Seguí-Crespo, Mar; Parra Picó, Javier; Ruíz Fortes, Pedro; Artola Reig, Alberto; Blanes-Mompó, Francisco J; Pérez-Cambrodí, Rafael J
To determine the usefulness of a silicone-hydrogel bandage contact lens (BCL) in the immediate postoperative period after uneventful myopic laser in-situ keratomileusis (LASIK). The study design was randomized but not masked and data collection was prospective. This study comprised 51 consecutive myopic eyes intervened by means of the LASIK technique to compensate their refractive error. Patients were randomly assigned to two different groups. The experimental group included 24 eyes of 12 patients that were fitted with a BCL immediately after the flap replacement. The control group included 27 eyes of 14 patients with no BCL. Patients were examined 24h after the surgery; the experimental group was analyzed immediately after the extraction of the BCL. Postoperative uncorrected distance visual acuity (UDVA) and postoperative topographic indexes were compared to baseline in both groups. The experimental group achieved worse results in the majority of the studied variables. Postoperative UDVA was worse in experimental group (p<0.01). Likewise, corneal asphericity (Q) was significantly higher in experimental group (p=0.024). Topographic indexes showed higher asymmetry in the corneal maps pertaining to experimental group. Specifically, the index of surface variance (ISV) (p=0.017) and index of vertical asymmetry (IVA) (p=0.031) were higher in experimental group. Also, the postoperative central corneal thickness (CCT) resulted in higher values for eyes pertaining to experimental group. The fitting of a silicone-hydrogel BCL after uneventful LASIK provokes morphological changes in the ocular structures that may lead to a worse UDVA secondary to a higher postoperative CCT and corneal edema. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
... glasses or contact lenses. The goal of this Web site is to provide objective information to the ... ask your doctor before undergoing LASIK surgery. This web site also provides information on FDA’s role in ...
... Consumer Devices Consumer Products Contact Lenses Types of Contact Lenses Share Tweet Linkedin Pin it More sharing ... Orthokeratology (Ortho-K) Decorative (Plano) Contact Lenses Soft Contact Lenses Soft contact lenses are made of soft, ...
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Jiang, Nan; Montelongo, Yunuen; Butt, Haider; Yetisen, Ali K
Contact lens is a ubiquitous technology used for vision correction and cosmetics. Sensing in contact lenses has emerged as a potential platform for minimally invasive point-of-care diagnostics. Here, a microlithography method is developed to fabricate microconcavities and microchannels in a hydrogel-based contact lens via a combination of laser patterning and embedded templating. Optical microlithography parameters influencing the formation of microconcavities including ablation power (4.3 W) and beam speed (50 mm s -1 ) are optimized to control the microconcavity depth (100 µm) and diameter (1.5 mm). The fiber templating method allows the production of microchannels having a diameter range of 100-150 µm. Leak-proof microchannel and microconcavity connections in contact lenses are validated through flow testing of artificial tear containing fluorescent microbeads (Ø = 1-2 µm). The microconcavities of contact lenses are functionalized with multiplexed fluorophores (2 µL) to demonstrate optical excitation and emission capability within the visible spectrum. The fabricated microfluidic contact lenses may have applications in ophthalmic monitoring of metabolic disorders at point-of-care settings and controlled drug release for therapeutics. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Kramer, Elise G; Boshnick, Edward L
This case report aims to explore the use of scleral lenses for the treatment of ocular and visual complications in an adult patient presenting with post-LASIK (Laser-Assisted in situ Keratomileusis) ectasia in both eyes with cross-linking in the right eye and intrastromal corneal ring segments (ICRS; Intacs, Addition Technology, Fremont, CA) in the left eye. Following a comprehensive eye exam and specific testing for contact lens fitting, scleral lenses were fitted with success in both eyes and dispensed. Due to progressive fibrosis and neovascularization of the inferior ICRS in the left eye, the inferior ICRS was removed and scleral lenses were refit with success. Prescribed scleral lenses helped the patient achieve optimal visual correction (20/20) as well as ocular protection of the cornea. Post-LASIK ectasia is a common finding among contact lens specialists today. When ICRS surgery is involved, the fitting of contact lenses may become more challenging. Scleral lenses offer a unique way of addressing many issues raised in this case report including corneal neovascularization and ectasia. This lens modality may be considered for any other case involving irregular corneal curvature following surgery resulting in reduced visual acuity. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
AD-A267 377 USAARL Report No. 93-19 Military Research with Contact Lenses By Roger W. Wiley PT - ELECTE - JUL2 619 9 3 -SE Visual Sciences Branch...31162 NO. ACCESSION NO. 62787A 7:787A879 TIC G 168 11. TITLE (include Securty ClaWfcation) (U) Military Research with Contact Lenses 12. PERSONAL...these compatibility problems, many military services are considering contact lenses as a possible refractive error correction option. In this paper, the
... Hey, that's an elephant." Your eyes need to bend light rays so the image can be focused sharply ... lenses that will correct the way your eye bends light. Remember, the target is right in the center ...
Contact lens wear may be indicated for cosmetic, professional, optical or therapeutic reasons. For each of these indications the arguments are given, why and when contact lenses are better than spectacle correction and which possibilities there are. Contact lens wear is contraindicated in certain eye diseases and in the case of problems of handling and hygiene. The author's preferences concerning the different contact lens materials are summarized briefly.
Badawy, Abdel-Rahman; Hassan, Muhammad Umair; Elsherif, Mohamed; Ahmed, Zubair; Yetisen, Ali K; Butt, Haider
Color vision deficiency (color blindness) is an inherited genetic ocular disorder. While no cure for this disorder currently exists, several methods can be used to increase the color perception of those affected. One such method is the use of color filtering glasses which are based on Bragg filters. While these glasses are effective, they are high cost, bulky, and incompatible with other vision correction eyeglasses. In this work, a rhodamine derivative is incorporated in commercial contact lenses to filter out the specific wavelength bands (≈545-575 nm) to correct color vision blindness. The biocompatibility assessment of the dyed contact lenses in human corneal fibroblasts and human corneal epithelial cells shows no toxicity and cell viability remains at 99% after 72 h. This study demonstrates the potential of the dyed contact lenses in wavelength filtering and color vision deficiency management. © 2018 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Amaya, L G; Speedwell, L; Taylor, D
We prospectively studied for three years the optical correction by contact lenses of 83 aphakic infants (141 eyes) who generally also had systemic and other ocular anomalies: 85% of the patients tolerated the lens wear for the whole study period. Complications occurred in 46 eyes and led to cessation of lens wear in two cases. Ten patients abandoned the lenses for other reasons. Thirty-four eyes needed subsequent intraocular surgery, mostly minor, and nine patients had strabismus surgery. Contact lenses are a versatile, safe, successful, and cost effective treatment for aphakia in infancy against which, before their widespread introduction for primary optical correction of infant aphakia, other methods of aphakic treatment need to be compared. PMID:2322512
speculate why no medical eye problems occurred. There are two possible reasons. One is the degree of patient education and adherence to instructions...Management of this situation can only be accomplished through continuing patient education . Contact lens wearers should also be aware of the problem
Marcus, Michael A.; Compertore, David; Gibson, Donald S.; Herbrand, Matthew E.; Ignatovich, Filipp V.
A table top instrument has been designed, constructed and tested to characterize all of the primary optical and physical properties of contact lenses. Measured optical properties include base power, cylinder power, cylindrical axis, prism, refractive index and wavefront aberrations. Measured physical properties include center thickness, lens diameter and lens sagittal depth. The instrument combines a Shack-Hartmann wavefront sensor (SHWS), a machine vision sensor, and a low coherence light interferometer (LCI) all coaxially aligned into a single tabletop unit. The unit includes a cuvette, mounted in a translatable sample chamber for holding the contact lens under test, and it can be configured to measure wet or dry contact lenses. During operation, the vision sensor measures the diameter of the lens, and locates the center of the lens. The lens is then aligned for other measurements. The vision sensor can also measure various alignment marks on the lens, as well as identify any alpha numerical features, which can be used to associate the lens orientation with the measured aberrations. The LCI measures the center thickness, sagittal depth and index of refraction of the contact lens. The base radius of curvature is then calculated using these measured parameters. The SHWS measures the lenses prescription power, including spherical, cylinder, prism, and higher order wavefront aberrations. NIST traceable calibration artifacts are used to calibrate the SHWS, machine vision and LCI modalities. Repeatability measurements on a contact lens in a saline solution are presented.
Mimura, Tatsuya; Usui, Tomohiko; Yamamoto, Hiroki; Yamagami, Satoru; Funatsu, Hideharu; Noma, Hidetaka; Honda, Norihiko; Fukuoka, Shima; Amano, Shiro
To assess the relationship between age and the incidence and severity of conjunctivochalasis in contact lens (CL) wearers by grading of conjunctivochalasis, and to compare the severity of conjunctivochalasis between CL wearers and nonwearers. Prospective, nonrandomized consecutive case study. A total of 600 CL wearers (94 hard CLs [HCL] and 506 soft CLs [SCL]) aged 11 to 60 years and 579 nonwearers aged 10 to 60 years were enrolled. The age, gender, medical history, ocular history, and the grade and other parameters of conjunctivochalasis at 3 locations (nasal, middle, and temporal areas) were determined in all subjects. The prevalence of conjunctivochalasis increased dramatically with age in all groups. The mean grade of conjunctivochalasis was higher in CL wearers than in nonwearers (nasal area, P < .00001; temporal area, P < .00001) and was higher in HCL wearers than in SCL wearers (nasal area, P < .00001; temporal area, P = .00003). Parameters such as the downward gaze-dependent or digital pressure-dependent changes of conjunctivochalasis and the presence of superficial punctate keratitis all increased with age in both CL wearers and nonwearers. The gaze-dependent and pressure-dependent changes of conjunctivochalasis showed an increase with age and the duration of CL wear in both SCL and HCL wearers. This was the first assessment of the severity of conjunctivochalasis in a large series of consecutive CL wearers. Our results strongly suggest that wearing CLs is an important risk factor for conjunctivochalasis.
Jones, Lisa A; Walline, Jeffrey J; Gaume, Amber; Rah, Marjorie J; Manny, Ruth E; Berntsen, David A; Chitkara, Monica; Kim, Ailene; Quinn, Nicole
The rate and reasons for discontinuation of contact lens wear by young patients are not well known. The Contact Lenses in Pediatrics (CLIP) Study surveyed participants 3 months after the final study visit to determine the percentage of participants who continued to wear contact lenses after study conclusion. The factors associated with continued contact lens wear and differences in behaviors between the children and teens were also determined to provide insights to practitioners who provide refractive correction for patients in those age groups. Three months after the CLIP Study completion, participants and parents returned mailed surveys that assessed post-study lens purchase and symptoms related to contact lens wear if contact lenses wear had been continued. Responses were compared between the children and teens using chi(2) or Fisher's exact test. Almost 92% of the surveys were returned. Eighty percent of teens' parents reported purchasing lenses after the study, vs. 63% of the children's parents (p=0.02). Symptoms reported at the last study visit were not significantly associated with future purchase, though there was a trend towards more light sensitivity in those who did not purchase more contact lenses (23.1% vs. 11.8%). Satisfaction with contact lenses was high among both those purchasing additional contact lenses and those who did not. Both children and teens reported similar frequencies of symptoms such as burning, itching or tearing eyes 3 months following study completion. Teens reported having contact-lens-related dry eyes more frequently than children. A large proportion of children and an even higher proportion of teens continued wearing their lenses 3 months after completing the CLIP Study. Children and teens reported similar contact lens comfort and low frequencies of most symptoms, though teens experienced more dry-eye symptoms. Overall, reports of symptoms in this sample were lower than had been reported in adult populations by other
The prevalence of myopia has been steadily rising, with 28 per cent of the global population said to be affected in 2010 and to rise to affect nearly 50 per cent by 2050. Increasing levels of myopia increase the risk of vision impairment and in particular, high myopia is associated with the risk of serious and permanent visual disability due to associated sight-threatening complications. To stem the burden associated with higher levels of myopia, there are efforts to slow the progression of myopia, and several optical and pharmaceutical strategies have been found useful in slowing myopia to varying degrees. More recently, numerous multifocal soft contact lenses and extended depth of focus soft contact lenses (collectively referred to as myopia control contact lenses) were found effective in slowing myopia. As opposed to overnight orthokeratology, myopia control contact lenses are worn during the day and the hypotheses proposed to explain the efficacy of these lenses are generally based on the premise that the stimulus for eye growth is a defocused retinal image with hyperopic blur either centrally or peripherally. Although the individual power profiles of the lenses vary, the contact lens generally incorporates 'positive power' to reduce the hyperopic blur and/or impose myopic defocus or in the case of the extended depth of focus lens, has a power profile designed to optimise retinal image quality for points on or in front of the retina. The use of soft contact lenses as a platform for myopia control offers an exciting and effective avenue to manage myopia but there is a need for further research on issues such as the mechanism underlying control of myopia, improving efficacy with lenses, and understanding rebound on discontinuation. More significantly, although contact lenses are generally safe and improve quality of life in older children, one of the major challenges for improved uptake and acceptance of contact lenses centres on the perceived risk of
Muntz, Alex; Subbaraman, Lakshman N.; Sorbara, Luigina; Jones, Lyndon
Tear exchange beneath a contact lens facilitates ongoing fluid replenishment between the ocular surface and the lens. This exchange is considerably lower during the wear of soft lenses compared with rigid lenses. As a result, the accumulation of tear film debris and metabolic by-products between the cornea and a soft contact lens increases, potentially leading to complications. Lens design innovations have been proposed, but no substantial improvement in soft lens tear exchange has been reported. Researchers have determined post-lens tear exchange using several methods, notably fluorophotometry. However, due to technological limitations, little remains known about tear hydrodynamics around the lens and, to-date, true tear exchange with contact lenses has not been shown. Further knowledge regarding tear exchange could be vital in aiding better contact lens design, with the prospect of alleviating certain adverse ocular responses. This article reviews the literature to-date on the significance, implications and measurement of tear exchange with contact lenses. PMID:25575892
Dixon, Phillip; Shafor, Chancellor; Gause, Samuel; Hsu, Kuan-Hui; Powell, Kristin Conrad; Chauhan, Anuj
Ophthalmic drugs are almost exclusively delivered via eye drops in spite of several deficiencies, including low bioavailability and poor compliance. Contact lenses have the potential to increase bioavailability by an order of magnitude, while also improving compliance. In this review, the authors summarize advances in therapeutic contact lenses. The major focus of the review is on patents on drug-eluting contact lenses, but non-drug-eluting contacts that offer a therapeutic benefit are also included. The content is divided based on the broad technology of the patent, including novel materials, molecular imprinting, diffusion barriers, colloid encapsulation, surface modification, layering, and other novel approaches. In addition to patents, research publications are also included to facilitate the understanding of the mechanisms and challenges. Among all non-invasive alternatives, contact lenses offer the highest bioavailability to the cornea due to the location of the lens in the immediate vicinity of the cornea. Several approaches have been patented to improve contact lens design for an extended release duration of drugs. Many technologies have successfully integrated suitable drug release profiles into contact lenses, but drug-eluting contacts are not yet commercialized likely due to regulatory challenges, including the high costs of clinical trials.
Wahl, Siegfried; Fornoff, Luise; Ochakovski, G Alex; Ohlendorf, Arne
The study investigated the effect of the design of multifocal contact lenses on the sensitivity to contrast and disability glare. Contrast sensitivity was measured in 16 young adults (mean age: 25.5±2.5years) at a distance of 2m under two conditions: no-glare and glare. Two designs (Center Near and Center Distance) of the Biofinity soft contact lens were used to simulate correction for presbyopes, while a correction with single vision trial lenses and contact lenses acted as controls. The design of the used multifocal contact lenses had a significant influence on the log area under the curve of the contrast sensitivity function (AUC-CSF). Compared to the spectacle lens correction, the AUC-CSF was significantly reduced, in case CS was measured with the Center Near design lens, under the no-glare (p<0.001) and the glare condition (p: p<0.001). In case of the Center Distance design contact lens, the AUC-CSF was significantly smaller in case CS was tested under glare (p=0.001). Disability glare (DG) was depending on the spatial frequency and the design of the multifocal lens, while the Center Distance design produced higher amounts of DG (p<0.001), compared to the other used corrections. The optical design of a multifocal contact lenses has a significant impact on the contrast sensitivity as well as the disability glare. In order to dispense the best correction in terms of contact lenses, the sensitivity to contrast under no-glare and glare conditions should be tested a medium spatial frequencies. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.
van der Worp, Eef; Bornman, Dina; Ferreira, Daniela Lopes; Faria-Ribeiro, Miguel; Garcia-Porta, Nery; González-Meijome, José M
Scleral contact lenses (ScCL) have gained renewed interest during the last decade. Originally, they were primarily used for severely compromised eyes. Corneal ectasia and exposure conditions were the primary indications. However, the indication range of ScCL in contact lens practices seems to be expanding, and it now increasingly includes less severe and even non-compromised eyes, too. All lenses that partly or entirely rest on the sclera are included under the name ScCL in this paper; although the Scleral Lens Education Society recommends further classification. When a lens partly rests on the cornea (centrally or peripherally) and partly on the sclera, it is called a corneo-scleral lens. A lens that rests entirely on the sclera is classified as a scleral lens (up to 25 mm in diameter maximum). When there is full bearing on the sclera, further distinctions of the scleral lens group include mini-scleral and large-scleral lenses. This manuscript presents a review of the current applications of different ScCL (all types), their fitting methods, and their clinical outcomes including potential adverse events. Adverse events with these lenses are rare, but the clinician needs to be aware of them to avoid further damage in eyes that often are already compromised. The use of scleral lenses for non-pathological eyes is discussed in this paper. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
... Consumer Updates Halloween Safety: Costumes, Candy, and Colored Contact Lenses Share Tweet Linkedin Pin it More sharing ... or witch, poor costume choices—including decorative (colored) contact lenses and flammable costumes—and face paint allergies ...
... these looks with decorative contact lenses (sometimes called “fashion,” “costume,” or “colored” contact lenses). These lenses don’ ... About FDA Contact FDA Browse by Product Area Product Areas back Food Drugs Medical Devices Radiation-Emitting ...
Łabuz, Grzegorz; López-Gil, Norberto; van den Berg, Thomas J T P; Vargas-Martín, Fernando
Multifocal contact lenses have been growing in popularity as a modality to correct presbyopic eyes, although visual side effects such as disability glare have been reported. The objective of this study was to investigate the effect of multifocal contact lenses on disability glare by means of ocular straylight. A prospective randomized, comparative study was performed that included 16 subjects free of ocular pathology. Straylight was measured using a commercial straylight meter with the natural and dilated pupil. Participants were fitted with Proclear Multifocal (Distance/Near), ACUVUE Oasys for Presbyopia, and Air Optix Aqua Multifocal randomized to the left or right eye. Straylight measurements were repeated with the contact lens in situ after the pupil dilation. Results obtained with the dilated pupil without contact lens acted as a control. Diameter of the natural and dilated pupil was 2.87 ± 0.40 mm and 7.45 ± 0.86 mm, respectively (P < .001). After pupil dilation, straylight increased from 0.92 ± 0.13 log(s) to 1.04 ± 0.11 log(s) (P < .001). Of the four studied lenses, a significant difference was only found between Air Optix and the control group (P = .006). The latter showed also slightly increased light scatter. A difference in measured straylight was found between the studied multifocal lenses. The observed variability and the straylight-pupil size dependency should be taken into account to avoid elevated straylight in multifocal contact lens wearers. The reason for the observed differences in straylight must be the subject of future studies.
Bailey, J.; Kaur, S.; Morgan, P. B.; Gleeson, H. F.; Clamp, J. H.; Jones, J. C.
Switchable liquid crystal contact lenses with electrically controllable focal powers have previously been investigated as an alternative to bifocal contact lenses and spectacles for the correction of presbyopia. The simplest lens design uses a meniscus shaped cavity within the lens to contain the liquid crystal. The design of such a lens is considered in detail, including the nematic alignment and electrodes materials. The organic transparent conductor PEDOT:PSS was used as both electrode and planar alignment. Four different configurations are considered, using both planar and homeotropic orientations with either homogenous or axial alignment. Controllable switching of the focal power was demonstrated for each mode and focal power changes of up to ΔP = 3.3 ± 0.2 D achieved. Such lens designs offer significant potential for a novel form of correction for this common visual problem.
Contact lenses as a means to deliver pharmaceuticals to the eye have seen a significant increase in research interest in the past few years. This review will detail the in vitro experiments which have investigated use of these contact lenses in the context of the desired pharmacological treatment goals in the management of infectious, inflammatory, allergic and glaucomatous diseases of the eye. The techniques researchers have employed to modify and tailor drug release rates from these materials, including the use of vitamin E diffusion barriers, modified ionicity, molecular imprinting and incorporation of drug reservoirs, will be discussed, as well as their impact on drug release kinetics. Finally, the demonstration of the feasibility of these materials when applied in vivo in animal models as well as in humans with and without disease will be presented and their results discussed relating to their implications for the future of the field. © 2017 Optometry Australia.
Gifford, Paul; Gifford, Kate Louise
The growing incidence of pediatric myopia worldwide has generated strong scientific interest in understanding factors leading to myopia development and progression. Although contact lenses (CLs) are prescribed primarily for refractive correction, there is burgeoning use of particular modalities for slowing progression of myopia following reported success in the literature. Standard soft and rigid CLs have been shown to have minimal or no effect for myopia control. Overall, orthokeratology and soft multifocal CLs have shown the most consistent performance for myopia control with the least side effects. However, their acceptance in both clinical and academic spheres is influenced by data limitations, required off-label usage, and a lack of clear understanding of their mechanisms for myopia control. Myopia development and progression seem to be multifactorial, with a complex interaction between genetics and environment influencing myopigenesis. The optical characteristics of the individual also play a role through variations in relative peripheral refraction, binocular vision function, and inherent higher-order aberrations that have been linked to different refractive states. Contact lenses provide the most viable opportunity to beneficially modify these factors through their close alignment with the eye and consistent wearing time. Contact lenses also have potential to provide a pharmacological delivery device and a possible feedback mechanism for modification of a visual environmental risk. An examination of current patents on myopia control provides a window to the future development of an ideal myopia-controlling CL, which would incorporate the broadest treatment of all currently understood myopigenic factors. This ideal lens must also satisfy safety and comfort aspects, along with overcoming practical issues around U.S. Food and Drug Administration approval, product supply, and availability to target populations. Translating the broad field of myopia research
Barber, J; Malin, A H
Language is important in the creation of a painful or non-painful context for fitting contact lenses. This article discusses two types of language use and demonstrates the consequent experience each creates for the patient. The authors also emphasize the importance of acceptance and utilization of responses offered by the patient to further the goals of a comfortable fitting experience. Finally, this article provides an example of a reliable and successful technique for rapidly inducing hypnosis for the purpose of obtaining a comfortable lens fitting.
... Updates What To Know If Your Child Wants Contact Lenses Share Tweet Linkedin Pin it More sharing ... removed at the first hint of a problem. Contact Lens Risks And Safety Tips Kids and contact ...
While gravity has its advantages in keeping us balanced and grounded here on Earth, scientists often find that they are at a disadvantage when trying to conduct research under its powerful, pulling influence. In these instances, the scientists prefer performing their studies in the weightless atmosphere of microgravity, where gravity is greatly reduced and solids, liquids, and gases behave differently. In 1993, Paragon Vision Sciences, Inc., of Mesa, Arizona, participated in a research project with NASA's Langley Research Center to perfect a process for developing contact lenses. The project called for three experiments that would fly onboard the Space Shuttle over the course of three separate missions, from 1993 to 1996. By unleashing contact lens materials to the microgravity settings of space, scientists from NASA and Paragon hoped to better understand how polymers - large molecules that make up plastics - are formed.
de Luis Eguileor, Beatriz; Etxebarria Ecenarro, Jaime; Santamaria Carro, Alaitz; Feijoo Lera, Raquel
To assess visual function in patients with irregular cornea who do not tolerate gas permeable (GP) corneal contact lenses and are fitted with GP scleral contact lenses (Rose K2 XL). In this prospective study, we analyzed 15 eyes of 15 patients who did not tolerate GP corneal contact lenses and were fitted with scleral contact lenses (Rose K2 XL). We assessed visual function using visual acuity and the visual function index (VF-14); we used the VF-14 as an indicator of patient satisfaction. The measurements were taken with the optical correction used before and 1 month after the fitting of the Rose K2 XL contact lenses. We also recorded the number of hours lenses had been worn over the first month. Using Rose K2 XL contact lenses, visual acuity was 0.06±0.07 logMAR. In all cases, visual acuity had improved compared with the measurement before fitting the lenses (0.31±0.18 logMAR; P=0.001). VF-14 scores were 72.74±12.38 before fitting of the scleral lenses, and 89.31±10.87 after 1 month of lens use (P=0.003). Patients used these scleral lenses for 9.33±2.99 comfortable hours of wear. Both visual acuity and VF-14 may improve after fitting Rose K2 XL contact lenses in patients with irregular corneas. In addition, in our patients, these lenses can be worn for a longer period than GP corneal contact lenses.
Moschos, Marilita M.; Nitoda, Eirini; Georgoudis, Panagiotis; Balidis, Miltos; Karageorgiadis, Eleftherios; Kozeis, Nikos
Background: Keratoconus is a chronic, bilateral, usuallly asymmetrical, non-inflammatory, ectatic disorder, being characterized by progressive steepening, thinning and apical scarring of the cornea. Initially, the patient is asymptomatic, but the visual acuity gradually decreases, resulting in significant vision loss due to the development of irregular astigmatism, myopia, corneal thinning and scarring. The classic treatment of visual rehabilitation in keratoconus is based on spectacles and contact lenses (CLs). Objective: To summarize the types of CLs used in the treatment of keratoconus. This is literature review of several important published articles focusing on the visual rehabilitation in keratoconus with CLs. Method: Gas permeable (GP) CLs have been found to achieve better best corrected visual acuity than spectacles, eliminating 3rd-order coma root-mean-square (RMS) error, 3rd-order RMS, and higher-order RMS. However, they have implicated in reduction of corneal basal epithelial cell and anterior stromal keratocyte densities. Soft CLs seem to provide greater comfort and lower cost, but the low oxygen permeability (if the lens is not a silicone hydrogel), and the inability to mask moderate to severe irregular astigmatism are the main disadvantages of them. On the other hand, scleral CLs ensure stable platforms, which eliminate high-order aberrations and provide good centration and visual acuity. Their main disadvantages include the difficulties in application and removal of these lenses along with corneal flattening and swelling. Result: The modern hybrid CLs are indicated in cases of poor centration, poor stability or intolerance with GP lenses. Finally, piggyback CL systems effectively ameliorate visual acuity, but they have been related to corneal neovascularization and giant papillary conjunctivitis. Conclusion: CLs seem to rehabilitate visual performance, diminishing the power of the cylinder and the high-order aberrations. The final choice of CLs is
Kanemoto, Masumi; Toshida, Hiroshi; Takahiro, Itagaki; Murakami, Akira
To investigate the use of the prosthetic iris-tinted soft contact lens, the SEED Opaque, during the past 5 years. The records of 42 outpatients (48 eyes) for whom the prosthetic soft contact lens was prescribed in the contact lens clinic of Juntendo University Hospital from July 2001 to June 2005 were investigated. An investigation was conducted in regard to the tint patterns of the prosthetic soft contact lens and the presence or absence of a transparent part in the middle, as a brown iris with a clear pupil or a solid pupil. The diagnosis, purpose of prescription, age when that lens was prescribed, complications, and changes in corrected visual acuities were analyzed retrospectively from the medical records. The mean age at the first prescription, total number of years of wearing prosthetic contact lenses, total number of prescriptions, and mean period to use each SEED Opaque lens were compared. The mean age at the first prescription of solid-pupil lens wearers was significantly younger than that for clear-pupil lens wearers (P<0.05, Mann-Whitney U test). The solid-pupil type had been prescribed for 30 eyes, all for cosmetic purposes. The clear-pupil type had been prescribed for five eyes for cosmetic purposes and for 13 eyes for improvement of visual function. Complications were shown in 40% of wearers. Contact lens-induced papillary conjunctivitis was highest, followed by punctate superficial keratopathy, superficial punctate keratitis, and corneal erosion. In comparison of corrected visual acuities before and after wearing the clear-pupil cosmetic soft contact lens, significant improvement was observed (P<0.05, paired t test). Although the SEED Opaque lens is a conventional soft contact lens, it is tailor-made for each patient. So it is possible to adjust the color and size of the cosmetic part and the pupil diameter. Further, corrected visual acuities could improve with the clear-pupil type for patients who had prescribed for improvement of visual function.
Wu, Yvonne T; Tran, Jess; Truong, Michelle; Harmis, Najat; Zhu, Hua; Stapleton, Fiona
Wearing goggles over contact lenses while swimming is often recommended by eye care professionals. Limited data are available to assess this recommendation. The purpose of this study was to examine whether wearing goggles while swimming limits bacterial colonization on contact lenses and whether the type of lens worn affects contamination rates. Twenty-three subjects underwent two swimming sessions at an ocean (salt water) pool (Maroubra beach Rock Pool, Sydney, Australia). Silicone hydrogel (Ciba Focus Night and Day) or hydrogel lenses (Ciba Focus Daily) were inserted into subjects' eyes before 30 min of swimming sessions, and subjects used modified goggles to mimic goggled and non-goggled conditions. At the end of each session, lenses were collected for microbial investigation. Viable bacterial colonies were classified as gram positive and gram negative and enumerated. The level of bacterial colonization on contact lenses between goggled and non-goggled conditions and between the two lens materials were compared. The range of colony forming units recovered from goggled lenses were 0 to 930 compared with 0 to 1210 on non-goggled lenses. The majority of subjects (16/23) had more microorganisms in the non-goggled condition than when wearing goggles (p = 0.03). Gram negative organisms were found in three non-goggled lenses. No significant difference was shown in the number of bacteria isolated from silicone hydrogel and hydrogel lenses (p > 0.6) irrespective of wearing goggles. Water samples had consistently higher numbers of bacterial counts than those adhered to the lenses; however, no association was found between the number of bacteria in the water sample and those found on the contact lenses. Consistently, fewer bacterial colonies were found on the goggled contact lens, thus suggesting goggles offer some protection against bacterial colonization of contact lenses while swimming. These data would support the recommendation encouraging lens wearers to use goggles
Katsoulos, Konstantinos; Rallatos, Gerasimos Livir; Mavrikakis, Ioannis
To present the management of three patients suffering from ptosis of various etiologies, with scleral contact lenses. Three patients (five eyes) with ptosis resulting from levator dehiscence due to long-term rigid gas permeable contact lens wear for keratoconus, phthisis bulbi, and myopathy due to Kearns-Sayre syndrome were identified during a 2-year period. They were fitted with scleral contact lenses in order to provide cosmesis by lifting the upper eyelid with the bulk of the lens, and simultaneously provide vision correction where applicable. The scleral contact lenses provided comfortable wear, significantly improved cosmesis as both palpebral aperture and marginal reflex distance were increased, and visual acuity was also subjectively and objectively improved. Two of the patients opted for the scleral contact lenses, whereas the parents of the third patient, a 10-year-old girl with Kearns-Sayre syndrome, chose to undergo ptosis surgery due to handling issues of the scleral contact lenses. Scleral contact lenses can be a useful addition to the treatment option for patients with complicated ptosis.
Acanthamoeba is a microbe that is very common in tap water. It has two forms: the trophozoite and the cyst. These trophozoites and cysts can stick to the surface of your contact lenses and then infect your eye.
Federal Aviation Regulations permit the routine use of contact lenses by civilian pilots to satisfy the distant visual acuity requirements for obtaining medical certificates. Specific information identifying the prevalence of both defective distant v...
Working Group 16 Aco For -FoI Operational Use of Contact Lenses NTIS CRA&I by Military Aircrew Ud,,) TB iceJ,-1stfication (L’Utilisation Op6rationnelle...Medical Panel (AMP) Working Group 16 was tasked in 1990 to consolidate the available information from practical experience in the use of contact lenses ...Medical Panel iv Executiy: Summary I Working Group Recommendations I Introduction 2 Military Aviation Experience with Contact Lenses 3 Early Studies with
Plowright, Andrew J; Maldonado-Codina, Carole; Howarth, Gillian F; Kern, Jami; Morgan, Philip B
To compare clinical and subjective quality-of-life (QoL) data for teenagers wearing daily disposable contact lenses or spectacles. This open-label study randomized subjects (aged 13 to 19 years) with no previous contact lens wear experience to nelfilcon A (DAILIES AquaComfort Plus) contact lenses or spectacles for 6 months. A full clinical workup, as well as subjective QoL measures using the Pediatric Refractive Error Profile and Quality of Life Impact of Refractive Correction questionnaires, was conducted at baseline and at week 4 and months 3 and 6, with an additional study visit at week 2 for subjects randomized to wear contact lenses. A total of 110 teenagers were enrolled in the study; 13 discontinued before study completion, 10 (17.5%) from the contact lens group and 3 (5.7%) from the spectacle group (p = 0.04). Visual acuity was good for both groups at all study visits. Biomicroscopy assessments were similar at baseline for both groups. Significant differences in Pediatric Refractive Error Profile responses were noted between vision correction groups across visits for appearance (p < 0.001), satisfaction (p < 0.001), activities (p < 0.001), peer perception (p = 0.003), and overall score (p < 0.001). For Quality of Life Impact of Refractive Correction, the contact lens group gave more favorable responses than the spectacle group (p = 0.02). After 6 months of wearing contact lenses, teenagers had a more positive attitude toward comfort, vision, and safety with contact lenses. No serious adverse events were reported during the study. The daily disposable lenses used in this study are suitable for vision correction for teenagers, offering improvements in QoL measures during the first month of wear, including appearance, satisfaction, activities, and peer perceptions, without negatively impacting vision or eye health. Teenagers were able to handle contact lenses with the same amount of confidence as spectacles.
Attempts to dispel rumors concerning contact lenses and tries to supply prudent-use practices for allowing contact lenses in industry and laboratories. Discusses federal regulations that impact the use of contact lenses in industry, policy statements from medical organizations on use of contact lenses in industrial environments, and the…
AlQattan, Bader; Yetisen, Ali K; Butt, Haider
Contact lenses are ubiquitous biomedical devices used for vision correction and cosmetic purposes. Their application as quantitative analytical devices is highly promising for point-of-care diagnostics. However, it is a challenge to integrate nanoscale features into commercial contact lenses for application in low-cost biosensors. A neodymium-doped yttrium aluminum garnet (Nd:YAG) laser (1064 nm, 3 ns pulse, 240 mJ) in holographic interference patterning mode was utilized to produce optical nanostructures over the surface of a hydrogel contact lens. One-dimensional (925 nm) and two-dimensional (925 nm × 925 nm) nanostructures were produced on contact lenses and analyzed by spectroscopy and angle-resolve measurements. The holographic properties of these nanostructures were tested in ambient moisture, fully hydrated, and artificial tear conditions. The measurements showed a rapid tuning of optical diffraction from these nanostructures from 41 to 48°. The nanostructures were patterned near the edges of the contact lens to avoid any interference and obstruction to the human vision. The formation of 2D nanostructures on lenses increased the diffraction efficiency by more than 10%. The versatility of the holographic laser ablation method was demonstrated by producing four different 2D nanopattern geometries on contact lenses. Hydrophobicity of the contact lens was characterized by contact angle measurements, which increased from 59.0° at pristine condition to 62.5° at post-nanofabrication. The holographic nanostructures on the contact lens were used to sense the concentration of Na + ions. Artificial tear solution was used to simulate the conditions in dry eye syndrome, and nanostructures on the contact lenses were used to detect the electrolyte concentration changes (±47 mmol L -1 ). Nanopatterns on a contact lens may be used to sense other ocular diseases in early stages at point-of-care settings.
Kim, Sujin; Lee, Jong Soo; Park, Young Kee; Lee, Seung Uk; Park, Young Min; Lee, Jong Heon; Lee, Ji-Eun
The aim was to evaluate the clinical results of fitting MSD miniscleral contact lenses (MSD; Happy Vision Corp, Anyang, Korea) in Korean patients with keratoconus. This report presents a retrospective case review of 38 keratoconic patients fitted with MSD lenses. Visual acuity, comfort, mean wear time, final lens parameters, relationships between sagittal depth and topographic indices, success rate with the first lens ordered and adverse events were documented. The mean logMAR visual acuity was improved from 0.85 ± 0.78 with glasses and 0.28 ± 0.29 with corneal rigid gas-permeable lenses to 0.10 ± 0.11 with miniscleral contact lenses. Ninety-seven per cent of patients found the miniscleral contact lenses to be comfortable and the mean daily wear time was 10.1 ± 2.3 hours. The mean sagittal depth was 4.70 ± 0.35 mm and there was no correlation between sagittal depth and topographic indices. An average of 3.4 trial lenses was needed to decide the ordered lens and 1.3 ordered lenses to achieve the optimal fitting. One patient discontinued the wear of the lenses after three months due to discomfort. The use of MSD miniscleral contact lenses is a good alternative for patients with keratoconus and for those who failed to respond to other types of lens rehabilitation that results in both successful visual outcome and comfort. © 2016 Optometry Australia.
Prasad, Gkg; Vyawahare, M K; Kapur, R; Sachdev, V S
A comprehensive clinical study on the effects of various aviation stresses on soft and semisoft contact lenses was carried out to find out their compatibility in aviation environment. Twenty subjects (11 aircrew and 9 non air-crew) participated in the study. Twelve of them were given soft lenses of water contents of 38%, 50% and 78% and rest 8 were given semisoft lenses of daily wear and extended wear type. The environmental trial consisted of exposure to hypoxia, rapid decompression, acceleration, pressure breathing, vibration and high temperature. On successful completion of environmental trials on ground simulators, the inflight trials on high performance aircraft, transport aircraft, passenger aircraft and helicopters were conducted. The soft lenses with low, medium and high water contents and extended wear semisoft lenses (large diameter) were found compatible with all types of aircraft flying.
Efron, Suzanne; Efron, Nathan; Morgan, Philip B
This study was conducted to investigate whether aspheric design soft contact lenses reduce ocular aberrations and result in better visual acuity and subjective appreciation of clinical performance compared with spherical soft contact lenses. A unilateral, double-masked, randomized and controlled study was undertaken in which ocular aberrations and high and low contrast logMAR visual acuity were measured on myopic subjects who wore aspheric design (Biomedics 55 Evolution, CooperVision) and spherical design (Biomedics 55, CooperVision) soft contact lenses. Ten subjects who had about -2.00 D myopia wore -2.00 D lenses and 10 subjects who had about -5.00 D myopia wore -5.00 D lenses. Measurements were made under photopic and mesopic lighting conditions. Subjects were invited to grade comfort, vision in photopic and mesopic conditions, and overall impression with the two lens types on 100 unit visual analogue scales. There was no significant difference in high contrast or low contrast visual acuity between the two lens designs of either power under photopic or mesopic conditions. Both lens designs displayed lower levels of spherical aberration compared with the "no lens" condition under photopic and mesopic light levels (p < 0.0001); however, there were no differences in aberrations between aspheric and spherical lens designs. There were no statistically significant differences in subjective appreciation of clinical performance between lens designs or lens powers. At least with respect to the brand of lenses tested, the fitting of aspheric design soft contact lenses does not result in superior visual acuity, aberration control, or subjective appreciation compared with equivalent spherical design soft contact lenses.
Tyagi, Garima; Alonso-Caneiro, David; Collins, Michael; Read, Scott
The aim of this study was to measure tear film surface quality (TFSQ) using dynamic high-speed videokeratoscopy during short-term (8 hrs) use of rigid and soft contact lenses. A group of 14 subjects wore 3 different types of contact lenses on 3 different nonconsecutive days (order randomized) in 1 eye only. The subjects were screened to exclude those with dry eye. The lenses included a polymethyl methacrylate (PMMA) hard, a rigid gas permeable (RGP; Boston XO), and a soft silicone hydrogel lens. Three 30-second long high-speed videokeratoscopy recordings were taken with contact lenses in situ, in the morning and again after 8 hrs of contact lens wear, both in normal and suppressed blinking conditions. Recordings were also made on a baseline day with no contact lens wear. The presence of a contact lens in the eye had a significant effect on the mean TFSQ in both natural and suppressed blinking conditions (P=0.001 and P=0.01, respectively, repeated-measures analysis of variance). The TFSQ was worse with all the lenses compared with no lens in the eye in the afternoon during both normal and suppressed blinking conditions (all P<0.05). In natural blinking conditions, the mean TFSQ for the PMMA and RGP lenses was significantly worse than the baseline day (no lens) for both morning and afternoon measures (P<0.05). This study shows that both rigid and soft contact lenses adversely affect the TFSQ in both natural and suppressed blinking conditions. No significant differences were found between the lens types and materials.
