Pub Date : 2024-01-01Epub Date: 2024-07-30DOI: 10.22374/jclrs.v8i1.61
Amy Nau, Cherie Nau, Ellen Shorter, Muriel Schornack, Jennifer Fogt, Jennifer Harthan
Background and objective: This study determined whether practitioners specializing in keratoconus (KC) adhere to published guidelines for disease management and to what extent comorbid conditions of dry eye, contact lens tolerance, and psychological consequences of KC are formally assessed as part of long-term management.
Materials and methods: This cross-sectional study used an IRB-approved, Internet-based, REDCap platform. Descriptive statistics are presented.
Results: A total of 222 participants qualified for participation. Most 134 (60%) followed young and unstable patients every 6 months and less frequent follow-up examinations for patients with stable findings, with 142 (64%) recommending annual examinations. Scleral lenses were the preferred optical correction method (36%), followed by corneal gas permeable lenses (21%). A total of 118 (55%, n=216) participants recommend crosslinking to any patient with documented disease progression regardless of age. Fewer than 25% of patients were referred for surgical correction of KC. Half of respondents, 114 (51%), reported testing for tear film dysfunction, while 108 (49%) never tested. No participants used a depression screening instrument.
Conclusion: Practitioners managing patients with KC largely adhere to current consensus recommendations. This survey identified several potentially high-impact, low-cost improvements to current practice patterns, including screening for dry eye and depression.
{"title":"Opportunities for Improving the Long-term Management of Keratoconus Patients.","authors":"Amy Nau, Cherie Nau, Ellen Shorter, Muriel Schornack, Jennifer Fogt, Jennifer Harthan","doi":"10.22374/jclrs.v8i1.61","DOIUrl":"10.22374/jclrs.v8i1.61","url":null,"abstract":"<p><strong>Background and objective: </strong>This study determined whether practitioners specializing in keratoconus (KC) adhere to published guidelines for disease management and to what extent comorbid conditions of dry eye, contact lens tolerance, and psychological consequences of KC are formally assessed as part of long-term management.</p><p><strong>Materials and methods: </strong>This cross-sectional study used an IRB-approved, Internet-based, REDCap platform. Descriptive statistics are presented.</p><p><strong>Results: </strong>A total of 222 participants qualified for participation. Most 134 (60%) followed young and unstable patients every 6 months and less frequent follow-up examinations for patients with stable findings, with 142 (64%) recommending annual examinations. Scleral lenses were the preferred optical correction method (36%), followed by corneal gas permeable lenses (21%). A total of 118 (55%, n=216) participants recommend crosslinking to any patient with documented disease progression regardless of age. Fewer than 25% of patients were referred for surgical correction of KC. Half of respondents, 114 (51%), reported testing for tear film dysfunction, while 108 (49%) never tested. No participants used a depression screening instrument.</p><p><strong>Conclusion: </strong>Practitioners managing patients with KC largely adhere to current consensus recommendations. This survey identified several potentially high-impact, low-cost improvements to current practice patterns, including screening for dry eye and depression.</p>","PeriodicalId":73690,"journal":{"name":"Journal of contact lens research & science","volume":"8 1","pages":"e37-e46"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11753081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Boston Keratoprosthesis Type 1 (KPro), an artificial cornea, is a therapeutic option for patients in need of corneal transplantation when the prognosis of traditional keratoplasty is guarded. Bandage contact lens wear is essential in the post-operative management of KPro eyes in order to maintain adequate corneal graft hydration, and minimize the risk of adverse complications. Suitable bandage contact lens selection is imperative to preserve keratoprosthesis function, and customized modifications of contact lens parameters may be necessary to ensure adequate fitting. The available contact lens options, modifications, and protocols for the continued care of Boston Keratoprosthesis are discussed. A simple, yet unreported modification for contact lenses fit over KPro eyes in the setting of ocular surface irregularities is proposed, which may hold clinical utility when fitting keratoprosthesis patients with scleral elevations and glaucoma filtrationdevices.
