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

Purpose: The term "midday fogging" is used to describe visual blur, which some scleral lens wearers experience during use. The purpose of this study was to determine whether fit characteristics and biomicroscopic findings in habitual scleral lens wearers contribute to symptoms of fogging.

Methods: This prospective, observational study analyzed 48 habitual scleral lens wearers who wore lenses in one or both eyes from five clinical sites. Participants indicated whether they experienced fogging. Slit Lamp biomicroscopy was performed to evaluate fluid reservoir (FR) depth and presence or absence of limbal clearance, edge lift or impingement, conjunctival prolapse, and front surface nonwetting. Presence or absence of mucous strands, fine particulate debris, and diffuse haze in the FR were also noted. Backward elimination binomial logistic regression using one eye per participant compared the findings of eyes with and without subjective fogging.

Results: Fogging was reported by 58% participants (28/48). Statistical analysis found no significant differences in scleral lens fitting characteristics of eyes with and without reported fogging. The presence of front surface nonwetting and diffuse haze were statistically higher in eyes with fogging.

Conclusion: In this study, front surface nonwetting and diffuse haze observed with Slit Lamp biomicroscopy were associated with patient-reported scleral lens fogging.

Objectives: Scleral lenses (SLs) represent a key treatment for visual rehabilitation in patients with irregular corneas, such as keratoconus (KC), pellucid marginal degeneration (PMD), and postlaser in situ keratomileusis (LASIK) ectasia. This study evaluates the impact of profilometry-guided SLs on visual acuity (VA) and ocular aberrations in these patients.

Methods: Medical records of 23 eyes from 23 patients with KC, PMD, and post-LASIK ectasia were reviewed. All patients were fitted with profilometry-guided SLs. High-contrast visual acuity (HCVA), low-contrast visual acuity (LCVA), and aberrometry parameters (Strehl ratio, higher-order root mean square (HO-RMS), coma, spherical aberration, and trefoil) were analyzed before and during SL wear.

Results: HCVA improved significantly from 0.62±0.09 logMAR at baseline to 0.03±0.01 logMAR with SL wear ( P <0.05). LCVA also showed significant improvements ( P <0.05). HO-RMS decreased from 2.70±0.54 D to 1.00±0.20 D ( P <0.05), with notable reductions in coma (1.31±0.21 D to 0.49±0.04 D) and trefoil (1.26±0.29 D to 0.34±0.09 D).

Conclusions: Profilometry-guided SLs significantly improve VA and reduce higher-order aberrations in patients with irregular corneas, offering an effective nonsurgical solution for enhancing vision quality in these complex cases.

Aims: To estimate the tear film concentration of oral ciprofloxacin in patients with bacterial keratitis and evaluate its correlation with various clinical factors.

Method: This prospective intraindividual study enrolled 52 patients (104 eyes), each with unilateral, microbiologically confirmed bacterial keratitis (n=52 eyes); the fellow eye (n=52 eyes) served as the healthy control. The etiology of keratitis was confirmed by corneal scraping followed by detection of bacteria on Gram stain and bacterial culture. In addition to empirical therapy with topical fortified cefazolin 5% and tobramycin 1.3%, changing drugs if necessary, according to the antibiotic sensitivity report, these patients received oral ciprofloxacin 500 mg BD for 5 days. Tear samples were collected from infected and noninfected eyes, respectively, 3 hr after the morning dose of day 5. These samples underwent liquid chromatography and mass spectrometry to estimate concentration of ciprofloxacin in tear film.

Result: Staphylococcus epidermidis was the most prevalent organism in our study (28.85%). The median ulcer area was 24 (4, 72) mm 2 . The median concentration of ciprofloxacin in tear samples from infected eyes was 547 (10.9, 3,490) ng/mL. In the noninfected eyes, the median concentration was 461 (3.86, 1730) ng/mL. The median concentration of ciprofloxacin in infected eyes was comparable with the minimum inhibitory concentration (MIC) for Staphylococcus species. Drug concentration in tear film had a strong positive correlation with ulcer area (Spearman rho=0.957; P =0.02) but weak positive correlation with the presence of infection (Spearman rho=0.245; P =0.08).