Donnchadha, Éanna Mac; Leal, Cristina; Esmonde, Harry
The complex modulus of a soft contact lens affects the optical performance, fitting, on-eye movement, wettability, physiological impact and overall comfort of the lens. However, despite acknowledgement that the mechanical behaviour of contact lenses is time-dependent, the rheological characteristics of contact lenses remain under-defined. While existing studies have focussed on elasticity to describe lens behaviour, this paper proposes using oscillatory squeeze film analysis to evaluate the complex modulus. The effects of excitation amplitude, repeatability and surface wetness are examined for four commercially available lenses. Slip at the lens/platen interface is considered along with bias introduced by pre-compressing the lens between platens. Test results when compared to results reported from other test methods indicate that a high degree of slip occurs at the lens platen interface suggesting that deformation is primarily due to biaxial extension. Copyright © 2018 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Key, James E
The concept of applying a lens to the cornea as a refractive appliance was first proposed in the early 19th century. By 1888, glass scleral lenses for the correction of optical defects and irregularities were manufactured and used. New materials, especially soft hydrogel lenses and rigid gas-permeable lenses, became available in the 20th century and allowed comfortable contact lenses to be made in any design needed. By the 21st century, the increasing use of silicone hydrogel lenses to address the oxygen need of the cornea has led to increased worldwide use. Of the 125 million global contact lens wearers, most are female and relatively young. Soft lenses are by far the dominant modality used, with silicone hydrogel lenses taking an increasing share of new fittings, particularly for overnight wear. Microbial keratitis, although relatively uncommon, remains the most serious potential complication for these lens wearers. Ongoing basic research, more powerful antimicrobial agents, and the development of safer lens materials are helping to alleviate this problem.
Zhang, Jiyan; Wang, Liru; Ma, Zhenya
A focimeter is one of the basic ophthalmic instruments used in every optometric practice, and verification of the accuracy and calibration of the instrument are of the utmost importance. For many years the International Standardization for Organization requires that calibrations for all kinds of focimeters shall be accomplished by using test lenses described in ISO 9342:1996. These test lenses must be of high quality and of nominal back vertex power that is known with high accuracy. With the development of science and technology, ISO 9342 was revised in 2005. A new part ISO 9342-2 had been drafted for test lenses used to calibrate focimeters with contact lens measurement, and the original ISO 9342 was turned into the current ISO 9342-1, which could only be used to calibrate fociemters with spectacle lens measurement. As one of the standard drafters, the background for the newly published ISO 9342-2 is introduced in this study, and comparison between test lenses of ISO 9342-1 and ISO 9342-2 is made. Further, the influence of tolerance and uncertainty in design and production of standard test lenses of ISO 9342-2 is analyzed. The paraxial approximation is used to relate the lens parameters with back vertex power and to calculate the uncertainty budget. Moreover, one set of test lenses conforming to ISO 9342-2 is manufactured and experiments are done with it. Results show that test lenses described in ISO 9342-2 can correct the measurement errors of focimeters used for measuring contact lenses well, especially for spherical aberration, and the correction is more effective for spherical contact lenses with high back vertex power.
Compañ, V; Andrio, A; López-Alemany, A; Riande, E; Refojo, M F
Oxygen transport through two extended wear (day and night) hydrogel contact lenses that contain organosilicon moieties (balafilcon A and lotrafilcon A) was studied in the hydrate (hydrogel) and dry (xerogel) states. The water uptake increased the oxygen permeability [(Dk)app] and transmissibility [Dk/L(av)] coefficients of the dry materials by about 70%. The (Dk)app for the hydrated lenses was determined following the so-called stack procedure. The values obtained were 107 +/- 4 barrer for balafilcon A and 141 +/- 5 barrer for lotrafilcon A, about 5-10 times larger than those previously reported for conventional (without organosilicon moieties) extended wear hydrogels contact lenses. The Dk/L(av) for -3.00 diopter lenses (harmonic average thickness, L(av) = 75 +/- 2 microm for lotrafilcon, and 85 +/- 2 microm for balafilcon) was 123 +/- 6 barrer/cm for balafilcon A and 183 +/- 8 barrer/cm for lotralicon A. The minimum oxygen transmissibility 87 barrer/cm stipulated by Holden and Mertz to avoid corneal edema with extended wear contact can be easily achieved with lotrafilcon and balafilcon lenses of diverse dioptric powers if the central and peripheral thickness of the lenses are kept below the critical level of oxygen transmissibility.
Morris, Carol A; Maltseva, Inna A; Rogers, Victoria A; Ni, Jing; Khong, Kathleen T; Derringer, Charles B; George, Melanie D; Luk, Andrew S
To assess contact lens preservative uptake and release from multipurpose solutions (MPS) and subsequent acquisition of lens antibacterial activity. Kinetics of uptake and release of poly (hexamethylene biguanide hydrochloride) (PHMB) or polyquaternium-1 (PQ-1) from various contact lenses were studied initially with the pure compounds and then after soaking in MPS containing these compounds. Lenses soaked in MPS were tested for antibacterial activity. Only lenses with a negatively charged component absorbed these preservatives. For lenses containing methacrylic acid (MA), uptake of PHMB from preservative-only solution was fast, yet little was released, in contrast to its rapid release from lenses containing other anionic groups. This trend persisted with PHMB-containing MPS. PQ-1 from preservative-only solution was only absorbed by lenses containing MA and was released from MA-containing hydrogels, but not significantly from an MA-containing silicone hydrogel. Lens uptake of PQ-1 was much lower from MPS and release was essentially undetectable from all lenses evaluated. Antibacterial lens activity was acquired by lenses containing MA after an overnight soak in MPS containing PQ-1, and for balafilcon A and omafilcon A after 5 exchanges in PHMB-containing MPS. Acquired activity was maintained during cycling between artificial tear protein solution and MPS. Lens preservative uptake and its subsequent release are dependent on lens chemistry, preservative nature, and other MPS components. A few lens/solution combinations acquired antibacterial activity after one or more overnight soaks in MPS, depending on the nature of the anionic lens component and the preservative. Uncharged lenses did not acquire antibacterial activity.
Zambelli, Alison M.; Brothers, Kimberly M.; Hunt, Kristin M.; Romanowski, Eric G.; Nau, Amy C.; Dhaliwal, Deepinder K.; Shanks, Robert M. Q.
Objectives To measure the diffusion of topical preparations of moxifloxacin, amphotericin B (AmB), and polyhexamethylene biguanide (PHMB) through silicone hydrogel (SH) contact lenses in vitro. Methods Using an in vitro model, the diffusion of three antimicrobials through SH contact lenses was measured. Diffused compounds were measured using a spectrophotometer at set time points over a period of four hours. The amount of each diffused antimicrobial was determined by comparing the experimental value to a standard curve. A biological assay was performed to validate the contact lens diffusion assay by testing antimicrobial activity of diffused material against lawns of susceptible bacteria (Staphylococcus epidermidis) and yeast (Saccharomyces cerevisiae). Experiments were repeated at least two times with a total of at least 4 independent replicates. Results Our data show detectable moxifloxacin and PHMB diffusion through SH contact lenses at 30 minutes, while amphotericin B diffusion remained below the limit of detection within the 4 hour experimental period. In the biological assay, diffused moxifloxacin demonstrated microbial killing starting at 20 minutes on bacterial lawns, whereas PHMB and amphotericin B failed to demonstrate killing on microbial lawns over the course of the 60 minute experiment. Conclusions In vitro diffusion assays demonstrate limited penetration of certain anti-infective agents through silicone hydrogel contact lenses. Further studies regarding the clinical benefit of using these agents along with bandage contact lens use for corneal pathology are warranted. PMID:25806673
Stapleton, Fiona; Keay, Lisa; Edwards, Katie; Holden, Brien
It was widely anticipated that after the introduction of silicone hydrogel lenses, the risk of microbial keratitis would be lower than with hydrogel lenses because of the reduction in hypoxic effects on the corneal epithelium. Large-scale epidemiological studies have confirmed that the absolute and relative risk of microbial keratitis is unchanged with overnight use of silicone hydrogel materials. The key findings include the following: (1) The risk of infection with 30 nights of silicone hydrogel use is equivalent to 6 nights of hydrogel extended wear; (2) Occasional overnight lens use is associated with a greater risk than daily lens use; (3) The rate of vision loss due to corneal infection with silicone hydrogel contact lenses is similar to that seen in hydrogel lenses; (4) The spectrum of causative organisms is similar to that seen in hydrogel lenses, and the material type does not impact the corneal location of presumed microbial keratitis; and (5) Modifiable risk factors for infection include overnight lens use, the degree of exposure, failing to wash hands before lens handling, and storage case hygiene practice. The lack of change in the absolute risk of disease would suggest that exposure to large number of pathogenic organisms can overcome any advantages obtained from eliminating the hypoxic effects of contact lenses. Epidemiological studies remain important in the assessment of new materials and modalities. Consideration of an early adopter effect with studies involving new materials and modalities and further investigation of the impact of second-generation silicone hydrogel materials is warranted.
Sticca, Matheus Porto; Carrijo-Carvalho, Linda C; Silva, Isa M B; Vieira, Luiz A; Souza, Luciene B; Junior, Rubens Belfort; Carvalho, Fábio Ramos S; Freitas, Denise
To report a series of cases of Acanthamoeba keratitis (AK) in scleral lens wearers with keratoconus to determine whether this type of contact lens presents a greater risk for development of infection. This study reports three patients who wore scleral contact lenses to correct keratoconus and developed AK. The diagnoses of AK were established based on cultures of the cornea, scleral contact lenses, and contact lens paraphernalia. This study investigated the risk factors for infections. The possible risks for AK in scleral contact lens wearers are hypoxic changes in the corneal epithelium because of the large diameter and minimal tear exchange, use of large amounts of saline solution necessary for scleral lens fitting, storing the scleral lens overnight in saline solution rather than contact lens multipurpose solutions, not rubbing the contact lens during cleaning, and the space between the cornea and the back surface of the scleral lens that might serve as a fluid reservoir and environment for Acanthamoeba multiplication. Two patients responded well to medical treatment of AK; one is still being treated. The recommendations for use and care of scleral contact lenses should be emphasized, especially regarding use of sterile saline (preferably single use), attention to rubbing the lens during cleaning, cleaning of the plunger, and overnight storage in fresh contact lens multipurpose solutions without topping off the lens solution in the case. Copyright © 2017. Published by Elsevier Ltd.
Many hereditary congenital and infectious ocular conditions affecting young infants and children if diagnosed early enough are no longer untreatable. Special contact lenses are now available and have been specifically developed to prevent blindness, amblyopia and establish binocular vision. Different types of contact lenses and materials from which they may be fashioned are discussed and clinical considerations outlined for treatment. Visual rehabilitation of a high order is possible with proper understanding of the particular problems affecting babies at birth, later and in early infancy.
Altay, Y; Balta, O; Burcu, A; Ornek, F
This study aims to report the outcomes of new-generation hybrid contact lenses for visual rehabilitation of postkeratoplasty patients. Twenty eyes of twenty postkeratoplasty patients were fitted with hybrid lenses. Each patient's keratometric values, ocular surface irregularity indices, central corneal thickness (CCT), uncorrected visual acuity (UCVA), spectacle-corrected visual acuity, contact lens-corrected visual acuity, contact lens fitting data, and contact lens daily wearing time were recorded. Follow-up examinations were performed at 1 st week, 1 st month, and 3 rd month visit after successful fitting of the lenses. The mean age of the patients was 38.42 ± 4.89 years. The mean spherical component of refractive error was -4.46 ± 2.1 D, and the mean astigmatism was -5.31 ± 1.55 D. The median UCVA was 1.00 logarithm of the minimum angle of resolution (logMAR) which improved to 0.40 logMAR after spectacle correction. The median visual acuity with hybrid contact lenses was 0.05 logMAR. The median CCT was 544.4 μm and increased to 549.2 μm at 3 months after contact lens wear. The difference was not statistically significant (P = 0.38). The mean follow-up of patients was 4.32 ± 0.45 months. Eighteen of twenty patients reported a mean of 8.37 ± 1.95 h comfortable wearing time per day during this period. Two patients discontinued contact lens wearing due to conjunctival hyperemia. No graft-related complications such as decompensation, rejection, and infection were documented during the follow-up period. The new-generation hybrid contact lenses can be considered helpful in the visual management of postcorneal graft patients, particularly who are unable to achieve an adequate visual outcome with spectacles.
Allen, E. D.; Davies, P. D.
Congenital idiopathic nystagmus is usually associated with poor vision which has generally proved resistant to treatment. This study reports the use of contact lenses in 8 patients, 5 of whom achieved an improvement in their visual acuity of 3 lines on the Snellen's chart. PMID:6671101
Jupiter, D G; Katz, H R
The purpose of this study was to measure improvement in best corrected visual acuity with rigid gas permeable (RGP) contact lenses compared to best corrected spectacle visual acuity for patients with irregular astigmatism. We compared best corrected visual acuity obtained with spectacle correction to best corrected visual acuity obtained with rigid gas permeable contact lenses for forty-eight eyes of 29 patients with irregular astigmatism. Patients with 20/20 spectacle visual acuity achieved, on average, no improvement in visual acuity with RGP contact lenses. Patients with 20/25-20/30 spectacle visual acuity achieved a one line average improvement. Patients with 20/40 spectacle visual acuity achieved a two line average improvement. Patients with 20/50-20/200 spectacle visual acuity achieved a four line average improvement and patients with spectacle visual acuity of 20/400, a six line average improvement. RGP contact lenses can provide a significant improvement in visual acuity compared to spectacle correction for patients with irregular astigmatism.
Mosuela, Reynalyn; Mustafa, Shelan; Gould, Simon; Hassanin, Hany; Alany, Raid G; ElShaer, Amr
There is an immense research interest to utilise contact lens (CLs) as a popular platform for ocular drug delivery. However, CLs are the major predisposing factors of bacterial keratitis which is commonly caused by adhesion of microbes such as Pseudomonas aeruginosa and Staphylococcus epidermidis. The aim of the current study is to explore the effect of surfactants; Poloxamer 188, Polysorbate 80 and Tetronic ® 90R4 (at 0.25% - 3% v/v) on the characteristics of CLs and on the adhesion abilities of Pseudomonas aeruginosa to the lenses' surfaces. CLs were formulated using a hydrophilic monomer; 2-hydroxyethyl methacrylate (HEMA) together with silicone-based polymer such as Poly dimethyl siloxane (PDMS) or 3,3,3-trifluoropropylsilane (FSA) then lenses were polymerized under UV light. The formulated CLs with surfactants were found to have an increased equilibrium water content (EWC) due to hydrophilic moiety present in surfactants. A relationship was deduced between EWC and surface contact angle of lenses containing surfactants; where an increased EWC was associated with a decrease in contact angle reflecting a more hydrophilic surfaces of CLs. Apart from the 3% Polysorbate 80 (p < .0001) CLs, all other formulations had light transmission values over 80%. Lenses with surfactants were found to have lower bacterial ATP concentration than lenses without surfactants. Poloxamer 188 in FSA lenses reduced bacterial adhesion from 4.22 × 10 -4 ± 1.30 × 10 -4 pM to 1.03 × 10 -4 ± 4.86 × 10 -5 pM, a reduction by 75.59% when compared to the control lenses (p = .002). Moreover, 1% Tetronic ® 90R4 in PDMS showed a reduction by 57.17% in ATP concentration. Polysorbate 80 in FSA exhibited the least bacterial adhesion with an average bacterial ATP concentration of 3.85 × 10 -5 ± 2.61 × 10 -5 pM; i.e 90.88% less bacterial ATP than control lenses (p = .001). Bioluminescence studies demonstrated a decrease in Pseudomonas
Papas, Eric B; Tilia, Daniel; Tomlinson, Daniel; Williams, Josh; Chan, Eddy; Chan, Jason; Golebiowski, Blanka
To establish whether increased end-of-day discomfort during soft contact lens wear is associated with short-term changes occurring to the lens itself. Twenty-seven subjects wore hydrogel lenses (Focus Dailies; Alcon) bilaterally for 10 hours on two separate days. Comfort was reported using 1-100 numerical rating scales (1 = intolerable discomfort, 100 = lens cannot be felt). Day 1 ratings were taken before lens insertion and at 0.05, 5, and 10 hours post-insertion. Day 2 ratings occurred at similar times, but lenses were removed after the 5-hour assessment and either reinserted (n = 14) or newly replaced (n = 12). An additional rating was taken 5 minutes after re-insertion. Wear then continued to the 10-hour point. In a separate study, 24 different subjects repeated these procedures using a silicone hydrogel lens (AirOptix Aqua; Alcon) with wear taking place on 3 days to permit lens replacement to be with existing as well as new lenses in all subjects. For hydrogel lenses, comfort scores (mean ± 95% CI) reported after 10 hours were 79.4 ± 8.3 when lenses were worn un-replaced, compared with 73.2 ± 9.2 for replacement with the existing lens. When replacement was with a brand new lens, the corresponding values were 72.9 ± 10.9 (un-replaced) versus 69.2 ± 12.8 (new lens replacement). For silicone hydrogel lenses, 10-hour comfort was 90.3 ± 3.2 (un-replaced) versus 92.2 ± 2.9 (replacement with existing lens) versus 90.0 ± 3.3 (replacement with new lens). Differences between replacement conditions were not significant in any case (analysis of variance, p > 0.05). Final comfort was not influenced by replacing lenses midway through the wearing period. Comfort decrements experienced by users of these daily contact lenses towards the later part of the wearing period are not caused by changes occurring to the lenses on this time scale. Possible alternative etiological factors include a fatigue-like response in one or more ocular tissues or stimulation of ocular
Cosar, C Banu; Acar, Suphi
To report a case of topography-guided LASIK in a patient after previous penetrating keratoplasty. A 20-year-old man who had previous penetrating keratoplasty in his right eye for keratoconus and was intolerant to spectacles and contact lenses underwent topography-guided LASIK. Three months postoperatively, the patient's uncorrected visual acuity in the right eye was 20/25(+2). Best spectacle-corrected visual acuity was 20/20, with a manifest refraction of +0.25 -0.75 x 40 degree. Topography-guided LASIK is a useful therapeutic modality to address corneal irregularity after penetrating keratoplasty.
Harris, M.G.; Rechberger, J.; Grant, T.
We evaluated the effectiveness of an in-office microwave disinfection procedure which allowed for the disinfection of up to 40 soft contact lenses at one time. Ciba AOSept cases filled with sterile unpreserved saline were contaminated with one of six FDA test challenge microorganisms at a concentration of approximately 10(3) colony forming units per milliliter (CFU/ml). Twenty cases were placed on the rotating plate of a standard 2450 MHz 650 W microwave oven in a 10-cm diameter circle. The cases were exposed to high intensity microwave irradiation for periods of 0 to 15 min. None of the 6 microorganisms evaluated survivedmore » 2 min or longer of microwave exposure. Our findings indicated that microwave irradiation can be a convenient, rapid, and effective method of disinfecting a number of soft contact lenses at one time and thus adaptable as an in-office soft contact lens disinfection procedure.« less
Beyer, Jill; Todani, Amit; Dohlman, Claes
To describe visually debilitating deposit formation on hydrogel contact lenses routinely used for protection in eyes with keratoprosthesis and to present different types of contact lenses that provide improved deposit resistance. Seven keratoprosthesis eyes with a history of rapid and severe deposit formation on their hydrogel lenses were evaluated and documented. The Schirmer values and blink rate of each patient were additionally analyzed. These patients were then subsequently refitted with varying types of contact lenses. When soft hydrogel lenses were replaced with lenses with water-impermeable centers, dramatically fewer deposits accumulated. Deposit formation on hydrogel lenses did not seem to correlate with low Schirmer values but rather with an insufficient blink rate. Excellent deposit resistance can be achieved in these patients with the use of hybrid contact lenses with rigid centers or large-diameter entirely rigid contact lenses.
Gritz, D C; Lee, T Y; McDonnell, P J; Shih, K; Baron, N
Two sources of ultraviolet (UV) radiation with peak wavelengths in the UV-C or UV-B ranges were compared for their ability to sterilize contact lenses infected with Pseudomonas aeruginosa, Streptococcus pneumoniae, Acanthamoeba castellani, Candida albicans, and Aspergillus niger. Also examined was the effect of prolonged UV light exposure on soft and rigid gas permeable (RGP) contact lenses. The UV-C lamp (253.7 nm, 250 mW/cm2 at 1 cm) was germicidal for all organisms within 20 minutes but caused destruction of the soft lens polymers within 6 hours of cumulative exposure. UV-C caused damage to RGP lenses in less than 100 hours. The UV-B lamp (290-310 nm, 500 mW/cm2 at 1 cm) was germicidal for all organisms tested (except Aspergillus) with a 180-minute exposure and caused less severe changes in the soft lens polymers than did the UV-C lamp, although cumulative exposure of 300 hours did substantially weaken the soft lens material. RGP materials were minimally affected by exposure to 300 hours of UV-B. Ultraviolet light is an effective germicidal agent but is injurious to soft lens polymers; its possible utility in the sterilization of RGP lenses and lens cases deserves further study.
Fogel, Joshua; Zidile, Chaya
Individuals are increasingly purchasing contact lenses over the Internet. No studies exist regarding Internet purchase of contact lenses and eye care health practices. One hundred fifty-one college students were surveyed regarding contact lenses purchase category (doctor's office, store, Internet). Pearson chi-square analyses compared purchase category with responses regarding U.S. Food and Drug Administration (FDA) recommendations for purchasing contact lenses online. Analysis of variance compared contact lenses purchase category with the Time Pressure Scale (TPS). Also, correlation analyses compared the TPS with Internet eye-health statements. Contact lens purchase categories included doctor's office (43.0%), store (55.0%), and Internet (22.5%), with individuals purchasing at multiple venues. With regard to the FDA recommendations, those who purchased contact lenses at a doctor's office more often adhered to the recommendations, whereas those who purchased contact lenses at a store or the Internet did so less often. Those who purchased contact lenses over the Internet had significantly higher TPS scores. In addition, higher TPS scores were significantly correlated with various statements regarding the Internet. Those who purchase contact lenses via the Internet or store do not follow a number of FDA contact lenses recommendations. Also, those with higher TPS scores trust possible non-evidence-based contact lenses Internet information. Implications with regard to the Fairness to Contact Lens Consumers Act are discussed.
Jones, Lyndon W; Chauhan, Anuj; Di Girolamo, Nick; Sheedy, Jim; Smith, Earl
Over the past 10 to 15 years, the availability of new materials and technologies has resulted in revolutionary concepts for contact lenses being proposed that go well beyond correcting vision. These novel uses include their prescribing to deliver topical ocular and systemic drugs, assist with ocular surface disease management, and limit the progression of myopia and novel methods to display visual information. How likely are these concepts to become commercially available, how successful will they be, and what are the potential issues to consider for them to come to market? To answer these questions, a panel of four experts were invited to discuss the benefits and pitfalls of these technologies and what challenges lay ahead of these concepts before their availability. Their responses provide a fascinating insight for the clinician into the likelihood of such revolutionary contact lenses being available in a clinical setting.
Tavazzi, Silvia; Rossi, Alessandra; Picarazzi, Sara; Ascagni, Miriam; Farris, Stefano; Borghesi, Alessandro
Soft contact lenses used for the correction of ametropia are often made of hydrogel and silicone-hydrogel materials. Since they are placed directly on the surface of the eye and they are hydrated by tears, eye cosmetics can compromise the lens performance and, even worse, can be transported from an external environment to the ocular surface through the contact lens. The diffusion of the dye component of a purple eyeshadow in soft contact lenses of different materials is here evaluated. Diffusivity is found to be typically higher in silicone-hydrogels than in hydrogels. In hydrogels, diffusivity is greater in the case of lower oxygen transmissibility. Despite differences between materials, absorbed mass of dye is much larger (10-100 times) than the expected mass by simple hydration and swelling of the contact lens. The most contaminated materials are also resistant to cleaning solutions. The results indicate that, notwithstanding the complexity of contact lens networks, diffusion of dye is found to follow Fick's law and it is driven by polymer-dye interaction, which governs lens hydration and swelling. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Braus, Barbara Katharina; Riedler, Daniela; Tichy, Alexander; Spergser, Joachim; Schwendenwein, Ilse
To compare two types of bandage contact lenses on the healthy canine eye. Six healthy Beagles. Two different types of bandage contact lenses (single sized human silicone contact lens 'PureVision 2' (Bausch & Lomb Incorporated, Rochester, NY, USA) and specially designed veterinary hydrogel contact lens 'AcriVet Pat D' (Bausch & Lomb Incorporated) were placed in 12 eyes of healthy Beagle dogs. Retention times and the effects of the lenses regarding irritation of the eye, changes in tear production, impact of contact lenses on tonometric readings, and cytologic and microbiological alterations of the canine eye were investigated. Mean retention times for veterinary hydrogel lenses with special dimensions were significantly shorter (2 days) than for one size human silicon lenses (8.8 days). Irritation scores were overall low for both types of lenses apart from one human lens causing severe irritation and keratoconjunctivitis as a sequel to folding and displacement. Tear production remained stable in human contact lenses. Intraocular pressure readings with a contact lens in place were only slightly altered; the most accurate readings were obtained through a human lens with an applanation tonometer. Cytology revealed a slight, nonsignificant increase in neutrophilic granulocytes with both types of lenses; the microflora did not change significantly. Human silicone lenses have significantly longer retention times and are less expensive than veterinary hydrogel lenses. In regard to irritation, bacterial growth and inflammation, both types of lenses can be recommended for use in canine eyes. © 2018 American College of Veterinary Ophthalmologists.
Emina, Michael Osita; Idu, Faustina Kemdinum
Purpose This is to determine the prevalence of bacterial and parasitic flora in asymptomatic disposable and extended contact lens wearers in Lagos State, Nigeria. Methods The study was carried out on 156 contact lenses from 78 asymptomatic wearers between the ages of 12 to 38 years. Eighty two disposable daily wear (DWCL) and 74 extended wear (EWCL) contact lenses were examined. The contact lenses’ swabs and the trays were transferred to the laboratory for microbial examination. Results Fifty two (70.27 %) extended wear contact lenses and 50 (60.98 %) disposable contact lenses examined were contaminated. Streptococcus spp. (4.23 %) were found in extended contact lenses and (3.9 %) in disposable contact lenses. Escherichia coli (15.49 %) were more in the extended contact lenses and were in higher proportion (14.74 %) than the other microorganisms in all the contact lenses. Klebsiella spp. (12.99 %) were more in the disposable lenses than in the extended wear lenses (12.69 %). there were more disposable lenses (41.56 %) with ‘no growth’. Amoebae were isolated from (6.49 %) disposable and (4.23 %) extended wear contact lenses. Seventeen (32.69 %) DWCL had mixed flora. There were significant differences between disposable and extended contact lenses, p < 0.05. Conclusions EWCL present more microorganisms and pose threat to the users. DWCL had more amoebae, which calls for suitable lens care methods. Further studies may be needed to determine the level of care required for contact lens users in developing countries.
Read, Michael L; Morgan, Philip B; Maldonado-Codina, Carole
This work sought to undertake a comprehensive investigation of the measurement errors associated with contact angle assessment of curved hydrogel contact lens surfaces. The contact angle coefficient of repeatability (COR) associated with three measurement conditions (image analysis COR, intralens COR, and interlens COR) was determined by measuring the contact angles (using both sessile drop and captive bubble methods) for three silicone hydrogel lenses (senofilcon A, balafilcon A, lotrafilcon A) and one conventional hydrogel lens (etafilcon A). Image analysis COR values were about 2 degrees , whereas intralens COR values (95% confidence intervals) ranged from 4.0 degrees (3.3 degrees , 4.7 degrees ) (lotrafilcon A, captive bubble) to 10.2 degrees (8.4 degrees , 12.1 degrees ) (senofilcon A, sessile drop). Interlens COR values ranged from 4.5 degrees (3.7 degrees , 5.2 degrees ) (lotrafilcon A, captive bubble) to 16.5 degrees (13.6 degrees , 19.4 degrees ) (senofilcon A, sessile drop). Measurement error associated with image analysis was shown to be small as an absolute measure, although proportionally more significant for lenses with low contact angle. Sessile drop contact angles were typically less repeatable than captive bubble contact angles. For sessile drop measures, repeatability was poorer with the silicone hydrogel lenses when compared with the conventional hydrogel lens; this phenomenon was not observed for the captive bubble method, suggesting that methodological factors related to the sessile drop technique (such as surface dehydration and blotting) may play a role in the increased variability of contact angle measurements observed with silicone hydrogel contact lenses.
Ozkagnici, Ahmet; Zengin, Nazmi; Kamiş, Omit; Gündüz, Kemal
To investigate the effects of daily wear opaquely tinted hydrogel soft contact lenses on contrast sensitivity functions, as measured using the Pelli-Robson chart viewed at 1 meter. Contrast sensitivity was measured in 48 healthy individuals before and 6 hours after soft contact lens wear. Twenty-four subjects used clear soft contact lenses and 24 used tinted soft contact lenses. The contrast sensitivity scores were significantly decreased monocularly and binocularly (P = 0.000 and P = 0.002, respectively) in the colored contact lens group whereas there were no significant changes in the clear contact lens group (P = 0.317 and P = 0.317, respectively). Color-tinted contact lenses were associated with a reduction of contrast sensitivity function. Therefore, those who wear colored contact lenses should be informed about the possible consequences of tinted contact lens wearing.
Xie, Zhuoying; Li, Linliang; Liu, Panmiao; Zheng, Fuyin; Guo, Liuyang; Zhao, Yuanjin; Jin, Lu; Li, Tingting; Gu, Zhongze
A circlular structural-colored contact lens is reported, which is fabricated by replicating self-assembled colloidal photonic crystal templates. The structural-colored contact lenses not only display variable and brilliant color under light illumination, but also avoid the addition of any colorants to the hydrogel lenses and prevent the potential harm posed by traditional colored contact lenses. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Bullimore, Mark A.
ABSTRACT Purpose There is increasing interest in fitting children with soft contact lenses. This review collates data from a range of studies to estimate the incidence of complications, specifically corneal infiltrative events and microbial keratitis, in patients under the age of 18 years. Methods Peer-review papers were identified using PubMed and the Web of Science. A broad range of studies are summarized including large-scale epidemiological studies of contact lens–related complications, hospital-based case series, long- and short-term prospective studies, and multicenter retrospective studies. Results Nine prospective studies representing 1800 patient years of wear in 7- to 19-year-olds include safety outcomes. In three large prospective studies representing between 159 and 723 patient years of soft contact lens wear in patients 8 to 14 years, the incidence of corneal infiltrative events is up to 136 per 10,000 years. Data from a large retrospective study show similar rates of corneal infiltrative events: 97 per 10,000 years in 8- to 12-year-olds (based on 411 patient years of wear) and 335 per 10,000 years in 13- to 17-year-olds (based on 1372 patient years of wear). None of the prospective studies report any cases of microbial keratitis. Five clinical studies where safety data are not reported constitute a further 493 patient years. One retrospective study found no cases of microbial keratitis occurred in 8- to 12-year-olds (411 patient years) and an incidence of 15 per 10,000 patient years in 13- to 17-year-olds (1372 patient years)—no higher than the incidence of microbial keratitis in adults wearing soft contact lenses on an overnight basis. Conclusions The overall picture is that the incidence of corneal infiltrative events in children is no higher than in adults, and in the youngest age range of 8 to 11 years, it may be markedly lower. PMID:28514244
Steinemann, Thomas L; Fletcher, Melissa; Bonny, Andrea E; Harvey, Raymond A; Hamlin, David; Zloty, Peter; Besson, Mike; Walter, Keith; Gagnon, Mike
To illustrate the implications of the unauthorized sale and unmonitored wearing of decorative cosmetic contact lenses resulting in ocular complications and to determine the prevalence of the use of cosmetic contact lenses obtained from unlicensed providers by adolescents. Observational case report, structured interview, and survey in a retrospective, observational, clinical practice setting. Reported sources of contact lenses were categorized as provider and nonprovider, and associations within the data were reviewed by using a Pearson correlation and chi-square test. Twelve patients (eight female and four male) were seen urgently for acute eye pain and redness after wearing plano decorative contact lenses. None of the patients had previously worn a contact lens. None of the lenses were dispensed by eye care professionals. Four patients developed blinding infections requiring hospital admission. Causative organisms included staphylococci, Pseudomonas, and acanthamoeba. One patient required a penetrating keratoplasty. One hundred fifty-nine patients were surveyed. Thirty-seven (23%) used decorative contact lenses. Lenses were obtained from an unlicensed provider 51% of the time. Education about lens care and handling was significantly associated with acquiring lenses from licensed providers (R = 0.74, P < 0.0001). Colored noncorrective contact lenses are being dispensed without a prescription or fitting from unlicensed vendors. Patients who acquire lenses from unauthorized providers are significantly less likely to be instructed on appropriate lens use and care. Consequently, uninformed lens wearers are experiencing acute vision-threatening infections and inflammation.
Sharma, S; Ramachandran, L; Rao, G N
Contact lens related Acanthamoeba keratitis has been more often associated with the use of soft contact lenses than with the use of rigid gas permeable (RGP) contact lenses. We studied the adherence of Acanthamoeba cysts and trophozoites to unworn RGP (silicone acrylate and fluoropolymer) and low and high water content soft contact lenses marketed in India. A human corneal isolate of Acanthamoeba polyphaga suspended in saline (1 x 10(5) amoebae/mL) was used. Lens segments were exposed to A. polyphaga cysts or trophozoites with or without shaking. After exposure for zero to 7 hours, lenses were either washed or not washed and the adherence was determined using light microscopy and a hemocytometer (per square millimeter of the lens). Both cysts and trophozoites immediately adhered to all four types of lenses. Adhesion increased with an increase in exposure time. The number of adherent cysts and trophozoites was higher (P = 0.043-0.0003) in the unwashed group of lenses at all exposure times for all lenses. Among washed groups, adherence was greatest with RGP silicone acrylate and high water content soft lenses. Trophozoites of Acanthamoeba showed greater adherence to RGP lenses, whereas cysts showed greater adherence to high water content soft lenses. Shaking did not have a significant effect on adherence. Adhesion of Acanthamoeba to contact lenses may play an important role in the pathogenesis of Acanthamoeba keratitis.
Rathi, Varsha M; Dumpati, Srikanth; Mandathara, Preeji S; Taneja, Mukesh M; Sangwan, Virender S
To assess visual improvement with scleral lenses (PROSE, prosthetic replacement of the ocular surface ecosystem, Boston Foundation for Sightight, USA) in patients with Pellucid marginal degeneration (PMD). This is a single-center, retrospective case-series involving patients with clinical PMD who underwent scleral lens-PROSE trial for improvement of visual acuity, from January 2009 to December 2012 at a tertiary center in India. Scleral lenses with different front surface eccentricities (FSE) were tried for improvement of visual acuity. Snellen visual acuity before and with PROSE wear was noted. Complications with PROSE wear to follow-up were noted. PROSE was dispensed to 12 patients (20 eyes) out of 19 patients having PMD. Location of PMD was inferior in fourteen and superior in two eyes. Four eyes had co-existing keratoconus. Nine were males and three were females. The indications for scleral lens were lens popping-out, failure of piggy-back contact lens and RGP failure. LogMAR Visual acuity improved significantly from 0.45±0.31 pre-PROSE to 0.05±0.08 post-PROSE (p=0.0001). The FSE ordered was 0.6 in 17 eyes, 0.3 in one eye and 0.8 in two eyes. Three patients had hydrops over follow-up; two patients underwent keratoplasty and one was managed conservatively with steroids and hyperosmotic agents. Seven patients did not order PROSE: reasons were - no perceived improvement in visual acuity (n=2), wanted to decide (n=2), continued glasses (n=1) and continued RGP contact lens (n=1). One patient had difficulty with self lens insertion. PROSE improves visual acuity in PMD; three patients developed hydrops over follow-up. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Campbell, Darren; Carnell, Sarah Maria; Eden, Russell John
Contact angle, as a representative measure of surface wettability, is often employed to interpret contact lens surface properties. The literature is often contradictory and can lead to confusion. This literature review is part of a series regarding the analysis of hydrogel contact lenses using contact angle techniques. Here we present an overview of contact angle terminology, methodology, and analysis. Having discussed this background material, subsequent parts of the series will discuss the analysis of contact lens contact angles and evaluate differences in published laboratory results. The concepts of contact angle, wettability and wetting are presented as an introduction. Contact angle hysteresis is outlined and highlights the advantages in using dynamic analytical techniques over static methods. The surface free energy of a material illustrates how contact angle analysis is capable of providing supplementary surface characterization. Although single values are able to distinguish individual material differences, surface free energy and dynamic methods provide an improved understanding of material behavior. The frequently used sessile drop, captive bubble, and Wilhelmy plate techniques are discussed. Their use as both dynamic and static methods, along with the advantages and disadvantages of each technique, is explained. No single contact angle technique fully characterizes the wettability of a material surface, and the application of complimenting methods allows increased characterization. At present, there is not an ISO standard method designed for soft materials. It is important that each contact angle technique has a standard protocol, as small protocol differences between laboratories often contribute to a variety of published data that are not easily comparable.
Marx, Sebastian; Lauenborg, Bo; Kern, Jami R
To evaluate the tolerability of and subject and investigator satisfaction with delefilcon A (DAILIES TOTAL1 ® ) daily disposable contact lenses in first-time contact lens wearers. This European multicenter, open-label, single-arm, two-week trial enrolled first-time contact lens wearers and fitted them with delefilcon A contact lenses. Assessments were made at dispensing and at Weeks 1 and 2. Subject-reported outcomes included comfort, quality of vision, convenience, and intent to purchase, which were ranked by agreement responses. Investigator-reported outcomes included slit-lamp biomicroscopy findings and lens fit satisfaction. Ninety-two subjects were included in the per protocol dataset. Mean scores at Weeks 1 and 2 for subject-reported quality of vision and ocular comfort were significantly higher with delefilcon A contact lenses than with the subjects' habitual spectacles during the day, at the end of the day, and overall (all p ≤ 0.02). Ninety-one percent of subjects reported that their study lenses were more comfortable than expected, 98% agreed that they were convenient to use, and 92% were interested in purchasing the lenses (all p < 0.001). Investigators reported that study lenses had an acceptable fit in at least 97% of subjects. Practitioners can expect favorable outcomes when transitioning first-time contact lens wearers from spectacles to delefilcon A daily disposable contact lenses. Copyright © 2017. Published by Elsevier Ltd.
Alemany, A L; Refojo, M F
To compare the percent hydration by wet weight of hydrogel contact lenses given by the manufacturers with the values obtained using the refractive index and the gravimetry methods. We used a Valentine refractometer to determine the refractive index of new hydrogel contact lenses at equilibrium swelling in the original solution and container. From the refractive indexes we then obtained the percent hydration of the lenses using a previously prepared graph of refractive index vs percent hydration of saccharose in a phosphate buffer solution (pH 7.0). We used an electronic analytical balance of 0.01 mg resolution to obtain the weights of new lenses when dry and at equilibrium swelling dry, and calculated the percent hydration of the lenses from the difference of the wet and dry weights. The hydration values of the contact lenses obtained from the index of refraction differed more than those obtained by gravimetry from the values given by the manufacturers. Acuvue lenses were an exception-the difference for them was negligible. Gravimetry is more accurate, but more cumbersome and time-consuming than the index of refraction for the determination of the hydration of the hydrogel contact lenses. However, when a fast and easy method is required to obtain the approximate hydration of hydrogel contact lenses, the use of the refractive index method can give acceptable results for most applications.
Xiao, Xinxin; Siepenkoetter, Till; Conghaile, Peter Ó; Leech, Dónal; Magner, Edmond
A lactate/O 2 enzymatic biofuel cell (EBFC) was prepared as a potential power source for wearable microelectronic devices. Mechanically stable and flexible nanoporous gold (NPG) electrodes were prepared using an electrochemical dealloying method consisting of a pre-anodization process and a subsequent electrochemical cleaning step. Bioanodes were prepared by the electrodeposition of an Os polymer and Pediococcus sp. lactate oxidase onto the NPG electrode. The electrocatalytic response to lactate could be tuned by adjusting the deposition time. Bilirubin oxidase from Myrothecium verrucaria was covalently attached to a diazonium-modified NPG surface. A flexible EBFC was prepared by placing the electrodes between two commercially available contact lenses to avoid direct contact with the eye. When tested in air-equilibrated artificial tear solutions (3 mM lactate), a maximum power density of 1.7 ± 0.1 μW cm -2 and an open-circuit voltage of 380 ± 28 mV were obtained, values slightly lower than those obtained in phosphate buffer solution (2.4 ± 0.2 μW cm -2 and 455 ± 21 mV, respectively). The decrease was mainly attributed to interference from ascorbate. After 5.5 h of operation, the EBFC retained 20% of the initial power output.