{"title":"CONTACT LENS MODIFICATIONS FOR BOSTON KERATOPROSTHESIS","authors":"Christina Cherny, Suzanne W. Sherman, D. Trief","doi":"10.22374/jclrs.v6i1.50","DOIUrl":"https://doi.org/10.22374/jclrs.v6i1.50","url":null,"abstract":"Boston Keratoprosthesis Type 1 (KPro), an artificial cornea, is a therapeutic option for patients in need of corneal transplantation when the prognosis of traditional keratoplasty is guarded. Bandage contact lens wear is essential in the post-operative management of KPro eyes in order to maintain adequate corneal graft hydration, and minimize the risk of adverse complications. Suitable bandage contact lens selection is imperative to preserve keratoprosthesis function, and customized modifications of contact lens parameters may be necessary to ensure adequate fitting. The available contact lens options, modifications, and protocols for the continued care of Boston Keratoprosthesis are discussed. A simple, yet unreported modification for contact lenses fit over KPro eyes in the setting of ocular surface irregularities is proposed, which may hold clinical utility when fitting keratoprosthesis patients with scleral elevations and glaucoma filtrationdevices.","PeriodicalId":73690,"journal":{"name":"Journal of contact lens research & science","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48789359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of specially designed reverse geometry lenses, known as orthokeratology (ortho-K) lenses, has gained popularity recently. There are various names to this technique: corneal reshaping therapy, corneal refractive therapy, overnight corneal reshaping, corneal molding system, Vision Shaping Treatment, and many more. The advantage of applying this technique is that it results in a temporary reduction of the refractive error by flattening the central cornea with overnight wear of the specially designed lens. Ortho-K lenses are also widely used as a modality for slowing myopia progression in children. With advances in technology and lens design, high refractive errors and astigmatism are now possible to correct. This case presentation summarizes a successful fitting of toric ortho-K lenses to reshape a toric cornea with highmyopia and astigmatism.
{"title":"RESHAPING TORIC CORNEAS WITH ORTHOKERATOLOGY","authors":"Fakhruddin Barodawala","doi":"10.22374/jclrs.v6i1.49","DOIUrl":"https://doi.org/10.22374/jclrs.v6i1.49","url":null,"abstract":"The use of specially designed reverse geometry lenses, known as orthokeratology (ortho-K) lenses, has gained popularity recently. There are various names to this technique: corneal reshaping therapy, corneal refractive therapy, overnight corneal reshaping, corneal molding system, Vision Shaping Treatment, and many more. The advantage of applying this technique is that it results in a temporary reduction of the refractive error by flattening the central cornea with overnight wear of the specially designed lens. Ortho-K lenses are also widely used as a modality for slowing myopia progression in children. With advances in technology and lens design, high refractive errors and astigmatism are now possible to correct. This case presentation summarizes a successful fitting of toric ortho-K lenses to reshape a toric cornea with highmyopia and astigmatism.","PeriodicalId":73690,"journal":{"name":"Journal of contact lens research & science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45285875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-14Epub Date: 2023-07-31DOI: 10.22374/jclrs.v6i1.53
Jennifer Swingle Fogt, Abigail Menner, Kim Patton
Introduction: Soft contact lens wearers are often prescribed the same lens material and modality for multiple years if patients express satisfaction and no significant problems with lens fit or ocular health are noted upon evaluation. Despite their satisfaction, it is possible that other lenses exist that could provide additional health or convenience benefits and still provide satisfied lens wear experience.
Methods: In this study, wearers of a specific monthly replacement lens brand (comfilcon A) were recruited for an open-label study. The habitual contact lens prescription was optimized for 2 weeks of wear and participants confirmed that they were satisfied with their habitual lenses before being refit with daily disposable lenses (verofilcon A). Participants responded to visual analog scale (VAS) survey about their initial impressions of the lenses. After 2 weeks of lens wear, participants completed a final study visit and completed surveys about lens wear experiences with the daily disposable study lenses.
Results: Fifteen male and 15 female participants completed the study. Median (IQR) binocular LogMAR visual acuity was -0.20(0.12), which is equivalent to 10/12.5 Snellen acuity. Initial impression surveys revealed median (interquartile range) of 92.5(22.3) for quality of vision; 95.0(19.3) for comfort; and 91.5(19.3) for satisfaction. At the final visit, median scores for EOD quality of vision was 86.5(24.0); EOD comfort was 84.5(30.3), and EOD dryness 25.5(47.0). Median overall VAS scores were 92.5(16.0) for vision; 88.0(18.3) for comfort, and 17.5(25.8) for dryness. Median satisfaction with the study lenses was scored 9(2.8) on a 1-10 scale.
Conclusions: In this study, satisfied wearers of comfilcon A reusable lens were refit with Verofilcon A daily disposable lenses and showed high satisfaction scores with the new lenses, showing that refitting these patients can allow patients to have lenses with more frequent replacement and maintain satisfaction with daily lens wear.