Conclusion: Oral ciprofloxacin reaches tear concentration similar to the reported MIC of staphylococcus species, therefore is a promising adjuvant to topical therapy in staphylococcal keratitis. Further larger scale, comparative studies are warranted to ascertain the same.

Purpose: To assess the practices, challenges, and barriers faced by optometrists in the control of childhood myopia in Nigeria.

Methods: This cross-sectional study collected information on demography, professional experience, clinical practice, and perceived barriers to effective myopia control options using a self-administered web-based survey. The survey was designed using a Likert scale and conducted between February 13 and April 21, 2024. Descriptive statistics were used to analyze the frequency of different management strategies and the various factors influencing decisions related to myopia management.

Results: The respondents were mostly male (51.7%), 49.5% worked in private practice, and 52.4% had less than five years of professional experience. The most frequently used myopia control options were single-vision distance spectacles (full correction), advice to spend more time outdoors, and visual hygiene. Single-vision distance contact lenses with full correction (63.4%) were the most recommended alternative option to single-vision distance spectacles (full correction), followed by visual hygiene practices (61.8%). Myopia control spectacle lenses were used by only 1.9% of the respondents. Major barriers to effective myopia control included the need for additional clinical equipment, medico-legal concerns, and minimal financial incentives, rated as "important" or "very important" by more than 45% of respondents.

Conclusions: Significant gaps in the adoption of advanced myopia control strategies were observed among Nigerian optometrists, largely because of perceived barriers such as financial constraints and medico-legal concerns.

Purpose: To compare the ocular comfort and tear film stability of low viscous and medium viscous lubricant eye drops in orthokeratology lens users.

Method: This is a prospective, two-arm, randomized, crossover trial. After a 7±2 day run-in and washout period, subjects were assigned to apply one of two eye drops to the orthokeratology lens bow every night before inserting their lenses. Low viscosity eye drops with sodium chloride 5.5 mg (AIM Artificial Tears, Aimedicine) and medium viscosity eye drops with 0.4% polyethylene glycol (Systane ULTRA Unit dose, Alcon) were used.

Results: The study included 40 subjects with a mean age of 10.40±2.64 years and an averaged spherical equivalent of-3.43±1.31 diopters. There were no significant differences in Ocular Surface Disease Index (OSDI), Schirmer,noncontact tear film break-up time (NiTBUT), corneal staining score (NEI), or topographic decentration between the two treatment groups.

Conclusion: Despite the disparity in viscosity, the difference in visual acuity, OSDI, Schirmer, NiTBUT, NEI, and topographic decentration failed to reach statistical significance. Therefore, wearing orthokeratology lenses with low or medium viscosity artificial tears did not significantly impact daily visual acuity, ocular surface parameters, or contact lens centration.

Purpose: This study aimed to identify the key demographic, biometric, and behavioral factors that impact the treatment effect of Ortho-K in low myopia and to discover the management ideas for low myopes undergoing Ortho-K treatment.

Methods: A 12-month retrospective study examined 380 individuals who received Ortho-K treatment. Stratification and multinomial logistic regression were conducted to identify biometric features and behavioral indicators associated with Ortho-K treatment outcomes in low myopes.

Results: The 12-month axial length growth was significantly longer in the low myopia group than in the moderate myopia group ( P <0.0001). Multivariate logistic regression analysis showed that Ortho-K only was 2.23 times more likely to have rapid axial growth than Ortho-K combined with 0.01% atropine in patients with low myopia ( P =0.01; odds ratio [OR]=2.23; 95% confidence interval [CI], 1.19-4.20). Multinomial logistic regression analyses showed that in patients with low myopia, female sex ( P <0.0001; OR=0.4; 95% CI, 0.22-0.72), young age ( P =0.01; OR=0.79; 95% CI, 0.66-0.93), flatter K mean ( P =0.004; OR=0.74; 95% CI, 0.61-0.91), and having two myopic parents ( P =0.03; OR=0.18; 95% CI, 0.05-0.71) were associated with worse treatment outcomes. A diet rich in white meats, such as fish and duck ( P =0.01; OR=0.06; 95% CI, 0.01-0.54), was protective behavioral factors associated with slower axial length growth in children with low myopia.