Batalu, Nicolae Dan; Semenescu, Augustin; Mates, Ileana Mariana; Negoita, Olivia Doina; Purcarea, Victor Lorin; Badica, Petre
Contact lenses are an attractive alternative for vision corrections. Their improvement can be achieved by optimizing the geometry, use of new materials, and application of high precision processing technologies. The optimized design can be obtained by computer-aided design, considering the principles of geometrical optics. Inventor Professional and other similar advanced 3D CAD software allows complex approaches, selection of suitable materials with better mechanical/ optical properties. This is useful for the preparation of the virtual design for 3D printing or CNC fabrication. A finite element analysis is also of interest for testing the best design/ material choice. In this paper, the finite element analysis for a tri-curve contact lens was applied. The selected materials were PMMA and polycarbonate. The applied compressive loads were in the range from 10 to 100MPa. Our results showed that the best scenario was for the polycarbonate, but PMMA also had a high safety factor. The maximum compression load with a reasonable safety factor (of 7-9 depending on materials) was 12MPa. PMID:29450337
Rathi, Varsha M; Sudharman Mandathara, Preeji; Vaddavalli, Pravin Krishna; Dumpati, Srikanth; Chakrabarti, Tamal; Sangwan, Virender S
The purpose of this study is to report on the use of fluid-filled scleral contact lenses (F-ScCL) in patients with vernal keratoconjunctivitis (VKC). We retrospectively reviewed charts of four patients who had worn F-ScCL (PROSE, Boston Foundation for Sight, Needham Heights, MA) from July 2006 for VKC with two associated conditions; keratoconus and limbal stem-cell deficiency (LSCD). Any previous refractive correction or complications were noted. The main goal of fitting F-ScCL was to improve visual acuity in keratoconus and to improve the ocular microenvironment in LSCD. Visual acuity before and during lens wear and the average wearing time in hours per day was noted. Four patients (7 eyes) with VKC wore F-ScCL for associated keratoconus (n=5 eyes), LSCD (n=2 eyes). The mean age of the patients was 17. 5 years. The LogMAR visual acuity was 0.4 and 0.18 before and during lens wear, respectively, at a mean follow-up of 14.8 months. The average lens wear was 8.30 hrs per day. Two patients developed acute hydrops at 2 and 12 months of lens wear and underwent descematopexy. Visual acuity with F-ScCL reduced by more than two lines because of the scar of healed hydrops. Of the 3 patients with keratoconus, 1 patient had used a piggy back lens system for 2.5 years before F-ScCL wear, and 2 patients had failed with rigid gas-permeable lens trial lenses. With coexisting keratoconus and VKC, F-ScCL improves vision and helps to maintain the health of the ocular surface.
Bilgihan, Kamil; Yuksel, Erdem; Deniz, Nuriye Gokcen; Yuksel, Nilay
Corneal collagen cross linking (CCL) with ultraviolet A (UVA) has been proposed as a treatment for the progression of corneal ectasia associated with keratoconus and post-laser-assisted in situ keratomileusis (LASIK) ectasia. Despite the reports about safety of procedure, we consider that UVA of sunlight can effect riboflavin saturated and de-epitelizated cornea early after CCL. To evaluate the UVA blockage capability of 11 different silicone hydrogel contact lenses which are widely used after CCL treatment. Eleven different silicone hydrogel and daily disposable contact lenses were evaluated. The UVA light at 365 nm wavelength for UVA source and UV light meter to measure UVA radiation were used. 3, 9 and 18 mW/cm(2) power of UV radiance was applied centrally to the each type of contact lenses. The power of UVA transmittance for each radiance and percentage of blockage were evaluated for each brand. Also, protection factor (PF) was calculated. The senofilcon A and narafilcon A had the highest blockage and lowest transmittance (p = 0.02). PF was significantly higher in the senofilcon A and narafilcon A at 3, 9 and 18 mW/cm(2) (p = 0.0001). And also, the hilafilcon B, filcon IV, nelfilcon A, enfilcon A, lotrafilcon A and lotrafilcon B had the highest UVA transmittance. The narafilcon A and the senofilcon A may be a good options for epithelial healing after CCL procedure to protect the cornea from UVA of sunlight. And also, the hilafilcon B, filcon IV, nelfilcon A, enfilcon A, lotrafilcon A and lotrafilcon B contact lenses that have high-UVA transmittance feature can be a treatment choice for contact lens-assisted CCL technique in thin corneas.
Land, Adrian D; Penno, Katie L; Brzezinski, Jennifer L
All contact lenses (corrective/noncorrective) are considered Class II or Class III medical devices under the Federal Food, Drug, and Cosmetic Act, which also states that contact lenses can only be obtained with a prescription. The Forensic Chemistry Center of the US Food & Drug Administration has examined over 300 decorative, noncorrective contact lenses obtained without a prescription. Our observations indicate that 60% of the counterfeit lenses and 27% of the unapproved lenses examined were positive for microbial contamination. Twenty-nine different brands of noncorrective contact lenses were examined, and 48% of them had at least one sample positive for microbial contamination. Each microorganism was further identified using DNA sequencing. Contaminated contact lenses are associated with numerous health risks, including ocular infections and conjunctivitis leading to permanent visual impairment or blindness. These results support the contention that acquiring contact lenses without a prescription is a considerable threat to consumer health and safety. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.
Green, J Angelo; Phillips, K Scott; Hitchins, Victoria M; Lucas, Anne D; Shoff, Megan E; Hutter, Joseph C; Rorer, Eva M; Eydelman, Malvina B
To assess material properties that affect preservative uptake by silicone hydrogel lenses. We evaluated the water content (using differential scanning calorimetry), effective pore size (using probe penetration), and preservative uptake (using high-performance liquid chromatography with spectrophotometric detection) of silicone and conventional hydrogel soft contact lenses. Lenses grouped similarly based on freezable water content as they did based on total water content. Evaluation of the effective pore size highlighted potential differences between the surface-treated and non-surface-treated materials. The water content of the lens materials and ionic charge are associated with the degree of preservative uptake. The current grouping system for testing contact lens-solution interactions separates all silicone hydrogels from conventional hydrogel contact lenses. However, not all silicone hydrogel lenses interact similarly with the same contact lens solution. Based upon the results of our research, we propose that the same material characteristics used to group conventional hydrogel lenses, water content and ionic charge, can also be used to predict uptake of hydrophilic preservatives for silicone hydrogel lenses. In addition, the hydrophobicity of silicone hydrogel contact lenses, although not investigated here, is a unique contact lens material property that should be evaluated for the uptake of relatively hydrophobic preservatives and tear components.
Steinemann, Thomas L; Pinninti, Usha; Szczotka, Loretta B; Eiferman, Richard A; Price, Francis W
To call attention to the unauthorized sale of cosmetic contact lenses, resulting in ocular complications. DESIGN Observational case report. Retrospective, observational, clinical practice setting. Six patients (five female and one male) were seen urgently for acute eye pain and redness after wearing cosmetic plano contact lenses. None of the patients had previously worn a contact lens or spectacle correction. None of the lenses were dispensed by eye care professionals. One patient developed pseudomonal keratitis, ultimately requiring penetrating keratoplasty for visual rehabilitation. Colored contact lenses are being dispensed without a prescription or fitting from unlicensed vendors, such as cosmetics, convenience, and accessory stores. Lenses are sold individually and without care instructions. Consequently, uninformed lens wearers are experiencing acute, vision-threatening infections and inflammation.
The Water Content Changes THESIS/Dl$$XF$T$77q Ln ~In Three Types Of Hydrogel Contact Lenses G EFRIGI EOTNME IO 7. AUTHOR(.) S. CONTRACT OR GRANT NUMBER...CONTENT CHANGES IN THREE TYPES OF HYDROGEL CONTACT LENSES A Thesis Presented to the Faculty of the Graduate School of Pacific University In Partial...Luehrs, O.D. May 1987 I : . 1 , A LONG TERM STUDY OF THE WATER CONTENT CHANGES IN THREE TYPES OF DYLH)ORGEL CONTACT LENSES Place: Pacific University
Dursch, T J; Liu, D E; Oh, Y; Radke, C J
Partitioning of aqueous packaging, wetting, and care-solution agents into and out of soft contact lenses (SCLs) is important for improving wear comfort and also for characterizing lens physico-chemical properties. We illustrate both features of partitioning by application of fluorescent-solute partitioning into DAILIES TOTAL1® (delefilcon A) water-gradient SCLs, which exhibit a layered structure of a silicone-hydrogel (SiHy) core sandwiched between thin surface-gel layers. Two-photon fluorescence confocal laser-scanning microscopy and attenuated total-reflectance Fourier-transform infrared spectroscopy (ATR-FTIR) characterize the lens and assess uptake profiles of six prototypical fluorescent solutes. Comparison of solute uptake in a SiHy-core prototype lens (i.e., O2OPTIX(TM)) validates the core SiHy structure of DAILIESTOTAL1®. To establish surface-layer charge, partition coefficients and water contents are obtained for aqueous pH values of 4 and 7.4. Solute fluorescence-intensity profiles clearly confirm a layered structure for the DAILIES TOTAL1® lenses. In all cases, aqueous solute partition coefficients are greater in the surface layers than in the SiHy core, signifying higher water in the surface gels. ATR-FTIR confirms surface-layer mass water contents of 82±3%. Water uptake and hydrophilic-solute uptake at pH 4 compared with that at pH 7.4 reveal that the surface-gel layers are anionic at physiologic pH 7.4, whereas both the SiHy core and O2OPTIX™ (lotrafilcon B) are nonionic. We successfully confirm the layered structure of DAILIES TOTAL1®, consisting of an 80-μm-thick SiHy core surrounded by 10-μm-thick polyelectrolyte surface-gel layers of significantly greater water content and aqueous solute uptake compared with the core. Accordingly, fluorescent-solute partitioning in SCLs provides information on gel structure and composition, in addition to quantifying uptake and release amounts and rates. Copyright © 2014 Acta Materialia Inc. Published by
Lee, Dasom; Cho, Seungkwon; Park, Hwa Sung; Kwon, Inchan
Ocular drug delivery through hydrogel contact lenses has great potential for the treatment of ocular diseases. Previous studies showed that the loading of lipophilic vitamin E to silicone-hydrogel contact lenses was beneficial in ocular drug delivery. We hypothesized that vitamin E loading to another type of popular hydrogel contact lenses, pHEMA-hydrogel contact lenses, improves ocular drug delivery by increasing the drug loading or the duration of drug release. Loading of vitamin E to pHEMA-hydrogel contact lenses significantly increased the loading of a hydrophilic drug surrogate (Alexa Fluor 488 dye) and two hydrophilic glaucoma drugs (timolol and brimonidine) to the lenses by 37.5%, 19.1%, and 18.7%, respectively. However, the release duration time was not significantly altered. Next, we hypothesized that the lipophilic nature of vitamin E attributes to the enhanced drug loading. Therefore, we investigated the effects of co-loading of another lipophilic vitamin, vitamin A, on drug surrogate delivery. We found out that vitamin A loading also increased the loading of the drug surrogate to pHEMA-hydrogel contact lenses by 30.3%. Similar to vitamin E loading, vitamin A loading did not significantly alter the release duration time of the drug or drug surrogate.
Lee, Dasom; Cho, Seungkwon; Park, Hwa Sung; Kwon, Inchan
Ocular drug delivery through hydrogel contact lenses has great potential for the treatment of ocular diseases. Previous studies showed that the loading of lipophilic vitamin E to silicone-hydrogel contact lenses was beneficial in ocular drug delivery. We hypothesized that vitamin E loading to another type of popular hydrogel contact lenses, pHEMA-hydrogel contact lenses, improves ocular drug delivery by increasing the drug loading or the duration of drug release. Loading of vitamin E to pHEMA-hydrogel contact lenses significantly increased the loading of a hydrophilic drug surrogate (Alexa Fluor 488 dye) and two hydrophilic glaucoma drugs (timolol and brimonidine) to the lenses by 37.5%, 19.1%, and 18.7%, respectively. However, the release duration time was not significantly altered. Next, we hypothesized that the lipophilic nature of vitamin E attributes to the enhanced drug loading. Therefore, we investigated the effects of co-loading of another lipophilic vitamin, vitamin A, on drug surrogate delivery. We found out that vitamin A loading also increased the loading of the drug surrogate to pHEMA-hydrogel contact lenses by 30.3%. Similar to vitamin E loading, vitamin A loading did not significantly alter the release duration time of the drug or drug surrogate. PMID:27678247
Tseng, Santos Shan-Yu; Yang, Winston Wen-Ching; Hsiao, John Ching-Jen
We report a case demonstrating the importance of trial fitting before the dispensing of prescription contact lenses. The patient was an 18-year-old computer-using experienced hydrogel lens wearer who ran out of contact lens supply. The patient purchased a brand new box of daily disposable lenses from a retail store having known his back vertex power. No trial fitting of the lenses was performed at the point of sale. After a day of wear of the lenses with significant computer use, the patient removed them and went to bed, but the next morning, presented on an emergency basis with severe pain and blurry vision in both eyes. Slit lamp examination showed significant bilateral corneal erosions that were treated with prophylactic antibiotics, steroids, and lubricants. A bandage contact lens was further given to his right eye. The characteristics of the daily disposable lenses and his computer overuse were viewed as contributing factors to the complication. The dispensing and wear of prescription contact lenses without a proper selection and fit led to bilateral corneal erosions in this patient. Though our case occurred in Taiwan, a jurisdiction where prescription contact lens sale is not regulated, the authors note that such a scenario could occur in jurisdictions where contact lens sale is regulated if, after confirmation of back vertex power, no effort is made to ensure that a purchased lens is safe or appropriate for a patient, such as when lenses are purchased through internet suppliers or in certain commercial retail settings.
Depry, Jennifer; Golding, Robert; Szczotka-Flynn, Loretta; Dao, Harry; Baron, Elma; Cooper, Kevin
UV-blocking contact lenses were evaluated to determine if they could provide adequate ocular protection during narrowband UVB phototherapy treatment. Theoretical safe exposure durations for the crystalline lens, cornea and conjunctiva were determined. A Cary 500 spectrophometer generated transmittance data for six UV-blocking and two non-UV-blocking contact lenses. An IL-1700 radiometer measured the lenses' radiation transmittance within the NB-UVB phototherapy unit. The lenses were exposed to a 1500-mJ/cm(2) dose of radiation from a 308-nm excimer laser to determine if the radiation would alter their protective properties. Theoretical safe exposure durations for eye structures were calculated using previous human and animal study data. All UV-blocking contact lenses showed less than 1E-7 W/cm(2) of radiation transmittance within the narrowband phototherapy unit. The excimer laser did not significantly alter the lenses' UV-blocking capabilities. The safe exposure durations for the cornea and crystalline lens were greater than 11 min with UV-blocking lenses, and that for the unprotected conjunctiva was approximately 11 s. Some UV-blocking contact lenses potentially provide sufficient ocular protection during narrowband UVB phototherapy treatment, as the crystalline lens and cornea are adequately protected should a patient open his or her eyes for a short time. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Legras, Richard; Rio, David
To compare theoretically optimised bifocal contact lens optical designs to commercially available optical designs for presbyopia. Retinal images were simulated, using a numerical eye model, from -6 (i.e., near vision) to +2 D for each 0.25 D. Ten optical profiles were simulated. Four of them corresponded to commercial contact lenses (i.e., Acuvue Oasys for Presbyopia®, Air Optix Aqua Multifocal®, Purevision Multifocal® and Distance Biofinity Multifocal®). We also included six optimised profiles: (1) a combination of primary and secondary spherical aberration, (2) bifocal profiles with 2, 5 and 8 concentric zones, and (3) a combination of spherical aberrations with the 5 and 8 zones profiles. Twenty subjects scored the quality of vision of calculated images (i.e., three high-contrast 0.40 logMAR letters) for each design and vergence with a five-item continuous grading scale. They viewed these images through their best sphero-cylindrical correction and a 3-mm pupil to limit the impact of their aberrations. To quantify the ability of a bifocal optic to maintain a certain level of quality of vision, we calculated two criteria: (1) the area under the through-focus quality of vision curve higher than 2 (i.e., limit between poor and fair quality of vision) normalised by the same area calculated on the naked eye's curve, and (2) the width of the curve at a level of 2 (i.e., depth-of-focus). Commercial contact lens profiles did not give an image quality and depth-of-focus as good as the theoretically optimised optical profiles. Based on these two criteria, the best bifocal profiles were those with 5 and 8 concentric zones. Important inter-individual variations were observed for all profiles. We also observed that some subjects did not obtain any benefit with all the designs whereas others seemed to be satisfied whatever the optical profiles. Our previously optimised designs with 5 and 8 zones gave the best benefit and depth-of-focus. As their image quality is better
Ortiz, Carolina; Jiménez, Raimundo
To study the influence of iris-coloring soft contact lenses, designed for changing apparent iris color, on optical quality and vision. Eighty subjects were included in this study. All participants were classified as emmetropic, with monocular best-corrected visual acuity of 20/20 or better. For 40 subjects, we measured the optical quality (aberrations, the Strehl ratio, and the objective scattering index) and visual performance before and after wearing the cosmetic soft contact lenses. We also measured the optical quality and visual performance for the other 40 subjects but with a different kind of lens (fantasy soft contact lenses). Iris-coloring soft contact lenses significantly increased coma-like and total higher-order aberrations and objective scattering index (p < 0.05). We also found a significant deterioration in the Strehl ratio. The contrast sensitivity function significantly decreased only after wearing the fantasy soft contact lenses (p = 0.047). Iris-coloring soft contact lenses deteriorate the optical quality and worsen the contrast sensitivity function. Iris-coloring soft contact lens wearers should be informed about the effects on optical quality and visual function.
Hong, Sojin; Lee, Jong Rak; Lim, Taehyung
We report a case of corneal deposition of pigments from cosmetic contact lenses after intense pulsed-light (IPL) therapy. A 30-year-old female visited our outpatient clinic with ocular pain and epiphora in both eyes; these symptoms developed soon after she had undergone facial IPL treatment. She was wearing cosmetic contact lenses throughout the IPL procedure. At presentation, her uncorrected visual acuity was 2/20 in both eyes, and the slit-lamp examination revealed deposition of the color pigment of the cosmetic contact lens onto the corneal epithelium. We scraped the corneal epithelium along with the deposited pigments using a no. 15 blade; seven days after the procedure, the corneal epithelium had healed without any complications. This case highlights the importance of considering the possibility of ocular complications during IPL treatment, particularly in individuals using contact lenses. To prevent ocular damage, IPL procedures should be performed only after removing the lenses and applying eyeshields.
Yuksel, Erdem; Yalcin, Nuriye Gokçen; Kilic, Gaye; Cubuk, Mehmet Ozgur; Ozmen, Mehmet Cuneyt; Altay, Aylin; Çağlar, Kayhan; Bilgihan, Kamil
To investigate the agents of bacterial contamination of contact lenses after corneal collagen cross-linking (CCL), and to present the possible changes of ocular flora after riboflavin/ultraviolet A. Seventy-two contact lenses of patients who underwent CCL and 41 contact lenses of patients who underwent photorefractive keratectomy (PRK) as control group were enrolled to the study. After 48 h of incubation, broth culture media was transferred to plates. Samples were accepted as positive if one or more colony-forming units were shown. There were positive cultures in 12 (16.7%) contact lenses in the CCL group and 5 (12.2%) had positive cultures in PRK group. Coagulase-negative staphlycocci (CNS) were the most frequent microorganism. Alpha hemolytic streptococci and Diphteroid spp. were the other isolated microorganisms. Bacterial colonization can occur during and early after the CCL procedure in epithelial healing. To prevent corneal infections after the treatment, prophylactic antibiotics should be prescribed.
Lee, Karen Lai Yin; Nguyen, Diana Phuong-Anh; Edrington, Timothy B; Weissman, Barry A
We calculated corneal surface oxygen tension under hybrid contact lenses (CLs) by extending existing models of CL oxygen diffusion to the circumstances of hybrid CL designs with tear vaults. Theoretical oxygen tensions at the corneal surface, if tear mixing and exchange are excluded, are calculated for hybrid CL (modern, high oxygen-permeable rigid center) designs with a single chamber corneal model using a computer software spreadsheet. Several specific in vivo instances of hybrid CL tear vaults are measured by both slitlamp biomicroscopy and optical coherence tomography (OCT). No significant difference was found between central thickness of hybrid CL rigid portions measured by Vigor gauge and OCT. The amount of central tear vault thickness was found to be significantly greater, however, when interpolated from biomicroscope images (500-1,554 μm, simulating a poorly fit lens) than from either OCT images (0-91 μm) or direct measurement through OCT software (0-96 μm). Using all measurements, excluding any potential contributions from tear exchange or mixing, we predict corneal surface tear pO2 values under several hybrid CLs to range from zero under a lens with an excessive vault to 112 mm Hg under a lens with a minimal vault. Tear vaults beneath the gas permeable portion of the hybrid CLs of 100 μm or less resulted in acceptable corneal surface oxygen values. Where tear vaults are greater than about 100 μm, predicted anterior corneal surface pO2 values are less likely to be adequate for optimal corneal physiology. Any significant tear exchange, however, should increase these values. Although measuring tear thickness, we noted that the photographic biomicroscope and the OCT methods provided inconsistent results, and thus limited the reliability of our primary result.
Taibbi, Giovanni; Wang, Zhong I; Dell’Osso, Louis F
We investigated the effects of contact lenses in broadening and improving the high-foveation-quality field in a subject with infantile nystagmus syndrome (INS). A high-speed, digitized video system was used for the eye-movement recording. The subject was asked to fixate a far target at different horizontal gaze angles with contact lenses inserted. Data from the subject while fixating at far without refractive correction and at near (at a convergence angle of 60 PD), were used for comparison. The eXpanded Nystagmus Acuity Function (NAFX) was used to evaluate the foveation quality at each gaze angle. Contact lenses broadened the high-foveation-quality range of gaze angles in this subject. The broadening was comparable to that achieved during 60 PD of convergence although the NAFX values were lower. Contact lenses allowed the subject to see “more” (he had a wider range of high-foveation-quality gaze angles) and “better” (he had improved foveation at each gaze angle). Instead of being contraindicated by INS, contact lenses emerge as a potentially important therapeutic option. Contact lenses employ afferent feedback via the ophthalmic division of the V cranial nerve to damp INS slow phases over a broadened range of gaze angles. This supports the proprioceptive hypothesis of INS improvement. PMID:19668758
Moore, Linda; Ferreira, Jannie T
The ultraviolet (UV) transmittance spectra of daily wear hydrogel and disposable silicone hydrogel contact lenses were measured. Average transmittance percentages were calculated for each lens for the entire UV spectrum and individually for the UVC, UVB and UVA portions of the spectrum. The significance of the differences in transmittance spectra obtained for the lenses was analysed using a one-way ANOVA planned comparisons test (alpha=0.05). The transmittance data were then used to calculate a UV protection factor (PF) for each contact lens brand tested. The PFs for 1-DAY ACUVUE MOIST (6.22), ACUVUE ADVANCE (10.02) and ACUVUE OASYS (11.96) contact lenses show that these contact lenses have superior UV-blocking capabilities. The PFs for Focus DAILIES (1.79), SofLens 1-day disposables (1.72), NIGHT & DAY (1.84), O2 Optix (1.99) and Purevision (2.62) show that these contact lenses posses more modest UV-blocking characteristics. This paper reviews the importance of protection of the anterior ocular surface from UV damage and quantifies the protection afforded by selected commercially available disposable contact lenses.
Rahmani, Saeed; Mohammadi Nia, Mohadeseh; Akbarzadeh Baghban, Alireza; Nazari, Mohammad Reza; Ghassemi-Broumand, Mohammad
Three major parts of sunlight consist of visible, ultraviolet and infrared radiation. Exposure to ultraviolet radiation (UVR) can result in a spectrum of skin and ocular diseases. UV-blocking contact lenses help provide protection against harmful UV radiation. We studied the ultraviolet and visible light rays transmission in some soft UV-blocking contact lenses. Four available tinted soft lenses (Acuvue Moist, Zeiss CONTACT Day 30 Air spheric, Pretty Eyes and Sauflon 56 UV) have been evaluated for UV and visible transmission. One-way ANOVA testing was performed to establish is there a statistically significant difference between the UV regions and visible spectra means for the contact lenses (α=0.05). Pretty Eyes, Zeiss CONTACT, Acuvue Moist and Sauflon 56 UV showed UV-B transmittance value of 0.65%, 10.69%, 1.22%, and 5.78%, respectively. Pretty Eyes and Acuvue Moist had UV-A transmittance values of 32% and 34%, Sauflon 56 UV and Zeiss CONTACT had transmittance values of 48% and 43%, respectively. All of the studied lenses transmitted at least 94.6% on the visible spectrum. The results of the one-way ANOVA statistical analysis show that a statistically significant difference exists within the group of contact lenses tested for the visible (p<0.001), UV-B (p<0.001) and UV-A (p<0.001) portions of the spectrum (α=0.05). Acuvue Moist has the best UV-blocking property and also visible transmission between other tested contact lenses in this study. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Gavara, Rafael; Compañ, Vicente
Oxygen permeability, diffusion coefficient of the sodium ions and water flux and permeability in different conventional hydrogel (Hy) and silicone-hydrogel (Si-Hy) contact lenses have been measured experimentally. The results showed that oxygen permeability and transmissibility requirements of the lens have been addressed through the use of siloxane containing hydrogels. In general, oxygen and sodium chloride permeability values increased with the water content of the lens but there was a percolation phenomenon from a given value of water uptake mainly in the Si-Hy lenses which appeared to be related with the differences between free water and bound water contents. The increase of ion permeability with water content did not follow a unique trend indicating a possible dependence of the chemical structure of the polymer and character ionic and non-ionic of the lens. Indeed, the salt permeability values for silicone hydrogel contact lenses were one order of magnitude below those of conventional hydrogel contact lenses, which can be explained by a diffusion of sodium ions occurring only through the hydrophilic channels. The increase of the ionic permeability in Si-Hy materials may be due to the confinement of ions in nanoscale water channels involving possible decreased degrees of freedom for diffusion of both water and ions. In general, ionic lenses presented values of ionic permeability and diffusivity higher than most non-ionic lenses. The tortuosity of the ionic lenses is lower than the non-ionic Si-Hy lenses. Frequency 55 and PureVision exhibited the highest water permeability and flux values and, these parameters were greater for ionic Si-Hy lenses than for ionic conventional hydrogel lenses. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2218-2231, 2017. © 2016 Wiley Periodicals, Inc.
Iskeleli, Güzin; Karakoç, Yunus; Aydin, Ozlem; Yetik, Hüseyin; Uslu, Haşim; Kizilkaya, Melda
To investigate the tear-film osmolarity of contact lens wearers for different types of contact lenses. Fifty six eyes of 56 cases were evaluated in four different groups according to the type of contact lens worn, with 14 eyes in each group. Groups 1 and 2 consisted of subjects who wore frequent-replacement daily wear soft contact lenses; group 1 lenses had 55% water content, and lenses in group 2 had 38% water content. Groups 3 and 4 consisted of subjects who wore rigid gas-permeable contact lenses, with a Dk value of 90 in group 3 and a Dk value of 52 in group 4. Tear-film osmolarity values in milliosmole (mosm) units were determined by auto-osmometer (Orstat 6030, Daiichi Kagacu, Kyoto, Japan) before and after contact lens wear for each group, and the results were compared statistically by ANOVA test. Before the period of contact lens wear, the tear-film osmolarity values of group 1, 2, 3, and 4 were 283.61+/-12.83 mosm, 285.23+/-8.94 mosm, 285.57+/-11.39 mosm, and 280.15+/-12.07 mosm, respectively. After the period of contact lens wear, these values were measured at 312.15+/-16.03 mosm in group 1, 316.54+/-12.14 mosm in group 2, 313.14+/-9.66 mosm in group 3, and 316.38+/-11.60 mosm in group 4. Although the difference between the values before and after the period of contact lens wear was statistically significant for each group (F=291.45; P=0.0005), there was no statistically significant difference among the groups. When a contact lens is placed in the eye, the lens alters the normal structure of the tear film and affects its rate of evaporation; therefore tear-film osmolarity may increase. In our study, all contact lenses produced a similar effect on tear-film osmolarity.
Garcia-Romo, Esperanza; Perez-Rico, Consuelo; Roldán-Díaz, Isabel; Arévalo-Serrano, Juan; Blanco, Román
To investigate the feasibility, effectiveness and acceptability of using prosthetic occluding contact lenses (OCLs) to treat moderate amblyopia in adults and of the role of the multifocal visual evoked potential (mfVEP) as a predictor of postamblyopic therapy. A comparative, prospective, interventional, case series pilot study with amblyopic adults (mean age: 40 years, range 20-50 years) allocated into two intervention groups: eye patching and OCL. The primary outcome variable was logarithm of the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA), and secondary outcomes were mfVEP amplitude and latency and patients' health-related quality of life National Eye Institute Visual Function Questionnaire (NEI VFQ-25). Significant improvements in pre- to postamblyopic therapy BCVA were seen at 1.5 months in the OCL group [0.29 logMAR, 95% confidence interval (CI): 0.10-0.47 versus 0.11 logMAR, 95% CI: 0.02-0.19; p < 0.001] and eye patching group (0.29 logMAR, 95% CI: 0.17-0.40 versus 0.18 logMAR, 95% CI: 0.12-0.23; p < 0.01). Post-treatment BCVA was inversely related to age (R: 0.009, 95% CI: -0.02 to -0.001; p = 0.04) and the presence of strabismus (R: -0.3, 95% CI: -0.434 to -0.17; p = 0.001). No significant changes in the number and size of the abnormal mfVEP amplitude and latency defects were observed after occlusion. The NEI VFQ-25 composite score showed significant improvement in the OCL users at 12 months compared to eye patching. Significant vision improvement can be achieved, making occlusion with OCLs an effective and more acceptable therapy for adults with amblyopia. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Del Águila-Carrasco, Antonio J; Domínguez-Vicent, Alberto; Pérez-Vives, Cari; Ferrer-Blasco, Teresa; Montés-Micó, Robert
To assess the effect of different disposable soft contact lenses upon corneal thickness, and upon anterior and posterior corneal curvatures using a dual-Scheimpflug imaging based device. Twenty-eight young, healthy subjects wore four different types of daily disposable soft contact lenses on four different days: Dailies Total1, Proclear 1 Day, Clariti 1-Day and 1-Day Acuvue Moist. The lenses had different material and water content. Pachymetry maps and keratometry values were obtained using the Galilei G4 twice a day: one before putting the lens on and one after an eight-hour period of contact-lens wear. Measurements were also recorded without any contact lenses being worn during a day. Clariti 1-Day lens caused the greatest thickening in the central (8.9±2.8 μm; p<0.01) and in the peripheral cornea (10.1±4.6 μm; p<0.01), whereas Dailies Total1 was the lens that had the most similar behaviour to the non-contact lens scenario. All the lenses caused a slight flattening in the anterior corneal curvature, except Clariti 1-Day, which induced a very slight steepening. The four lenses caused a steepening of different magnitude in the posterior corneal curvature. The magnitude of the changes introduced by the use of soft contact lenses over the eight-hour wearing period was rather small. Thus it is probable it will not influence the vision nor the comfort of the subject. Also, variations on corneal parameters seem to depend on the type of contact lens used. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Hondur, Ahmet; Bilgihan, Kamil; Cirak, Meltem Yalinay; Dogan, Ozgur; Erdinc, Alper; Hasanreisoglu, Berati
To evaluate the extent and agents of bacterial contamination of bandage disposable soft contact lenses after laser subepithelial keratectomy (LASEK) and to correlate the findings with clinical data. Disposable soft contact lenses were collected from 52 eyes of 26 consecutive patients treated with LASEK for myopia. The patients were treated with a fixed combination of tobramycin and diclofenac until epithelial closure. The lenses were removed on the fourth or fifth postoperative day with sterile forceps and immediately placed in sterile tubes containing culture media brain-heart infusion broth. The lenses were evaluated for microbial colonization. Of the 52 contact lenses analyzed, six (11.5%) had positive cultures. However, no clinical finding of infection was noted. Isolated microorganisms were coagulase-negative staphylococci (two lenses), Stenotrophomonas maltophilia (two lenses), Acinetobacter species (one lens), and Aeromonas hydrophila (one lens). Except for one case, the microorganisms were sensitive to the administered antibiotic. The risk of infectious keratitis after LASEK seems to be low. Except for staphylococci, the isolated microorganisms have not been previously reported to colonize the ocular surface or cause keratitis after refractive surgery. These findings may suggest a changing trend of potentially infectious agents after surface ablation.
Omali, Negar Babaei; Subbaraman, Lakshman N.; Coles-Brennan, Chantal; Fadli, Zohra; Jones, Lyndon W.
ABSTRACT Within a few minutes of wear, contact lenses become rapidly coated with a variety of tear film components, including proteins, lipids, and mucins. Tears have a rich and complex composition, allowing a wide range of interactions and competitive processes, with the first event observed at the interface between a contact lens and tear fluid being protein adsorption. Protein adsorption on hydrogel contact lenses is a complex process involving a variety of factors relating to both the protein in question and the lens material. Among tear proteins, lysozyme is a major protein that has both antibacterial and anti-inflammatory functions. Contact lens materials that have high ionicity and high water content have an increased affinity to accumulate lysozyme during wear, when compared with other soft lens materials, notably silicone hydrogel lenses. This review provides an overview of tear film proteins, with a specific focus on lysozyme, and examines various factors that influence protein deposition on contact lenses. In addition, the impact of lysozyme deposition on various ocular physiological responses and bacterial adhesion to lenses and the interaction of lysozyme with other tear proteins are reviewed. This comprehensive review suggests that deposition of lysozyme on contact lens materials may provide a number of beneficial effects during contact lens wear. PMID:26002002
Omali, Negar Babaei; Subbaraman, Lakshman N; Coles-Brennan, Chantal; Fadli, Zohra; Jones, Lyndon W
Within a few minutes of wear, contact lenses become rapidly coated with a variety of tear film components, including proteins, lipids, and mucins. Tears have a rich and complex composition, allowing a wide range of interactions and competitive processes, with the first event observed at the interface between a contact lens and tear fluid being protein adsorption. Protein adsorption on hydrogel contact lenses is a complex process involving a variety of factors relating to both the protein in question and the lens material. Among tear proteins, lysozyme is a major protein that has both antibacterial and anti-inflammatory functions. Contact lens materials that have high ionicity and high water content have an increased affinity to accumulate lysozyme during wear, when compared with other soft lens materials, notably silicone hydrogel lenses. This review provides an overview of tear film proteins, with a specific focus on lysozyme, and examines various factors that influence protein deposition on contact lenses. In addition, the impact of lysozyme deposition on various ocular physiological responses and bacterial adhesion to lenses and the interaction of lysozyme with other tear proteins are reviewed. This comprehensive review suggests that deposition of lysozyme on contact lens materials may provide a number of beneficial effects during contact lens wear.
Mancino, R; Iori, A; Palma, S; Corsi, A; Cancrini, G; Cerulli, L
Three female patients, aged from 17 to 44 years, developed Acanthamoeba keratitis associated with the use of soft contact lenses and cosmetic contact lens. Two of these patients were myopic and wore soft contact lenses for optical purpose, while the third patient used a cosmetic lens. In this paper we describe the related risk factors, the success of cultural procedures and the outcome of medical management. In 2 out of the 3 cases we obtained cultures positive for Acanthamoeba, from the contact lenses and the contact-lens case. The isolated strains belong to the group II according to Pussard and Pons and they were proven pathogen for experimentally infected mice. All infections were treated successfully; however in 2 out of the 3 patients the visual acuity was reduced to the light perception.
Gaiser, Hilary; Ho, Connie; Janier, Nicole; Wee, Amy; Johnson, Catherine; Watanabe, Ronald
To describe practitioner experiences regarding ocular complications in patients wearing decorative contact lenses, and to investigate the compliance of unauthorized distributors of decorative contact lenses to current Food and Drug Administration (FDA) and Federal Trade Commission (FTC) regulations. Also, to provide data to support a more targeted public health approach to reducing the incidence of illegal contact lens sales and associated ocular complications. An institutional review board-approved online survey was distributed through mass email to a list of 98 optometrists in the Boston, MA area. Concurrently, an empirical evaluation of independent, online decorative contact lens sellers who were not associated with FDA-approved contact lens manufacturers was performed to determine their adherence to FDA and FTC guidelines. The first 18 noncoincidental websites that resulted from a Google search for "costume contact lens sellers" and "cosmetic contact lens sellers" were examined as to the brands and parameters of lenses being sold, whether or not a valid prescription was required or verified, and if consumer education was provided. Twenty-two optometrists completed the online survey. Seventy-seven percent of respondents reported having patients with complications from decorative contact lenses that were purchased both legally and illegally. The most common age group for complications was 18 to 25 years (61%). One third of complications were seen in first-time lens wearers, half of whom never received proper care instructions or were unaware that care instructions existed. One quarter of the lenses were purchased illegally with unlicensed stores being the most common place of purchase. Of the 18 online sites examined, 72% of sellers failed to adhere to FTC and FDA regulations. A significant number of individuals who obtain contact lenses illegally from unauthorized sources are young adults. Most unauthorized sellers reviewed did not adhere to the proper protocol
Sulley, Anna; Young, Graeme; Lorenz, Kathrine Osborn; Hunt, Chris
To evaluate the ease with which astigmats from three groups of current non-wearers of toric contact lenses can be fitted with current toric soft lenses, and to determine toric lens-wearing success. This was a 1-month, randomized, bilateral, open-label, daily wear study involving 200 subjects and 16 investigational sites in the UK. Three groups of astigmatic subjects aged from 16 to 60 and with a mean age of 36 years (67 spherical soft contact lens users, SW; 72 contact lens drop-outs, DO; and 61 neophytes, Neo) were fitted with one of two toric soft lens types: a daily disposable toric soft lens (1 Day Acuvue Moist for Astigmatism, Johnson & Johnson Vision Care) or a 2-weekly replacement, re-usable toric soft lens (Acuvue Oasys for Astigmatism, Johnson & Johnson Vision Care). Subjects were evaluated after 1 month of wear and success rates calculated according to pre-set criteria for acceptable fit, orientation stability, visual acuity, quality of vision, and overall comfort. Eighty-eight percent of lenses were fitted at the first attempt. Of 198 subjects dispensed with lenses, 182 (92%) completed the study. When analysed by subject group, the success rates according to the pre-set criteria were 80% (53/66), 74% (52/70), and 70% (39/56) for the SW, DO and Neo groups respectively. Comfort was the most common reason for failure with all three groups; however, visual problems were more common in the DO and Neo groups (13% vs 6%). VA with the study lenses was significantly better in the SW group compared to their habitual lenses. For the DO and Neo groups combined (i.e. spectacle wearers), visual acuity was comparable to their habitual spectacles. A high proportion of astigmats who are not using toric soft contact lenses can be fitted with current lenses. Previous contact lens drop-outs and neophyte wearers achieve visual acuity comparable to spectacles when fitted with toric soft lenses. Spherical contact lens wearing astigmats achieve superior visual acuity when
Alipour, Fateme; Kheirkhah, Ahmad; Jabarvand Behrouz, Mahmoud
To evaluate fitting feasibility and efficacy of mini scleral contact lenses in moderate to severe dry eye patients. Prospective interventional case series, this study included those patients with grades III and IV dry eye disease, whose symptoms could not be controlled by conventional treatments. Demographic data, UCVA, BSCVA were evaluated before fitting. Mini scleral lens fit was assessed by single experienced practitioner and best corrected vision with mini scleral lens was assessed. After dispensing mini scleral lens, BCVA with mini scleral lens, and possible contact lens related problems were assessed in each visit. Ocular comforts, frequency of artificial tear use, contact lens handling problems were asked in each follow up visit. For those who did not choose to wear lenses, the reason was asked. All data were analyzed using descriptive statistical tests. Twenty eyes of 13 patients were fitted. Mini scleral lens was dispensed for 19 eyes in them assessment of fit was either ideal (n=9) or acceptable (n=10). Seven patients got their lenses; four patients (seven eyes) of them were satisfied with their lenses based on decrease in discomfort and dry eye symptoms, decrease artificial tear need frequency and improvement in visual acuity during mean follow up period of 18.25 months (range: 15-20). None of them was affected with any contact lens related complication. Mini scleral contact lenses can be considered helpful in management of moderate to severe dry eye. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Williams, Geraint P; Wu, Benjamin; Liu, Yu Chi; Teo, Ericia; Nyein, Chan L; Peh, Gary; Tan, Donald T; Mehta, Jodhbir S
Hyperopia is a common refractive error, apparent in 25% of Europeans. Treatments include spectacles, contact lenses, laser interventions and surgery including implantable contact lenses and lens extraction. Laser treatment offers an expedient and reliable means of correcting ametropia. LASIK is well-established however SMILE (small-incision lenticule extraction) or lenticule implantation (derived from myopic laser-correction) are newer options. In this study we compared the outcomes of hyperopic LASIK, SMILE and lenticule re-implantation in a primate model at +2D/+4D treatment. While re-implantation showed the greatest regression, broadly comparable refractive results were seen at 3-months with SMILE and LASIK (<1.4D of intended), but a greater tendency to regression in +2D lenticule reimplantation. Central corneal thickness showed greater variation at +2D treatment, but central thickening during lenticule reimplantation at +4D treatment was seen (-17± 27μm LASIK, -45 ± 18μm SMILE and 28 ± 17μm Re-implantation; p <0.01) with expected paracentral thinning following SMILE. Although in vivo confocal microscopy appeared to show higher reflectivity in all +4D treatment groups, there were minimal and inconsistent changes in inflammatory responses between modalities. SMILE and lenticule re-implantation may represent a safe and viable method for treating hyperopia, but further optimization for lower hyperopic treatments is warranted.
D'Avenio, Giuseppe; Poli, Cecilia; Daniele, Carla; Grigioni, Mauro
Contact lens are a widespread medical device. In view of the importance of a proper oxygenation of the cornea, new materials are continuously being tested, with a high permeability to oxygen. Taking into account the limitations of the methods for testing soft contact lenses, as presented in the relevant international standards, this paper focuses on the polarographic method and on the approach of measuring oxygen permeability of stacked contact lenses. The effect of the interspersed saline solution layers on the measurable permeability of the stack is considered, using Fick's law of diffusive flux, and a proposal for accuracy improvement in oxygen permeability measurements is presented.