{"title":"EVALUATION OF WEAR EXPERIENCE WITH WATER SURFACE DAILY DISPOSABLE LENSES IN SATISFIED REUSABLE SOFT CONTACT LENS WEARERS.","authors":"Jennifer Swingle Fogt, Abigail Menner, Kim Patton","doi":"10.22374/jclrs.v6i1.53","DOIUrl":"10.22374/jclrs.v6i1.53","url":null,"abstract":"<p><strong>Introduction: </strong>Soft contact lens wearers are often prescribed the same lens material and modality for multiple years if patients express satisfaction and no significant problems with lens fit or ocular health are noted upon evaluation. Despite their satisfaction, it is possible that other lenses exist that could provide additional health or convenience benefits and still provide satisfied lens wear experience.</p><p><strong>Methods: </strong>In this study, wearers of a specific monthly replacement lens brand (comfilcon A) were recruited for an open-label study. The habitual contact lens prescription was optimized for 2 weeks of wear and participants confirmed that they were satisfied with their habitual lenses before being refit with daily disposable lenses (verofilcon A). Participants responded to visual analog scale (VAS) survey about their initial impressions of the lenses. After 2 weeks of lens wear, participants completed a final study visit and completed surveys about lens wear experiences with the daily disposable study lenses.</p><p><strong>Results: </strong>Fifteen male and 15 female participants completed the study. Median (IQR) binocular LogMAR visual acuity was -0.20(0.12), which is equivalent to 10/12.5 Snellen acuity. Initial impression surveys revealed median (interquartile range) of 92.5(22.3) for quality of vision; 95.0(19.3) for comfort; and 91.5(19.3) for satisfaction. At the final visit, median scores for EOD quality of vision was 86.5(24.0); EOD comfort was 84.5(30.3), and EOD dryness 25.5(47.0). Median overall VAS scores were 92.5(16.0) for vision; 88.0(18.3) for comfort, and 17.5(25.8) for dryness. Median satisfaction with the study lenses was scored 9(2.8) on a 1-10 scale.</p><p><strong>Conclusions: </strong>In this study, satisfied wearers of comfilcon A reusable lens were refit with Verofilcon A daily disposable lenses and showed high satisfaction scores with the new lenses, showing that refitting these patients can allow patients to have lenses with more frequent replacement and maintain satisfaction with daily lens wear.</p>","PeriodicalId":73690,"journal":{"name":"Journal of contact lens research & science","volume":"6 1","pages":"e18-e24"},"PeriodicalIF":0.0,"publicationDate":"2022-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10506162/pdf/nihms-1923233.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10657923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obinwanne Junior Chukwuemeka, D. Echendu, Isaura Ilorena D'Alva Brito dos Santos, Sharon Onwuka, Osazee Agbonlahor
Purpose: To determine if regional variation in post lens fluid reservoir thickness (PLFT) during scleral lens wear leads to regional variation in oxygen transmissibility and corneal edema during 4 hours of non-fenestrated scleral lens wear.Methods: About 20 healthy subjects (mean age, 28.8 ± 4.2 years) were fitted with nonfenestrated rotationally symmetric scleral lenses. Anterior segment optical coherence tomography was used to measure cornea thickness before and after lens wear, PLFT 10 minutes and 4 hours after lens application, and scleral lens thickness (with the scleral lens in situ) 4 hours after scleral lens application. These measurements were limited to the central 6 mm and divided into three zones (central, mid-peripheral, and peripheral zones). In the mid-peripheral and peripheral zones, eight principal meridians were measured, generating 17 measurement points in total. Scleral lens thickness and PLFT measurements were corrected for optical distortions by a series of equations. Oxygen transmissibility was calculated by dividing the scleral lens oxygen permeability by the optically-corrected scleral lens thickness, taking into account the oxygen permeability of saline and fluid reservoir thickness.Results: A significant regional variation in PLFT (F = 12.860, P = 0. 012) was observed after 10 minutes of the lens application, PLFT was thickest and thinnest in the inferotemporal and the superonasal region of the peripheral zones( 322.6 ± 161.8 µm and 153.8 ± 96.4 µm, respectively); however, this variation was not statistically significant at 4 hours of scleral lens wear (F = 4.692; P = 0.073). Despite significant regional variation in oxygen transmissibility (F = 48.472; P = 0.001) and relatively low oxygen transmissibility through the scleral lens, induced corneal edema did not vary significantly in different regions (F = 3.346; P = 0.126). In the central corneal region, the induced corneal edema correlated moderately with PLFT (r = 0.468; P = 0.037) and oxygen transmissibility (r = -0.528; P = 0.017). This relationship was insignificant in the peripheral cornea.Conclusion: The inferotemporal peripheral region had the thickest PLFT and least oxygen transmissibility, and the superonasal region had the vice versa. Despite significant variation in PLFT and oxygen transmissibility initially, in healthy corneas, this variation does not seem to induce statistically significant regional variation in corneal edema. Increased central PLFT and decreased oxygen transmissibility moderately correlate with central corneal edema.