Conclusions: Patients with low myopia who exhibit one or more of the demographic and biometric risk factors (young age, female, flat mean K, and two myopic parents) require heightened attention in clinic settings because of their increased risk of myopia progression. Ortho-K combined with 0.01% atropine may achieve better efficacy than Ortho-K only in low myopes. A diet rich in white meat is protective and controlled behavioral factors for these patients.

Purpose: Microbial keratitis accounts for significant proportion of corneal blindness. To know the underlying etiological micro-organism, performing corneal scraping is important for initiating the correct antibiotic therapy. A study was conducted to compare the efficacy and safety of 26-gauge needle and Kimura spatula for the same.

Methods: A prospective, comparative randomized pilot study was conducted to compare Kimura spatula (group 1) to 26-gauge needle (group 2). In total, 115 patients were recruited in the 2 groups-67 in group 1 and 48 in group 2.

Results: Both the groups were comparable in adequacy of sample, microbiological staining and culture, and safety ( P >0.05). However, in subgroup analysis, the number of fully adequate samples was higher and nonadequate samples was lower in the 26-gauge needle group ( P =0.004).

Conclusion: Both Kimura spatula and 26-gauge needle are safe and effective tools for corneal scraping. However, in adequacy, cost-effectiveness, easy availability, disposable nature, and nondependency on sterilization unit, 26-gauge needle is superior to Kimura spatula.

Aim: This study aims to investigate the psychosocial effects of corneal tattooing in patients with corneal leukoma.

Materials and methods: Aesthetic pigmentation was applied to patients with corneal leukomas. The Hospital Anxiety and Depression Scale (HADS), Social Appearance Anxiety Scale (SAAS), and the International Brief Version of the Fear of Negative Evaluation Scale, which were validated by Turkish speakers, were performed before and 3 months after corneal tattooing for aesthetic purposes. A review and interpretation of questionnaire scores was conducted under the supervision of authors from psychiatric departments. For demographic and clinical data, 20 questions were asked of patients before tattooing and 14 questions were asked 3 months after tattooing.

Results: According to all tests, all scores drastically decreased after corneal tattooing. In the HADS test, the mean preoperative depression score was 8.80, while the postoperative was 4.39 ( P <0.001). The mean preoperative anxiety score was 7.52, and the postoperative score was 4.41 ( P <0.001). The mean preoperative SAAS score was 50.64, with the postoperative score equaling 33.68 ( P <0.001). Finally, the mean preoperative BNFES score was 35.14, and the postoperative was 24.57 ( P <0.001). All values are statistically strongly significant ( P <0.001).

Conclusion: Patients with corneal leukomas are at higher risk of significant depression and anxiety symptoms for many reasons, such as low vision, trauma, multiple surgery, strabismus, and ptosis. In conclusion, addressing corneal leukoma through appropriate ophthalmological interventions not only improves visual function but also alleviates appearance-related psychological distress. Integrating psychiatric assessment into the care process may further enhance the overall quality of life through a holistic, patient-centered approach.

Objectives: To investigate seasonal variations in the effect of controlling myopia progression using orthokeratology (Ortho-K) in Chinese myopic children.

Methods: One hundred sixteen myopic children aged 7 to 12 years who completed 1 year of Ortho-K treatment. Based on initial time wearing Ortho-K, subjects were classified as four groups: spring group (March-May), summer group (June-August), autumn group (September-November), and winter group (December-February). Axial length (AL) was measured every 3 months for 1 year by partial coherence interferometer. Axial elongation over time and between groups was compared.

Results: The effect of myopia control using Ortho-K was influenced by seasonal variation. After adjusting study groups (type of Ortho-K), age, AL, spherical equivalent refractive error (SER), and ocular parameters at the baseline, the mean axial elongation over 1 year wearing Ortho-K was 0.33±0.08 mm for spring group, 0.30±0.10 mm for summer group, 0.21±0.08 mm for autumn group, and 0.22±0.09 mm for winter group ( P <0.001). Statistically significantly higher mean axial elongation was observed in winter months than that in summer (0.09±0.06 mm vs. 0.05±0.05 mm, P <0.001).

Conclusions: In general, axial elongation in myopic children receiving Ortho-K in summer months was approximately 56% of that in winter. Initial time wearing Ortho-K in autumn/winter months, the effect of myopia control is better than in spring/summer. Our results indicated that seasonal variation should be taken into account in studies related to Ortho-K.