Tsukiyama, Junko; Miyamoto, Yuko; Kodama, Aya; Fukuda, Masahiko; Shimomura, Yoshikazu
Previous reports showed that cosmetic cleansing oil for removing makeup, which contains mineral oil and surfactant, can deform some silicone hydrogel contact lenses (SHCLs) when applied directly to the lenses, although plasma-coated SHCLs (lotrafilcon A and B) were not affected. In the present study, we investigated hydrogel lenses and SHCLs in both wet and dry conditions. Several brands of hydrogel and SHCLs were immersed in a cleansing oil solution containing Sudan Black B for 5 min under wet and dry conditions. The lenses under the wet condition were simply picked up from the saline, whereas those under the dry condition were blotted with paper wipes. After immersing, the excess solution remaining on the lenses was removed by finger rubbing with a multipurpose solution. The lenses were then examined using a stereomicroscope, and their mean brightness was measured and compared. The cosmetic cleansing oil was not absorbed by the hydrogel lenses under wet or dry conditions. However, four of seven brands of SHCLs absorbed the cosmetic cleansing oil under both conditions (dry and wet), whereas asmofilcon A absorbed it only under the dry condition. Lotrafilcon B and delefilcon A did not absorb cleansing oil even under the dry condition. Hydrogel lenses resist cosmetic cleansing oil. However, SHCLs have different degrees of resistance depending on the lens material. Some SHCLs absorbed cosmetic cleansing oil more under dry conditions than under wet conditions.
Tuli, Sonal S; Iyer, Sandhya A; Driebe, William T
To review studies of fungal keratitis related to contact lenses and determine whether the recent insurgence is a new phenomenon or an exacerbation of an ongoing trend. A review of the recent literature on contact lens-related fungal ulcers and a comparison to older studies. The incidence of fungal keratitis associated with contact lenses increased from 5% in the 1980s to between 10% and 25% in the 1990s and was noted to be 44% in Florida at the turn of the century. The most recent study from Florida showed that the incidence had increased from 29% in the late 1990s to 52% in the early 2000s, even before the Fusarium keratitis epidemic in 2004 and 2005. This increase mainly represented an increase in the number related to nontherapeutic contact lenses. Contact lens-related fungal keratitis was relatively rare 20 years ago. However, the incidence has progressively increased since then. Contact lens-related fungal ulcers had become more common even before the recent Fusarium keratitis epidemic. This change may be related to changing contact lens care habits and younger patients being fitted with contact lenses.
It is well established that both acute and chronic ultraviolet (UV) exposure can lead to various ophthalmic pathologic conditions in the anterior segment. Several scientific studies have demonstrated that after UV exposure, the unprotected cornea is vulnerable to damage in the epithelial, stromal, and endothelial cellular layers. DNA damage, apoptosis, and altered protease expression are all examples of harmful changes that can occur within the cornea after irradiation. Beyond the cornea, damage associated with UV exposure, such as decreased antioxidant levels and increased reactive oxygen species production, has been noted in the aqueous humor and crystalline lens. Ultraviolet-blocking contact lenses have the potential to provide protection against such exposure to harmful UV radiation. Experimental use of UV-absorbing contact lenses prevented detrimental cellular changes to the cornea and maintained corneal clarity after UV exposure. Additionally, studies suggest that shielding the aqueous humor and crystalline lens from irradiation with UV-absorbing contact lenses aids in protection against precataractous changes. Despite ongoing research, to date, neither chronic nor clinical studies have been performed in humans to demonstrate that wearing UV-blocking contact lenses reduces the risk of developing cataracts or other ocular disorders within the anterior segment. This article will discuss the impact of UV exposure on ocular tissue and the need for adequate UV protection, with particular emphasis on UV-blocking contact lenses.
Kramann, Christina; Boehm, Nils; Lorenz, Katrin; Wehrwein, Nelli; Stoffelns, Bernhard M; Pfeiffer, Norbert; Grus, Franz H
The aim of this study was to analyze and compare the effects of rigid gas permeable and soft contact lenses on the protein composition in the tear film of contact lens wearers. Wearers of soft contact lenses (CL_S, n = 13) and rigid gas permeable contact lenses (CL_H, n = 13) were recruited for this study. Thirteen non-contact lens wearers were also included as the control. Tears were collected using Schirmer strips and frozen until use. The tears were eluted and analyzed on ProteinChips SELDI-TOF (surface-enhanced laser desorption and ionization in time of flight mass spectrometry; Bio-Rad, USA) with different chromatographic surfaces (cationic and anionic exchanger and reversed phase surface). The SELDI spectra were analyzed by multivariate statistical analysis and artificial neural networks in order to find a biomarker panel which differentiates best between the groups. In order to identify protein/peptide peaks from SELDI spectra which showed a significant difference between groups, fractionated tear samples were analyzed using MALDI-TOF MS (matrix-assisted laser desorption/ionization time-of-flight mass spectrometry). For validation of biomarkers, we used an antibody microarray approach. Complex patterns of tear proteins and peptides were detected in the control group and in both contact lens groups. The tear protein composition in both wearers of rigid gas permeable (CL_H) and soft contact lenses (CL_S) differed significantly from protein composition in non-contact lens wearers (p < 0.01). The identification of biomarkers revealed an increase of Protein S100 A8 in the group of wearers of soft contact lenses (CL_S) and a decrease of a main tear protein, lysozyme, in both contact lens groups. The identified biomarker cystatin was upregulated in the group of rigid gas permeable lens wearers (CL_H), whereas the protein intensity of secretoglobin was significantly reduced in this group. Using the microarray approach, detected alterations could be
Zhu, Qiurong; Yang, Bi; Deng, Nan; Li, Yifan; Wang, Tingwei; Qi, Huang; Liu, Longqian
To assess the prevalence and general knowledge of contact lens wearers among college students in Chengdu, a metroplolitan of Chinaand find out the routine habits of use and hygienic conditions when wearing contact lenses. The questionnaire was distributed to 1,600 ametropic participants who were from 8 different universities. Data about demographics, general contact lens handling habits, personal attitudes, hygiene behaviors and eye health conditions were collected. We made the analysis ofthe demographics and wearing of contact lenses. Possible reasons for behaviors related to the care of contact lenses were analyzed. The prevalence of contact lens use was 19.80%. Most users (82.15%) were females. An aesthetic effect was cited as the first reason for using (57.91%). The comfort of eyes was the first consideration (75.76%) when buying. To keep clean and use safe, 86.20% subjects washed hands before handling and 83.50% cleaned the lens carefully after removing. There was significant difference between males and females regarding the replacement of the solution (p=0.014). 32.66% wears knew the removal of protein deposits. A total of 54.88% were not informed of the potential complications of contact lens. The incidence of ocular discomfort was 44.78%. Only 3.03% of the students paid regular visits to ophthalmic clinics. The prevalence of contact lenses was relatively low in Chengdu. The wears had limited knowledge about using and careof contact lens. More education on standard lens wear and care should be provided to wearers. Copyright © 2018 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Reverey, Julia F; Fromme, Roland; Leippe, Matthias; Selhuber-Unkel, Christine
To compare the potential of different soft contact lenses to be contaminated with Acanthamoeba castellanii as a function of material parameters and cleaning procedures. Different unworn soft hydrogel and silicone hydrogel contact lenses were incubated with human pathogenic A. castellanii. The adhesion of the acanthamoebae was investigated on the contact lenses and put into relation to their material parameters. The efficacy of a recommended contact lens cleaning procedure in reducing A. castellanii adhesion was investigated. We found that material parameters such as elastic modulus, silicone content, ionic properties and swelling do not influence the adhesion of acanthamoebae to soft contact lenses. A material parameter that influenced adhesion significantly was the water content of the lens. With increasing water content, the adhesion of acanthamoebae increased. By following the cleaning instructions of the manufacturer the contamination of the lenses with A. castellanii could be reduced to a minimum, as shown both on contact lenses and in control experiments. With this study we show that for the tested lenses, the adhesion of A. castellanii to contact lenses is independent of the silicone content of the lens, but depends nonlinearly on the water content of the lens. Furthermore, we demonstrate that applying proper lens cleaning procedures minimizes the risk of acanthamoebae adhesion to contact lenses. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Simmons, P A; Tomlinson, A; Connor, R; Hay, J; Seal, D V
Attachment of Acanthamoeba species to hydrogel contact lenses is a possible route of infection in Acanthamoeba keratitis. In this study, Acanthamoeba adsorption was compared with extent of lens deposition in worn lenses of different hydrogel polymers. After wear, lenses (80 lenses of 5 different types) were analyzed for total protein, surface area of deposition, and Acanthamoeba castellani trophozoite and cyst adsorption. Adsorption of Acanthamoeba trophozoites to worn lenses was greater than adsorption to unworn lenses for four of the five lens polymers (p < 0.01). Adsorption of cysts was greater for one of the five lens polymers (p < 0.001); all other adsorption assays showed no change with wear (p > 0.05). Adsorption was affected by both the water content and ionicity of the lens polymer. These results show that adsorption of Acanthamoeba to worn hydrogel contact lenses is greater than or equal to adsorption to unworn lenses.
Lin, Meng C.; Svitova, Tatyana F.
Purpose To investigate the release of surface-active agents (surfactants) from unworn soft contact lenses and their influence on the lens surface wettability in vitro. Methods Surface tension (ST) of blister pack solutions was measured by pendant-drop technique. STs at the air-aqueous interface and contact angles (CAs) of four conventional and seven silicone hydrogel (SiH) soft contact lenses (SCLs) were evaluated in a dynamic-cycling regime using a modified captive-bubble tensiometer-goniometer. Measurements were performed immediately after removal from blister packs, and after soaking in a glass vial filled with a surfactant-free solution, which was replaced daily for one week. Lens surface wettability was expressed as adhesion energy (AE) according to Young’s equation. Results STs of all blister pack solutions were lower than the reference ST of pure water (72.5 mN/m), indicating the presence of surfactants. When lenses were depleted of surfactants by soaking, the STs of all studied lenses and advancing CAs of selected lenses increased (p < 0.001). Receding CAs of all studied lenses were 12° ± 5° and were not affected by the presence of surfactants. For most of the conventional lenses, the surface wettability was largely dependent on surfactants, and reduced significantly after surfactant depletion. In contrast, most SiH lenses exhibited stable and self-sustained surface wettability in vitro. Conclusions The manufacturer-added surfactants affected wetting properties of all studied SCLs, although to different degrees. PMID:20400924
Cheng, Lily; Muller, Susan J; Radke, Clayton J
Modern application of soft contact lenses demands safe and comfortable wear over extended time periods up to one month. Lenses that exhibit and sustain complete water wetting allow thick tear-film deposition, minimize film rupture, and permit smooth tear recovery upon lid closure. Water contact angles determined using an air bubble captive on a lens best gauge the in-vivo wetting state. To achieve highly water wetting lenses demands that contact-angle hysteresis be eliminated and that the advancing and receding angles both approach zero. Since lens wear exposes the anterior surface to tear proteins, lens wettability should be measured in the presence of tear-film components. A captive-bubble technique is applied to measure the advancing and receding contact angles of two commercial silicone-hydrogel lenses: PureVision (PV) and Focus Night & Day (CF) and a standard HEMA (hydroxethyl-methacrylate) hydrogel lens: Acuvue (AV). In the captive-bubble method, an air bubble immersed in aqueous solution is brought into contact with the contact lens. The contact angle through water during bubble expansion yields the receding angle. Bubble contraction gives the water advancing angle. Contact-angle hysteresis is the difference between the advancing and receding angles. In isotonic solution, all three lenses display considerable contact-angle hysteresis with advancing angles of almost 90 degrees. When lysozyme and/or mucin were added to the aqueous solution, hysteresis was eliminated, and equivalent and high water wetting was achieved for the three lenses. Only the advancing angle in isotonic solution provided discriminating evidence for differences in surface chemistry. Covalent attachment of polyethyleneglygol (PEG) to the PV lens surface achieved complete water wetting independent of the presence of tear protein in the solution. The captive-bubble technique provides contact angles that are relevant to on-eye lens wear. Both advancing and receding contact angles are important
Kim, Joohee; Kim, Minji; Lee, Mi-Sun; Kim, Kukjoo; Ji, Sangyoon; Kim, Yun-Tae; Park, Jihun; Na, Kyungmin; Bae, Kwi-Hyun; Kyun Kim, Hong; Bien, Franklin; Young Lee, Chang; Park, Jang-Ung
Wearable contact lenses which can monitor physiological parameters have attracted substantial interests due to the capability of direct detection of biomarkers contained in body fluids. However, previously reported contact lens sensors can only monitor a single analyte at a time. Furthermore, such ocular contact lenses generally obstruct the field of vision of the subject. Here, we developed a multifunctional contact lens sensor that alleviates some of these limitations since it was developed on an actual ocular contact lens. It was also designed to monitor glucose within tears, as well as intraocular pressure using the resistance and capacitance of the electronic device. Furthermore, in-vivo and in-vitro tests using a live rabbit and bovine eyeball demonstrated its reliable operation. Our developed contact lens sensor can measure the glucose level in tear fluid and intraocular pressure simultaneously but yet independently based on different electrical responses.
Kim, Joohee; Kim, Minji; Lee, Mi-Sun; Kim, Kukjoo; Ji, Sangyoon; Kim, Yun-Tae; Park, Jihun; Na, Kyungmin; Bae, Kwi-Hyun; Kyun Kim, Hong; Bien, Franklin; Young Lee, Chang; Park, Jang-Ung
Wearable contact lenses which can monitor physiological parameters have attracted substantial interests due to the capability of direct detection of biomarkers contained in body fluids. However, previously reported contact lens sensors can only monitor a single analyte at a time. Furthermore, such ocular contact lenses generally obstruct the field of vision of the subject. Here, we developed a multifunctional contact lens sensor that alleviates some of these limitations since it was developed on an actual ocular contact lens. It was also designed to monitor glucose within tears, as well as intraocular pressure using the resistance and capacitance of the electronic device. Furthermore, in-vivo and in-vitro tests using a live rabbit and bovine eyeball demonstrated its reliable operation. Our developed contact lens sensor can measure the glucose level in tear fluid and intraocular pressure simultaneously but yet independently based on different electrical responses. PMID:28447604
Willcox, Mark D.P.; Hume, Emma B.H.; Vijay, Ajay K.; Petcavich, Robert
Purpose To examine the ability of silver nano-particles to prevent the growth of Pseudomonas aeruginosa and Staphylococcus aureus in solution or when adsorbed into contact lenses. To examine the ability of silver nano-particles to prevent the growth of Acanthamoeba castellanii. Methods Etafilcon A lenses were soaked in various concentrations of silver nano-particles. Bacterial cells were then exposed to these lenses, and numbers of viable cells on lens surface or in solution compared to etafilcon A lenses not soaked in silver. Acanthamoeba trophozoites were exposed to silver nano-particles and their ability to form tracks was examined. Results Silver nano-particle containing lenses reduced bacterial viability and adhesion. There was a dose-dependent response curve, with 10 ppm or 20 ppm silver showing > 5 log reduction in bacterial viability in solution or on the lens surface. For Acanthamoeba, 20 ppm silver reduced the ability to form tracks by approximately 1 log unit. Conclusions Silver nanoparticles are effective antimicrobial agents, and can reduce the ability of viable bacterial cells to colonise contact lenses once incorporated into the lens.
Nakagawara, Van B; Wood, Kathryn J; Montgomery, Ron W
Since 1976, the use of contact lenses by civilian pilots has been permitted to correct distant vision for obtaining a Federal Aviation Administration (FAA) aeromedical certificate. This study examined the civil airman population's experience with contact lens use for a 30-year period (1967 to 1997). Population totals for airmen who carried pathology codes 161 (contact lens) and 158 (orthokeratology) from January 1, 1967 through December 31, 1997 were used to calculate prevalence rates by class of medical certificate and age. The National Transportation Safety Board and FAA databases were queried to determine if contact lens use had contributed to aviation mishaps. The prevalence of contact lens use grew faster for first-class medical certificate holders and airmen > or = 40 years of age during the period. The frequency of airmen with orthokeratology increased by 23 times in a 10-year period. Reports from five aviation accidents and one incident suggested that contact lens use was a contributing factor in these mishaps. Professional pilots and older airmen were found to be more inclined to use contact lenses. The increasing use of contact lenses and the rapid changes in contact lens technology warrant continued monitoring to ensure aviation safety.
Ben Yaish, Shai; Zlotnik, Alex; Raveh, Ido; Yehezkel, Oren; Belkin, Michael; Lahav, Karen; Zalevsky, Zeev
We present novel technology for extension in depth of focus of imaging lenses for use in ophthalmic lenses correcting myopia, hyperopia with regular/irregular astigmatism and presbyopia. This technology produces continuous focus without appreciable loss of energy. It is incorporated as a coating or engraving on the surface for spectacles, contact or intraocular lenses. It was fabricated and tested in simulations and in clinical trials. From the various testing this technology seems to provide a satisfactory single-lens solution. Obtained performance is apparently better than those of existing multi/bifocal lenses and it is modular enough to provide solution to various ophthalmic applications.
Alipur, Fateme; Hosseini, Seyedeh Simindokht
To evaluate visual results, comfort of use, safety, and efficacy of mini scleral contact lenses in optical management in patients with traumatic aphakia and severe concomitant irido-corneal injury. In a case series, eight eyes with post traumatic aphakia and severe concomitant irido-corneal injury that were evaluated at the Contact Lens Clinic of Farabi Eye Hospital, Tehran, Iran for contact lens fitting and could not be corrected with conventional corneal RGP contact lenses were fitted with miniscleral contact lenses. Uncorrected visual acuity (UCVA), best spectacle corrected visual acuity (BSCVA), and BCVA (Best corrected visual acuity) with miniscleral lens were recorded. Slit lamp examination, comfortable daily wearing time, and any contact lens-related complication were documented in each follow-up visit. The mean UCVA and BSCVA of the cases was >2.7 and 0.41 LogMAR, respectively (BSCVA could not be assessed in one case due to severe corneal irregularity). The mean final BCVA with the miniscleral lens was 0.05 LogMAR (range from 0.4 to -0.04 LogMAR). The mean follow-up period was 14.6 months. The mean comfortable daily wearing time (CDWT) was 11.6 h, ranging from 8 to 16 h. The only contact lens-related complication was mild redness and irritation that was observed in 2 patients during the follow-up visits. All patients were comfortable with handling these lenses. Miniscleral contact lenses can be considered a safe and effective option in aphakia patients with concurrent corneal scarring secondary to ocular injury for whom surgical intervention would be complicated.
McAnally, Cindy; Bartell, John
Objective: The aim of this study was to use antimicrobial efficacy endpoint methodology to determine compatibility of multipurpose disinfecting solutions (MPSs), lens cases, and hydrogel lenses for disinfection (AEEMC) against International Organization for Standardization (ISO)–specified microorganisms and clinical ocular isolates of Stenotrophomonas maltophilia. Methods: Six MPSs (PQ/Aldox 1, 2, and 3; PQ/Alexidine; PQ/PHMB; and PHMB) were challenged against ISO-specified microorganisms and S. maltophilia using the AEEMC test. AEEMC tests were performed with and without balafilcon A, etafilcon A, and senofilcon A lenses in lens cases with organic soil. Exposure times included disinfection time (DT) and 24 hr. Additionally, all six MPSs were challenged with two strains of S. maltophilia, based on the ISO Stand-alone test. Results: The efficacy against bacteria for PQ/Aldox and PQ/Alexidine MPSs was not diminished by the presence of lenses. The efficacy of PQ/PHMB and PHMB MPSs against Serratia marcescens was significantly reduced compared with the no-lens control at DT for at least one lens type. The PHMB MPS with lenses present also demonstrated reduced efficacy against Staphylococcus aureus at DT versus the control. PQ/Aldox MPSs retained activity against Fusarium solani with lenses present; however, all other test MPSs demonstrated reduced F. solani efficacy at DT with lenses present. With lenses, all MPSs showed reduced efficacy against Candida albicans. Conclusions: AEEMC antimicrobial efficacy test results vary based on challenge microorganism, contact lenses, and MPS biocide systems. This study highlights the importance of evaluating MPSs for compatibility with lenses and lens cases. PMID:27598555
Gabriel, Manal M; McAnally, Cindy; Bartell, John
The aim of this study was to use antimicrobial efficacy endpoint methodology to determine compatibility of multipurpose disinfecting solutions (MPSs), lens cases, and hydrogel lenses for disinfection (AEEMC) against International Organization for Standardization (ISO)-specified microorganisms and clinical ocular isolates of Stenotrophomonas maltophilia. Six MPSs (PQ/Aldox 1, 2, and 3; PQ/Alexidine; PQ/PHMB; and PHMB) were challenged against ISO-specified microorganisms and S. maltophilia using the AEEMC test. AEEMC tests were performed with and without balafilcon A, etafilcon A, and senofilcon A lenses in lens cases with organic soil. Exposure times included disinfection time (DT) and 24 hr. Additionally, all six MPSs were challenged with two strains of S. maltophilia, based on the ISO Stand-alone test. The efficacy against bacteria for PQ/Aldox and PQ/Alexidine MPSs was not diminished by the presence of lenses. The efficacy of PQ/PHMB and PHMB MPSs against Serratia marcescens was significantly reduced compared with the no-lens control at DT for at least one lens type. The PHMB MPS with lenses present also demonstrated reduced efficacy against Staphylococcus aureus at DT versus the control. PQ/Aldox MPSs retained activity against Fusarium solani with lenses present; however, all other test MPSs demonstrated reduced F. solani efficacy at DT with lenses present. With lenses, all MPSs showed reduced efficacy against Candida albicans. AEEMC antimicrobial efficacy test results vary based on challenge microorganism, contact lenses, and MPS biocide systems. This study highlights the importance of evaluating MPSs for compatibility with lenses and lens cases.
Panek, W C; Boothe, W A; Lee, D A; Zemplenyi, E; Pettit, T H
We evaluated a miniaturized digital and electronic tonometer, the Tono-Pen, for accuracy of intraocular pressure measurement in the presence of a contact lens. In the manometric study, the Tono-Pen was used to measure a known intraocular pressure, ranging from 10 mm Hg to 60 mm Hg in a cadaver eye over soft contact lenses with different powers and a plano-T bandage lens. There was significant bias in pressure measurement over all contact lenses except for the plano-T, which had no bias at any level. In the clinical study, the intraocular pressures of 40 eyes in 20 normal patients were measured with and without a plano-T contact lens in place. Analysis of variance showed no significant interactive effect between the right and left eyes, with or without the lens. There was no significant difference in the Tono-Pen measurement of intraocular pressure over a plano-T contact lens compared with no lens.
Kollbaum, Pete S.; Bradley, Arthur; Thibos, Larry N.
Purpose The purpose of the current study was to examine the on- and off-eye optical performance of two types of soft contact lenses (hydrogel and silicone hydrogel). Methods The monochromatic aberrations (lambda = 850 nm) of contact lenses were measured on-eye using a clinical Shack-Hartmann ocular aberrometer. Additionally, we used an off-eye single-pass contact lens aberrometer (lambda = 540 nm) in which the soft contact lens was placed within a wet cell. Comparison of the lower and higher order aberrations measured with these two methods required compensation for different wavelengths and knowledge of the refractive index of the contact lens materials. Results The measured on-eye sphere and spherical aberration values were generally similar to those measured off-eye and those specified by the lens manufacturers for both types of soft contact lenses. However, there were notable differences, especially for high plus-powered lenses, which typically exhibited lower sphere power on the eye than expected from the lens specifications and from the off-eye measured powers, both of which were almost identical. Longitudinal spherical aberration varied with lens power in the hydrogel lenses, as expected from geometrical optics theory. Longitudinal spherical aberration measurements on- and off-eye, however, deviated significantly from that expected of a thin lens with spherical surfaces due to surface asphericities. The difference between on- and off-eye optics can be modeled as a tear lens, or as relative lens thickness changes caused by lens flexure. Conclusions The results of the current study reveal that the major difference between the on-eye lens optics and the manufacturers’ specifications are not due to lens errors, but due to eye-lens interactions, which could be either lens flexure or a tear lens forming behind the soft contact lens. PMID:23969894
Laser-Assisted In Situ Keratomileusis; Laser vision correction; Nearsightedness - Lasik; Myopia - Lasik ... length of the eye. LASIK uses an excimer laser (an ultraviolet laser) to remove a thin layer ...
Maulvi, Furqan A; Choksi, Harsh H; Desai, Ankita R; Patel, Akanksha S; Ranch, Ketan M; Vyas, Bhavin A; Shah, Dinesh O
In the present work a novel cyclosporine-loaded Eudragit S100 (pH-sensitive) nanoparticles-laden contact lenses were designed to provide sustained release of cyclosporine at therapeutic rates, without leaching of drug during sterilization and storage period (shelf life). The nanoparticles were prepared by Quasi-emulsion solvent diffusion technique using different weight ratios of cyclosporine to Eudragit S100. The contact lenses with direct drug entrapment were also fabricated (DL-50) for comparison. The percentage swelling and optical transparency of nanoparticles-laden contact lenses were improved in comparison to DL-50 lenses. The nanoparticles-laden contact lenses showed sustained drug release profiles, with inverse relationship to the amount of nanoparticles loaded in the contact lenses. It was interesting to note that nanoparticles form nanochannels/cavities after dissolution of Eudragit S 100 in tear fluid pH=7.4 (in vitro release study). This followed the precipitation of drug in hydrogel matrix of contact lenses. As the amount of nanoparticles loading increased, more number of cavities were formed, which caused the formation of large cavities in contact lens matrix. This in turn precipitated the drug. The nanoparticles-laden contact lenses with 1:1 (drug: Eudragit) weight ratio showed the most promising results of sustaining the drug release up to 156h, without affecting optical and physical properties of contact lenses. Packaging study confirmed that the drug was not leached in packaging solution (buffer, pH=6.5) from nanoparticles-laden lenses during shelf life period. In-vivo study in rabbit tear fluid showed sustained release up to 14days. The study revealed the application of pH-sensitive nanoparticles-laden contact lenses for controlled release of cyclosporine without altering the optical and physical properties of lens material. Copyright © 2017 Elsevier B.V. All rights reserved.
Pearson, R M; Efron, N
In celebration of the centenary of August Müller's pioneering work on contact lenses, we present, for the first time, a full translation into English of Part III of his inaugural dissertation. Müller describes his attempts to correct his own -14.00 diopters of myopia with "cornea-lenses," which were essentially glass scleral lenses. His inability to tolerate lens wear for more than half an hour was probably due to a) limbal pressure as a result of the primary optic diameter being too small, and b) the use of water to occupy the space between the lens and cornea, which would have induced severe corneal edema. Many of the observations and recommendations embodied in Müller's thesis, such as the importance of a good fit, adequate tear flow and rounded edges, are still relevant to contact lens practice today.
Menzies, Kara L; Rogers, Ronan; Jones, Lyndon
The purpose of this study was to measure the advancing and receding contact angles (CAs) of five daily disposable (DD) lenses and the osmolality, surface tension (ST), and pH of each blister pack solution. The advancing and receding CAs were measured directly out of the blister pack for five DD lenses: omafilcon A (CooperVision), nelfilcon A (CIBA Vision), modified nelfilcon A (CIBA Vision), etafilcon A (Johnson & Johnson), and narafilcon A (Johnson & Johnson). Advancing CAs were measured using sessile drop and Wilhelmy balance methods. Receding CAs were measured using the Wilhelmy balance method. ST, pH, and osmolality were measured for each blister pack solution from all the DD lenses. The advancing CAs for the nelfilcon A lenses were statistically lower (P<0.05) than the advancing CAs of the other three lenses. The receding CAs for etafilcon A were statistically lower (P<0.05) than the receding CAs for the other four lenses. The pH of all the blister pack solutions was relatively neutral (7.01-7.43). The ST of the blister pack solution for the modified nelfilcon A was significantly lower (P<0.05) than the ST of all other blister pack solutions. The osmolality of the blister pack solutions for the etafilcon A and narafilcon A lenses were significantly higher (P<0.05) than the other blister pack solutions. The modified nelfilcon A lens had low advancing CAs and low receding CAs showing minimal hysteresis. The blister pack solution for the modified nelfilcon A lens had the lowest ST, a low osmolality, and a neutral pH.
Wei, Xiaojia; Aliwarga, Yulina; Carnt, Nicole A.; Garrett, Qian; Willcox, Mark D.P.
Purpose Previous studies have demonstrated deposition of tear proteins onto worn contact lenses. In this study, we used proteomic techniques to analyze the protein deposits extracted from worn daily wear silicone hydrogel contact lenses in combination with different lens care solutions. Methods Worn lenses were collected and protein deposits extracted using urea and surfactant. Protein extracts were desalted, concentrated, and then separated using one-dimensional gel electrophoresis. Individual protein components in extracts were identified using liquid chromatography combined with tandem mass spectrometry (LC-MS-MS) after trypsin digestion. Results One-dimensional gel electrophoresis revealed that lysozyme and other small proteins (around 20 kDa) were the most abundant proteins in the extracts. LC-MS-MS revealed a wide array of proteins in lens extracts with lysozyme and lipocalin 1 being the most commonly identified in deposit extracts. Conclusions Worn contact lenses deposit a wide array of proteins from tear film and other sources. Protein deposit profiles varied and were specific for each contact lens material. PMID:18989384
Seal, D V; Bennett, E S; McFadyen, A K; Todd, E; Tomlinson, A
Acanthamoeba-associated keratitis occurs most often in contact lens wearers. The contact lens material may affect its ability to act as a mechanical vector, permitting transfer of viable amoebae from the storage case to the corneal surface. The purpose of this study was to investigate the effects of ionicity and water content on the comparative quantitative adherence of Acanthamoeba trophozoites and cysts to new, unworn hydrogel contact lenses and rigid gas-permeable contact lens materials. Sixteen quarter segments of each of 8 types of unworn hydrogel lenses representative of FDA groups 1 to 4 were exposed to freshly prepared cultures of either trophozoites or cysts of A. castellanii or A. polyphaga for 1.5 h, and then washed. Three types of rigid lens button were similarly exposed to A. castellanii trophozoites or cysts. Adherent trophozoites and cysts were then enumerated. All hydrogel lenses showed binding of both trophozoites and cysts, with the former predominating in every case. It was primarily the ionic nature of a lens surface and secondly its water content that was associated with increased quantitative adherence of Acanthamoeba. Neither form of the amoebae bound to any of the hard lens buttons. Greater relative potential exists for contamination of ionic and high-water content hydrogels by Acanthamoeba. This combination may influence mechanical transmission of the protozoon to the corneal surface. Adherence to hard lenses (as buttons) did not occur if a postincubation wash step was performed.
... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Rules applicable to prescriptions for contact lenses and related issues. 456.5 Section 456.5 Commercial Practices FEDERAL TRADE COMMISSION TRADE REGULATION RULES OPHTHALMIC PRACTICE RULES (EYEGLASS RULE) § 456.5 Rules applicable to prescriptions for...
Lau, Charis; Tosatti, Samuele; Mundorf, Michelle; Ebare, Kingsley; Osborn Lorenz, Kathrine
Cosmetic contact lenses are increasingly popular because of their eye enhancing cosmetic benefits. The pigment particles used in these lenses can impact lens surface characteristics. This article examines the surface characteristics and the differences between the clear and the pigmented regions among five limbal ring design lenses. Scanning electron microscopy was used to determine the location and depth of the pigment particles from the lens surface. The coefficient of friction (CoF) was determined with a Basalt-MUST microtribometer at clear and pigmented regions on either the front or the back surface. Atomic force microscopy was used to determine the surface roughness of each lens in root-mean-square (RMS) units at clear and pigmented regions. A linear mixed model for repeated measures was used for the analysis of the CoF and RMS roughness to compare all lenses. Four lens types had pigments exposed on the surface and one lens type had pigment fully enclosed. The CoF difference between clear and pigmented regions were similar and not statistically significant (P=0.0124) for the lens type with pigments enclosed, whereas the CoF difference for the other four lens types showed statistically significant difference (P<0.0001). Of the lenses tested here, cosmetic contact lenses with pigments enclosed in the lens matrix provided a more consistent surface between clear and pigmented regions compared with lenses that had exposed pigments.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Pucker, Andrew D; Nichols, Jason J
To determine the impact of the rinse step in "no rub" contact lens care systems relative to its ability to assist in removing loosely associated and bound tear film proteins from a worn silicone hydrogel lens. After informed consent, subjects were fitted with lotrafilcon B contact lenses (CIBA Vision). If the fit was acceptable, subjects were asked to wear the lenses on a daily wear basis for 5 (+2, -0) days for an outcome visit. Subjects were instructed to use AQuify Multi-Purpose Disinfecting Solution (CIBA Vision) following the manufacturer's "no rub" instructions. At the outcome visit, contact lenses were then collected by a gloved examiner, with a sterile metal forceps, who rinsed the right lens but did not rinse the left lens on removal from the eyes. Protein was extracted with a 50:50 0.2% trifluoroacetic acid-acetonitrile solution and quantified using a Bradford analyses. Twenty contact lens wearers were enrolled in this study. For the non-rinsed lenses, the first extraction yielded 13.4 +/- 9.2 microg/lens of protein, whereas the second extraction yielded 5.8 +/- 2.8 microg/lens of protein. For the rinsed lenses, the first extraction yielded an average of 3.0 +/- 1.9 microg/lens of protein, whereas the second extraction yielded an average of 4.0 +/- 2.3 microg/lens. Repeated measures analysis of variance showed a significant interaction (F-statistic = 18.9, p < 0.0001) between the rinse of a lens and extraction number. Rinsing a contact lens after removal from the eye removes well more than one-half of the protein associated with it. Further, to biochemically recover all protein from a silicone hydrogel lens, it may be important to perform more than one chemical extraction from it.
Pucker, Andrew D.; Nichols, Jason J.
PURPOSE To determine the impact of the rinse step in “no rub” contact lens care systems relative to its ability to assist in removing loosely associated and bound tear film proteins from a worn silicone hydrogel lens. METHODS After informed consent, subjects were fitted with lotrafilcon B contact lenses (CIBA Vision, Inc). If the fit was acceptable, subjects were asked to wear the lenses on a daily wear basis for 5 (+2, −0) days for an outcome visit. Subjects were instructed to use AQuify Multi-Purpose Disinfecting Solution (CIBA Vision, Inc) following the manufacturer's “no rub” instructions. At the outcome visit, contact lenses were then collected by a gloved examiner, with a sterile metal forceps, who rinsed the right lens but did not rinse the left lens upon removal from the eyes. Protein was extracted with a 50:50 0.2% trifluoroacetic acid-acetonitrile solution and quantified using a Bradford analyses. RESULTS Twenty contact lens wearers were enrolled in this study. For the non-rinsed lenses, the first extraction yielded 13.4 ± 9.2 µg/lens of protein, while the second extraction yielded 5.8 ± 2.8 µg/lens of protein. For the rinsed lenses, first extraction yielded an average of 3.0 ± 1.9 µg/lens of protein, while the second extraction yielded an average of 4.0 ± 2.3 µg/lens. Repeated measures ANOVA showed a significant interaction (F-statistic = 18.9, p< 0.0001) between the rinse of a lens and extraction number. CONCLUSIONS Rinsing a contact lens following removal from the eye removes well over one-half of the protein associated with it. Further, in order to biochemically recover all protein from a silicone hydrogel lens, it may be important to perform more than one chemical extraction from it. PMID:19609231
Yen, Chih-Ta; Ye, Jhe-Wen
The design of complex contact lenses involves numerous uncertain variables. How to help an optical designer to first design the optimal contact lens to reduce discomfort when wearing a pair of glasses is an essential design concern. This study examined the impact of aberrations on contact lenses to optimize a contact lens design for myopic and astigmatic eyes. In general, two aspherical surfaces can be assembled in an optical system to reduce the overall volume size. However, this design reduces the spherical aberration (SA) values at wide contact radii. The proposed optimization algorithm with optical design can be corrected to improve the SA value and, thus, reduce coma aberration (TCO) values and enhance the modulation transfer function (MTF). This means integrating a modified genetic algorithm (GA) with a neural network (NN) to optimize multiple-quality characteristics, namely the SA, TCO, and MTF, of contact lenses. When the proposed optional weight NN-GA is implemented, the weight values of the fitness function can be varied to adjust system performance. The method simplifies the selection of parameters in the optimization of optical systems. Compared with the traditional CODE V built-in optimal scheme, the proposed scheme is more flexible and intuitive to improve SA, TCO, and MTF values by 50.03%, 45.78%, and 24.7%, respectively.
Atabek Yigit, Elif; Ercal, Nuran
To investigate the use of contact lenses to release N-acetylcysteine (NAC) and N-acetylcysteine amide (NACA) that have frequently used for the treatment of some eye diseases. Three commercial contact lenses were used: Soflens Multi-Focal, 1-Day ACUVUE TruEye, and Frequency 55. All contact lenses were individually kept for 3 days in 10 mL of 3 mM NAC or NACA solutions in phosphate-buffered saline (PBS). After the loading period, the lenses were removed from the solution and put into 5 mL of PBS for 3 days (static mode). During this period, samples were taken at specified times and analyzed by high-pressure liquid chromatography. From the release profiles of NAC and NACA, it was found that both NAC and NACA could be released from the lenses within 72 hours. Frequency 55 released 95.9%±2.7% of loaded NAC and 60.0%±2.1% of loaded NACA in 24 hours, whereas 1-Day ACUVUE TruEye released 80.9%±1.2% of loaded NAC and 54.0%±1.9% of loaded NACA and Soflens Multi-Focal released 72.8%±2.8% of loaded NAC and 51.9%±2.3% of loaded NACA during that same period. The lenses could achieve the appropriate delivery of drugs during their intended time of wear. The amount of released NACA was less than that of NAC because of the more hydrophobic structure of NACA. According to the power law, the values of the exponential constant n were found to be below 0.5, indicating that the behavior observed was "less Fickian".
Lira, M; Santos, L; Azeredo, J; Yebra-Pimentel, E; Real Oliveira, M E C D
The purpose of this work was to evaluate the ability of four silicone-hydrogel contact lenses (galyfilcon A, balafilcon A, lotrafilcon A and lotrafilcon B) to retain their equilibrium water content before and after wear, through measurements of refractive index and compare with that of a conventional disposable hydrogel contact lens (etafilcon A). The refractive indices of 115 contact lenses were measured using an automated refractometer (CLR 12-70, Index Instruments, Cambridge, U.K.) before and after a schedule of daily wear by 58 patients for 30 days in the case of silicone-hydrogel lenses and 15 days for the conventional contact lenses. In the silicone-hydrogel contact lenses the changes on the refractive indices were not statistically significant, however after being worn the refractive index of the conventional etalfilcon A hydrogel contact lens increased significantly (p<0.001). The results presented here show that after being worn the silicone-hydrogel contact lens, show more capacity to retain or to reach their initial equilibrium water content than conventional hydrogel contact lenses. This suggests that the silicone-hydrogel contact lenses are less susceptible to spoilation over time maintaining its biocompatibility and contributing to the clinical success of lens performance.
Kelly, L D; Xu, L
Contact lens wear is a predominant risk factor for Acanthamoeba keratitis. The exact nature of the relationship between organism concentration and contact lens adherence is poorly understood. We investigated the effect of Acanthamoeba inoculation concentration on adherence to four categories of contact lenses of varying polymers and water content. Acanthamoeba polyphaga was harvested in log growth phase at 5 days subculture and suspended in PBS at concentrations of 1 x 10(2), 10(3), 10(4), 10(5), and 10(6) organisms/mL (trophozoite:cyst ratio 90:10 +/- 2). Sterile unworn polymacon, etafilcon, lidofilcon, and bufilcon contact lens segments were exposed to Acanthamoeba for 2 hours. Acanthamoeba adherence was quantified using phase contrast microscopy. For all lens types, trophozoite adherence increased as the concentration of inoculum increased, but the relationship was not directly proportional. In all cases the minimal adherence was observed at 10(2). Trophozoite adherence increased disproportionate to cysts for all contact lens types. The greatest adherence was to lidofilcon lenses. At all concentrations adherence was greater to lidofilcon than etafilcon or polymacon, and greater to bufilcon than etafilcon or polymacon at the P < 0.01 level. Adherence was significantly greater to lidofilcon than bufilcon only at 1 x 10(5) and 10(6); P < 0.05 (ANOVA). This study suggests that adherence of A. polyphaga to contact lenses increases with the number of organisms in the inoculum, but the relationship is not directly proportional. The number of adherent organisms varies by contact lens type, with the greatest adherence to lidofilcon and the least to etafilcon lenses.
Shayani Rad, Maryam; Mohajeri, Seyed Ahmad
Ciprofloxacin (Cipro) is an antibiotic, widely used in form of ophthalmic drops (0.3%) for the treatment of eye infections. In this study, vitamin E was used as a hydrophobic barrier to improve and prolong the amount and time of Cipro release from silicone-based soft contact lenses. Three different commercial contact lenses (Air Optix, Biofinity, and Acuvue Oasys) were soaked in vitamin E solutions (0.1 and 0.2 g/mL). The effect of vitamin E on Cipro loading amount and drug releasing profile was evaluated in artificial tear. Swelling properties and diameter changes of the lenses were also investigated in aqueous media in presence and absence of vitamin E. The data indicated that vitamin E, as a hydrophobic barrier, significantly decreased the water content of silicone-based soft contact lenses. After vitamin E loading, a 5% to 18% increase was observed in lens diameter in the hydrated state, whereas the lens diameter increased by 11% to 23% in the dry state. In all commercial lenses, vitamin E loading in a 0.2-g/mL solution caused a 27.94% to 37.08% increase in Cipro binding. The results indicated that applying vitamin E loading solutions, with 0.1 and 0.2 g/mL concentrations, could effectively enhance Cipro release time from 2 hr (in a pure non-vitamin E-loaded lens) to 14 to 17 and 30 to 33 days, respectively. These values showed an increase by a factor of 168 to 204 and 360 to 396 in Cipro release time after using vitamin E loading solutions with 0.1 and 0.2 g/mL concentrations, respectively, compared with pure non-vitamin E-loaded soft contact lenses. This study indicated that vitamin E acts as an effective hydrophobic barrier, in increasing the Cipro loading capacity of silicone-based contact lenses and prolonging the drug release into the artificial tear.