{"title":"REGIONAL VARIATION IN FLUID RESERVOIR THICKNESS, OXYGEN TRANSMISSIBILITY AND CORNEAL OEDEMA DURING SCLERAL LENS WEAR","authors":"Obinwanne Junior Chukwuemeka, D. Echendu, Isaura Ilorena D'Alva Brito dos Santos, Sharon Onwuka, Osazee Agbonlahor","doi":"10.22374/jclrs.v5i1.48","DOIUrl":"https://doi.org/10.22374/jclrs.v5i1.48","url":null,"abstract":"Purpose: To determine if regional variation in post lens fluid reservoir thickness (PLFT) during scleral lens wear leads to regional variation in oxygen transmissibility and corneal edema during 4 hours of non-fenestrated scleral lens wear.Methods: About 20 healthy subjects (mean age, 28.8 ± 4.2 years) were fitted with nonfenestrated rotationally symmetric scleral lenses. Anterior segment optical coherence tomography was used to measure cornea thickness before and after lens wear, PLFT 10 minutes and 4 hours after lens application, and scleral lens thickness (with the scleral lens in situ) 4 hours after scleral lens application. These measurements were limited to the central 6 mm and divided into three zones (central, mid-peripheral, and peripheral zones). In the mid-peripheral and peripheral zones, eight principal meridians were measured, generating 17 measurement points in total. Scleral lens thickness and PLFT measurements were corrected for optical distortions by a series of equations. Oxygen transmissibility was calculated by dividing the scleral lens oxygen permeability by the optically-corrected scleral lens thickness, taking into account the oxygen permeability of saline and fluid reservoir thickness.Results: A significant regional variation in PLFT (F = 12.860, P = 0. 012) was observed after 10 minutes of the lens application, PLFT was thickest and thinnest in the inferotemporal and the superonasal region of the peripheral zones( 322.6 ± 161.8 µm and 153.8 ± 96.4 µm, respectively); however, this variation was not statistically significant at 4 hours of scleral lens wear (F = 4.692; P = 0.073). Despite significant regional variation in oxygen transmissibility (F = 48.472; P = 0.001) and relatively low oxygen transmissibility through the scleral lens, induced corneal edema did not vary significantly in different regions (F = 3.346; P = 0.126). In the central corneal region, the induced corneal edema correlated moderately with PLFT (r = 0.468; P = 0.037) and oxygen transmissibility (r = -0.528; P = 0.017). This relationship was insignificant in the peripheral cornea.Conclusion: The inferotemporal peripheral region had the thickest PLFT and least oxygen transmissibility, and the superonasal region had the vice versa. Despite significant variation in PLFT and oxygen transmissibility initially, in healthy corneas, this variation does not seem to induce statistically significant regional variation in corneal edema. Increased central PLFT and decreased oxygen transmissibility moderately correlate with central corneal edema.","PeriodicalId":73690,"journal":{"name":"Journal of contact lens research & science","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44141200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background and objective: The fitting of orthokeratology (ortho-k) and multifocal soft contact lenses (SCL) is becoming increasingly popular worldwide for reducing the rate of myopia progression. However, overnight wear use of lenses and microbial contamination of contact lenses and storage vials has been shown to increase the risk of corneal inflammatory and infiltrative events (CIEs). Therefore, we conducted a pilot study to compare the rate, level, and type of microbial contamination of contact lenses and storage vialswhen participants wear ortho-k and SCL in combination with a hydrogen-peroxide disinfecting system. Material and Methods: A prospective, single-centre, randomized, crossover study was conducted to evalu-ate the rate and level of contact lens and storage vials contamination during the use of ortho-k and SCL along with a hydrogen-peroxide disinfecting solution over two 10 day wearing periods. Ocular signs and symptoms were assessed during lens wear at baseline and after each wearing period. In addition, contact lens and storage vials were collected, and the type and amount of microbial contamination were evaluated using viable culture and standard identification methods.Results: Twenty-five adults were enrolled, and 21 completed the study. One (5%) ortho-k lens, five (24%) ortho-k storage vials, one (5%) SCL and one (5%) SCL storage vial were contaminated (P > 0.05), predominantly with Gram-positive bacteria. None of the participants had contamination with both ortho-k and SCL. No significant differences were found between the ocular signs, including conjunctival redness and roughness, or conjunctival or corneal staining (all P > 0.05), irrespective of using ortho-k or SCL. Conclusion: This study provides the first data that directly compares microbial contamination of ortho-K versus SCL in patients using a hydrogen-peroxide disinfection system. However, the overall microbial contamination rate of contact lens storage vials was much lower (30%) than the previously reported study with ortho-k lens wear. The results support conducting a larger clinical trial designed to understand differences in microbial contamination with different lens materials and modalities.
