens use. Six participants withdrew from this study for varied reasons, including unmet visual expectations and difficulty adhering to the lens-wearing regimen. Notably, the dropout group exhibited higher baseline low-order aberrations and less prolate corneas than those who persisted with the treatment ( P <0.05).

Conclusions: Orthokeratology with CRT is efficacious and safe for the correction of low-to-moderate myopia in adults, but a portion of patients discontinue the treatment in the first 6 months of contact lens wear. Special care should be taken when recommending orthokeratology in patients with higher levels of myopia and corneas with less prolate shape, providing more realistic expectations and even changing to dual axis or more sophisticated designs.