Zimmerman, Aaron B; Marks, Amanda
To report a case of neurotrophic keratitis in which scleral contact lenses improved vision from 20/100 to 20/20, however, due to poor lens care, an incident of microbial keratitis developed. A 64-year-old man with an ocular history of neurotrophic keratitis secondary to herpes simplex in each eye was successfully fit with scleral lenses. He subsequently developed microbial keratitis due to a number of risk factors. The lesion was culture negative, yet was very responsive to treatment with moxifloxacin. The lesion fully healed, and the patient did not suffer additional vision loss. This case demonstrates the ability of scleral lenses to correct visual impairments secondary to poor epithelial integrity and illustrates the importance of the practitioner providing detailed lens care instruction.
Rocha, Guilherme Andrade do Nascimento; Miziara, Patrícia Oliveira Braga; Castro, Ana Clara Vieira de; Rocha, Arthur Andrade do Nascimento
To report the visual rehabilitation outcomes and complications of patients fitted with mini-scleral rigid gas-permeable (RGP) contact lenses (mini-SCLs) after penetrating keratoplasty. We retrospectively reviewed 27 eyes (21 patients) that were fitted with mini-SCLs between October 2013 and December 2014. We analyzed demographic data, previous corneal disorders, visual outcomes, interval from keratoplasty to contact lens fitting, topographic and specular microscope data, fitted contact lens parameters, and complications. The patients were divided into two groups according to the elapsed time since surgery: Group A, grafts with <10 years (n=14 eyes); and Group B, grafts with ≥10 years (n=13 eyes). Lens use was discontinued in four eyes, and microbial keratitis developed in one eye during follow-up. No corneal graft rejection was observed. The mean interval between grafting and initial contact lens fitting was 10.6 ± 7.3 years (range: 1-29 years). The most frequent reason for keratoplasty was keratoconus (22 eyes, 81.4%). The mean contact lens-corrected visual acuity (CLCVA) was 0.09 ± 0.12 logMar (range: 0.50-0.00 logMar). The average topographic astigmatism, mean steepest keratometry (Kmax), and average cellularity on specular microscopy were 6.19 ± 3.49 diopters (D), 58.4 ± 7.8 D, and 1,231 ± 723 cells/mm2, respectively. Mini-SCL use allowed successful visual rehabilitation after corneal keratoplasty, particularly in patients who required corrective lenses for low visual acuity and were unable to wear RGP contact lenses. Our results indicate that mini-scleral lenses may be an option for the treatment of corneal irregularities, such as those associated with keratoplasty.
Vincent, Stephen J
Ocular pathology that manifests at an early age has the potential to alter the vision-dependent emmetropisation mechanism, which co-ordinates ocular growth throughout childhood. The disruption of this feedback mechanism in children with congenital or early-onset visual impairment often results in the development of significant ametropia, including high levels of spherical refractive error, astigmatism and anisometropia. This review examines the use of contact lenses as a refractive correction, low vision aid and therapeutic intervention in the rehabilitation of patients with bilateral, irreversible visual loss due to congenital ocular disease. The advantages and disadvantages of the use of contact lenses for increased magnification (telescopes and microscopes) or field expansion (reverse telescopes) are discussed, along with the benefits and practical considerations for the correction of pathological high myopia. The historical and present use of therapeutic tinted contact lenses to reduce photosensitivity and nystagmus in achromatopsia, albinism and aniridia are also presented, including clinical considerations for the contact lens practitioner. In addition to the known optical benefits in comparison to spectacles for high levels of ametropia (an improved field of view for myopes and fewer inherent oblique aberrations), contact lenses may be of significant psycho-social benefit for patients with low vision, due to enhanced cosmesis and reduced conspicuity and potential related effects of improved self-esteem and peer acceptance. The contact lens correction of patients with congenital vision impairment can be challenging for both practitioner and patient but should be considered as a potential optical or therapeutic solution in modern low vision rehabilitation. © 2017 Optometry Australia.
Sterner, Olof; Aeschlimann, Rudolf; Zürcher, Stefan; Osborn Lorenz, Kathrine; Kakkassery, Joseph; Spencer, Nicholas D; Tosatti, Samuele G P
To characterize the effect of lubricant composition and in vitro ageing on the coefficient of friction (CoF) of a wide range of commercially available soft contact lenses (SCLs). The CoF of SCLs was characterized by means of microtribometry against a mucin-coated glass disk. One reusable (RU) silicone-hydrogel (SiHy) lens, senofilcon A, and two daily disposable (DD) lenses, etafilcon A (hydrogel) and nelfilcon A (hydrogel), were tested under different lubricant solutions, including a tear-like fluid (TLF) containing proteins and lipids. Five RU (balafilcon A [SiHy], comfilcon A [SiHy], etafilcon A [hydrogel], lotrafilcon B [SiHy], senofilcon A [SiHy]) and five DD (delefilcon A [SiHy], etafilcon A [hydrogel; two lens types], narafilcon A [SiHy], nelfilcon A [hydrogel]) lenses were tested before and after exposure to an in vitro ageing process, consisting of continuous immersion and withdrawal from TLF for 18 hours. The CoF in TLF was further compared to previously published data collected in a different lubricant. After in vitro ageing, three RU (balafilcon A, etafilcon A, comfilcon A) and three DD (delefilcon A, etafilcon A, nelfilcon A) lenses displayed a significant increase in CoF (P < 0.05). Lenses that contained poly (vinyl pyrrolidone; PVP) showed unaltered CoF after ageing. An in vitro methodology to simulate in vivo wearing of contact lenses has been proposed. The results suggest that certain lens materials show increased CoF after ageing, with potential clinical implications. The results indicate that the presence of a persistent wetting agent is of advantage to maintain a low CoF after prolonged wearing.
Lee, Ga-Hyun; Lee, Ji-Eun; Park, Mi-Kyung; Yu, Hak-Sun
To evaluate adhesion of Acanthamoeba trophozoites to different silicone hydrogel contact lens (SHCL) generations with and without multipurpose contact lens care solution (MPS) treatment. Acanthamoeba lugdunensis L3a trophozoites were inoculated onto discs trimmed from SHCLs: first generation, Air Optix (Lotrafilcon B) with a plasma surface treatment, second generation, Acuvue Oasys (Senofilcon A), which contains an internal wetting agent (Hydraclear), and third generation, Biofinity (Comfilcon A) with no surface treatment. After 18-hour inoculation, the number of adherent trophozoites on SHCLs was counted as the control under phase contrast microscopy. The effects of the 3 different MPSs, Opti-Free Express, ReNu Fresh, and Biotrue, soaking SHCLs for 6 hours, on Acanthamoeba adhesion were analyzed. Scanning electron microscopic examination was performed for assessment of Acanthamoeba attached on the lens surface. Acanthamoeba trophozoites showed greater adhesion to Air Optix than to Acuvue Oasys and Biofinity (P < 0.05). On Air Optix and Acuvue Oasys, the number of adherent Acanthamoeba was significantly reduced compared with the control after treatment with Opti-Free Express (P < 0.05), but not significantly reduced by treatment with ReNu Fresh and Biotrue (P > 0.05). Acanthamoeba did not adhere to Biofinity regardless of MPSs treatment. Attachment of the acanthopodia of Acanthamoeba on the curved ridge of the Air Optix lens surface was observed. Acanthamoeba showed greater affinity for the first-generation SHCL and seemed to be more attached on SHCLs with more ridges. MPS with myristamidopropyl dimethylamine reduced the adhesion rate.
Polse, Kenneth A
Robert B. Mandell is the quintessential modern clinical scientist. Over his long academic career, he has pioneered many advances in contact lens practice, ranging from a more complete understanding of corneal shape to the effects of contact lenses on corneal health. His classic text, Contact Lens Practice, first published in 1965, was reprinted 14 times in four editions up to 1988. Mandell's contributions to the advancement of the profession of optometry have always been characterized by a genuine concern for the patient and a steadfast belief that his research must have relevance to the practice of optometry.
Anstey, A; Taylor, D; Chalmers, I; Ansari, E
Nine brands of contact lens marketed as "UV protective" were tested for ultraviolet (UV) transmission in order to assess potential suitability for psoralen-sensitised patients. UV-transmission characteristics of hydrated lenses was tested with a Bentham monochromator spectro-radiometer system. All lenses showed minimal transmission loss in the visible band. The performance of the nine lenses was uniform for ultraviolet B radiation with negligible transmission, but showed variation in transmission for ultraviolet A radiation. None of the lenses complied with UV-transmission criteria used previously to assess UV-blocking spectacles. Only two lenses had UV-blocking characteristics which came close to the arbitrary criteria used. The performance of ordinary soft and hard lenses was very similar, with negligible blocking of UV radiation. None of the nine contact lenses marketed as "UV protective" excluded sufficient UVA to comply with criteria in current use to assess UV protection in spectacles for psoralen-sensitised patients. However, the improved UV-blocking characteristics of contact lenses identified in this paper compared to previous studies suggests that such a contact lens will soon become available. Meanwhile, contact lens-wearing systemically sensitised PUVA patients should continue to wear approved spectacles for eye protection whilst photosensitised with psoralen.
Visser, Esther-Simone; Wisse, Robert P L; Soeters, Nienke; Imhof, Saskia M; Van der Lelij, Allegonda
To evaluate the performance of medical contact lenses (CLs) for a wide range of clinical indications. Prospective cross-sectional study. A total of 281 eyes were evaluated in 281 consecutive patients (≥18 years of age; CL use ≥3 months) who visited the contact lens service in a tertiary academic clinic for a scheduled follow-up visit. The main outcome measured were clinical indications for CL wear; CL type; change in corrected distance visual acuity (CDVA) with CL use; CL wearing duration; CL wearing time; subjective performance measured using a visual analog scale (VAS) questionnaire (score range: 0-100); and effectiveness of the lens-selection algorithm. Wearing CLs significantly improved CDVA compared to wearing spectacles (median change: -0.15 logMAR, range: 1.00 to -2.10; P<.001). Daily-wear CLs were worn by 77% of patients for a median of 15h/day (range: 5-18h/day), median 7 days/week (range: 1-7 days/week). High subjective scores were measured, with similar results obtained between the scleral lens and soft lens groups. The medical CL fitting was found to be generally effective (the overall satisfaction rating was ≥70 for 81% of patients). Fitting CLs based on the lens-selection algorithm yielded positive clinical results, including improved visual acuity, satisfactory wearing time, and high overall subjective performance. Moreover, subjective performance was similar between users of scleral lenses and users of soft lenses. These results underscore the importance of prescribing scleral lenses and the need for tertiary eye clinics to offer patients a variety of CL types. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Gause, Samuel; Hsu, Kuan-Hui; Shafor, Chancellor; Dixon, Phillip; Powell, Kristin Conrad; Chauhan, Anuj
Ophthalmic drug for the anterior chamber diseases are delivered into tears by either eye drops or by extended release devices placed in the eyes. The instilled drug exits the eye through various routes including tear drainage into the nose through the canaliculi and transport across various ocular membranes. Understanding the mechanisms relevant to each route can be useful in predicting the dependency of ocular bioavailability on various formulation parameters, such as drug concentration, salinity, viscosity, etc. Mathematical modeling has been developed for each of the routes and validated by comparison with experiments. The individual models can be combined into a system model to predict the fraction of the instilled drug that reaches the target. This review summarizes the individual models for the transport of drugs across the cornea and conjunctiva and the canaliculi tear drainage. It also summarizes the combined tear dynamics model that can predict the ocular bioavailability of drugs instilled as eye drops. The predictions from the individual models and the combined model are in good agreement with experimental data. Both experiments and models predict that the corneal bioavailability for drugs delivered through eye drops is less than 5% due to the small area of the cornea in comparison to the conjunctiva, and the rapid clearance of the instilled solution by tear drainage. A contact lens is a natural choice for delivering drugs to the cornea due to the placement of the contact in the immediate vicinity of the cornea. The drug released by the contact towards the cornea surface is trapped in the post lens tear film for extended duration of at least 30min allowing transport of a large portion into the cornea. The model predictions backed by in vivo animal and clinical data show that the bioavailability increases to about 50% with contact lenses. This realization has encouraged considerable research towards delivering ocular drugs by contact lenses. Commercial
Keir, Nancy; Luensmann, Doerte; Woods, Craig A; Bergenske, Peter; Fahmy, Mary; Fonn, Desmond
To explore the effect of masking on subjective responses when wearing daily disposable (DD) contact lenses. In an adaptation phase, habitual wearers of Manufacturer-A (MFA) (n = 43) and Manufacturer-B (MFB) (n = 53) wore MFA-brand 1 or MFB-brand 1 DDs, respectively, for 30 days, open-label. Subjects were then randomly assigned to one of two experiments. Each experiment included two, 3-day crossover phases. An enhanced version of MFA and MFB lenses (MFA-brand 2 and MFB-brand 2) were worn contralaterally to evaluate potential differences in masking result between manufacturers. Experiment 1: subjects were fully masked to lens and packaging (FM) then unmasked (UM). Experiment 2: subjects were FM then partially masked using an over-label (PM). Comfort ratings (0-100) were recorded for each lens daily and preference between lenses was recorded on day 3 for each crossover phase. The mean difference between 0-100 ratings or preference when FM or PM versus UM for the same lens was considered a measurement of the effect associated with masking. The purpose of the study was withheld from subjects to minimize bias. The effect associated with masking for habitual wearers of MFA and MFB lenses was less than 1 out of 100 (0 ± 2.5) in both experiments. Fifty-eight subjects (60%) expressed no preference when FM. This decreased to 29 (30%) when UM or PM (proportion test, p < 0.001). Approximately half the subjects had a change in lens preference when they were UM or PM, primarily in favor of their habitual lens manufacturer. Masking did not have a measurable impact on 0-100 ratings with the DD lenses used in this study but did have an impact on lens preference. Subjects were more likely to express a preference when they handled the lenses and were exposed to the lens packaging and, in some cases, able to read the lens brand and lens manufacturer.
Costa, Manuel F. M.
Optical triangulation as a non-destructive test method extensively proved its usefulness on the dimensional and topographic inspection of a large range of objects and surfaces. In this communication the issue of microtopographic and thickness inspection of hard contact lenses (RPG) is addressed. The use of optical triangulation is discussed based on the results of the application of our MICROTOP.03.MFC microtopographer to this kind of tasks will be presented.
Zeri, Fabrizio; De Cusatis, Mario; Lupelli, Luigi; Swann, Peter Graham
To investigate if the accuracy of intraocular pressure (IOP) measurements using rebound tonometry over disposable hydrogel (etafilcon A) contact lenses (CL) is affected by the positive power of the CLs. The experimental group comprised 26 subjects, (8 male, 18 female). IOP measurements were undertaken on the subjects' right eyes in random order using a Rebound Tonometer (ICare). The CLs had powers of +2.00D and +6.00D. Measurements were taken over each contact lens and also before and after the CLs had been worn. The IOP measure obtained with both CLs was significantly lower compared to the value without CLs (t test; p<0.001) but no significant difference was found between the two powers of CLs. Rebound tonometry over positive hydrogel CLs leads to a certain degree of IOP underestimation. This result did not change for the two positive lenses used in the experiment, despite their large difference in power and therefore in lens thickness. Optometrists should bear this in mind when measuring IOP with the rebound tonometer over plus power contact lenses. Copyright © 2016 The Authors. Published by Elsevier Espana.. All rights reserved.
Nilagiri, Vinay Kumar; Metlapally, Sangeetha; Kalaiselvan, Parthasarathi; Schor, Clifton M; Bharadwaj, Shrikant R
This study showed an improvement in three-dimensional depth perception of subjects with bilateral and unilateral keratoconus with rigid gas-permeable (RGP) contact lens wear, relative to spectacles. This novel information will aid clinicians to consider RGP contact lenses as a management modality in keratoconic patients complaining of depth-related difficulties with their spectacles. The aim of this study was to systematically compare changes in logMAR acuity and stereoacuity from best-corrected spherocylindrical spectacles to RGP contact lenses in bilateral and unilateral keratoconus vis-à-vis age-matched control subjects. Monocular and binocular logMAR acuity and random-dot stereoacuity were determined in subjects with bilateral (n = 30; 18 to 24 years) and unilateral (n = 10; 18 to 24 years) keratoconus and 20 control subjects using standard psychophysical protocols. Median (25th to 75th interquartile range) monocular (right eye) and binocular logMAR acuity and stereoacuity improved significantly from spectacles to RGP contact lenses in the bilateral keratoconus cohort (P < .001). Only monocular logMAR acuity of affected eye and stereoacuity improved from spectacles to RGP contact lenses in the unilateral keratoconus cohort (P < .001). There was no significant change in the binocular logMAR acuity from spectacles to RGP contact lenses in the unilateral keratoconus cohort. The magnitude of improvement in binocular logMAR acuity and stereoacuity was also greater for the bilateral compared with the unilateral keratoconus cohort. All outcome measures of cases with RGP contact lenses remained poorer than control subjects (P < .001). Binocular resolution and stereoacuity improve from spectacles to RGP contact lenses in bilateral keratoconus, whereas only stereoacuity improves from spectacles to RGP contact lenses in unilateral keratoconus. The magnitude of improvement in visual performance is greater for the binocular compared with the unilateral keratoconus cohort.
Mochizuki, Hiroshi; Yamada, Masakazu; Hatou, Shin; Kawashima, Motoko; Hata, Seiichiro
Recent studies have shown that low tear phospholipid levels are associated with tear film instability in hydrophilic contact lens wearers. The concentration of secretory phospholipase A2 (sPLA2), the enzyme that hydrolyzes phospholipids, in tears is known to exceed the levels found in serum by four orders of magnitude. This study was performed to determine the levels of sPLA2 from the deposition on two different frequent-replacement contact lens materials. Polymacon and etafilcon A contact lenses worn for 2 weeks by 16 experienced contact lens wearers were used for the analysis. Total lipids were determined by the sulfo-phospho-vanillin reaction. Phospholipids in lipid extracts were estimated by phosphorus determination with ammonium molybdate through enzymatic digestion. Total protein was measured by bicinchoninic acid analysis. Double-antibody sandwich enzyme-linked immunosorbent assay was used to determine sPLA2 concentrations. Total lipid deposition was found to be greater in the polymacon group (66.3+/-16.3 microg/lens) than in the etafilcon A group, although phospholipids were not detected in either group. The etafilcon A group had greater deposition of protein (3.7+/-0.7 mg/lens) than the polymacon group had. The etafilcon A group deposited statistically significantly more group IIa sPLA2 (1.1+/-0.3 microg/lens) than the polymacon group (0.07+/-0.04 microg/lens) did (P<0.001). There was a significant difference in the lipid and protein deposition profiles in the two lenses tested. A significant amount of sPLA2 in the deposition on contact lenses may play a role in tear film instability in hydrophilic contact lens wearers.
de Jong, Bram; van der Meulen, Ivanka J E; van Vliet, Johannes M J; Lapid-Gortzak, Ruth; Nieuwendaal, Carla P; van den Berg, Thomas J T P
To study the effects of corneal scars and the treatment of these scars with rigid gas-permeable (RGP) contact lenses on quality of vision including straylight. Visual effects were related to scar characteristics such as size and grade. Straylight and best-corrected visual acuity were measured in 23 patients with corneal scars during and after RGP contact lens wear. Contralateral eyes were used as controls, and age-normal values in case of bilateral scars. Straylight measurements were performed using the compensation comparison method of the Oculus C-Quant instrument. Scarred eye straylight values were 1.53 log(s) without contact lens and 1.60 log(s) with contact lens (P=0.043). Healthy eyes without contact lens had a mean straylight value of 1.13 log(s), corresponding to age-normal values. Contact lens wear increased straylight in healthy eyes to 1.26 log(s) (P<0.001). Visual acuity improved from 0.66 logarithm of minimal angle of resolution (logMAR) to 0.19 logMAR with contact lens wear in eyes with a corneal scar (P<0.001). Corneal scars can have a strong effect on quality of vision by diminishing visual acuity and increasing straylight. The increase in straylight from corneal scars on its own can lead to a serious visual handicap. Contact lens treatment did not improve straylight, but showed a slight worsening. As the recovery of visual acuity with contact lens wear far exceeded straylight increase, contact lenses remain a clinically useful treatment option in most patients with corneal scars.
Bonanno, Joseph A; Clark, Christopher; Pruitt, John; Alvord, Larry
To determine the tear oxygen tension under a variety of conventional and silicone hydrogel contact lenses in human subjects. Three hydrogel and five silicone hydrogel lenses (Dk/t = 17 to 329) were coated on the back surface with an oxygen sensitive, bovine serum albumin-Pd meso-tetra (4-carboxyphenyl) porphine complex (BSA-porphine). Each lens type was placed on the right eye of 15 non-contact lens wearers to obtain a steady-state open eye tear oxygen tension using oxygen sensitive phosphorescence decay of BSA-porphine. A closed-eye oxygen tension estimate was obtained by measuring the change in tear oxygen tension after 5 min of eye closure. In separate experiments, a goggle was placed over the lens wearing eye and a gas mixture (PO2 = 51 torr) flowed over the lens to simulate anterior lens oxygen tension during eye closure. Mean open eye oxygen tension ranged from 58 to 133 torr. Closed eye estimates ranged from 11 to 42 torr. Oxygen tension under the goggle ranged from 8 to 48 torr and was higher than the closed eye estimate for six out of the eight lenses, suggesting that the average closed eye anterior lens surface oxygen tension is <51 torr. For Dk/t >30, the measured tear oxygen tension is significantly lower than that predicted from previous studies. The phosphorescence decay methodology is capable of directly measuring the in vivo post lens PO2 of high Dk/t lenses without disturbing the contact lens or cornea. Our data indicate that increasing Dk/t up to and beyond 140 continues to yield increased flux into the central cornea.
Ascaso, Francisco J; Huerva, Valentín
: The incidence of diabetes mellitus is dramatically increasing in the developed countries. Tight control of blood glucose concentration is crucial to diabetic patients to prevent microvascular complications. Self-monitoring of blood glucose is widely used for controlling blood glucose levels and usually performed by an invasive test using a portable glucometer. Many technologies have been developed over the past decades with the purpose of obtaining a continuous physiological glycemic monitoring. A contact lens is the ideal vehicle for continuous tear glucose monitoring of glucose concentration in tear film. There are several research groups that are working in the development of contact lenses with embedded biosensors for continuously and noninvasively monitoring tear glucose levels. Although numerous aspects must be improved, contact lens technology is one step closer to helping diabetic subjects better manage their condition, and these contact lenses will be able to measure the level of glucose in the wearer's tears and communicate the information to a mobile phone or computer. This article reviews studies on ocular glucose and its monitoring methods as well as the attempts to continuously monitor the concentration of tear glucose by using contact lens-based sensors.
Vijay, Ajay Kumar; Willcox, Mark D P
Contact lens cases become contaminated with microbes during use. We wished to compare the adhesion of uncommon bacterial contaminants isolated from lens cases to contact lenses with and without organic soil. Strains of Delftia acidovorans (001), Stenotrophomonas maltophilia (002 and 006), and Achromobacter xylosoxidans (001) isolated from contact lens cases (test strains) and Pseudomonas aeruginosa (Paer1) isolated from eyes at the time of infiltrative response (control strain) were used. Bacteria were grown and resuspended in phosphate-buffered saline (PBS) or 10% organic soil (heat-killed Saccharomyces cerevisiae resuspended in complement inactivated bovine serum). Two silicone hydrogel (senofilcon A and comfilcon A) and one hydrogel lens (etafilcon A) lens materials were used. Bacteria (1.0×10 and 1.0×10 colony-forming units/mL; CFU/mL) adhered to lenses for 24 hr and the numbers of bacteria adherent to each lens type (with and without organic soil) were estimated by culture. All the four test strains adhered in significantly greater numbers to contact lenses after incubation in inoculum prepared with organic soil compared with PBS-D. acidovorans 001 (0.7 log10 CFU; P<0.05), S. maltophilia 002 (1.7 log10 CFU; P<0.05), S. maltophilia 006 (0.9 log10 CFU; P<0.05), and A. xylosoxidans 001 (0.4 log10 CFU; P<0.05). However, the presence of organic soil did not increase adhesion of P. aeruginosa Paer1 (-0.1 log10 CFU; P>0.05). Achromobacter xylosoxidans 001 (P<0.01), D. acidovorans 001 (P<0.01), and S. maltophilia 002 (P<0.01) significantly differed in their adhesion to the three contact lens materials. Bacteria that are commonly found in contact lens cases adhered to contact lenses in relatively high numbers in the presence of organic soil. This might indicate that a similar phenomenon occurs in the presence of tears. This may facilitate their transfer from the lens to the cornea and the production of corneal infiltrates.
Michaud, Langis; Frenette, Benoît
Purpose. This study aimed to evaluate outcomes from the use of a sodium hyaluronate (SH)-based comfort drop, instilled before the insertion of contact lenses, in a population of symptomatic contact lens wearers. Methods. This was a cross-over, open-label, multi-sites study. Subjects were fitted with silicone hydrogel lenses and followed for two months. Before insertion of the lenses, SH drops was instilled in the lens for half of the group. The other half did the same on the second month. Objectives and subjective outcomes were measured and compared before from baseline with the ones collected after usage of SH drops. PMID:24575306
Thite, Nilesh; Shah, Ukti; Mehta, Jasmin; Jurkus, Janice
To understand the potential barriers, motivators and enablers in dispensing multifocal contact lenses (MFCL). Two focus group discussions were conducted to design questionnaires regarding the prescribing habits for multifocal contact lenses (MFCL). Questions on potential barriers and motivators were included. The questionnaires were distributed among 133 eye care practitioners across Mumbai, India. Practitioners fitting one or less patient per month with MFCL completed the survey describing potential barriers, while those who prescribed more MFCL's per month completed the survey describing enablers and motivators. Responses from 102 practitioners were received. Most common potential barriers in prescribing MFCL were increased chair time (75%), lack of readily available trials (69%) and limitation in power range (63%). Lack of awareness among patients (90%) was the most common barrier from patients' outlook. Professional satisfaction (88%) and better business proposition (82%) were observed as main motivators while availability of the trials (84%) and correct patient selection (82%) were the major enablers. Graduate Optometrists felt dispensing MFCL did not offer a good business proposition (p=0.02). Experienced practitioners were observed to be least motivated (p=0.01) and believed that their patients found these lenses expensive (p=0.02). To enhance the MFCL practice, barriers like lack of awareness and limitations in power range must be addressed. Trial lens availability may motivate practitioners to prescribe MFCL. Further probing is required to understand lack of motivation among experienced practitioners. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.
Harvitt, D M; Bonanno, J A
To develop a noninvasive measurement of tear oxygen tension and to determine tear oxygen tension and calculated oxygen flux rates during wear of contact lenses of varying oxygen transmissibility (Dk/L). The basis of the tear oxygen tension (PO2) measurement is phosphorescence quenching of Pd-meso-tetra-(4-carboxyphenyl) porphine by oxygen. A fiber-optic bundle, positioned approximately 2 mm from a cuvette or from the corneal surface, delivers an excitation flash (< 4 microseconds, 539 +/- 23 nm) and collects the phosphorescence emission (> 645 nm) of the dye at 1 MHz for 2 ms. Porphine (500 microM) + 1% albumin is instilled directly into the tears of a sedated rabbit, and phosphorescence is measured before and after contact lens insertion. Phosphorescence intensity decay lifetimes are related inversely to PO2 and follow the Stern-Volmer relationship. Calibration control experiments revealed a temperature effect on lifetime of 1% per degree, dye concentration independence over a 100-fold dilution, and no significant pH effect between 6.8 and 7.9. Phosphorescence lifetimes indicated that tear PO2 beneath contact lenses reached steady state within 3 to 8 minutes. Mean steady state tear PO2 (mm Hg +/- SE; N > 7) beneath contact lenses was: polymethylmethacrylate (Dk/L = 0), tear PO2 = 0.58 +/- 0.22; Oxyflow f30 (Dk/L = 15.3), tear PO2 = 27.7 +/- 3.4; Fluorex 700 Dk/L = 30), tear PO2 = 52.5 +/- 3.8; Oxyflow 151 (Dk/L = 51.9), tear PO2 = 78.7 +/- 23.9. Steady state tear PO2 beneath an Oxyflow f30 after application of topical anesthetic and 10 minutes of lens wear was 41 +/- 1.2 mm Hg, significantly higher than without anesthetic. Phosphorescence-based measurements allow the direct, sensitive, and noninvasive assessment of oxygen availability beneath a contact lens. Oxygen levels beneath permeable contact lenses found by direct measurement are significantly lower than what mathematical models predict. The measured values, however, are close to PO2 estimates using the
Lin, David Pei-Cheng; Chang, Han-Hsin; Yang, Li-Chien; Huang, Tzu-Ping; Liu, Hsiang-Jui; Chang, Lin-Song; Lin, Chien-Hsun
Purpose Weekly disposable soft contact lenses have been widely used recently, but their shield effects against ultraviolet (UV) irradiation remain to be evaluated. This study investigated the bioprotective effects of several weekly soft contact lenses against UVB irradiation on the corneal surface in a mouse model. Methods Fifty ICR mice were randomly divided into five groups: (1) blank control, (2) exposed to UVB without contact lens protection, (3) exposed to UVB and protected with Vifilcon A contact lenses, (4) exposed to UVB and protected with Etafilcon A contact lenses, and (5) exposed to UVB and protected with HEMA+MA contact lenses. The exposure to UVB irradiation was performed at 0.72 J/cm2/day after anesthesia for a 7-day period, followed by cornea surface assessment for smoothness, opacity, and grading of lissamine green staining. Tissue sections were prepared for hematoxylin and eosin staining and immunohistochemical detection by using antibodies against myeloperoxidase, cytokeratin-5, P63, Ki-67, nuclear factor-kappa B (p65), cyclooxygenase-2, Fas L, and Fas. Results The results showed impaired corneal surface with myeloperoxidase+ polymorphonuclear leukocyte infiltration into the stroma after UVB exposure, in contrast to the intact status of the blank controls. The corneas with Etafilcon A and HEMA+MA contact lenses maintained more cells positive for cytokeratin-5, P63, and Ki-67 compared to those with Vifilcon A or without contact lens protection. Furthermore, less proinflammatory factors, including nuclear factor-kappa (p65), cyclooxygenase-2, Fas L, and Fas, were induced in the corneas protected by Etafilcon A and HEMA+MA. Conclusions This study demonstrated various protective effects of weekly disposable contact lenses against UVB irradiation. The mouse model used in the present study may be used extensively for in vivo assessment of UV shield efficacy. PMID:23734085
Zhou, Bo; Li, Yuanting; Randall, Nicholas X; Li, Lei
The frictional property of soft contact lenses could have a great impact on their clinical performance. However, to date, only a handful of studies have been conducted to understand the friction mechanism(s) of the soft contact lens. In the current paper, the friction of senofilcon-A contact lenses has been studied with a stainless steel ball as the counterface in a saline solution. The load applied was between 0.5 mN and 100 mN and the sliding velocity ranges from 0.01 cm/s to 0.5 cm/s. It was found that the friction force is proportional to normal load as described by Amonton's law and this unexpected behavior can be attributed to the fact that viscous flow contributes little to the overall friction and that solid-solid contact dominates the friction of senofilcon-A. It was also found that the coefficient of the friction increases with the velocity and the quantitative relationship between them can be explained reasonably well with a previously proposed "repulsion-adsorption" model. The impacts of material chemistry, water content, test media, applied load and the sliding velocity on the friction mechanism(s) are also discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.
Porcar, Esteban; Montalt, Juan Carlos; España-Gregori, Enrique; Peris-Martínez, Cristina
To analyse the visual quality achieved by fitting corneo-scleral contact lenses (CScL) in an uncommon case of bilateral keratoconus, high hyperopia and astigmatism. A 45-year-old man presented for eye examination due to the unsatisfactory quality of his vision wearing soft toric contact lenses. He presented high hyperopia and astigmatism with bilateral keratoconus. He was fitted with CScL to correct his irregular astigmatism and ocular aberrations. A diagnostic trial set was used in the fitting process and he was assessed according to standardised fitting methodology. Visual acuity, corneal topography, biometry and ocular aberrations were evaluated. The follow-up period was 1year. The best spectacle-corrected visual acuity was 20/32 with +8.00/-4.50×30° for the right eye (RE) and 20/25 with +7.75/-2.25×120° for the left eye (LE). After CScL fitting, visual acuity was improved to 20/20 and 20/16 for the RE and LE, respectively. The patient wore these contact lenses an average of 13h a day. The total high order aberrations decreased by approximately 79% in the RE (2.37-0.50μm) and 47% in the LE (1.04-0.55μm) after CScL fitting. Visual quality and wearing time were maintained after 1year wearing CScL. In addition, no adverse ocular effects were found during this period. The present case report describes how the patient had CScL fitted successfully for management of keratoconus with high hyperopia and astigmatism. They provided optimal visual quality, along with prolonged use times and no adverse effects to the cornea. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Walline, Jeffrey J; Gaume Giannoni, Amber; Sinnott, Loraine T; Chandler, Moriah A; Huang, Juan; Mutti, Donald O; Jones-Jordan, Lisa A; Berntsen, David A
The Bifocal Lenses In Nearsighted Kids (BLINK) study is the first soft multifocal contact lens myopia control study to compare add powers and measure peripheral refractive error in the vertical meridian, so it will provide important information about the potential mechanism of myopia control. The BLINK study is a National Eye Institute-sponsored, double-masked, randomized clinical trial to investigate the effects of soft multifocal contact lenses on myopia progression. This article describes the subjects' baseline characteristics and study methods. Subjects were 7 to 11 years old, had -0.75 to -5.00 spherical component and less than 1.00 diopter (D) astigmatism, and had 20/25 or better logMAR distance visual acuity with manifest refraction in each eye and with +2.50-D add soft bifocal contact lenses on both eyes. Children were randomly assigned to wear Biofinity single-vision, Biofinity Multifocal "D" with a +1.50-D add power, or Biofinity Multifocal "D" with a +2.50-D add power contact lenses. We examined 443 subjects at the baseline visits, and 294 (66.4%) subjects were enrolled. Of the enrolled subjects, 177 (60.2%) were female, and 200 (68%) were white. The mean (± SD) age was 10.3 ± 1.2 years, and 117 (39.8%) of the eligible subjects were younger than 10 years. The mean spherical equivalent refractive error, measured by cycloplegic autorefraction was -2.39 ± 1.00 D. The best-corrected binocular logMAR visual acuity with glasses was +0.01 ± 0.06 (20/21) at distance and -0.03 ± 0.08 (20/18) at near. The BLINK study subjects are similar to patients who would routinely be eligible for myopia control in practice, so the results will provide clinical information about soft bifocal contact lens myopia control as well as information about the mechanism of the treatment effect, if one occurs.
Filipecki, Jacek; Kotynia, Katarzyna; Filipecka, Katarzyna
Hydrogel and silicone-hydrogel polymeric materials are widely used in ophthalmology for the manufacture of contact lenses. An important aspect is the investigation of the structure of these materials. This study has been conducted in order to compare the degree of disorder and presence of free volumes in the internal structure of the polymeric soft contact lenses Omafilcon A (hydrogel) and Comfilcon A (silicone-hydrogel). Differences in the occurrence of trapping centers for positrons and free volumes between the types of investigated contact lenses have been demonstrated. Two types of polymeric contact lenses were used as materials: Omafilcon A (hydrogel) and Comfilcon A (silicone-hydrogel). The study was performed using positron annihilation lifetime spectroscopy (PALS). When the results of the measurements has been obtained, a graphical curve has created to describe the relationship of the number of annihilation acts in time. Significant changes were observed between the contact lenses investigated in positron trapping in macropores (based on a two-state model) and the presence of free volumes (based on the Tao-Eldrup model). The use of the positron annihilation two-state model made it possible to demonstrate that a higher positron trapping rate in macropores occurs in the silicone-hydrogel contact lens. Additionally, calculations using the Tao-Eldrup model show the existence of free volumes in both types of materials. The size and fraction of free volumes is much larger in the silicone-hydrogel contact lens.
Severinsky, Boris; Behrman, Shmuel; Frucht-Pery, Joseph; Solomon, Abraham
To evaluate the success rate of highly gas permeable scleral contact lenses (SCL) for visual rehabilitation after penetrating keratoplasty (PK), over a period of up to 9 years. A total database of 31 consecutive patient fitted with SCL between January 2004 and December 2009 was retrospectively reviewed. Demographic data, etiology prior to lens fitting, visual outcomes, follow up time and complications were analyzed. All eyes were fitted due to inadequate spectacle-corrected vision after successful penetrating keratoplasty or failure of other contact lens modalities. Out of 31 patients fitted, 28 (33 eyes) continue to wear SCL for periods between 0.5 and 8.8 years. The mean duration of follow-up after contact lens fitting was 5.2 ± 2.2 years. The mean age of corneal graft was 17.6 ± 11.4 years (range 4.3-42), and the mean interval between PK and initial contact lens fitting was 12.2 ± 10.7 years (range 0.7-36.0). The average steepest keratometry of our cohort was 55.0 ± 7.5 diopter (D) and the refractive astigmatism was 8.0 ± 4.4 D. The mean contact lens corrected visual acuity (BCVAcl) was 0.78 ± 0.25 (range 0.3-1.2). Twenty-three (82%) patients achieved a functional vision of 0.5 or more. During the studied period, ten (30.0%) eyes presented at least one graft rejection episode and two eyes (6%) had an episode of microbial keratitis. Corneal transplants of 20 years or more show a higher rate of refits due to ectasia recurrence. Scleral lenses should be considered as lens of choice in eyes with complex corneal geometry, as besides visual rehabilitation, their use may delay or prevent further surgical involvement. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Jones, Lyndon; Powell, Charles H
Contact lens solutions are highly complex mixtures of biocides (preservatives), surfactants, and other agents designed to disinfect, clean, and wet contact lenses. The commercialization of silicone hydrogel (SiHy) lenses has resulted in unique challenges to the manufacturers of contact lens solutions, because the properties of these materials differ markedly from those seen previously with poly-hydroxyethyl methacrylate-based hydrogels. Historically, hydrogel lens uptake and release of low-molecular weight preservatives such as chlorhexidine and thimerosal were known to result in allergic reactions, resulting in corneal irritation, stinging, conjunctival hyperemia, development of corneal infiltrates, palpebral lid changes, and corneal staining. However, little is known about the interaction of modern care systems with modern soft lens materials. Factors to be considered when evaluating the uptake and release of care components include the water content, charge, relative hydrophobicity, surface treatment, and porosity of the lens material, in conjunction with the concentration, charge/molecule, ionicity in the product matrix, molecular weight, and hydrophobicity of the care component in question. These factors control the sorption of the solution components by lenses, resulting in a variety of differences in the amount of the component taken up into the lens material and the amount and rate of subsequent release onto the ocular surface. Because both natural (ocular) and environmental biota become part of the solution-lens system during regimen use of any lens care product, these extraneously introduced substances should also be considered regarding their potential for uptake and either subsequent release onto the ocular surface or functioning as a scaffold for the adhesion of microbes. This article will review current knowledge concerning these interactions and investigate what clinically observable complications may arise from these interactions. It also reviews
Szczotka-Flynn, Loretta; Lass, Jonathan H; Sethi, Ajay; Debanne, Sara; Benetz, Beth Ann; Albright, Matthew; Gillespie, Beth; Kuo, Jana; Jacobs, Michael R; Rimm, Alfred
This study determined which microbiologic, clinical, demographic, and behavioral factors are associated with corneal infiltrative events (CIEs) during continuous wear of silicone hydrogel (SH) contact lenses. Subjects (n = 205) were fitted with lotrafilcon A lenses for continuous wear and observed for 1 year. The main exposures of interest were corneal staining and bacterial lens contamination. Kaplan-Meier (KM) plots were used to estimate the cumulative unadjusted probability of remaining CIE free, and Cox proportional hazards regression was used to model the hazard of having a CIE, as a function of key predictor variables. The KM-unadjusted cumulative probability of remaining CIE free was 73.3%. Approximately 53% of subjects had repeated episodes of corneal staining (mild or greater), and 11.3% had repeated episodes of moderate or greater corneal staining. Corneal staining was not associated with the development of a CIE. The frequency of substantial bacterial bioburden on worn lenses at the time of a CIE was 64.7%, compared with only 12.2% during uncomplicated wear. The presence of substantial lens bacterial bioburden was associated with the development of a CIE (adjusted hazards ratio [HR], 8.66; 95% confidence interval [CI], 2.88-26.01). Smoking was also associated with a CIE (adjusted HR, 4.13; 95% CI, 1.27-13.45). Corneal staining is common during continuous wear of SH lenses, but it is not associated with the development of a CIE. Smoking and substantial lens bacterial bioburden pose prominent risks of a CIE. In this study, more than 70% of the total risk of CIE in those with substantial lens bioburden is attributable to this exposure. (ClinicalTrials.gov number, NCT00727402).