{"title":"MICROBIAL BIOBURDEN OF ORTHOKERATOLOGY AND HYDROGEL CONTACT LENSES AND STORAGE CASES USING A HYDROGEN-PEROXIDE DISINFECTING SYSTEM","authors":"Ananya Datta, Erin S Tomiyama, K. Richdale","doi":"10.22374/jclrs.v5i1.43","DOIUrl":"https://doi.org/10.22374/jclrs.v5i1.43","url":null,"abstract":"Background and objective: The fitting of orthokeratology (ortho-k) and multifocal soft contact lenses (SCL) is becoming increasingly popular worldwide for reducing the rate of myopia progression. However, overnight wear use of lenses and microbial contamination of contact lenses and storage vials has been shown to increase the risk of corneal inflammatory and infiltrative events (CIEs). Therefore, we conducted a pilot study to compare the rate, level, and type of microbial contamination of contact lenses and storage vialswhen participants wear ortho-k and SCL in combination with a hydrogen-peroxide disinfecting system. \u0000Material and Methods: A prospective, single-centre, randomized, crossover study was conducted to evalu-ate the rate and level of contact lens and storage vials contamination during the use of ortho-k and SCL along with a hydrogen-peroxide disinfecting solution over two 10 day wearing periods. Ocular signs and symptoms were assessed during lens wear at baseline and after each wearing period. In addition, contact lens and storage vials were collected, and the type and amount of microbial contamination were evaluated using viable culture and standard identification methods.Results: Twenty-five adults were enrolled, and 21 completed the study. One (5%) ortho-k lens, five (24%) ortho-k storage vials, one (5%) SCL and one (5%) SCL storage vial were contaminated (P > 0.05), predominantly with Gram-positive bacteria. None of the participants had contamination with both ortho-k and SCL. No significant differences were found between the ocular signs, including conjunctival redness and roughness, or conjunctival or corneal staining (all P > 0.05), irrespective of using ortho-k or SCL. \u0000Conclusion: This study provides the first data that directly compares microbial contamination of ortho-K versus SCL in patients using a hydrogen-peroxide disinfection system. However, the overall microbial contamination rate of contact lens storage vials was much lower (30%) than the previously reported study with ortho-k lens wear. The results support conducting a larger clinical trial designed to understand differences in microbial contamination with different lens materials and modalities.","PeriodicalId":73690,"journal":{"name":"Journal of contact lens research & science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43948517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Guillon, Kishan Patel, Ruchi Gupta, Trisha Patel, C. Maissa
Objectives: To evaluate the reproducibility of tear film kinetics (TFK) measurements during the full interblink period in habitual wearers of delefilcon A daily disposable contact lenses under different environmentalconditions.Methods: Two independent studies were performed, one involving 90 eyes measurements in 49 subjects and the second involving 58 eyes measurements in 32 subjects, after 3 hours of conventional wear in normal environmental conditions (NEC) and an additional 3 hours of computer use under adverse environmental conditions (AEC), defined as 20% relative humidity (RH). Digital videos were obtained by non-invasive Tearscope illumination, followed by a parallel-group post-hoc comparative analysis by masked investigators of the videos obtained during the two studies. Parameters analyzed included non-invasive break-up time (NIBUT); dehydration speed (DS) between the initial break and the spontaneous blink, and minimum protected area (MPA) of the lens surface by the tear film.Results: After 3 hours of wear in normal environmental conditions, the overall population (n=148) had a mean NIBUT of 7.1 ± 7.0 sec, a mean DS of 0.28 ± 0.66 mm2/sec, and a mean MPA of 93.4 ± 16.6%. After an additional 3 hours in AEC, mean NIBUT was 8.4 ± 9.8 mm2/sec, mean DS was 0.26 ± 0.75 mm2/sec, and MPA was 95.2 ± 14.0%. The TFK characteristics in the two studies were similar for each environmental condition: after 3 hours of conventional wear, the mean [95% CI] differences between the two studies were −0.9 [−3.2, +1.4] sec for NIBUT, 0.00 [−0.22, +0.22] mm2/s for DS, and 2.0 [−3.5, +7.4] % for MPA; after an additional 3 hours of wear in 20% RH, the mean [95% CI] differences between the two studies were −1.3 [−4.5, +1.9] sec for NIBUT, −0.03 [−0.28, +0.22] mm2/s for DS and −0.3 [−4.9, +4.3] % for MPA. Conclusions: This analysis showed that the measurement of pre-contact lens TFK carried out in two differ-ent studies involving habitual wearers of delefilcon A having worn their contact lenses for an initial 3 hours under NEC and a further 3 hours under low (20%) hygrometry (AEC) produced similar on-eye wettability, including a long NIBUT, slow DS following the initial break, and wide MPA at the next blink. The results establish the reproducibility of the measurement of pre-contact lens TFK using the Tearscope; by quantifying the measurement variability, the data makes it possible to carry out precise sample size calculations in future studies involving pre-contact lens TFK measurements to quantify on-eye wettability under both normal and adverse environmental low (20% RH) hygrometric conditions.