Lass, Jonathan H.; Sethi, Ajay; Debanne, Sara; Benetz, Beth Ann; Albright, Matthew; Gillespie, Beth; Kuo, Jana; Jacobs, Michael R.; Rimm, Alfred
Purpose. This study determined which microbiologic, clinical, demographic, and behavioral factors are associated with corneal infiltrative events (CIEs) during continuous wear of silicone hydrogel (SH) contact lenses. Methods. Subjects (n = 205) were fitted with lotrafilcon A lenses for continuous wear and observed for 1 year. The main exposures of interest were corneal staining and bacterial lens contamination. Kaplan-Meier (KM) plots were used to estimate the cumulative unadjusted probability of remaining CIE free, and Cox proportional hazards regression was used to model the hazard of having a CIE, as a function of key predictor variables. Results. The KM-unadjusted cumulative probability of remaining CIE free was 73.3%. Approximately 53% of subjects had repeated episodes of corneal staining (mild or greater), and 11.3% had repeated episodes of moderate or greater corneal staining. Corneal staining was not associated with the development of a CIE. The frequency of substantial bacterial bioburden on worn lenses at the time of a CIE was 64.7%, compared with only 12.2% during uncomplicated wear. The presence of substantial lens bacterial bioburden was associated with the development of a CIE (adjusted hazards ratio [HR], 8.66; 95% confidence interval [CI], 2.88–26.01). Smoking was also associated with a CIE (adjusted HR, 4.13; 95% CI, 1.27–13.45). Conclusions. Corneal staining is common during continuous wear of SH lenses, but it is not associated with the development of a CIE. Smoking and substantial lens bacterial bioburden pose prominent risks of a CIE. In this study, more than 70% of the total risk of CIE in those with substantial lens bioburden is attributable to this exposure. (ClinicalTrials.gov number, NCT00727402). PMID:20538985
Hiraoka, Takahiro; Ishii, Yuko; Okamoto, Fumiki; Oshika, Tetsuro
To investigate the influence of cosmetically tinted soft contact lenses on ocular higher-order aberrations and visual performance, and to analyze the relationship between these parameters after the lens wear. In 44 eyes of 22 subjects, visual acuity, contrast sensitivity under photopic and mesopic conditions, and ocular higher-order aberrations were evaluated before and after wearing the tinted soft contact lenses (1-day Acuvue Colours; Vistakon, Jacksonville, FL). Contrast sensitivity under a photopic condition was determined at 3, 6, 12, and 18 cycles per degree, and the area under the log contrast sensitivity function (AULCSF) was calculated. Mesopic contrast sensitivity with and without glare was assessed. Ocular higher-order aberrations for a 4-mm pupil were measured, and coma-like, spherical-like, and total higher-order aberrations were determined. The tinted contact lens wearing resulted in significant decreases in log contrast sensitivity at all spatial frequencies (P < 0.05) and AULCSF (P < 0.0001), although 100% contrast visual acuity did not change. Log mesopic contrast sensitivity with and without glare was also reduced significantly by the lens wear (P < 0.0001). The contact lens wear significantly increased coma-like, spherical-like, and total higher-order aberrations (P < 0.0001). The induced changes in higher-order aberrations were analyzed in relation to the changes in contrast sensitivity function. Although the changes in coma-like and spherical-like aberrations did not correlate significantly with those in AULCSF (P > 0.05), the changes in total higher-order aberrations showed a significant correlation with those in AULCSF (P < 0.05). On the other hand, there was no significant relationship between the changes in higher-order aberrations and the changes in log mesopic contrast sensitivity with and without glare (P > 0.05). Cosmetically tinted contact lenses increase ocular higher-order aberrations and worsen contrast sensitivity under both
Contact lens correction for refractive error in patients with monocular visual impairment may be desirable. However, the potential for damage to the sound eye must always be considered in such patients. This report outlines the prescription and management of contact lens wear in a monocular patient. The case report is followed by a discussion of the risks of vision loss associated with contact lens wear. The author conducted a clinical interview, refraction, ocular examination, and contact lens evaluation of a 38-year-old female patient who had undergone a lensectomy in her right eye and the enucleation of her left eye. The patient presented wearing a conventional aphakic hydrogel contact lens in her right eye. She routinely wore her contact lens for up to 16 hours daily and occasionally slept while wearing it. Best-corrected spectacle acuity was 20/40-2 with +13.75 diopter sphere in her right eye. Clinical examination showed 3 to 4 mm of well-perfused neovascularization with associated pannus in the superior quadrant of her cornea and 1 to 2 mm of peripheral neovascularization in the remainder of the cornea. She was refit with a 2-week replacement hydrogel contact lens that partially corrected her refractive error, and she was encouraged to wear polycarbonate spectacles full time for the remainder of her refractive correction and for protection of the right eye. Monocularly impaired patients who choose to wear contact lenses for the correction of refractive error should be aware of the risk of potentially sight-threatening contact lens complications. The importance of meticulous hygiene and appropriate contact lens wearing schedules should be emphasized with monocular patients. They should also be encouraged to wear the appropriate spectacle correction to reduce the risk of injury to their sound eyes.
Tan, Bryan U.; Purcell, Tracy L.; Torres, Luis F.; Schanzlin, David J.
Purpose The objective of this study is to describe the authors’ results with intrastromal corneal ring segments (Intacs) and a new variation of lamellar keratoplasty, termed intralamellar keratoplasty (ILK), for the treatment of keratoconus (KCN) and post–laser-assisted in situ keratomileusis (LASIK) ectasia. Methods A retrospective review of contact lens–intolerant KCN and post-LASIK ectasia cases that had surgery with either Intacs or ILK was performed. The end points were mean uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), spherical equivalent (SE), manifest and topographic cylinder, and restoration of contact lens tolerance. Results Intacs were implanted in 13 keratoconic or post-LASIK ectasia eyes of 11 subjects. Mean UCVA improved by 1 line (range, −5 to +8); mean BCVA improved by 1 line (range, −1 to +4). Mean manifest SE was essentially unchanged. Mean manifest cylinder was reduced by 2.77 diopters (D), mean topographic cylinder was decreased by 2.29 D, and 12 of 13 eyes were successfully able to wear contact lenses. Four eyes with advanced KCN underwent ILK. Mean UCVA improved by 1 line (range, 0 to 12); mean BCVA improved by 4 lines (range, 1 to 10). Mean SE was lessened by 1.13 D. Mean manifest cylinder was reduced by 1.82 D and mean topographic cylinder by 1.14 D. Half the subjects were successfully fit with contact lenses. Conclusion Both Intacs and ILK improved mean UCVA, BCVA, and manifest and topographic astigmatism. In most cases, good contact lens fit was achieved with visual rehabilitation to levels that obviated penetrating keratoplasty. PMID:17471342
Lee, Sangkyu; Jo, Insu; Kang, Sangmin; Jang, Bongchul; Moon, Joonhee; Park, Jong Bo; Lee, Soochang; Rho, Sichul; Kim, Youngsoo; Hong, Byung Hee
Recently, smart contact lenses with electronic circuits have been proposed for various sensor and display applications where the use of flexible and biologically stable electrode materials is essential. Graphene is an atomically thin carbon material with a two-dimensional hexagonal lattice that shows outstanding electrical and mechanical properties as well as excellent biocompatibility. In addition, graphene is capable of protecting eyes from electromagnectic (EM) waves that may cause eye diseases such as cataracts. Here, we report a graphene-based highly conducting contact lens platform that reduces the exposure to EM waves and dehydration. The sheet resistance of the graphene on the contact lens is as low as 593 Ω/sq (±9.3%), which persists in an wet environment. The EM wave shielding function of the graphene-coated contact lens was tested on egg whites exposed to strong EM waves inside a microwave oven. The results show that the EM energy is absorbed by graphene and dissipated in the form of thermal radiation so that the damage on the egg whites can be minimized. We also demonstrated the enhanced dehydration protection effect of the graphene-coated lens by monitoring the change in water evaporation rate from the vial capped with the contact lens. Thus, we believe that the graphene-coated contact lens would provide a healthcare and bionic platform for wearable technologies in the future.
Szczotka, L B; Capretta, D M; Lass, J H
Computerized videokeratoscope software programs now have the ability to assist in the design of rigid gas permeable (RGP) contact lenses and simulate fluorescein patterns. We evaluated the performance of Computed Anatomy's Topographic Modeling System (TMS-1) and its Contact Lens Fitting Program (version 1.41) in fitting RGP lenses in 31 subjects. Computerized topographic analysis, balanced manifest refraction, slit lamp examination, and keratometry were performed. Initial lens parameters were ordered according to manufacturer's programmed recommendations for base curve, power, lens diameter, optic zone diameter, and edge lift. Final lens parameters were based on clinical performance. Lenses were recorded for base curve changes of 0.1 mm or more, power alterations of +/- 0.50 D or more, or for any alteration in diameter/optic zone. Twenty-seven patients were analyzed for all five recommended parameters. Thirteen of 27 patients (48%) required no parameter changes. Nine of 27 patients (33%) required one parameter change, four of 27 patients (15%) required two parameter changes, and one patient (4%) needed three parameters altered. The most prevalent change was a power alteration, required in nine of 27 patients (33%); however, comparisons of all initial to final parameters showed no statistically significant differences. Comparison of initial base curves to that which would have been chosen via standard keratometry also showed no significant difference. This study found the TMS-1 default lens recommendations to be clinically unacceptable. This system, however, could be an alternative method of initial lens selection if used to titrate a fit or if software enhancements are incorporated to account for lens movement and flexure.
Tarkowski, Witold; Moneta-Wielgoś, Joanna; Młocicki, Daniel
Demodex mites may be a potential etiological factor in the development of various eye and skin disorders. The aim of the study was to investigate the presence of Demodex in the hair follicles of eyelashes and their potential influence on abandoning soft contact lenses which had been previously well tolerated by their users. A group of 62 users of contact lenses (28 with emerging discomfort and 34 without discomfort) were examined. There is a need to check the existence of a relationship between D. folliculorum or/and D. brevis infestation and the emergence of intolerance to the presence of soft contact lenses. The removed lashes were examined under light microscopy, applying standard parasitological methods if demodicosis is suspected. A positive result was assumed if at least one adult stage, larva, protonymph/nymph, or egg of D. folliculorum and/or D. brevis was present. A positive correlation was observed between the presence of Demodex and intolerance to contact lenses by their existing users (p < 0.05), and Demodex sp. infections were observed in 92.86% of patients with intolerance to contact lenses. Our results provide further evidence for the pathogenic role played by the mites in the development of eye diseases. PMID:26290865
Tarkowski, Witold; Moneta-Wielgoś, Joanna; Młocicki, Daniel
Demodex mites may be a potential etiological factor in the development of various eye and skin disorders. The aim of the study was to investigate the presence of Demodex in the hair follicles of eyelashes and their potential influence on abandoning soft contact lenses which had been previously well tolerated by their users. A group of 62 users of contact lenses (28 with emerging discomfort and 34 without discomfort) were examined. There is a need to check the existence of a relationship between D. folliculorum or/and D. brevis infestation and the emergence of intolerance to the presence of soft contact lenses. The removed lashes were examined under light microscopy, applying standard parasitological methods if demodicosis is suspected. A positive result was assumed if at least one adult stage, larva, protonymph/nymph, or egg of D. folliculorum and/or D. brevis was present. A positive correlation was observed between the presence of Demodex and intolerance to contact lenses by their existing users (p < 0.05), and Demodex sp. infections were observed in 92.86% of patients with intolerance to contact lenses. Our results provide further evidence for the pathogenic role played by the mites in the development of eye diseases.
Kelly, L D; Xu, L
Approximately 85% of Acanthamoeba-contaminated contact lens systems in asymptomatic patients have concurrent bacterial contamination. Pseudomonas aeruginosa and Xanthomonas maltophilia are common contact lens contaminants; we investigated the effect of coincubation of Acanthamoeba adherence to contact lenses. A. castellanii, 1 x 10(5) organisms/ml, was coincubated with P. aeruginosa or X. maltophilia, 1 x 10(8) CFU/ml in phosphate-buffered saline. Sterile, unworn polymacon, etafilcon A or lidofilcon contact lens were investigated. The experimental groups were: (I) lenses exposed to bacteria for 1 h, then Acanthamoeba for 2 h; (II) lenses exposed concurrently to bacteria and Acanthamoeba for 2 h; (III) Acanthamoeba coincubated with bacteria for 24 h, then lenses exposed for 2 h; (IV) lenses exposed to Acanthamoeba for 2 h (control). For all experimental groups, Acanthamoeba adherence was greater to lidofilcon than to polymacon and etafilcon. For both P. aeruginosa and X. maltophilia, neither group I nor group II displayed greater Acanthamoeba adherence than group IV. Group III exhibited significantly less adherence than group IV for lidofilcon and polymacon. The decrease in group III adherence reflected an overall decrease in Acanthamoeba trophozoite concentration. Short bacteria/Acanthamoeba coincubation times did not result in increased Acanthamoeba adherence. Twenty-four-hour coincubation resulted in decreased adherence for Pseudomonas and unchanged adherence rates for Xanthomonas. This model suggests that Pseudomonas or Xanthomonas co-contamination does not necessarily facilitate quantitative Acanthamoeba contact lens adherence.
Sousa, Sidney Júlio de Faria E; Dias, Vanderson Glerian; Marcomini, Luís Antonio Gorla
This is the report of a case of bilateral Acanthamoeba keratitis in a 19-year-old woman who bought a pair of disposable soft contact lenses in a boutique. She wore this same pair of lenses for 3 months daily without the appropriate care. This led to bilateral corneal transplantation with cataract extraction and also trabeculectomy in the right eye. When last seen, both grafts were crystal clear but the visual acuities were far from satisfactory. She also had bilateral secondary glaucoma, barely controlled by topical medication. Actually, the physical features and the wearing time characteristics of the disposable soft contact lenses created unprecedented difficulties to the medical surveillance of their wearers. Without the right assistance they tend to become careless regarding routine cleaning. They also feel free to buy less expensive lenses, to use saline instead of lens solutions, to violate the limits of wearing time and to extend the use over the sleeping period. Additionally, the aggressive marketing and the wide distribution of these lenses increase the chances that economically or educationally unprepared people will acquire them. The question that remains is: Is the present case an accidental event or an example of what is likely to happen in the future if the indiscriminate selling of disposable soft contact lenses continues to evolve?
Domínguez-Vicent, Alberto; Esteve-Taboada, Jose Juan; Recchioni, Alberto; Brautaset, Rune
To assess the power profile and in vitro optical quality of scleral contact lenses with different powers as a function of the optical aperture. The mini and semiscleral contact lenses (Procornea) were measured for five powers per design. The NIMO TR-1504 (Lambda-X) was used to assess the power profile and Zernike coefficients of each contact lens. Ten measurements per lens were taken at 3- and 6-mm apertures. Furthermore, the optical quality of each lens was described in Zernike coefficients, modulation transfer function, and point spread function (PSF). A convolution of each lens PSF with an eye-chart image was also computed. The optical power fluctuated less than 0.5 diopters (D) along the optical zone of each lens. However, the optical power obtained for some lenses did not match with its corresponding nominal one, the maximum difference being 0.5 D. In optical quality, small differences were obtained among all lenses within the same design. Although significant differences were obtained among lenses (P<0.05), these showed small impact in the image quality of each convolution. Insignificant power fluctuations were obtained along the optical zone measured for each scleral lens. Additionally, the optical quality of both lenses has showed to be independent of the lens power within the same aperture.
Kallinikos, Panagiotis; Morgan, Philip; Efron, Nathan
To monitor quantitative changes in stromal keratocyte density and the level of tear film inflammatory mediators following extended contact lens wear. Twenty-two subjects aged 32 +/- 11 years participated in this cross-sectional study. Eleven subjects had worn silicone hydrogel (Si-H) lenses on a 30-day continuous wear basis for 12 months. Eleven subjects had worn rigid gas permeable lenses on the same basis for 12 months. Eleven age-matched control subjects were also recruited. Ultrasound pachometry, confocal microscopy, and tear fluid sample collection were performed on all subjects. Tear samples were assayed for epidermal growth factor (EGF), hepatocyte growth factor (HGF) and interleukin (IL)-8. Corneal thickness was similar for all subject groups. Total keratocyte density was not different between the 3 groups; however, keratocyte density was lower for rigid lens wearers in the anterior to mid stroma and lower for Si-H lens wearers in the posterior stroma compared with control subjects. Rigid lens wearers exhibited an irregular keratocyte distribution across the corneal stroma. EGF concentration and rate of release was greater in the tears collected from the rigid lens wearers and Si-H lens wearers, and IL-8 concentration was higher in the samples collected from the rigid lens wearers compared with the samples collected from the control subjects. Mechanical stimulation of the corneal surface due to the physical presence of a contact lens and the consequent release of inflammatory mediators may account for a loss or redistribution of keratocytes.
Montalt, Juan Carlos; Porcar, Esteban; España-Gregori, Enrique; Peris-Martínez, Cristina
To assess the visual quality achieved by fitting corneo-scleral contact lenses (CScL) for keratoconus management. Thirty patients with keratoconus presented to have CScL fitted because of the unsatisfactory visual quality they experienced with their contact lenses or spectacles. The eye examination included visual acuity assessment, anterior eye biomicroscopy, ocular fundus examination, corneal topographic analysis, endothelial-cell count, contrast sensitivity and aberrometry. The fitting process was performed using a diagnostic trial set. Subjective visual quality and comfort, and contact lens wear time were also reported. Patients were monitored for one year. Three patients discontinued CScL wear before one year. Therefore, 27 eyes of 27 patients (19 male and 8 female) participated in this study. The mean age was 36.1 ± 13.1 (mean ± SD) years. Statistically significant differences were found in logMAR visual acuity between the best spectacle-corrected vision and after CScL fitting (mean ± SD, 0.23 ± 0.30 and 0.00 ± 0.14, respectively; p < 0.001). The total high-order aberrations decreased significantly (55%), and the spatial frequencies of contrast sensitivity all improved to normal range values of the population. Furthermore, high subjective visual quality and comfort ratings, and prolonged usage times (mean ± SD, 13.44 ± 2.38 h a day) were reported. No adverse ocular effects or clinically relevant changes in corneal parameters, visual quality, comfort or usage time were found one year after wearing CScL. This CScL seems to be safe and healthy, providing optimal visual quality, comfort and prolonged usage times in patients with keratoconus. Copyright © 2018 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Wang, Bingjie; Naidu, Rajeev K; Qu, Xiaomei
To explore the safety profile and overall visual improvement over the course of RGP contact lens wear on children with unilateral or bilateral amblyopia resulting from myopia. This was a retrospective analysis case series study. Clinical records of 15 patients who were fitted with RGP contact lenses at the Shanghai Eye and EENT Hospital of Fudan University between the period of January 2009 to December 2014 were reviewed. The inclusion criteria for review included patients with myopia of -3.00DS or greater in one or both eyes and an initial best-corrected visual acuity (BCVA) of logMAR 0.4 or worse for 3year olds, and logMAR 0.3 or worse for 4 years old and above. One or both myopic eyes were fitted with RGP lenses. 15 subjects and 22 amblyopic eyes were included. The mean baseline BCVA was logMAR0.70±0.38, which improved to a VA of 0.23±0.28 at the time of review (p<0.05). Baseline myopia also increased from -8.18±2.93DS to -11.41±3.76DS (p<0.05). The final visual acuity at the time of this review was correlated with the initial refractive error (r=-0.695, p<0.05) as well as the initial BCVA (r=0.854, p<0.05). There was also a strong correlation between initial refractive error and initial BCVA (r=0.-801, p<0.05) CONCLUSION: RGP contact lens wear is a safe and effective refractive treatment option in young children with amblyopia due to myopia. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Mohammadi, Saman; Jones, Lyndon; Gorbet, Maud
In this study, we compared, for the first time, the release of a 432 kDa prostaglandin analogue drug, Latanoprost, from commercially available contact lenses using in vitro models with corneal epithelial cells. Conventional polyHEMA-based and silicone hydrogel soft contact lenses were soaked in drug solution ( solution in phosphate buffered saline). The drug release from the contact lens material and its diffusion through three in vitro models was studied. The three in vitro models consisted of a polyethylene terephthalate (PET) membrane without corneal epithelial cells, a PET membrane with a monolayer of human corneal epithelial cells (HCEC), and a PET membrane with stratified HCEC. In the cell-based in vitro corneal epithelium models, a zero order release was obtained with the silicone hydrogel materials (linear for the duration of the experiment) whereby, after 48 hours, between 4 to 6 of latanoprost (an amount well within the range of the prescribed daily dose for glaucoma patients) was released. In the absence of cells, a significantly lower amount of drug, between 0.3 to 0.5 , was released, (). The difference observed in release from the hydrogel lens materials in the presence and absence of cells emphasizes the importance of using an in vitro corneal model that is more representative of the physiological conditions in the eye to more adequately characterize ophthalmic drug delivery materials. Our results demonstrate how in vitro models with corneal epithelial cells may allow better prediction of in vivo release. It also highlights the potential of drug-soaked silicone hydrogel contact lens materials for drug delivery purposes. PMID:25207851
Rahmani, Saeed; Nia, Mohadeseh Mohammadi; Baghban, Alireza Akbarzadeh; Nazari, Mohammadreza; Ghassemi-Broumand, Mohammad
To compare ultraviolet (UV) ray transmission in four UV-blocking soft contact lenses with Z80.20 standards set by the American National Standards Institute (ANSI). Four soft contact lenses including Acuvue Oasys (Johnson & Johnson, Ireland), Acuvue 2 (Johnson & Johnson, Ireland), Zeiss CONTACT Day 30 (Zeiss, Germany), and Sauflon 55 UV (Sauflon, UK) were evaluated for UV transmission. One-way ANOVA testing was performed to compare mean values of UVA and UVB transmission for the contact lenses. Acuvue Oasys, Acuvue 2, Zeiss CONTACT Day 30 and Sauflon 55 UV showed UV-B transmittance values of 0.24%, 1.46%, 10.37%, and 2.52%, respectively. Corresponding values for UV-A transmittance were 20.81%, 33.49%, 44.03% and 42.53%, respectively. One-way ANOVA showed a statistically significant difference among the tested contact lenses in terms of UV-B (P < 0.001) and UV-A (P < 0.001) transmission. Acuvue Oasys met the ANSI criteria for UV transmission and may thus be a good choice for eye and vision care specialists and contact lens wearers seeking UV protection.
Beattie, Tara K; Tomlinson, Alan
To determine if plasma surface treatment of Focus Night & Day silicone hydrogel contact lenses affects the attachment of Acanthamoeba. Unworn lotrafilcon A contact lenses with (Focus Night & Day) and without surface treatment and Acuvue, conventional hydrogel lenses, were quartered before 90-min incubation with Acanthamoeba castellanii trophozoites. After incubation and rinsing, the trophozoites attached to one surface of each quarter were counted by direct light microscopy. Sixteen replicates were observed for each lens type. Logarithmic transformation of data allowed the use of parametric analysis of variance. No significant difference in attachment was established between the untreated lotrafilcon A and the conventional hydrogel lenses (P<0.001); however, surface treatment of the native Focus Night & Day material produced a significant increase in attachment (P<0.001). Commercially available Focus Night & Day lenses are subjected to a plasma surface treatment to reduce lens hydrophobicity; however, this procedure results in an enhanced acanthamoebal attachment. It is possible that the silicone hydrogel lens could be at a greater risk of promoting Acanthamoeba infection if exposed to the organism because of the enhanced attachment characteristic of this material. Eye care professionals should be aware of the enhanced affinity that Acanthamoeba show for this lens and accordingly emphasise to patients the significance of appropriate lens hygiene. This is particularly important where lenses are worn in a regime that could increase the chance of exposure to the organism, i.e., 6 nights/7 days extended wear or daily wear, where lenses will be stored in a lens case, or where lenses are worn when in contact with potentially contaminated water sources, i.e., swimming or showering.
Gao, Shaohui; Wu, Junshu; Li, Lili; Wang, Yong; Zhong, Xingwu
To evaluate the efficacy of silicone hydrogel contact lenses on ocular surface after Sub-Bowman Keratomileusis (SBK). Forty-six patients suffered from myopia underwent a bilateral SBK. Post-operatively, one eye of each patient wore a PureVision contact lens for 24 h as a treated eye and the contralateral eye was as a blank control. Afterwards, corneal fluorescein (FL) staining, tear break-up time (TBUT), schirmer I test (SIT), central corneal thickness (CCT), ocular surface disease index (OSDI), corneal hysteresis (CH), corneal resistance factor (CRF) and corneal flap complications were assessed 1 d (except for CH and CRF), 1 week, 1 month and 3 months postoperatively. Following SBK, in contrast to the control, corneal fluorescein staining of treated eyes were significantly reduced and tear break-up time of treated eyes were significantly improved at 1 d and 1 week after SBK. However, Schirmer I test of treated and control eyes were not different after SBK. Central corneal thickness of treated eyes were significantly thinner than that of control at 1 d after SBK, however, there were no differences at other time points. Ocular surface disease index of treated eyes were obviously alleviated more than that of control at 1 d after SBK, but no differences were found at other visits. Moreover, Corneal hysteresis and corneal resistance factor of treated and un-treated eyes were not different after surgery. And also the rate of corneal flap complications were not different between treated and control eyes after SBK. Silicone hydrogel contact lenses played a positive role in accelerating corneal epithelial healing, enhancing tear film stability and reducing discomfort of patients in the early stage after SBK.
Severinsky, Boris; Millodot, Michel
Purpose To evaluate the indications and efficacy of high gas permeable scleral contact lenses (GP-SCL). Methods A total database of 97 consecutive patients (140 eyes) fitted with GP-SCL between January 2003 and December 2008, was retrospectively analyzed to determine the benefits of fitting scleral lenses. All lenses were fitted by preformed technique and were non-fenestrated. Patients included keratoconus – 88 eyes (63 %); corneal irregularities after penetrating keratoplasty – 39 eyes (28 %); various ocular surface disorders: Stevens-Johnson syndrome (SJS), graft versus host disease (GVHD) and exposure keratopathy – 6 eyes (4 %); post refractive surgery keratoectasia – 4 eyes (3 %), and high refractive error – 3 eyes (2 %). Results Mean follow up was 27.5 months (range 1–71), mean wearing time in successful wearers group was 12.2 hours per day (range 10–16), mean wearing time in group of wearers who dropped out using GP-SCL, was 5.8 hours (range 3–8). Keratoconus patients achieved median best corrected visual acuity (BCVA) of 20/32, 84 % of patients achieved BCVA of 20/40 or more. The post keratoplasty group achieved median BCVA of 20/25, 92 % of patients achieved BCVA of 20/40 or better. In the other groups, median BCVA was as follows: ocular surface disorders – 20/50, keratoectasia – 20/30, high refractive error – 20/32. Positive fluid-venting was highly associated with successful GP-SCL wearing. Twenty patients (21 %) failed to wear GP-SCL. Conclusions GP-SCL's expand the management of various corneal abnormalities. The main indication for GP-SCL is optical correction of an irregular corneal surface, especially keratoconus and corneal transplant.
Mahadevan, Rajeswari; Jagadeesh, Divya; Rajan, Rajni; Arumugam, Amudha Oli
This case report describes an experience with prosthetic replacement of ocular surface ecosystem (PROSE) device in an Indian patient with post-LASIK corneal ectasia. Keratoconus and corneal ectasia (post-LASIK) are characterized by progressive thinning and steepening of the cornea. Common symptoms experienced by patients in such conditions range from mild to severe vision impairments to an array of visual symptoms such as glare and ghosting. Scleral lenses are considered a vision-saving device when all other modalities fail. The patient in this case report had larger palpebral aperture, steeper cornea, and increased toricity of the sclera. Although a larger-diameter device is preferable in steeper corneas, a device with a smaller diameter and a flatter haptic was prescribed because of scleral toricity. There is a need to study scleral profile as well because scleral toricity can produce symptoms in patients even after 6 hours of device wear. After a few days of adaptation, the vault of the PROSE device can change because of haptic alignment on the sclera. This case report gives an overview of how the scleral profile can have an effect on the corneal/contact lens relationship when using a PROSE device.
Walker, Maria K; Bergmanson, Jan P; Miller, William L; Marsack, Jason D; Johnson, Leah A
The modern scleral contact lens (ScCL) has evolved from the very first contact lens fitted 128 years ago. Originally manufactured in glass and oxygen impermeable plastics, these lenses are available today in high Dk gas permeable materials that allow permeation of oxygen, reducing many of the complications that were seen with older generation ScCL. However, as with any new contact lens modality, the modern ScCL brings with it a new set of complications and fitting limitations. Pubmed searches under different keywords were conducted. Existing literature provides some reports of infection with the scleral devices, although these are often seen in severely compromised corneas, while hypoxic and inflammatory complications are rarely reported in the literature. Furthermore, the somewhat complex relationship of a scleral lens on the eye can create fitting and removal challenges. Anomalies such as conjunctival prolapse, epithelial bogging, midday fogging, and limbal bearing have been reported, and appear to be unique sequelae to scleral lens wear. Although this revolutionary technology broadens the scope in which practitioners can treat patients with irregular ocular surfaces, reports of these complications indicate that there is still a need for continued research to further enhance the clinical outcomes of this promising contact lens modality. Published by Elsevier Ltd.
Rebeix, V; Sommer, F; Marchin, B; Baude, D; Tran, M D
Spoilage is a primary factor in the biocompatibility of soft contact lenses (SCL) within the lacrimal fluid. Tears are a complex mixture of proteins, lipids, natural surfactants and salts. The spoilation process is due to a contribution of all these components and of the nature of SCL materials themselves. The aim of this study was to set up methods to observe and quantify lacrimal deposits and to select efficient surfactants for preventing protein deposits. The present study was performed on PMMA-NVP SCL. The behaviour of SCL in presence of tears was studied by means of an in vitro artificial tear model consisting of the main tears components and quantified by a colorimetric technique (BCA) performed directly on the lenses. The nature of the deposit was observed directly by atomic force microscopy (AFM) in a liquid medium showing the same adsorption trend noticed in the quantitative results and identifying specific adsorption sites. The assessment of surfactant adsorption was performed using Maron's method, as a mean to evaluate the affinity of surfactant to the surface, while the action of selected surfactants on pre-treated SCL was assessed using the BCA method. Promising results were obtained with these two different methods which can be used easily for the pre-selection of surfactants for further cleaning solution formulation studies.
Compañ, V; López-Alemany, A; Riande, E; Refojo, M F
The instrument oxygen transmissibility (IOT) of organosilicon hydrogels, measured by electrochemical procedures, is 5-10 times larger than that of conventional hydrogels. A method is described that allows the estimation of the oxygen tension at the lens-cornea interface for closed- and open-eyelids situations by combining the IOT of the hydrogels and corneal parameters such as corneal thickness, corneal permeability and oxygen flux across the cornea. From these results the biological oxygen apparent transmissibility (BOAT) is obtained, an important parameter which an multiplication with the pressure of oxygen on the external part of the lens gives the oxygen flux onto the cornea. Contact lenses with oxygen transmissibility higher than 100 Dk/t units [1 Dk/t unit=10(-9) [cm(3) O(2) (STp) cm(-2)s(-1)(mmHg)(-1)] posses a large oxygen tension at the lens-cornea interface that substantially reduces the oxygen flux onto the cornea. Lenses whose oxygen transmissibility is lower than 50 Dk/t units allow a rather small oxygen flux onto the cornea under closed eyelids condition that prevent their use for extended wear.
Rad, Maryam Shayani; Mohajeri, Seyed Ahmad
The purpose of the present study was to evaluate the efficacy of commercial soft contact lenses, loaded with vitamin E, as ocular drug delivery systems for simultaneous loading and release of ciprofloxacin (Cipro) and betamethasone (BMZ) in artificial tears. In this study, we applied vitamin E as a barrier to increase BMZ-Cipro loading into three commercial silicone-based soft contact lenses and control their simultaneous release into the artificial lachrymal fluid. Two different concentrations of vitamin E solution (0.1 and 0.2 g/ml) were used, and various parameters including changes in lens diameter, water content, ultraviolet-visible light (UV-Vis) transmittance, drug-binding properties, and drug release profile were investigated. The obtained results indicated that vitamin E significantly reduced the swelling properties of contact lenses in aqueous media, while it enhanced the lens diameter in both dry and hydrated states. Vitamin E had no significant effects on visible transmittance, while it blocked UV radiation, which could be harmful for the eye surface. Our findings revealed that vitamin E improved the simultaneous loading amount of BMZ-Cipro into soft contact lenses. Additionally, BMZ and Cipro release rates significantly reduced after using vitamin E as a hydrophobic diffusion barrier. After soaking the lenses in 0.1 and 0.2 g/ml of vitamin E solution, BMZ release time increased by 28.8-81.6 and 182.4-201 folds, respectively. Moreover, Cipro release time increased by 12-18 and 1152-2313 folds, respectively. The results of the present study indicated the efficacy of vitamin E as a diffusion barrier in developing a controlled drug delivery system for the simultaneous loading of BMZ and Cipro and sustaining their release from soft contact lenses.
Powell, Charles H; Lally, John M; Hoong, Lisa D; Huth, Stanley W
To determine if the silicone-type components of new high Dk lens materials contribute significantly to uptake and/or release of two common antimicrobial agents, myristamidopropyl dimethylamine (Aldox) and poly[hexamethylene biguanide hydrochloride] (PHMB), found in multipurpose solutions. Five commercial contact lenses were cycled in lens cases in a PHMB- and an Aldox-containing MPS. Single-cycle soaks (6, 16 or 64h) and multi-cycle soaks (6, 16, 142 and 48h) were used to assess kinetics and saturation effects of uptake. Lens capacity for uptake of each entity was determined using a semi-saturation model. Release kinetics was assessed for these semi-saturated lenses (100-mL MPS-soaked) in 2mL of a tear mimic fluid. Lenses that exhibited low uptake in a single cycle (with 3mL of MPS) became saturated within approximately 3 cycles. PHMB uptake was highest with non-silicone hydrogel (non-SiHy) and/or ionic lenses (approximately 70% depletion in 16h). PHMB uptake by non-ionic SiHy lenses was low (<40% depletion in a single 3-mL soak of 64h). Aldox uptake was highest for all SiHy lenses (approximately 80% depletion in 16h). PHMB uptake capacity was highest by ionic and non-SiHy lenses, while Aldox uptake capacity was much higher with all SiHy lenses than with any non-SiHy lens. The slower desorption of PHMB (t(1/2)= approximately 120min) compared to Aldox (t(1/2)= approximately 20min) may partially explain observed higher staining after 2-4h with PHMB products used with some lenses, whereas any clinical effects from Aldox would be expected to manifest soon after insertion.
Weyns, Marlies; Koppen, Carina; Tassignon, Marie-José
Most ophthalmologists are unaware of the therapeutic applications of gas-permeable scleral contact lenses for the prevention and treatment of ocular complications in patients with facial nerve palsy and concomitant neuroparalysis. The case reports refer to 3 patients who developed unilateral lagophthalmos and corneal anesthesia after an acoustic neuroma or intracranial tumor resection. Two patients explicitly requested a tarsorrhaphy to be opened because they were incapacitated by the limited visual acuity and visual field. Tarsorrhaphy was not an acceptable aesthetic solution for the third patient. Fluid-ventilated scleral lenses were fitted because they protect the cornea by creating a precorneal fluid reservoir while optimizing visual acuity. The follow-up periods were 3, 17, and 18 years. Two patients wear the contact lenses full time, but the wearing time is limited to 10 hours per day for the third patient. All patients were instructed not to wear their lenses while sleeping. Two eyes required a corneal transplant, but lens wear could be resumed 4 to 6 weeks after transplantation. The learning curve for the insertion and removal of this large-diameter lens is the main obstacle for a patient, especially when there is loss of corneal sensation. Scleral lens wear is a valid long-term alternative to standard treatment options such as tarsorrhaphy for patients with corneal exposure and corneal anesthesia as a consequence of postsurgery facial nerve paralysis. Scleral contact lenses provide these patients with effective protection of the ocular surface in an aesthetically acceptable way while optimizing visual function.
Chandler, Heather L; Reuter, Kathleen S; Sinnott, Loraine T; Nichols, Jason J
To determine whether class I ultraviolet (UV) light-blocking contact lenses prevent UV-induced pathologic changes in a rabbit model. Twelve rabbits were assigned to 1 of 3 treatment groups (n = 4), as follows: senofilcon A (class I UV blocking) contact lenses; lotrafilcon A contact lenses (no reported UV blocking); no contact lens. The contralateral eye was patched without a contact lens. Animals received UV-B (1.667 J/cm(2)) exposure daily for 5 days. Postmortem tissue was examined as follows: in the cornea, the expression of matrix-metalloproteinases (MMPs) was evaluated by zymography, and apoptosis was evaluated by TUNEL and caspase-3 ELISA; ascorbate in the aqueous humor was evaluated by nuclear magnetic resonance spectroscopy; crystalline lens apoptosis was evaluated by TUNEL and caspase-3 ELISA. Exposed corneas showed a significant increase in MMP-2 and -9, TUNEL-positive cells, and caspase-3 activity in the lotrafilcon A group compared with the senofilcon A group (all P = 0.03). A significant decrease in aqueous humor ascorbate was observed in the exposed lotrafilcon A lens-wearing group compared with the exposed senofilcon A lens-wearing group (P = 0.03). Exposed crystalline lenses had significantly increased caspase-3 activity in the lotrafilcon A group compared with the senofilcon A group (P = 0.03). Increased numbers of TUNEL-positive cells were noted in both the lotrafilcon A and the non-contact lens groups. The authors show that senofilcon A class I UV-blocking contact lenses are capable of protecting the cornea, aqueous humor, and crystalline lens of rabbits from UV-induced pathologic changes.
Silva, D; Fernandes, A C; Nunes, T G; Colaço, R; Serro, A P
The irritation/discomfort associated with the use of contact lenses (CLs) is often related to the eyelid-lens friction. Although the use of such devices is widespread, the information about the influence of the lacrimal fluid biomolecules on the tribological behavior of the CLs hydrogels is scarce. In this work, we investigated the effect of the presence of albumin and cholesterol in the lubricant medium, on the frictional response of two model hydrogels for CLs: a hydroxyethylmethacrylate based hydrogel, HEMA/PVP, and a silicone based one, TRIS/NVP/HEMA. Tribological experiments were done in a nanotribometer, in water and in the presence of solutions of those biomolecules. It was observed a significant increase of the friction coefficient (μ) for HEMA/PVP when the lubricant contains cholesterol, and for TRIS/NVP/HEMA when it contains albumin. Solid-state NMR and DSC analysis revealed that HEMA/PVP hydrated in cholesterol solution has a lower amount of free and loosely bound water than the hydrogel hydrated in water. Therefore, a smaller amount of water shall be released into the contact region during the friction tests with cholesterol solution, leading to a thinner film in the contact zone, and consequently to a higher μ. Concerning TRIS/NVP/HEMA, QCM-D studies showed that this hydrogel adsorbs less albumin than HEMA/PVP and that the formed film is more rigid, which can explain the increase of μ. The obtained results contribute to understand the influence of lacrimal fluid composition on the tribological behavior of CLs materials, being relevant for the selection and optimization of these devices. Understanding the tribological behavior of contact lenses (CLs) materials in contact with the lacrimal fluid and the role of its components is of major importance to optimize the comfort and overall success of these devices. Nevertheless, the available information on this subject in the literature is scarce. In this work, the effect of albumin and cholesterol (two of
Mukherjee, Achyut; Ioannides, Antonis; Aslanides, Ioannis
To evaluate and compare Comfilcon A and Senofilcon A silicone hydrogel contact lenses used as a therapeutic bandage following transepithelial excimer laser photorefractive keratectomy (PRK). Patients undergoing transepithelial PRK for myopia were prospectively recruited. Included patients had a Comfilcon A silicone hydrogel lens inserted in one eye, with a Senofilcon A lens in the contralateral eye. Postoperative assessment of subjective pain, epithelial healing and visual recovery was at day 1, 3 and 7. Contact lens factors including centration, movement and deposits were assessed. 48 eyes of 24 patients were included in the study. Mean age was 31 years (SD 11) and mean refractive error -4.5 D (SD 1.8). Mean pain score at day 1 was significantly higher in the Comfilcon group at 4.6 (SD 2.7) vs. 1.5 (SD2.5) in the Senofilcon group (P<0.005). Mean time to healing was 3.17 days (SD 0.37) in the Comfilcon group, and 3.21 days (SD 0.4) in the Senofilcon group, with no difference in defect size. There was a pronounced central raphe in 1 eye in the Comfilcon group vs. 5 eyes in the Senofilcon group (P=0.19). Significantly more eyes demonstrated no lens movement in the Senofilcon group (18 vs. 4, P=0.0001). The variation in material characteristics and lens geometry of different silicone hydrogel lenses affects their clinical characteristics in therapeutic roles. Other factors than oxygen permeability may affect pain and epithelial healing, with superior pain relief from the less permeable Senofilcon lens in this study. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.
Yan, Peng; Kapasi, Mustafa; Conlon, Ronan; Teichman, Joshua C; Yeung, Season; Yang, Yelin; Ziai, Setareh; Baig, Kashif
To evaluate short-term visual outcome, patient acceptance, and tolerance of mini-scleral contact lenses (SCLs) in the management of various corneal pathologies. Retrospective case series. Thirty-two patients (40 eyes) who received mini-SCLs. Single-centre retrospective case series, between February 2010 and January 2013, of 32 patients (40 eyes) with various corneal pathologies who were offered either Maxim 5R, Maxim 7, or Maxim 7 × 11 mini-SCLs for nonsurgical optimization of visual correction. Patients were followed up at 1 and 3 months for assessment of best-corrected visual acuity, comfort, length of daily wear, and complications. Thirty-two patients (40 eyes), with a mean age of 41 ± 16 years, opted to receive mini-SCLs. Eighteen patients had previously undergone surgery such as penetrating keratoplasty, deep anterior lamellar keratoplasty, and intraocular lens implantation. The median best-corrected visual acuity improved from 0.3 logMAR (range 0-1.3) before mini-SCLs, to 0.05 logMAR (range 0-1) with mini-SCLs (p < 0.0001). At 1-month follow-up, the median length of wear was 10 hours/day (range 1.5-15). At 3-month follow-up, the median length of wear was 12 hours/day (range 2-15). All eyes were comfortable at initial use of mini-SCLs and 91% were comfortable at 3-month follow-up. Mini-SCLs may be a comfortable management option for patients with keratoconus and other corneal pathologies who are unable to achieve adequate visual outcome with traditional spectacles or rigid gas-permeable contact lenses. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.
Ţălu, Ştefan; Bramowicz, Miroslaw; Kulesza, Slawomir; Fiorillo, Ilenia; Giovanzana, Stefano
The aim of this exploratory study was to investigate the micromorphology of surfaces of rigid gas permeable (RGP) contact lenses (CLs) using atomic force microscopy (AFM) followed by fractal analysis. In order to characterize in a quantitative manner the micromorphology of surfaces of new and unworn RGP CLs made of twelve different materials, AFM was taken and then analyzed using fractal methods. Surface topography was sampled in an intermittent-contact mode in air, on square areas of 5 × 5 µm 2 (MultiMode with Nanoscope V (Bruker). Spatial characteristics of 3-D surface texture were obtained using parameters defined in ISO 25178-2: 2012 norm. The surface texture turned out to have complex 3-D nanoscale geometry. For quantitative characterization of the properties of surface geometry at nanometer level of CL on the global scale, a series of fractal parameters was used. Statistical and fractal parameters of 3-D surfaces can be used by manufacturers to assess the micromorphology of CLs in order to improve their 3-D surface texture characteristics. These parameters can also be used in an elastic-plastic finite element model with contact elements to simulate the friction, wear and micro-elastohydrodynamic lubrication at a nanometer scale between the CL with the corneal surface.
Xu, Qiheng; Liao, Haiyang; Feng, Sumao
To ensure the functionality, safe reliability and amenity of contact lens, the center thickness tc , diameter φt and base curves r0 are three key parameters to be measured. For purpose of measuring the parameters tc , φt and r0 of contact lens in a single compact instrument with high accuracy and efficiency, a new method based on digital image processing is proposed and examined. Firstly, aim at establishing appropriate measurement environment and obtaining the measuring images properly, the instrument structure is designed and implemented according to the characteristics of contact lenses. Several main environmental factors affects the accuracy has been considered, such as measuring medium and temperature. Secondly, the procedure of the geometric features location and coordinate conversion is analyzed and demonstrated. Thanks to the Canny-Zernike edge detection, the feature points in the image can be effectively positioned at sub-pixel level without increasing the hardware costs. In order to map the feature points' pixel coordinates to world coordinates, the homography between the measuring plane and the imaging plane is estimated based on the pinhole imaging model. Lastly, with the specific obtained feature world coordinates, the distance formula and least squares curve fitting are used to calculate the object parameters. The instrument prototype and experimental analysis show that the proposed technique has advantages in terms of accuracy, volume reduction and efficiency over existing optical-mechanical techniques.
Varikooty, Jalaiah; Keir, Nancy; Woods, Craig A; Fonn, Desmond
To determine whether the refractive index (RI) of a soft contact lens can be evaluated using refractometry while the lens remains on the eye and to compare this with more traditional ex vivo RI measurements. A slitlamp apparatus was modified to incorporate a customized Atago hand refractometer. With a double-masked study design, nine adapted symptomatic soft contact lens wearers wore a contact lens in each eye (lotrafilcon B and etafilcon A) in a randomized order. In vivo RI was determined from the relative Brix scale measurements immediately after lens insertion and after 1 and 10 hr of lens wear. Ex vivo refractometry was performed after 10 hr of lens wear for comparison. Means +/- standard errors of the means are reported. In vivo RI values at baseline were 1.422 +/- 0.0004 (lotrafilcon B) and 1.405 +/- 0.0021 (etafilcon A); after 1 hr of lens wear, values were 1.423 +/- 0.0006 and 1.408 +/- 0.0007, respectively; and after 10 hr of lens wear, values were 1.424 +/- 0.0004 and 1.411 +/- 0.0010, respectively. Ex vivo RI values at the end of the 10 hr wearing period were 1.424 +/- 0.0003 (lotrafilcon B) and 1.412 +/- 0.0017 (etafilcon A). The change in in vivo RI across the day was statistically significant for the etafilcon A lens (repeated-measures analysis of variance, P<0.01) but not for the lotrafilcon B lens (P>0.05). This novel adaptation of refractometry was able to measure the RI of soft contact lenses during wear (without lens removal). End of day RI measurements using in vivo and ex vivo refractometry were comparable with each other. Future work is required to determine whether this in vivo method can improve our understanding of the relationships between soft contact lens RI, hydration, on-eye lens performance, and symptomology.
Scholtz, Sibylle K; Auffarth, Gerd U
Alhazen, ibn al-Haytham, (965 Basra - c. 1040 in Cairo) was a Muslim polymath who made significant contributions to the principles of optics, being the first to recognize the optical effect by transparent objects in the 11th century. His insights led to a fundamental revolution, enabling older presbyopic persons to read again. Today many more options are available to help visually impaired people correct their sight defects. This article will give an historical overview of the sight aids which are available today and will describe the very first beginnings of the development of the "reading stone" or "glasses". Further, it will also give a chronological overview of more modern techniques, e.g., intraocular lenses, contact lenses and the options of refractive surgery.
Bakaraju, Ravi C; Ehrmann, Klaus; Falk, Darrin; Ho, Arthur; Papas, Eric
A physical model eye capable of carrying soft contact lenses (CLs) was used as a platform to evaluate optical performance of several commercial multifocals (MFCLs) with high- and low-add powers and a single-vision control. Optical performance was evaluated at three pupil sizes, six target vergences, and five CL-correcting positions using a spatially filtered monochromatic (632.8 nm) light source. The various target vergences were achieved by using negative trial lenses. A photosensor in the retinal plane recorded the image point-spread that enabled the computation of visual Strehl ratios. The centration of CLs was monitored by an additional integrated en face camera. Hydration of the correcting lens was maintained using a humidity chamber and repeated instillations of rewetting saline drops. All the MFCLs reduced performance for distance but considerably improved performance along the range of distance to near target vergences, relative to the single-vision CL. Performance was dependent on add power, design, pupil, and centration of the correcting CLs. Proclear (D) design produced good performance for intermediate vision, whereas Proclear (N) design performed well at near vision (p < 0.05). AirOptix design exhibited good performance for distance and intermediate vision. PureVision design showed improved performance across the test vergences, but only for pupils ≥4 mm in diameter. Performance of Acuvue bifocal was comparable with other MFCLs, but only for pupils >4 mm in diameter. Acuvue Oasys bifocal produced performance comparable with single-vision CL for most vergences. Direct measurement of single-pass images at the retinal plane of a physical model eye used in conjunction with various MFCLs is demonstrated. This method may have utility in evaluating the relative effectiveness of commercial and prototype designs.
Subbaraman, Lakshman N; Bayer, Simone; Glasier, Mary-Ann; Lorentz, Holly; Senchyna, Michelle; Jones, Lyndon
The purpose of this study was to investigate the impact of using a rewetting drop (RWD) containing surface active agents (OPTI-FREE RepleniSH; Alcon, Fort Worth, TX) on the clinical performance and protein deposition when using a continuous-wear (CW) silicone hydrogel (SH) contact lens. Subjects wore lotrafilcon A SH lenses on a 30-day CW basis for two consecutive 1-month periods while inserting either 0.9% unpreserved unit-dose saline (control) or multidose OPTI-FREE RepleniSH (test RWD). Subjective comfort and symptoms were assessed after 2 and 4 weeks with each product. After 1 month of wear with each product, lenses were collected and analyzed in the laboratory for total protein, total lysozyme, and percentage of denatured lysozyme. Symptoms of dryness and comfort varied across the day regardless of drop type (p < 0.001) with dryness being maximal on waking, least in the middle of the day, and increased towards the evening. The test RWD provided greater comfort on insertion (p = 0.02), better visual quality (p < 0.01), and less mucous discharge on waking (p = 0.02) than the control product. Lysozyme deposition was significantly reduced after the use of the test RWD as compared to saline (0.73 +/- 0.5 microg/lens vs. 1.14 +/- 0.7 microg/lens; p < 0.001) as was total protein deposition (1.17 +/- 0.7 microg/lens vs. 1.86 +/- 0.8 microg/lens; p < 0.001). Lysozyme denaturation was also reduced with the use of the test RWD compared with the control (76 +/- 10% vs. 85 +/- 7%; p < 0.01). The use of a RWD containing surface active agents provided greater subjective satisfaction, reduced lysozyme and total protein deposition, and reduced denatured lysozyme than a RWD containing saline alone.
Phan, Chau-Minh; Bajgrowicz, Magdalena; McCanna, David J; Subbaraman, Lakshman N; Jones, Lyndon
To evaluate the effects of two commercial silicone hydrogel contact lenses (CLs) soaked with natamycin (NA) or fluconazole (FL) on the growth of Candida albicans in an in vitro eye model. Three-D printed molds were used as a cast for making eye-shaped models comprising potato dextrose agar. Senofilcon A (SA) and lotrafilcon B (LB) CLs were incubated with either 2 mL of NA or FL at a concentration of 1 mg/mL for 24 hr. To simulate a fungal infection, the eye models were coated with C. albicans. The drug-soaked lenses were placed on top of the eye models. Seven experimental conditions were examined: (1) NA-SA, (2) NA-LB, (3) FL-SA, (4) FL-LB, (5) SA, (6) LB, and (7) control-no lens. At specified time points (t=1, 8, 16, 24, 48 hr), the agar eyes from each experimental condition were removed from the incubator and photographed. The yeast cells from the 24 and 48 hr time point were also analyzed using light microscopy. At 24 and 48 hr, there was considerable growth observed for all conditions except for the NA-SA and NA-LB conditions. When observed under the microscope at 24 and 48 hr, the morphology of the yeast cells in the FL-SA and SA condition were similar to that of the control (oval shaped). There was limited hyphae growth observed for LB and significant visible hyphae growth for the NA-LB group. For NA-SA, NA-LB, and FL-LB groups, the cells were significantly smaller compared with the control. For NA-SA and NA-LB, there was limited growth of C. albicans observed on the eye models even after 48 hr. Under the microscope, the cell morphology differ noticeably between each testing condition, and is dependent on drug-lens combinations.
Phan, Chau-Minh; Weber, Sarah; Mueller, Jennifer; Yee, Alan; Jones, Lyndon
To develop a simple extraction procedure to quantify the uptake of four topical ocular pharmaceutical drugs into contact lenses (CLs). Four silicone hydrogel (SH) CLs (balafilcon A, senofilcon A, lotrafilcon B, comfilcon B) and four conventional hydrogel (CH) CLs (nesofilcon A, hilafilcon B, nelfilcon A, etafilcon A) were evaluated. The drugs studied were natamycin, moxifloxacin, timolol maleate, and ketotifen fumarate. For drug incubation, three CLs of each type were placed in 1 mL of 1 mg/mL drug-loading solution for 24 hours. The lenses were then extracted in 2 mL methanol for 2 hours. This process was repeated to obtain a total of three extraction cycles. Detection of natamycin, moxifloxacin, ketotifen fumarate, and timolol maleate were measured by absorbance at 305, 287, 297, and 295 nm, respectively. The majority of the drugs were extracted after the first extraction cycle ( P < 0.001). For moxifloxacin and timolol, CH CLs had higher drug uptake than SH CLs ( P < 0.05). There were no differences in drug uptake between CH CLs and SH CLs for natamycin and ketotifen ( P > 0.05). This study provides a simple approach to determine drug uptake into CLs. This method can also be modified, such as changing the extraction time, extraction cycles, or extraction solvent to better suit other drugs and CL combinations. There is considerable interest in using CLs for ocular drug delivery. Accurately quantifying drug uptake on CLs has been a challenge. Hence, this study provides a simple method to quantify drug uptake in CLs.
Srinivasan, Sruthi; Otchere, Heinz; Yu, Mili; Yang, Jeffery; Luensmann, Doerte; Jones, Lyndon
This study evaluated the impact of various cosmetics on the surface properties of silicone hydrogel (SiHy) contact lens materials. In this in vitro experiment, 7 SiHy contact lens materials were coated with 1 of 9 cosmetics, including common hand creams (3), eye makeup removers (3), and mascaras (3). Dark-field microscopy images were taken to determine pixel brightness (PB) after cosmetic exposure, which describes the visible surface deposition (n=6 for each lens type), with a higher PB indicating increased deposition. The sessile drop technique was used to determine the advancing contact angle (CA). Measurements were repeated for both methods after a single peroxide-based cleaning cycle. Pixel brightness was significantly higher for mascara-coated lenses compared with the other cosmetic products (P<0.01). The peroxide-based lens care solution removed most deposits from the nonwaterproof mascara for 4 lens types, whereas deposits remained relatively unchanged for 1 waterproof mascara (P>0.05). Hand creams and makeup remover had minimal impact on PB. Changes in CA measurements after cosmetic application were highly lens dependent. Hand creams caused primarily a decrease in CA for 5 of the 7 lens types, whereas 1 of the waterproof mascaras caused a significant increase of 30 to 50° for 3 lens types. Some mascara-lens combinations resulted in increased CA and PB, which could have an impact on in vivo lens performance. Nonwaterproof mascara was mostly removed after a cleaning cycle. Further research is needed to understand the clinical implications for SiHy lens wearers using cosmetics.
Abbey, Ashkan M.; Gregori, Ninel Z.; Surapaneni, Krishna; Miller, Darlene
Purpose While manufacturers recommend cleaning ophthalmic lenses with detergent and water and then a specific disinfectant, disinfectants are rarely used in ophthalmic practices. The aim of this pilot study was to evaluate the efficacy of detergent and water versus bleach, a recommended disinfectant, to eliminate common ocular bacteria and viruses from ophthalmic lenses. Methods Three bacterial strains (Staphylococcus epidermidis, Corynebacterium straitum, and methicillin-resistant Staphylococcus aureus (MRSA) and two viral strains (adenovirus and herpes simplex virus (HSV) type-1) were individually inoculated to 20 gonioscopy and laser lenses. Lenses were washed with detergent and water and then disinfected with 10% bleach. All lenses were cultured after inoculation, after detergent and water, and after the bleach. Bacterial cultures in thioglycollate broth were observed for 3 weeks and viral cultures for 2 weeks. The presence of viruses was also detected by multiplex polymerase chain reaction (PCR). Results All 20 lenses inoculated with Staphylococcus epidermidis, Corynebacterium straitum, adenovirus, and HSV-1 showed growth after inoculation, but no growth after detergent/water and after the bleach. All lenses showed positive HSV and adenovirus PCR after inoculation and negative PCR after detergent/water and after bleach. All MRSA contaminated lenses showed growth after inoculation and no growth after detergent and water. However, one lens showed positive growth after bleach. Conclusions Cleaning with detergent and water appeared to effectively eliminate bacteria and viruses from the surface of contaminated ophthalmic lenses. Further studies are warranted to design practical disinfection protocols that minimize lens damage. PMID:24747806
Bhamra, Tarnveer Singh; Tighe, Brian J
This review summarises the way in which mechanical property measurements combined with clinical perception have influenced the last half century of materials evolution in contact lens development. Literature concerning the use of in-vitro testing in assessment of the mechanical behaviour of contact lenses, and the mutual deformation of the lens material and ocular tissue was examined. Tensile measurements of historic and available hydrogel lenses have been collected, in addition to manufacturer-generated figures for the moduli of commercial silicone hydrogel lenses. The three conventional modes of mechanical property testing; compression, tension and shear each represent different perspective in understanding the mutual interaction of the cornea and the contact lens. Tensile testing provides a measure of modulus, together with tensile strength and elongation to break, which all relate to handling and durability. Studies under compression also measure modulus and in particular indicate elastic response to eyelid load. Studies under shear conditions enable dynamic mechanical behaviour of the material to be assessed and the elastic and viscous components of modulus to be determined. These different methods of measurement have contributed to the interpretation of lens behaviour in the ocular environment. An amalgamated frequency distribution of tensile moduli for historic and currently available contact lens materials reveals the modal range to be 0.3-0.6MPa. Mechanical property measurements of lens materials have enabled calibration of an important aspect of their ocular interaction. This together with clinical feedback has influenced development of new lens materials and assisted clinical rationalisation of in-eye behaviour of different lenses. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Rathi, Varsha M; Taneja, Mukesh; Dumpati, Srikanth; Mandathara, Preeji S; Sangwan, Virender S
To report the rare coexistence of keratoconus and Stevens-Johnson syndrome (SJS) managed with scleral contact lenses (ScCLs). This is a retrospective case series. Five patients (9 eyes) who had coexisting SJS and corneal ectasia were identified from the database during the 2-year period. Diagnosis of SJS was based on a positive history of drug reactions, signs of ocular surface disease, and the presence of keratinization of lid margins. Keratoconus was diagnosed by slit-lamp biomicroscopy. Five eyes of 3 patients had coexisting SJS and keratoconus and were dispensed with ScCLs (PROSE, prosthetic replacement of the ocular surface ecosystem; Boston Foundation for Sight, Needham Heights, MA). All these patients had photophobia. Visual acuity improved in all these patients with ScCL wear. Two patients (4 eyes) were excluded from this study because they had SJS with generalized corneal thinning from limbus to limbus, corneal opacification, and pannus. One patient developed deep vessels in the cornea on prolonged ScCL wear. Reduction in the ScCL wear schedule and change of material with a higher Dk resulted in regression of vascularization. Case 3 developed conjunctival congestion and was uncomfortable wearing ScCLs, although visual acuity was 20/40. He discontinued using ScCL wear. Keratoconus, a noninflammatory condition of the cornea coexisted with inflammatory SJS. Managing such patients with ScCLs may improve vision and comfort.
Paradiso, P; Colaço, R; Mata, J L G; Krastev, R; Saramago, B; Serro, A P
In this article, liposome-based coatings aiming to control drug release from therapeutic soft contact lenses (SCLs) materials are analyzed. A PHEMA based hydrogel material loaded with levofloxacin is used as model system for this research. The coatings are formed by polyelectrolyte layers containing liposomes of 1,2-dimyristoyl-sn-glycero-3-phosphocholine (DMPC) and DMPC + cholesterol (DMPC + CHOL). The effect of friction and temperature on the drug release is investigated. The aim of the friction tests is to simulate the blinking of the eyelid in order to verify if the SCLs materials coated with liposomes are able to keep their properties, in particular the drug release ability. It was observed that under the study conditions, friction did not affect significantly the drug release from the liposome coated PHEMA material. In contrast, increasing the temperature of release leads to an increase of the drug diffusion rate through the hydrogel. This phenomenon is recorded both in the control and in the coated samples. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1799-1807, 2017. © 2016 Wiley Periodicals, Inc.
Falk, Magnus; Andoralov, Viktor; Silow, Maria; Toscano, Miguel D; Shleev, Sergey
A microscale membrane-less biofuel cell, capable of generating electrical energy from human lachrymal liquid, was developed by utilizing the ascorbate and oxygen naturally present in tears as fuel and oxidant. The biodevice is based on three-dimensional nanostructured gold electrodes covered with abiotic (conductive organic complex) and biological (redox enzyme) materials functioning as efficient anodic and cathodic catalysts, respectively. Three-dimensional nanostructured electrodes were fabricated by modifying 100 μm gold wires with 17 nm gold nanoparticles, which were further modified with tetrathiafulvalene-tetracyanoquinodimethane conducting complex to create the anode and with Myrothecium verrucaria bilirubin oxidase to create the biocathode. When operated in human tears, the biodevice exhibited the following characteristics: an open circuit voltage of 0.54 V, a maximal power density of 3.1 μW cm(-2) at 0.25 V and 0.72 μW cm(-2) at 0.4 V, with a stable current density output of over 0.55 μA cm(-2) at 0.4 V for 6 h of continuous operation. These findings support our proposition that an ascorbate/oxygen biofuel cell could be a suitable power source for glucose-sensing contact lenses to be used for continuous health monitoring by diabetes patients.
Weber, Sarah La Porta; Hazarbassanov, Rossen Mihaylov; Nasaré, Alex; Gomes, José Álvaro Pereira; Hofling-Lima, Ana Luisa
To evaluate conjunctival impression cytology and HLADR expression changes after wearing scleral contact lenses (ScCLs) for moderate to severe dry eye disease (DED). Prospective interventional case series. Forty-one eyes from 25 patients with moderate to severe DED were evaluated for Esclera ScCL treatment. Best-corrected visual acuity (BCVA) and slit-lamp findings were assessed. Impression cytology specimens were obtained from DED patients at the baseline and after wearing ScCLs for 12 months. The impression cytology specimens were analyzed using morphological results score, and HLA-DR positive cells were detected and quantified. The values were compared to assess the IC changes after wearing ScCLs. Forty-one eyes from 25 patients were fitted with ScCLs to manage DED. The underlying diseases were Stevens-Johnson syndrome (22 eyes), Sjogren's syndrome (11 eyes), graft-versus-host disease (2 eyes), dry eye after keratomileusis (2 eyes) and undifferentiated ocular surface disease (4 eyes). The HE-PAS impression cytology score did not differ significantly before and after wearing ScCLs for 12 months in DED patients (p>0.05). The percentage of eyes expressing the HLA-DR antigen in the temporal conjunctiva after wearing ScCL for 12 months significantly increased in patients with Sjogren's syndrome (11.11% to 66.66%; p=0.0498). In groups with Stevens Johnson syndrome and other ocular surface disorders, we did not observe statistically significant differences (p>0.05). The ScCLs did not change the parameters used to evaluate inflammatory processes, which were measured using conjunctival impression cytology and HLA-DR expression, except in Sjogren syndrome, in which there was an unexpected increase in HLA expression. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Zheng, Bin; Shen, Lijun; Walker, Maria K; Zhang, Zongduan; Zheng, Jingwei; She, Xiangjun; Zhou, Jing; Xu, Zhaoxia; Chen, Yan
To evaluate the clinical value of rigid gas permeable contact lenses (RGPCLs) in patients with traumatic corneal scarring and address implications of primary corneal repair. Eighteen subjects with a history of corneal laceration were fit with RGPCLs. Scar locations were divided into two zones; each patient was examined using Pentacam. Entering data included uncorrected visual acuity (UCVA), spectacle-corrected visual acuity (SVA), time between injury and RGPCL fitting, location and size of scar, and amount of corneal astigmatism. Follow-up data included RGPCL visual acuity (RGPCLVA), RGPCL-related complications, and dropout characteristics. Visual acuity values were converted to logMAR for analysis. No serious complications occurred. The average time between suture removal and RGPCL fitting was 5.7±5.5 months. Average corneal astigmatism was -3.44±2.09 diopters. One subject had developed corneal ectasia. RGPCLVA was more than 0.1 in three subjects: one experienced primary corneal repair complications, and two subjects (<10 years) developed amblyopia. In both zones, the difference in RGPCLVA outcome between zone I and zone II was not statistically significant (F=0.060, P=0.809). The difference between SVA in zones I and II was found to be statistically significant (F=6.131, P=0.026), as were the differences between SVA and RGPCLVA (F=8.598, P=0.010). The scar size had no significant influence on RGPCLVA, SVA, or UCVA. Four participants (22.2%) were successfully fit. Dropout characteristics included ocular discomfort, inconvenience, parental apprehension, and low motivation. Rigid gas permeable contact lens is an ideal method for evaluating visual potential in patients with traumatic corneal astigmatism. Pentacam examinations of those patients with poor RGPCLVA can help an ophthalmologist find and understand existing problems in suture techniques.
Osuagwu, Uchechukwu L; Ogbuehi, Kelechi C
To assess the transmittance, in the 200-700nm electromagnetic radiation spectrum, by popularly used tinted soft contact lenses (CLs). The spectra transmittances of ultraviolet (UV)-blocking (I Day Acuvue Define, Freshlook ONE DAY) and non-UV-blocking (Durasoft 3, Tutti, and NeoCosmo) tinted soft CLs were tested. The transmittance of each lens, including nine different colors of Freshlook CL was recorded on spectrophotometer, and the data used to also calculate a UV protection factor (PF) for each lens brand tested, with a higher value indicating a higher level of protection. The UV-blocking CLs significantly reduced UVC, UVB & UVA transmission and thereby meet the American National Standards Institution standard for class 2 UV blockers: a maximum of 30% transmittance of UVA and 5% transmittance of UVB wavelengths. In contrast, the Durasoft 3, Tutti, and NeoCosmo CLs demonstrated negligible UV-blockage. The Acuvue Define CL offered the greatest protection from UVC (PF=69) and UVB (PF=55), but with only 35% luminous transmittance, while the Freshlook CL (especially gemstone green) offered the best protection from UVA (PF=24) and showed about 55% translucency. Overall, the UV-blocking CLs performed equally well across the UV spectrum. Different colors of Freshlook CL transmitted statistically and clinically significantly different amounts of visible light but similar amounts of UVR. Freshlook and Acuvue Define CLs which are designated as UV-blockers significantly reduced UVR transmission to safe levels whereas Tutti, NeoCosmo and Durasoft 3 did not. Transmission within the Freshlook CL family was more dependent on color in the visible light spectrum, but not in the UV-spectrum, where the gemstone green performing best among the tested colors. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Chahal, Harinder S; Estrada, Marcela; Sindt, Christine W; Boehme, Jacob A; Greiner, Mark A; Nerad, Jeffrey A; Carter, Keith D; Allen, Richard C; Shriver, Erin M
To describe the role and efficacy of scleral contact lenses (SCLs) in the treatment of progressive keratopathy in patients who have undergone periocular surgical procedures, to investigate the financial impact of these surgical interventions, and to demonstrate the role of oculoplastic surgery in improving scleral contact lens fit. A retrospective medical record review was performed to identify patients who both received SCLs and were examined by the oculoplastics service at the University of Iowa between January 1990 and December 2015. Inclusion criteria also required a minimum of 12 months of patient follow up after being fit with a SCL. The indication for SCL use, as well as clinical outcomes and cumulative relative value units (RVUs) of prior oculoplastic treatments and SCL therapy were recorded for each patient. Six hundred and fifty-nine patients were fitted with SCLs at the authors' institution during the 25-year study period, 43 of whom were examined by the oculoplastics service for reasons related to their SCL. Patients who were fitted for SCLs before (27 patients) or after (16 patients) evaluation in the oculoplastics clinic presented with a variety of corneal and periocular pathology. Corneal indications for SCLs in patients seen secondarily in the oculoplastics clinic included decreased corneal sensation (from CN V palsy or neurotrophic keratopathy), decreased corneal healing from limbal stem cell deficiency, exposure keratopathy, and keratoconjunctivitis sicca secondary to Sjogren's syndrome or orbital radiation. Indications for oculoplastic clinic evaluation in current scleral lens patients included lagophthalmos, trichiasis, epiphora, cicatricial changes in the eyelids or fornices, and eyelid or eyebrow malposition affecting SCL centration. In all 27 patients, surgical intervention resulted in improved SCL centration. Sixteen patients (5 with CN VII palsy, 4 with CN V and CN VII palsy, 4 with neurotrophic keratitis, and 3 with cicatricial entropion
Kim, Eon; Bakaraju, Ravi C; Ehrmann, Klaus
To evaluate the repeatability of power profiles measured on NIMO TR1504 (Lambda-X, Belgium) and investigate the effects of lens decentration on the power profiles for single vision (SV), bifocal (BF) and multifocal (MF) contact lenses. Accuracy of the sphere power was evaluated using single vision BK-7 calibration glass lenses of six minus and six plus powers. Three SV and four BF/MF contact lenses - three lenses each, were measured five times to calculate the coefficients of repeatability (COR) of the instrument. The COR was computed for each chord position, lens design, prescription power and operator. One lens from each type was measured with a deliberate decentration up to ±0.5mm in 0.1mm steps. For all lenses, the COR varied across different regions of the half-chord position. In general, SV lenses showed lower COR compared to the BF/MF group lenses. There were no noticeable trends of COR between prescription powers for SV and BF/MF lenses. The shape of the power profiles was not affected when lenses were deliberately decentered for all SV and PureVision MF lenses. However, for Acuvue BF lenses, the peak to trough amplitude of the power profiles flattened up to 1.00D. The COR across the half-chord of the optic zone diameter was mostly within clinical relevance except for the central 0.5mm half-chord position. COR were dependent on the lens type, whereby BF/MF group produced higher COR than SV lenses. The effects of deliberate decentration on the shape of power profiles were pronounced for lenses where the profiles had sharp transitions of power. Copyright © 2015 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.
Abbey, Ashkan M; Gregori, Ninel Z; Surapaneni, Krishna; Miller, Darlene
Although manufacturers recommend cleaning ophthalmic lenses with detergent and water and then with a specific disinfectant, disinfectants are rarely used in ophthalmic practices. The aim of this pilot study was to evaluate the efficacy of detergent and water versus that of bleach, a recommended disinfectant, to eliminate common ocular bacteria and viruses from ophthalmic lenses. Three bacterial strains (Staphylococcus epidermidis, Corynebacterium straitum, and methicillin-resistant Staphylococcus aureus and 2 viral strains (adenovirus and herpes simplex virus [HSV] type-1) were individually inoculated onto 20 gonioscopy and laser lenses. The lenses were washed with detergent and water and then disinfected with 10% bleach. All the lenses were cultured after inoculation, after washing with detergent and water, and after disinfecting with the bleach. Bacterial cultures in thioglycollate broth were observed for 3 weeks, and viral cultures were observed for 2 weeks. The presence of viruses was also detected by multiplex polymerase chain reaction (PCR). All 20 lenses inoculated with S. epidermidis, C. straitum, adenovirus, and HSV-1 showed growth after inoculation but no growth after washing with detergent/water and after disinfecting with the bleach. All lenses showed positive HSV and adenovirus PCR results after inoculation and negative PCR results after washing with detergent/water and after disinfecting with bleach. All methicillin-resistant S. aureus-contaminated lenses showed growth after inoculation and no growth after washing with detergent and water. However, 1 lens showed positive growth after disinfecting with bleach. Cleaning with detergent and water seemed to effectively eliminate bacteria and viruses from the surface of contaminated ophthalmic lenses. Further studies are warranted to design practical disinfection protocols that minimize lens damage.
Veli, Muhammed; Ozcan, Aydogan
We present a cost-effective and portable platform based on contact lenses for noninvasively detecting Staphylococcus aureus, which is part of the human ocular microbiome and resides on the cornea and conjunctiva. Using S. aureus-specific antibodies and a surface chemistry protocol that is compatible with human tears, contact lenses are designed to specifically capture S. aureus. After the bacteria capture on the lens and right before its imaging, the captured bacteria are tagged with surface-functionalized polystyrene microparticles. These microbeads provide sufficient signal-to-noise ratio for the quantification of the captured bacteria on the contact lens, without any fluorescent labels, by 3D imaging of the curved surface of each lens using only one hologram taken with a lens-free on-chip microscope. After the 3D surface of the contact lens is computationally reconstructed using rotational field transformations and holographic digital focusing, a machine learning algorithm is employed to automatically count the number of beads on the lens surface, revealing the count of the captured bacteria. To demonstrate its proof-of-concept, we created a field-portable and cost-effective holographic microscope, which weighs 77 g, controlled by a laptop. Using daily contact lenses that are spiked with bacteria, we demonstrated that this computational sensing platform provides a detection limit of ∼16 bacteria/μL. This contact-lens-based wearable sensor can be broadly applicable to detect various bacteria, viruses, and analytes in tears using a cost-effective and portable computational imager that might be used even at home by consumers.
Artigas, José M; Navea, Amparo; García-Domene, M Carmen; Gené, Andrés; Artigas, Cristina
To determine the spectral transmission of contact lenses (CLs), with and without an ultraviolet (UV) filter to evaluate their capacity for protection under UV radiation from artificial illumination (incandescent, fluorescent, xenon (Xe) lamps, or white LEDs (light-emitting diode)). The transmission curves of nine soft CLs were obtained by using a PerkinElmer Lambda 35 UV-vis spectrophotometer. A CIE standard was used for the emission spectra of incandescent and fluorescent lamps, and Xe lamps and white LEDs were measured by using an International Light Technologies ILT-950 spectroradiometer. Five of the nine soft CLs analysed state that they incorporate UV filters, but the other four do not specify anything in this regard. The spectral transmission of all the CLs studied is excellent in the visible region. The CLs with UV filters filter out this radiation more or less effectively. Xe lamps emit a part in the UV region. Incandescent, fluorescent and white LEDs do not emit at all in the UV. Incorporating UV filters is important when the illumination is from a Xe lamp since this light source emits in the UV region. This, however, does not occur with incandescent and fluorescent lamps or white LEDs. The CLs that do incorporate UV filters meet all the standard requirements that the U.S. FDA (Food and Drug Administration) has for UV-blocking CLs Class II (OcularScience, CooperVision and Neolens), and AcuvueMoist and HydronActifresh400 even comply with the stricter Class I. The CLs without UV filters let UVA, UVB and even some UVC through. Copyright © 2015. Published by Elsevier Ltd.
Gomes, Thiago dos Santos; Magnet, Angela; Izquierdo, Fernando; Vaccaro, Lucianna; Redondo, Fernando; Bueno, Sara; Sánchez, Maria Luisa; Angulo, Santiago; Fenoy, Soledad; Hurtado, Carolina; del Aguila, Carmen
Purpose Acanthamoeba keratitis (AK) is a painful and potentially blinding corneal infection caused by Acanthamoeba spp. In Madrid, environmental studies have demonstrated a high presence of these free-living amoebae in tap water. Since most of AK cases occur in contact lenses (CL) wearers with inadequate hygiene habits, the presence of Acanthamoeba in discarded CL has been studied and compared with other common etiological agents of keratitis, such as Pseudomonas aeruginosa and Staphylococcus aureus. Methods One hundred and seventy-seven healthy individuals from Madrid contributed their discarded CL and answered a questionnaire on hygiene habits. DNA was extracted from the CL solution and analyzed by real-time PCR for Acanthamoeba, Pseudomonas aeruginosa and Staphylococcus aureus. These CL and their solutions were also cultured on non-nutrient agar to isolate Acanthamoeba. Results Among the 177 samples, Acanthamoeba DNA was detected in 87 (49.2%), P. aeruginosa DNA in 14 (7.9%) and S. aureus DNA in 19 (10.7%). Cultivable amoebae, however, were observed in only one sample (0.6%). This isolate was genotyped as T4. The habits reported by this CL owner included some recognized risk factors for AK, but in this study only the practice of “not cleaning the CL case” presented some statistical significant association with Acanthamoeba DNA presence. Detection of the investigated bacterial DNA did not demonstrate statistical significant association with the studied practices, but the presence of P. aeruginosa revealed a possible inhibition of Acanthamoeba in these samples. Conclusions The PCR results suggest a high presence of Acanthamoeba spp. in healthy CL wearers from Madrid, but we can assume that CL solutions are properly disinfecting the CL since only 1.1% of the positive PCR samples correspond to viable amoebae and, after four years, only one participant reported stronger ocular problems. Nevertheless, more studies are necessary to corroborate this hypothesis. PMID
Taylor, Kenneth R; Caldwell, Matthew C; Payne, Angeletta M; Apsey, Douglas A; Townley, J Richard; Reilly, Charles D; Panday, Vasudha A
To evaluate the relative pain with 3 U.S. Food and Drug Administration-approved bandage soft contact lenses (SCLs) applied after photorefractive keratectomy (PRK). Joint Warfighter Refractive Surgery Center, Lackland Air Force Base, Texas, USA. Prospective comparative case series. Patients having PRK were randomized to a senofilcon A (Acuvue Oasys), balafilcon A (Purevision), or lotrafilcon A (Air Optix) bandage SCL in each eye postoperatively. Patients were evaluated 1 and 4 days postoperatively and completed a survey rating absolute pain in each eye on a visual analog scale. The study enrolled 54 patients. At 1 and 4 days, eyes with the senofilcon A lens had the lowest pain scores followed by eyes with the lotrafilcon A lens and then eyes with the balafilcon A lens. Averaging qualitative results from 1 and 4 days showed that eyes with the senofilcon A lens were reported as having more pain by 4% of patients, eyes with the lotrafilcon A lens by 27%, and eyes with the balafilcon A lens by 53%; 16% reported no difference (P<.001). Quantitatively, the senofilcon A lens was 40% more comfortable than the lotrafilcon A lens and 65% more comfortable than the balafilcon A lens on average. The lotrafilcon A lens was 38% more comfortable than the balafilcon A lens on average (P<.01). There was a statistically and clinically significant difference in post-PRK pain between the 3 bandage SCLs. The senofilcon A lens caused the least pain. Dr. Reilly is a consultant to Alcon Laboratories, Inc. and Abbott Medical Optics, Inc. but was not at the time of the study. No other author has a financial or proprietary interest in any material or method mentioned. Published by Elsevier Inc.
Compañ, Vicente; Oliveira, Cristina; Aguilella-Arzo, Marcel; Mollá, Sergio; Peixoto-de-Matos, Sofia C; González-Méijome, José M
We defined the theoretical oxygen tension behind modern scleral contact lenses (CLs) made of different rigid gas permeable (RGP) materials, assuming different thickness of the tear layer behind the lens. A second goal was to show clinically the effect of the postlens tear film on corneal swelling. We simulated the partial pressure of oxygen across the cornea behind scleral CLs made of different lens materials (oxygen permeability Dk, 75-200 barrer) and different thickness (Tav, 100-300 μm). Postlens tear film thicknesses (Tpost-tear) ranging from 150 to 350 μm were considered. Eight healthy subjects were fitted randomly with a scleral lens with a thin and a thick postlens tear layer in two different sessions for a period of 3 hours under open-eye conditions. The CLs with less than 125 barrer of Dk and a thickness over 200 μm depleted the oxygen availability at the lens-cornea interface below 55 mm Hg for a postlens tear film of 150 μm. For a postlens tear film thickness of 350 μm, no combination of material or lens thickness will meet the criteria of 55 mm Hg. Our clinical measures of corneal edema showed that this was significantly higher (P < 0.001, Wilcoxon signed ranks test) with the thicker compared to the thinner Tpost-tear (mean ± SD, 1.66 ± 1.12 vs. 4.27 ± 1.19%). Scleral RGP CLs must be comprised of at least 125 barrer of oxygen permeability and up to 200 μm thick to avoid hypoxic effects even under open eye conditions. Postlens tear film layer should be below 150 μm to avoid clinically significant edema. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.
Phan, Chau-Minh; Bajgrowicz, Magdalena; Gao, Huayi; Subbaraman, Lakshman N; Jones, Lyndon W
Rapid drug release followed by a plateau phase is a common observation with drug delivery from contact lenses (CLs) when evaluated in a vial. The aim of this study was to compare the release of fluconazole from seven commercially available daily disposable CLs using a conventional vial-based method with a novel in vitro eye model. An eye model was created using two 3-dimensional printed molds, which were filled with polydimethylsiloxane to obtain an inexpensive model that would mimic the eyeball and eyelid. The model was integrated with a microfluidic syringe pump, and the flow-through was collected in a 12-well microliter plate. Four commercial daily disposable conventional hydrogels (nelfilcon A, omafilcon A, etafilcon A, ocufilcon B) and three silicone hydrogels (somofilcon A, narafilcon A, delefilcon A) were evaluated. These CLs were incubated with fluconazole for 24 h. The drug release was measured in a vial containing 4.8 mL of phosphate-buffered saline and in the polydimethylsiloxane eye model with a 4.8-mL tear flow across 24 h. Overall, conventional hydrogel CLs had a higher uptake and release of fluconazole than silicone hydrogel CLs (p < 0.05). A higher drug release was observed in the vial condition compared with the eye model (p < 0.001). In the vial system, the drugs were rapidly released from the CL within the first 2 h, followed by a plateau phase. In contrast, drug release in the eye model under low tear volume was sustained and did not reach a plateau across 24 h (p < 0.05). Rapid drug release results from using a vial as the release system. Under low tear volume at physiological tear flow, commercial CLs can maintain a sustained drug release profile for up to 24 h. However, eyes with fungal keratitis may have increased tearing, which would significantly accelerate drug release.