{"title":"REPRODUCIBILITY OF MEASUREMENTS OF PRE-CONTACT LENS TEAR FILM KINETICS UNDER NORMAL AND ADVERSE ENVIRONMENTAL CONDITIONS","authors":"M. Guillon, Kishan Patel, Ruchi Gupta, Trisha Patel, C. Maissa","doi":"10.22374/jclrs.v5i1.41","DOIUrl":"https://doi.org/10.22374/jclrs.v5i1.41","url":null,"abstract":"Objectives: To evaluate the reproducibility of tear film kinetics (TFK) measurements during the full interblink period in habitual wearers of delefilcon A daily disposable contact lenses under different environmentalconditions.Methods: Two independent studies were performed, one involving 90 eyes measurements in 49 subjects and the second involving 58 eyes measurements in 32 subjects, after 3 hours of conventional wear in normal environmental conditions (NEC) and an additional 3 hours of computer use under adverse environmental conditions (AEC), defined as 20% relative humidity (RH). Digital videos were obtained by non-invasive Tearscope illumination, followed by a parallel-group post-hoc comparative analysis by masked investigators of the videos obtained during the two studies. Parameters analyzed included non-invasive break-up time (NIBUT); dehydration speed (DS) between the initial break and the spontaneous blink, and minimum protected area (MPA) of the lens surface by the tear film.Results: After 3 hours of wear in normal environmental conditions, the overall population (n=148) had a mean NIBUT of 7.1 ± 7.0 sec, a mean DS of 0.28 ± 0.66 mm2/sec, and a mean MPA of 93.4 ± 16.6%. After an additional 3 hours in AEC, mean NIBUT was 8.4 ± 9.8 mm2/sec, mean DS was 0.26 ± 0.75 mm2/sec, and MPA was 95.2 ± 14.0%. The TFK characteristics in the two studies were similar for each environmental condition: after 3 hours of conventional wear, the mean [95% CI] differences between the two studies were −0.9 [−3.2, +1.4] sec for NIBUT, 0.00 [−0.22, +0.22] mm2/s for DS, and 2.0 [−3.5, +7.4] % for MPA; after an additional 3 hours of wear in 20% RH, the mean [95% CI] differences between the two studies were −1.3 [−4.5, +1.9] sec for NIBUT, −0.03 [−0.28, +0.22] mm2/s for DS and −0.3 [−4.9, +4.3] % for MPA. Conclusions: This analysis showed that the measurement of pre-contact lens TFK carried out in two differ-ent studies involving habitual wearers of delefilcon A having worn their contact lenses for an initial 3 hours under NEC and a further 3 hours under low (20%) hygrometry (AEC) produced similar on-eye wettability, including a long NIBUT, slow DS following the initial break, and wide MPA at the next blink. The results establish the reproducibility of the measurement of pre-contact lens TFK using the Tearscope; by quantifying the measurement variability, the data makes it possible to carry out precise sample size calculations in future studies involving pre-contact lens TFK measurements to quantify on-eye wettability under both normal and adverse environmental low (20% RH) hygrometric conditions.","PeriodicalId":73690,"journal":{"name":"Journal of contact lens research & science","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44947811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. DeNaeyer, D. Sanders, L. Michaud, S. Morrison, Maria K. Walker, J. Jedlicka, Timothy S. Farajian, E. V. D. Worp
Background and Objective To determine the relationships between corneal and scleral elevation topography in subjects with corneal ectasias and normal corneas. Material and Methods This is a multi-site retrospective study. Ocular surface topography (sMap3D, Precision Ocular Metrology, US) was collected on 115 eyes with prolate cornea profile (Group A) and 227 eyes showing corneal ectasia (Group B). Sagittal height (SAG 1) was measured in the axis of the highest elevated point of the cornea (apex), defined by the meridian joining this apex to the geometrical center of the cornea at an 16 mm chord diameter (8-mm radius). Another sag value was evaluated 180° away (SAG 2) at the same diameter/radius. The difference in height between SAG 1 and SAG 2 represents a quadrant specific effect (QSE). Conjunctival toricity is estimated by comparing the best fit of the conjunctival/scleral shape data to a toric (Sin2) curve; the root- mean-squared error (RMSE) of this curve, a measure of irregularity, was also calculated. Results The ectasia subjects demonstrated greater QSE, (p<0.001), standard toricity (p<0.001) and RMSE (p<0.001) on the sclera compared to normal cornea cases. If the apex of the ectasia was ≥1.25mm from the corneal center, the asymmetry was greater. Within the Group A, standard toricity was significantly higher than QSE (p<0.001) suggesting a more regular conjunctival pattern. As a proof, a significantly greater proportion of cases in Group B vs. Group A (57% vs. 26%, p<0.001) were found with conjunctival irregular shape, as previously defined. In both groups, subjects graded as having spherical/toric scleral shape had significantly lower RMSE values than those graded as having irregular shapes (p<0.001). Conclusion Subjects with corneal ectasia have a different scleral shape compared to those with normal corneal profiles, largely presenting as a quadrant specific effect along the same axis. This difference is higher if the apex of the ectasia is ≥1.25 mm from the corneal center. RMSE seems to correlate with scleral shape classification in both groups.
{"title":"Correlation of Corneal and Scleral Topography in Cases with Ectasias and Normal Corneas","authors":"G. DeNaeyer, D. Sanders, L. Michaud, S. Morrison, Maria K. Walker, J. Jedlicka, Timothy S. Farajian, E. V. D. Worp","doi":"10.22374/JCLRS.V3I1.33","DOIUrl":"https://doi.org/10.22374/JCLRS.V3I1.33","url":null,"abstract":"Background and Objective \u0000To determine the relationships between corneal and scleral elevation topography in subjects with corneal ectasias and normal corneas. \u0000 \u0000Material and Methods \u0000This is a multi-site retrospective study. Ocular surface topography (sMap3D, Precision Ocular Metrology, US) was collected on 115 eyes with prolate cornea profile (Group A) and 227 eyes showing corneal ectasia (Group B). Sagittal height (SAG 1) was measured in the axis of the highest elevated point of the cornea (apex), defined by the meridian joining this apex to the geometrical center of the cornea at an 16 mm chord diameter (8-mm radius). Another sag value was evaluated 180° away (SAG 2) at the same diameter/radius. The difference in height between SAG 1 and SAG 2 represents a quadrant specific effect (QSE). Conjunctival toricity is estimated by comparing the best fit of the conjunctival/scleral shape data to a toric (Sin2) curve; the root- mean-squared error (RMSE) of this curve, a measure of irregularity, was also calculated. \u0000 \u0000Results \u0000The ectasia subjects demonstrated greater QSE, (p<0.001), standard toricity (p<0.001) and RMSE (p<0.001) on the sclera compared to normal cornea cases. If the apex of the ectasia was ≥1.25mm from the corneal center, the asymmetry was greater. Within the Group A, standard toricity was significantly higher than QSE (p<0.001) suggesting a more regular conjunctival pattern. As a proof, a significantly greater proportion of cases in Group B vs. Group A (57% vs. 26%, p<0.001) were found with conjunctival irregular shape, as previously defined. In both groups, subjects graded as having spherical/toric scleral shape had significantly lower RMSE values than those graded as having irregular shapes (p<0.001). \u0000 \u0000Conclusion \u0000Subjects with corneal ectasia have a different scleral shape compared to those with normal corneal profiles, largely presenting as a quadrant specific effect along the same axis. This difference is higher if the apex of the ectasia is ≥1.25 mm from the corneal center. RMSE seems to correlate with scleral shape classification in both groups.","PeriodicalId":73690,"journal":{"name":"Journal of contact lens research & science","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45030005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. P. Aitsebaomo, Jeannette Wong-Powell, W. Miller, Farshid Amir
Purpose Since Scleral Lenses (SL) rest entirely on the sclera and may affect underlying anatomical structures that may influence aqueous humor flow, it is important to determine the effect of SL wear on intra-ocular pressure (IOP). Methods Nine subjects with normal corneas were recruited for an Institutional Review Board-approved study. Best fit SL from a 15.8 mm diameter 0.4mm thick diagnostic-lens set was fitted on a randomly selected eye, with a silicone-hydrogel soft lens (soft lens) on the other eye. Three IOP measurements were taken with rebound iCare tonometer prior to lens application (baseline data measured at about 9:30AM), and immediately after lens removal (final data measured at about 5:30PM). Baseline and final lens vault was determined with anterior segment Zeiss optical coherence tomography (OCT). Mean baseline and final IOP for each eye was analyzed with a Student-t-test, 2-way repeated ANOVA, and the Bland-Altman plot. RESULTS IOP was elevated with SL wear for all subjects. Soft lens eyes showed a slight elevation for some but decreased in others. Mean IOP change was 5.81 ± 1.62 mm Hg for SL and -0.62 ± 0.88 mm Hg for soft lens eyes. When mean IOP in SL eyes was compared to soft lens eyes, unpaired t-test showed a significant difference (p <0.05) between the means. Bland-Altman bias was 6.43 (SD of bias 3.139). Repeated ANOVA also showed a significant difference between baseline and final IOP. CONCLUSIONS The results indicate that SL wear can elevate IOP. Eye care practitioners (ECP) must consider this possible outcome in treating patients wearing SL. Additional studies are needed to determine the clinical implications of SL wear on IOP.
{"title":"Influence of Scleral Lens on Intraocular Pressure","authors":"A. P. Aitsebaomo, Jeannette Wong-Powell, W. Miller, Farshid Amir","doi":"10.22374/JCLRS.V3I1.34","DOIUrl":"https://doi.org/10.22374/JCLRS.V3I1.34","url":null,"abstract":"Purpose \u0000Since Scleral Lenses (SL) rest entirely on the sclera and may affect underlying anatomical structures that may influence aqueous humor flow, it is important to determine the effect of SL wear on intra-ocular pressure (IOP). \u0000 \u0000Methods \u0000Nine subjects with normal corneas were recruited for an Institutional Review Board-approved study. Best fit SL from a 15.8 mm diameter 0.4mm thick diagnostic-lens set was fitted on a randomly selected eye, with a silicone-hydrogel soft lens (soft lens) on the other eye. Three IOP measurements were taken with rebound iCare tonometer prior to lens application (baseline data measured at about 9:30AM), and immediately after lens removal (final data measured at about 5:30PM). Baseline and final lens vault was determined with anterior segment Zeiss optical coherence tomography (OCT). Mean baseline and final IOP for each eye was analyzed with a Student-t-test, 2-way repeated ANOVA, and the Bland-Altman plot. \u0000 \u0000RESULTS \u0000IOP was elevated with SL wear for all subjects. Soft lens eyes showed a slight elevation for some but decreased in others. Mean IOP change was 5.81 ± 1.62 mm Hg for SL and -0.62 ± 0.88 mm Hg for soft lens eyes. When mean IOP in SL eyes was compared to soft lens eyes, unpaired t-test showed a significant difference (p <0.05) between the means. Bland-Altman bias was 6.43 (SD of bias 3.139). Repeated ANOVA also showed a significant difference between baseline and final IOP. \u0000 \u0000CONCLUSIONS \u0000The results indicate that SL wear can elevate IOP. Eye care practitioners (ECP) must consider this possible outcome in treating patients wearing SL. Additional studies are needed to determine the clinical implications of SL wear on IOP.","PeriodicalId":73690,"journal":{"name":"Journal of contact lens research & science","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49562084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objectives: The purpose of this study was to evaluate the performance (i.e. vision, comfort and fit) of spherical and front-surface toric scleral lenses in subjects with regular, healthy corneas. Methods: Scleral lenses were fitin the eyes (n = 16) of healthy subjects (n = 9) with regular corneas, absent of pathology, and studied using an observational, multi-visit design. Lens fit was objectively evaluatedby an experienced practitioner.Following 1 month of successful lens wear, participants completedsubjective satisfaction surveys regarding the scleral lens wearing experience. Results: According to participant surveys, scleral lenses were subjectively preferred over soft toric or gas permeable contact lenses in 88% of eyes, including in all eyes fit with a front-surface toric scleral lens (n = 3). Seventy-five percent (75%) of eyes achieved visual acuity of 0.1 logMAR or better, while all eyes with prior spectacle wear achieved visual acuity with a scleral lens within 1 Snellen line of spectacle correction. Seventy-five percent (75%) of eyes achieved good subjective comfort with a scleral lens. No participants reported poor subjective vision and/or comfort. Conclusions: Our findings suggest that subjects preferred the performance of a scleral lens (spherical or front-surface toric) compared to a soft toric or gas permeable contact lens. Moreover, scleral lenses may provide a viable, alternative contact lens modality option for patients considering discontinuation of traditional soft toric and/or rigid contact lens wear; so long as the factors associated with hypoxia remain minimized. Key Words: scleral lens; scleral contact lens; front-surface toric scleral lens; lens performance; normal eyes; healthy eyes
{"title":"Preliminary Clinical Exploration of Scleral Lens Performance on Normal Eyes","authors":"M. Barnett, Jonathon E Ross, B. Durbin-Johnson","doi":"10.22374/JCLRS.V2I2.32","DOIUrl":"https://doi.org/10.22374/JCLRS.V2I2.32","url":null,"abstract":"Abstract \u0000Objectives: The purpose of this study was to evaluate the performance (i.e. vision, comfort and fit) of spherical and front-surface toric scleral lenses in subjects with regular, healthy corneas. \u0000Methods: Scleral lenses were fitin the eyes (n = 16) of healthy subjects (n = 9) with regular corneas, absent of pathology, and studied using an observational, multi-visit design. Lens fit was objectively evaluatedby an experienced practitioner.Following 1 month of successful lens wear, participants completedsubjective satisfaction surveys regarding the scleral lens wearing experience. \u0000Results: According to participant surveys, scleral lenses were subjectively preferred over soft toric or gas permeable contact lenses in 88% of eyes, including in all eyes fit with a front-surface toric scleral lens (n = 3). Seventy-five percent (75%) of eyes achieved visual acuity of 0.1 logMAR or better, while all eyes with prior spectacle wear achieved visual acuity with a scleral lens within 1 Snellen line of spectacle correction. Seventy-five percent (75%) of eyes achieved good subjective comfort with a scleral lens. No participants reported poor subjective vision and/or comfort. \u0000Conclusions: Our findings suggest that subjects preferred the performance of a scleral lens (spherical or front-surface toric) compared to a soft toric or gas permeable contact lens. Moreover, scleral lenses may provide a viable, alternative contact lens modality option for patients considering discontinuation of traditional soft toric and/or rigid contact lens wear; so long as the factors associated with hypoxia remain minimized. \u0000Key Words: scleral lens; scleral contact lens; front-surface toric scleral lens; lens performance; normal eyes; healthy eyes","PeriodicalId":73690,"journal":{"name":"Journal of contact lens research & science","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46784441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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