Gomes, Thiago Dos Santos; Magnet, Angela; Izquierdo, Fernando; Vaccaro, Lucianna; Redondo, Fernando; Bueno, Sara; Sánchez, Maria Luisa; Angulo, Santiago; Fenoy, Soledad; Hurtado, Carolina; Del Aguila, Carmen
Acanthamoeba keratitis (AK) is a painful and potentially blinding corneal infection caused by Acanthamoeba spp. In Madrid, environmental studies have demonstrated a high presence of these free-living amoebae in tap water. Since most of AK cases occur in contact lenses (CL) wearers with inadequate hygiene habits, the presence of Acanthamoeba in discarded CL has been studied and compared with other common etiological agents of keratitis, such as Pseudomonas aeruginosa and Staphylococcus aureus. One hundred and seventy-seven healthy individuals from Madrid contributed their discarded CL and answered a questionnaire on hygiene habits. DNA was extracted from the CL solution and analyzed by real-time PCR for Acanthamoeba, Pseudomonas aeruginosa and Staphylococcus aureus. These CL and their solutions were also cultured on non-nutrient agar to isolate Acanthamoeba. Among the 177 samples, Acanthamoeba DNA was detected in 87 (49.2%), P. aeruginosa DNA in 14 (7.9%) and S. aureus DNA in 19 (10.7%). Cultivable amoebae, however, were observed in only one sample (0.6%). This isolate was genotyped as T4. The habits reported by this CL owner included some recognized risk factors for AK, but in this study only the practice of "not cleaning the CL case" presented some statistical significant association with Acanthamoeba DNA presence. Detection of the investigated bacterial DNA did not demonstrate statistical significant association with the studied practices, but the presence of P. aeruginosa revealed a possible inhibition of Acanthamoeba in these samples. The PCR results suggest a high presence of Acanthamoeba spp. in healthy CL wearers from Madrid, but we can assume that CL solutions are properly disinfecting the CL since only 1.1% of the positive PCR samples correspond to viable amoebae and, after four years, only one participant reported stronger ocular problems. Nevertheless, more studies are necessary to corroborate this hypothesis.
Luensmann, Doerte; Yu, Mili; Yang, Jeffery; Srinivasan, Sruthi; Jones, Lyndon
To evaluate the impact of cosmetics on silicone hydrogel (SiHy) contact lens shape, lens power, and optical performance. In this in vitro experiment, 7 SiHy materials were coated with 9 marketed brands of cosmetics, including hand creams (HCs) (3), eye makeup removers (MRs) (3), and mascaras (3). Diameter, sagittal depth, and base curve were determined using the Chiltern (Optimec Limited), whereas lens power and optical performance were assessed using the Contest Plus (Rotlex). Six replicates were used for each lens and cosmetic combination. Measurements were repeated after a cleaning cycle using a one-step hydrogen peroxide solution. Makeup removers had the greatest impact on diameter, sagittal depth, and base curve, resulting in changes of up to 0.5, 0.15, and 0.77 mm, respectively. The HCs and mascaras had little impact on these parameters; however, differences were observed between lens types. Optical performance was reduced with all mascaras, and a decrease of greater than 2 units on a 0 to 10 scale (10=uniform power distribution) was seen for 5 lens types exposed to waterproof mascara (P<0.01). Most HCs and MRs had minimal impact on image quality. Lens power did not change with any of the cosmetics (± 0.25 diopter; P>0.05). Lens cleaning resulted in some recovery of the lens parameters, and efficiency varied between cosmetics. Some eye MRs and waterproof mascaras changed the shape and optical performance of some SiHy lenses. Further research is needed to understand the clinical implications for SiHy lens wearers using cosmetics.
Desai, Ankita R; Maulvi, Furqan A; Pandya, Mihir M; Ranch, Ketan M; Vyas, Bhavin A; Shah, Shailesh A; Shah, Dinesh O
Glaucoma is a chronic disease, which is currently treated using frequent high dose applications of an eye drop solution; this method is tedious, and most of patients are non-compliant to it. Contact lenses are emerging as a convenient option to sustain the release of ophthalmic drugs. However, the incorporation of a drug/formulation changes the optical and physical properties of contact lenses. Contact lens users have also reported pink eye syndrome; this makes contact lenses unsuitable to be accepted as a medical device. The objective of the present study was to design novel timolol and hyaluronic acid (comfort agent)-loaded semi-circular ring-implanted contact lenses that could uphold the release at therapeutic rates without compromising the critical lens properties. The drug-loaded rings were individually implanted within the periphery of the contact lenses using modified cast-moulding technology. Atomic force microscopy showed an average roughness of 12.38 nm for the implanted lens that was significantly lower as compared to that of the Freshlook contact lenses (116.27 nm). A major amount of timolol was leached (from 46.47 to 58.79%) during the monomer extraction and moist sterilization (autoclave) steps; therefore, the lenses were sterilized by radiation and packaged under dry conditions (dehydrated). The in vitro release data showed sustained release of timolol and hyaluronic acid up to 96 h. The in vivo drug release study on rabbit eyes showed the presence of timolol in tear fluid up to 72 h. The in vivo pharmacodynamics studies showed a reduction in IOP till 144 h with a low drug loading (154 μg) as compared to the case of a single instillation eye drop solution (250 μg). This study has demonstrated the successful application of implantation technology to co-deliver timolol and hyaluronic acid from contact lenses for an extended period of time to treat glaucoma.
Kwok, L Stephen; Kuznetsov, Valerian A; Ho, Arthur; Coroneo, Minas T
Peripheral light-focusing (PLF) is an occult form of ultraviolet radiation (UVR) hazardous to the human eye. In PLF, obliquely incident light is refracted from the peripheral cornea to concentrated sites inside the anterior segment. In the current study, the directionality of this phenomenon for UVR and whether PLF is established in outdoor settings exposed to sunlight were investigated. The protection provided by a UV-blocking contact lens was also evaluated. UVA and UVB sensors were placed on the nasal limbus of an anatomically based model eye. The temporal limbus was exposed to a UV light source placed at various angles behind the frontal plane. PLF was quantified with the sensor output. The ensemble was mounted in the orbit of a mannequin head and exposed to sunlight in three insolation environments within the region of Sydney, Australia. PLF for UVA and UVB was determined with no eyewear or with sunglasses and commercially available soft contact lenses, with and without UV-blocking capability. The intensity of UVA peaked at approximately 120 degrees incidence, the level at which the UVB response was also at its maximum. The intensification of UVA was up to x18.3. The intensity of PLF for UVA and UVB was reduced by an order of magnitude by a UV-blocking contact lens, whereas a clear contact lenses had a much lesser effect. Only the UV-blocking contact lens achieved a significant effect on UVA and UVB irradiance in the urban, beach, and mountain locales (P < 0.056). The results identify another type of sunlight hazard: the peripheral focusing of obliquely incident light. UVR from albedo (reflected ambient light) is capable of establishing PLF in the anterior segment, but this can be shielded by UV-blocking soft contact lenses. Sunglasses may be unable to shield oblique rays, unless side protection is incorporated. Contact lenses can offer UVR protection against all angles of incidence, including the peak-response angle. They can also protect the eye in settings
Yuksel Elgin, Cansu; Iskeleli, Guzin; Aydin, Ovgu
To investigate changes in tear and ocular surface of patients with keratoconus using rigid gas permeable contact lenses (RGPCL) and compare them against keratoconus patients who were not using lenses as well as a control group of healthy subjects. 24 keratoconus patients using RGPCL (Group 1) 22 patients who were not using lenses (Group 3) and 21 healthy subjects (Group 3) were included in the study. Subjective complaints about the subjects' eyes have been investigated using the ocular-surface disease index (OSDI). After the control of best-corrected visual acuity, anterior chamber and fundus examinations were performed. Schirmer (p-value=0.01) and tear break up mean comparison tests (p-value=0.002) revealed significant differences across different groups but tear osmolarity analysis did not (p-value >0.05). Oxford and OSDI scores were compatible with Schirmer and tear break up test comparisons. (for both p-value=0.001) Moreover, no statistical differences were seen in impression cytology measures between groups. (p-value >0.05) CONCLUSIONS: The erosion in the tear film stability is in line with the erosion in the ocular surface epithelium. Taking into account the statistical indifference between the impression cytology measures across groups, the break up time differences may be attributed to the collagen destruction in tear. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Afzha, Rooh; Chatterjee, Anirban; Subbaiah, Shobha Krishna; Pradeep, Avani Rangaraju
Background: Ultrasonic scaler is a preferential treatment modality among the clinicians. However, the aerosol/splatter generated is a concern for patients and practitioners. Therefore, the purpose of this study was to evaluate contamination of contact lenses of the dentist after scaling and root planing using ultrasonic scalers with and without protective eyewear. Materials and Methods: Thirty patients were randomly selected for scaling and root planing and divided into 2 groups of 15 each. Group A – dentist wearing contact lenses and protective eyewear. Group B - dentist wearing only contact lenses. After scaling and root planing using ultrasonic scalers, the lenses were subjected to culture and 16S rRNA (16S ribosomal RNA) gene sequencing. Results: In Group A – 15 out of thirty samples were contaminated, in Group B – all the thirty samples were contaminated. Most of the samples showed Gram-positive bacteria and 5 samples were contaminated with fungi. 16S rRNA gene sequencing of forty contaminated samples showed that 31 were contaminated with Streptococcus mutans and 9 with Staphylococcus aureus. Conclusion: Keeping in mind the limitation of the study for the absence of negative control, we would like to conclude that dental practitioners should better avoid contact lenses in a dental setup because of the risk of contamination of the contact lenses from the various dental procedures which can produce aerosol/splatter and if worn, it is recommended to wear protective eyewear. PMID:27563200
Ali, Maryam; Horikawa, Shin; Venkatesh, Siddarth; Saha, Jishnu; Hong, Jong Wook; Byrne, Mark E
Zero-order or concentration independent release kinetics are highly desirable from drug delivery devices. In this paper we demonstrate experimentally, for the first time, zero-order release of a small molecular weight therapeutic, ketotifen fumarate (MW=425), from molecularly imprinted hydrogels used as therapeutic contact lenses. We performed dynamic, in vitro drug release studies from imprinted hydrogel contact lenses within a novel microfluidic device that simulates the volumetric flow rates, tear volume and tear composition of the eye. Imprinted gels with multiple functional monomers and complexation points to the drug demonstrated a significantly delayed release of drug compared to less functionalized systems. There were no statistical differences in experimentally determined equilibrium swollen polymer volume fractions, which correlate with molecular weight between crosslinks and mesh size of the gel. Under infinite sink conditions, imprinted contact lenses demonstrated Fickian (concentration dependent) release kinetics with diffusion coefficients ranging from 4.04 x 10(-9) to 5.57 x 10(-10) cm(2)/s. The highest functionalized gel exhibited a diffusion coefficient averaging ten times smaller than less functionalized gels and released drug for over 5 days with 3 distinct rates of release. Under physiological volumetric flow rates, the release rate was constant for a duration of 3.5 days delivering a therapeutically relevant dosage and was fit to a power law model indicating zero-order release characteristics with n=0.981+/-0.006 (r(2)=0.997). This work demonstrates the potential of micro/nanofluidic devices to determine physiological release rates and stresses the importance of matching local conditions to adequately characterize drug delivery devices. It also demonstrates the enormous potential for molecular imprinting to further tailor therapeutic release kinetics via the imprinting process.
Altoaimi, Basal H; Kollbaum, Pete; Meyer, Dawn; Bradley, Arthur
Multifocal or multi-zone contact lenses are increasingly being fit to young eyes in an attempt to control myopia progression. However, success in achieving this aim may depend on how much the eye accommodates. The purpose of the current work was to evaluate the ability of an open-field clinical autorefractor to measure on-axis refractive state and accommodation in eyes fit with multifocal contact lenses (CLs). Refractive state was measured with a Grand Seiko WAM-5500 autorefractor (www.grandseiko.com) and a clinical Shack-Hartmann Complete Ophthalmic Analysis System (COAS) aberrometer (www.wfsci.com) in subjects fit bilaterally with single vision aspheric contact lenses, centre distance, and centre near zonal multifocal CLs, and an experimental myopia control multi-zone bifocal CLs (MiSight). Autorefractor measurements were obtained when aligned with the pupil centre, pupil margin, and mid-periphery. Accuracy of refractive state measurements was evaluated using a fully presbyopic (62-year-old) dilated (pupil diameter = 7.1 mm) eye measured through known added spherical powers (trial lenses) of +1.00 D to +6.00 D. Refractive state and accommodation were measured for seven young myopic eyes (23.71 ± 2.87 years) with six target vergences ranging from -0.33 D to -5.00 D. Irrespective of the CL fitted, measured changes in refractive state of the calibration eye were within ≤0.25 D of the added sphere power and the slope (measured refractive state/trial lens power) was approximately -1.0 D/D for both Shack-Hartmann (COAS) aberrometer and Grand Seiko instruments. Also, the Grand Seiko data were highly repeatable (mean measurement standard deviation = 0.04 D) as long as measurements occurred at the same pupil location, but exhibited a hyperopic bias that increased to +1.00 D when eyes were fit with CLs containing significant negative spherical aberration. Centre and marginal refractive states could differ by >3.00 D due to the combined spherical aberration contained in
Karaküçük, Sarper; Mirza, G Ertuğrul; Karaküçük, Inci; Akal, Ali; Er, Mustafa
To determine whether nitric oxide (NO) is detectable in the tear fluid of patients with mild forms of papillary conjunctivitis who wear rigid gas-permeable contact lenses. Tear samples were taken from 12 users of rigid gas-permeable contact lenses and 12 healthy controls. Samples were analyzed, and the levels of NO were determined. The mean level of NO in those who wore contact lenses was 118.98 micromol/L (95% CI: 91.85-146.10 micromol/L); whereas the level of NO found in the control subjects was 114.84 micromol/L (95% CI: 102.54-127.14 micromol/L). The difference was statistically insignificant (P>0.05). Nitric oxide levels in the tear fluid of rigid gas-permeable contact lens users did not correlate with the presence of mild symptoms of papillary conjunctivitis.
Dominguez-Godinez, Carmen Olalla; Martin-Gil, Alba; Carracedo, Gonzalo; Guzman-Aranguez, Ana; González-Méijome, José Manuel; Pintor, Jesús
Purpose To evaluate the possible use of soft contact lenses (CL) to improve the secretagogue role of diadenosine tetraphosphate (Ap4A) promoting tear secretion. Methods Two conventional hydrogel CL (Omafilcon A and Ocufilcon D) and two silicone hydrogel (SiH) CL (Comfilcon A and Balafilcon A) were used. Ap4A was loaded into the lenses by soaking in a 1 mM Ap4A solution during 12 h. In vitro experiments were performed by placing the lenses in multi-wells during 2 h containing 1 ml of ultrapure water. 100 μl aliquots were taken at time zero and every minute for the first 10 min, and then every 15 min. In vivo experiments were performed in New Zealand rabbits and both the dinucleotide release from SiH and tear secretion were measured by means of Schirmer strips and high-pressure liquid chromatography (HPLC) analysis. Results Ap4A in vitro release experiments in hydrogel CL presented a release time 50 (RT50) of 3.9 ± 0.2 min and 3.1 ± 0.1 min for the non-ionic and the ionic CL, respectively. SiH CL released also Ap4A with RT50 values of 5.1 ± 0.1 min for the non-ionic and 2.7 ± 0.1 min for the ionic CL. In vivo experiments with SiH CL showed RT50 values of 9.3 ± 0.2 min and 8.5 ± 0.2 min for the non-ionic and the ionic respectively. The non-ionic lens Ap4A release was able to induce tear secretion above baseline tear levels for almost 360 min. Conclusion The delivery of Ap4A is slower and the effect lasts longer with non-ionic lenses than ionic lenses.
Li, Shi-Ming; Kang, Meng-Tian; Wu, Shan-Shan; Meng, Bo; Sun, Yun-Yun; Wei, Shi-Fei; Liu, Luoru; Peng, Xiaoxia; Chen, Zhuo; Zhang, Fengju; Wang, Ningli
To evaluate the effect of soft contact lens with concentric ring bifocal and peripheral add multifocal designs on controlling myopia progression in school-aged children. We systematically searched MEDLINE, EMBASE, Cochrane Library and reference lists of included trials. Methodological quality of included trials was assessed using Jadad Scale and Newcastle-Ottawa Quality Assessment Scale items. We identified five randomised controlled trials (RCTs) and three cohort studies with a total of 587 myopic children. Compared with the control group, concentric ring bifocal soft contact lenses showed less myopia progression with a weighted mean difference (WMD) of 0.31 D (95% CI, 0.05~0.57 D, p = 0.02) and less axial elongation with a WMD of -0.12 mm (95% CI, approximately -0.18 to -0.07 mm, p < 0.0001) at 12 months. Relative to the control group, peripheral add multifocal soft contact lenses showed less myopia progression with a WMD of 0.22 D (95% CI 0.14~0.31 D, p < 0.0001) and less axial elongation of -0.10 mm (95% CI -0.13~0.07 mm, p < 0.0001) at 12 months, respectively. The soft contact lenses with concentric ring bifocal and peripheral add multifocal designs produced additional myopia control rates of 30~38% for slowing myopia progression and 31~51% for lessening axial elongation within 24 months. Both concentric ring bifocal and peripheral add multifocal soft contact lenses are clinically effective for controlling myopia in school-aged children, with an overall myopia control rates of 30~50% over 2 years. Concentric ring bifocal soft contact lenses seem to have greater effect than peripheral add multifocal soft contact lenses. © 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.
Michaud, Langis; Bennett, Edward S; Woo, Stephanie L; Reeder, Renee; Morgan, Bruce W; Dinardo, Amy; Harthan, Jennifer S
This study aims to address the clinical performance of a large diameter rigid gas permeable lens (LRGP) in a group of subjects with low-to-moderate (0.75-2.75 D) refractive astigmatism. An additional goal was to determine whether soft toric or LRGP contact lenses performed better objectively in the correction of astigmatism and to determine which modality is preferred by subjects. This was a multisite prospective cross-over clinical study. Ten asymptomatic contact lens wearers per site (four university clinics) were recruited and randomly assigned to group A or group B. Group A was assigned to start wearing Comfilcon A soft toric lens first, for two weeks, and then crossed over to LRGP lenses (Boston XO, 14.3 mm diameter miniscleral lens). Group B initially wore LRGP lenses and then crossed over to soft toric lenses. For each type of lens worn, low-contrast and high-contrast visual acuity (VA) were evaluated at distance. At the conclusion of the study, after two months, all subjects completed a questionnaire in which they were asked to indicate their preference for one type of lens (soft toric or LRGP) and to rate the quality of vision in day-to-day activities. Thirty-six of 38 (94.7%) subjects completed the study with 75% preferring the vision of the LRGP lens as compared to the soft toric lenses worn in the study. 52.7% expressed a preference to continue with this modality despite only 38.8% reporting that these LRGP lenses are easy or very easy to handle. Wear time, subjective comfort, and subjective vision ratings exhibited no significant difference between the two groups. In a population of asymptomatic contact lens wearers, LRGP lenses can be considered as a good alternative to soft toric lenses for the correction of refractive astigmatism.
Filipecki, J; Kocela, A; Korzekwa, P; Miedzinski, R; Filipecka, K; Golis, E; Korzekwa, W
A study has been conducted in order to determine presence of free volume gaps in the structure of structure of polymer hydrogel contact lenses made in phosphoryl choline technology and of the degree of defect of its structure. The study was made by means of positron annihilation lifetime spectroscopy. As a result of the conducted measurements, curves were obtained, which described numbers of counts of the acts of annihilation in the time function. The conducted studies revealed existence of three components τ(1), τ(2) and τ(3). The τ(3) component is attributed to the pick-off annihilation of o-Ps orthopositronium trapping by free volume gaps and provides information about geometrical parameters of the volumes. At the same time, the UV-vis-NIR spectrometry examination was conducted on the same samples in the spectral range 200-1,000 nm.
Ramachandran, L; Janakiraman, D; Sharma, S; Rao, G N
This study was undertaken to determine the extent of adhesion of cysts and trophozoites of Acanthamoeba to worn disposable hydrogel lenses and to study the effect of time, lens material, and washing on the adhesion. Etafilcon A (58% water content) and Polymacon (38% water content) lenses worn on a 6 night extended wear basis and collected aseptically in PBS pH 7.2, were used for the study. Unworn lenses of the same materials were used as controls. Segments of lenses were incubated in Acanthamoeba suspension (cysts and trophozoites) and examined at 0, 5, and 24 hours, either washed or unwashed, for adherent Acanthamoeba. The amoebae adherent per square mm surface of the lens were enumerated. Levels of adhesion in various groups were compared using Wilcoxon sign rank test. At 0 hours, unwashed worn Polymacon lenses showed significantly greater adherence than Etafilcon A lenses compared to the controls (P = 0.0469). However, there was no difference at 5 and 24 hours exposure time between the lenses. At 24 hours the adhesion of Acanthamoeba was greater for washed worn lenses of both types compared to washed lenses of controls (P = 0.002, 0.012). Amoebae adhered with equal affinity to both types of lenses but adhered with greater affinity to worn lenses than unworn lenses. Adhesion of Acanthamoeba to worn disposable lenses may be a factor in the pathogenesis of Acanthamoeba keratitis in disposable lens wearers.
Svitova, Tatyana F.; Lin, Meng C.
Purpose To explore interfacial behaviors and effect of temperature and dilatation on dynamic properties of multilayered human tear lipids extracted from silicone hydrogel (SiH) lenses worn by asymptomatic Asian and Caucasian subjects. Methods Interfacial properties of lipids extracted from Focus® N&D lenses worn by 14 subjects continuously for 1 month were studied. The lipids were deposited on an air bubble immersed in a model tear electrolytes (MTE) solution to form 100 ± 20 nm-thick films. Surface pressure was recorded during slow expansion/contraction cycles to evaluate compressibility and hysteresis of lipid films. Films were also subjected to fast step-strain dilatations at temperatures 22°–45° C for their visco-elastic properties assessment. Results Iso-cycles for Asian and Caucasian lipids were similar at low surface pressures, but had distinctly different compressibility and hysteresis at dynamic pressures exceeding 30 mN/m. Rheological parameters of reconstituted lipids were also dissimilar between Asian and Caucasian. The elastic modulusE∞ for Caucasian lipids was 1.5 times higher than that for Asian lipids, whereas relaxation time (t) was on average 1.3 times higher for Asian. No significant changes were observed in rheological properties of both Asian and Caucasian lipids when temperature increased from 22.0° to 36.5° C. However, for Caucasian lipids, E∞ reduced considerably at temperatures above 42.0° C, while t remained unchanged. For Asian lipids, both E∞ and t started to decline as temperature increased to 38° C and higher. Conclusions Higher elastic modulus of Caucasian lipids and elasticity threshold at certain deformations indicate stronger structure and intermolecular interactions as compared with more viscous Asian lipids. The differences in interfacial behaviors between Asian and Caucasian lipids may be associated with the differences in their chemical compositions. PMID:24270592
Ritzmann, Markus; Caroline, Patrick J; Börret, Rainer; Korszen, Emily
The purpose of this study was to evaluate the shape of the anterior sclera by measuring the sagittal height and corneoscleral transition angles in the four cardinal and four oblique segments of the eye. In this study, 78 normal eyes of 39 subjects were evaluated. The sagittal height, corneoscleral angle and scleral angle were measured at three chord lengths (10.0mm, 12.8mm and 15.0mm) in all eight segments of the anterior eye using optical coherence tomography (Zeiss Visante AS-OCT). Scleral toricity was calculated for each eye, defined as the greatest sagittal height difference found between two perpendicular meridians. At a 12.8mm chord length, the shape of the anterior eye was found to be nearly rotationally symmetric, and at a chord of 15.0mm the shape became more asymmetric. The average sagittal heights of the eight segments at a 12.8mm chord ranged from 2890μm to 2940μm; at a 15.0mm chord they ranged from 3680μm to 3790μm. The average scleral angles at a 15.0mm chord ranged from 35.17° to 38.82°. Significant differences between opposing segments were found in the sagittal height and scleral angle measurements at a chord of 15.0mm (sagittal height p≤0.0021; scleral angle p≤0.0105). The nasal measurements revealed flatter scleral angles and concave corneoscleral transitions, whereas temporal scleral angles were steeper, with tangential or convex corneoscleral transitions. These findings are important to consider when designing and fitting contact lenses that rest beyond the boundaries of the limbus, such as scleral lenses. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Lonnen, James; Putt, Karson S; Kernick, Edward R; Lakkis, Carol; May, Lauren; Pugh, Randall B
To assess the efficacy of a novel ultraviolet (UV) lens device on the killing of Acanthamoeba cysts and the impact of efficacious doses of UV upon soft contact lens parameter and material characteristics. Prospective, in vitro, experimental study of a device. A UV lens device was constructed and used to expose Acanthamoeba cysts to various levels of UV irradiation. Once an efficacious dose, as defined by a greater than 3 log reduction, was determined (130 mJ/cm(2)), 6 soft contact lens materials (etafilcon A, senofilcon A, galyfilcon A, lotrafilcon A, polymacon, and comfilcon A) were exposed to that dose for 30 cycles and tested for visual parameters, mechanical parameters, and cytotoxicity. The UV device produced an average log reduction of over 3.5 log of Acanthamoeba cysts when the lens and solution inside of the inset case was irradiated with 130 mJ per cm(2) of UV or greater. After 30 cycles of 130 mJ per cm(2) UV dose each, no gross changes were observed in mechanical properties or cytotoxicity tests in any soft contact lenses tested. In visual parameters, polymacon and lotrafilcon A exhibited a shift in sphere power and diameter, respectively. The novel UV lens device was able to provide a marked log reduction to Acanthamoeba cysts, one of the most resistant ocular disease-causing organisms found in lens cases, without a detrimental effect on many lens materials. Copyright © 2014 Elsevier Inc. All rights reserved.
Fortuin, Marten F; Schilperoort, John; Evans, Bruce Jw; Edgar, David F; Manon, Hector M Tello; Kiers, Henri
To compare comfort-related outcomes when wearing rigid gas permeable (RGP) contact lenses made of two different materials and using two cleaning regimes. In a double-masked lens material cross-over study, subjects (n = 28 who completed the study) were refitted with new lenses made from (A) Boston XO material in one eye and made from (B) ONSI-56 material in the other eye. The lenses made from materials A and B were worn on the right eye and the left eye following the pattern AB-BA-AB (or vice versa) during the first, second, and third 5 week trial periods respectively. Miraflow cleaner (1st and 2nd period) was replaced by Boston Advance cleaner in the 3rd period. Comfort-related outcomes were assessed by a numerical rating scale (NRS) after each period. Subjects rated six comfort-related factors: satisfaction, sharpness of vision, end of day comfort, maximum comfortable wearing time, maximum wearing time and foreign body feeling. Additionally we obtained subjects' preferences for type of lens and lens cleaner during an exit interview. The sessile drop method was used to measure static contact angles. The mean of the contact angle measured for the Boston XO material was 93.3° and for the ONSI-56 material was 75.8 °. Mean 'end of the day comfort', 'satisfaction' and 'lens feeling' scores reached statistical significance (anova periods 1, 2 and 3, p's: 0.005, 0.028, 0.046, n = 23) with marginal differences in favour of those eyes that had worn lenses made of the ONSI-56 material (differences in mean scores on a 1-10 NRS never exceeded 0.7, 0.5 and 0.2 points in periods 1, 2, 3 respectively). At the exit interview 60% of the subjects (n = 17) were not able to express a preference for wearing either of the lenses, while 29% reported some preference for lenses made of the ONSI-56 material (n = 8) and 11% for wearing lenses made of the Boston XO material (n = 3) within one or more periods. The differences in comfort-related outcomes between contact lenses made from two
Park, Jihun; Kim, Joohee; Kim, So-Yun; Cheong, Woon Hyung; Jang, Jiuk; Park, Young-Geun; Na, Kyungmin; Kim, Yun-Tae; Heo, Jun Hyuk; Lee, Chang Young; Lee, Jung Heon; Bien, Franklin; Park, Jang-Ung
Recent advances in wearable electronics combined with wireless communications are essential to the realization of medical applications through health monitoring technologies. For example, a smart contact lens, which is capable of monitoring the physiological information of the eye and tear fluid, could provide real-time, noninvasive medical diagnostics. However, previous reports concerning the smart contact lens have indicated that opaque and brittle components have been used to enable the operation of the electronic device, and this could block the user’s vision and potentially damage the eye. In addition, the use of expensive and bulky equipment to measure signals from the contact lens sensors could interfere with the user’s external activities. Thus, we report an unconventional approach for the fabrication of a soft, smart contact lens in which glucose sensors, wireless power transfer circuits, and display pixels to visualize sensing signals in real time are fully integrated using transparent and stretchable nanostructures. The integration of this display into the smart lens eliminates the need for additional, bulky measurement equipment. This soft, smart contact lens can be transparent, providing a clear view by matching the refractive indices of its locally patterned areas. The resulting soft, smart contact lens provides real-time, wireless operation, and there are in vivo tests to monitor the glucose concentration in tears (suitable for determining the fasting glucose level in the tears of diabetic patients) and, simultaneously, to provide sensing results through the contact lens display. PMID:29387797
Gargallo, Ana; Arines, Justo
We have adapted low cost webcams to the slit lamps objectives with the aim of improving contact lens fitting practice. With this solution we obtain good quality pictures and videos, we also recorded videos of eye examination, evaluation routines of contact lens fitting, and the final practice exam of our students. In addition, the video system increases the interactions between students because they could see what their colleagues are doing and take conscious of their mistakes, helping and correcting each others. We think that the proposed system is a low cost solution for supporting the training in contact lens fitting practice.
Walsh, James E; Bergmanson, Jan P G; Saldana, Gerardo; Gaume, Amber
Peak solar UV radiation (UVR) intensities are typically experienced in summer months. People living in the southern states of the United States, where the UVR frequently exceeds the recommended minimum erythema dose (MED), are at particular risk, especially outdoor workers. The present study analyzed summertime MED readings in Houston, TX, to assess the frequency of intensities regarded as unhealthy. The study also sought to assess whether UV-blocking hydrogel contact lenses provide ocular protection from these high doses. Readings, taken at midday using a UVR biometer, were analyzed to assess the potential UVR risk. The spectral response of the meter, modified by the spectral transmission curves of the contact lenses, allowed us to mathematically assess the ocular protection provided. In addition, ambient UVR measurements were taken at midday, using a portable UVR radiometer. The detector was adapted so that a standard diameter hydrogel contact lens could be placed over it to quantify the UV-blocking capabilities of the lens. The MED readings showed that the recommended safety standards were exceeded approximately at local midday 90% of the time. Model calculations and empirical data demonstrated that contact lenses attenuated the MED readings by up to 90%, bringing them well within the recommended Environmental Protection Agency safety standards. The efficacy of the model used in this study was verified through direct comparison of the modeled and measured data. UV-blocking hydrogel soft contact lenses reduce the MED to the human eye and therefore limit the lifetime ocular dose. These lenses are highly recommended to prevent the development of UVR-related ocular pathologic conditions.
Salopek-Rabatić, Jasminka; Pavan, Josip; Kastelan, Snjezana; Rabatić, Leon
Anisometropy as a first step on a way forward future amblyopic child, can be prevent and treat if this condition is recognased on time. Second step is wisdom, right contact lens fit on bothes eyes. As follow, some ortoptic-pleoptic procedures depending on (objective, subjective squinting angle, state of fusion, visus on bothes eyes and separatly each eay and condition of nervus opticus (VEP), normal or absent retinal corespondence, are recomended. There is no limit how old a child is, but best choice and best compliance is age between five and twelve. Contact lens materiales, different fit procedures, right diagnosys and tips all about are discussed.
Walther, Hendrik; Phan, Chau-Minh; Subbaraman, Lakshman N; Jones, Lyndon
We evaluate the differences in lipid uptake and penetration in daily disposable (DD) contact lenses (CL) using a conventional "in-vial" method compared to a novel in vitro eye model. The penetration of fluorescently labelled 22-(N-(7-Nitrobenz-2-Oxa-1,3-Diazol-4-yl)Amino)-23,24-Bisnor-5-Cholen-3beta-Ol (NBD)-cholesterol on three silicone hydrogel (SH) and four conventional hydrogel (CH) DD CLs were investigated. CLs were incubated for 4 and 12 hours in a vial, containing 3.5 mL artificial tear solution (ATS), or were mounted on an in vitro eye-blink platform designed to simulate physiologic tear flow (2 mL/24 hours), tear volume and "simulated" blinking. Subsequently, CLs were analyzed using laser scanning confocal microscopy and ImageJ. Penetration depth and fluorescence intensities of NBD-cholesterol varied between the incubation methods as well as lens materials. Using the traditional vial incubation method, NBD-cholesterol uptake occurred equally on both sides of all lens materials. However, using our eye-blink model, cholesterol penetration was observed primarily on the anterior surface of the CLs. In general, SH lenses showed higher intensities of NBD-cholesterol than CH materials. The traditional "in-vial" incubation method exposes the CLs to an excessively high amount of ATS, which results in an overestimation for cholesterol deposition. Our model, which incorporates important ocular factors, such as intermittent air exposure, small tear volume, and physiological tear flow between blinks, provides a more natural environment for in vitro lens incubation. In vitro measurements of CLs are a common approach to predict their interactions and performance on the eye. Traditional methods, however, are rudimentary. Therefore, this study presents a novel in vitro model to evaluate CLs, which consequently will enhance elucidations of the interactions between CLs and the eye.
Vincent, Stephen J; Alonso-Caneiro, David; Collins, Michael J
To examine the time course of the reduction in central corneal clearance and horizontal and vertical lens translation (decentration) during miniscleral contact lens wear and the theoretical influence upon the optics of the post-lens tear layer. Repeated high-resolution OCT images were captured over an 8h period of miniscleral contact lens wear (using a rotationally symmetric 16.5mm diameter lens) in 15 young, healthy participants with normal corneae. Central corneal clearance and lens decentration were derived from OCT images using semi-automated image processing techniques. Central corneal clearance decreased exponentially over time, reducing by 76±8μm over 8h. Fifty percent of this reduction occurred within 45min of lens wear and seventy-five percent within 2h, with thinning of the post-lens tear layer plateauing 4h after lens insertion. Lens translation exhibited a similar pattern of change (0.18±0.04mm temporal and 0.20±0.09mm inferior decentration) stabilising 1.5-2h after insertion. The change in the lens fit over time resulted in a small reduction in the power of the post-lens tear layer (-0.12±0.01 D) and induced a prismatic effect of 0.01±0.16 Δ base out and 0.50±0.19 Δ base down relative to the pupil centre. For the miniscleral contact lens studied, horizontal and vertical lens decentration followed an exponential decay over 8h that plateaued approximately 2h after lens insertion, while central post-lens tear layer thinning plateaued after 4h of lens wear. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Abahussin, Mohammed; AlAnazi, Muteb; Ogbuehi, Kelechi C; Osuagwu, Uchechukwu L
To assess the prevalence and general knowledge of contact lens (CL) wear among women users and to examine the practice of CL dispensation by non-ophthalmic stores. One thousand four hundred and sixty-six female university students, between 16 and 31 years of age, and 1766 registered beauty stores in the region were randomly interviewed using self-administered questionnaires. The questions addressed general care/handling of CLs, CL case and solution hygiene practices by patients, the CL selection available in the shops, the type of instructions given to consumers, and who gives these instructions. The prevalence of CL use was 70.2% (1029/1466). Fifty percent were part time users of CLs, and cosmetic reasons were the major reason (63.3%) for CL use. Approximately 38.7% of the respondents used CL without consultation with an eye care practitioner. The main purchasing locations were optical shops (51%), beauty salons (38%), and pharmacies (11%). Concerning contact lens care, 89.4% of the respondents adequately washed their hands before handling CLs and 72.7% changed their solutions daily, while 7.7% admitted to occasional overnight wear of their CL and 27.6% sometimes shared their CLs with friends. Interestingly, 80.3% of the 1327 shops sold CLs with no prescription, and 61.4% gave no instructions to the patients during purchase. There is a high prevalence of CL use by female university students in Saudi Arabia, especially for cosmetic purposes. Although, there was good awareness with regard to general lens care practices, some users shared their lenses with friends, and the rate of sale of CLs without prescriptions in ordinary shops was high. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Yun, Jun-Won; Hailian, Quan; Na, Yirang; Kang, Byeong-Cheol; Yoon, Jung-Hee; Cho, Eun-Young; Lee, Miri; Kim, Da-Eun; Bae, SeungJin; Seok, Seung Hyeok; Lim, Kyung-Min
In an effort to explore the use of alternative methods to animal testing for the evaluation of the ocular irritancy of medical devices, we evaluated representative contact lenses with the bovine corneal opacity and permeability test (BCOP) and an in vitro eye irritation test using the three-dimensionally-reconstructed human corneal epithelium (RhCE) models, EpiOcular™ and MCTT HCE™. In addition, we compared the obtained results with the ISO standard in vivo rabbit eye irritation test (ISO10993-10). Along with the positive controls (benzalkonium chloride, BAK, 0.02, 0.2, and 1%), the extracts of 4 representative contact lenses (soft, disposable, hard, and colored lenses) and 2 reference lenses (dye-eluting and BAK-coated lenses) were tested. All the lenses, except for the BAK-coated lens, were determined non-irritants in all test methods, while the positive controls yielded relevant results. More importantly, BCOP, EpiOcular™, and MCTT HCE™ yielded a consistent decision for all the tested samples, with the exception of 0.2% BAK in BCOP, for which no prediction could be made. Overall, all the in vitro tests correlated well with the in vivo rabbit eye irritation test, and furthermore, the combination of in vitro tests as a tiered testing strategy was able to produce results similar to those seen in vivo. These observations suggest that such methods can be used as alternative assays to replace the conventional in vivo test method in the evaluation of the ocular irritancy of ophthalmic medical devices, although further study is necessary. Copyright © 2016. Published by Elsevier Ltd.
Chalmers, Robin L; Wagner, Heidi; Kinoshita, Beth; Sorbara, Luigina; Mitchell, G Lynn; Lam, Dawn; Richdale, Kathryn; Zimmerman, Aaron
To compare the habits of United States (US) soft contact lens (SCL) wearers who bought SCLs from their eye care practitioner (ECP), on the internet/telephone, or at retail (not where they were examined) to test the effect of proximity to the prescriber on SCL wear and care practices. Adult SCL wearers completed an adapted Contact Lens Risk Survey (CLRS) online that queried items related to risk factors for SCL-related complications. Responses from subjects who purchased at the ECP, via the internet/telephone, or at a retail store were compared (Chi-Square). Purchase sources were: ECP 646 (67%, 44±12 yrs, 17% male), Retail 104 (11%, 45±13 yrs, 28% male), and Internet/telephone 218 (23%, 45±12 yrs, 18% male); age (p=0.51), gender (p=0.021). Internet purchasers had fewer annual eye exams (79% ECP, 83% retail, 66% internet/telephone, p=0.007), purchased more hydrogel SCLs (34% ECP, 29% retail, 45% internet/telephone, p=0.0034), and paid for SCLs with insurance less often (39% ECP, 29% retail, 19% internet/telephone, p<0.0001). Other behaviors were similar across groups (p>0.05). In this sample, the purchase location of SCL wearers had limited impact on known risk factors for SCL-related complications. Internet purchasers reported less frequent eye exams and were more likely to be wearing hydrogel SCLs. Closer access to the ECP through in-office SCL purchase did not improve SCL habits or reduce the prevalence of risk behaviors. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Reza, Syed Azer; Riza, Nabeel A.
To the best of the author's knowledge, demonstrated is the first opto-fluidic technology- based sensor for detection of liquid levels. An opto-fluidic Electronically Controlled Variable Focus Lens (ECVFL) is used to change the spatial intensity profile of the low power optical beam falling on the liquid surface. By observing, tuning and measuring the liquid surface reflected intensity profile to reach its smallest size, the liquid level is determined through a beam spot size versus ECVFL focal length calibration table. Using a 50 μW 632.8 nm laser wavelength liquid illuminating beam, a proof-of-concept sensor is tested using engine oil, vegetable oil, and detergent fluid with measured liquid levels over a 75 cm range. This non-contact Radio Frequency (RF) modulation-free sensor is particularly suited for hazardous fluids in window-accessed sealed containers including liquid carrying vessels in Electromagnetic Interference (EMI) rich environments.
Qu, Wenwen; Hooymans, Johanna M M; Qiu, Jun; de-Bont, Nik; Gelling, Onko-Jan; van der Mei, Henny C; Busscher, Henk J
Surface properties of lens cases are determinant for their cleanability and for microbial transmission from lens cases to contact lenses (CLs). PEG-polymer-brush-coatings are known to decrease microbial adhesion more than other surface-coatings. Here, we applied a robust, silica nanoparticles-based brush-coating to polypropylene cases to evaluate their ease of cleaning and probability of bacterial transmission to CLs. Adhesion forces of nine bacterial strains (Pseudomonas, Staphylococci, and Serratia) to rigid CLs, polypropylene, and silica nanoparticles-based brush-coated polypropylene were measured using atomic-force-microscopy and subjected to Weibull analyses to yield bacterial transmission probabilities. Biofilms of each strain were grown in coated and uncoated cases and rinsed with a NaCl or antimicrobial lens care solution. Residual, viable organisms were quantified. Bacterial adhesion forces of all strains were significantly, up to tenfold smaller on brush-coated than on uncoated polypropylene. This yielded, higher transmission probabilities to a CL, but mild-rinsing yielded 10-100 fold higher removal of bacteria from brush-coated than from polypropylene cases. Moreover, due to weak adhesion forces, bacteria on brush-coated cases were two-to-three fold more susceptible to an antimicrobial lens care solution than on polypropylene cases. Therewith, the design of lens case surfaces is a compromise between ease of cleaning and transmission probability to CLs. Copyright © 2013 Wiley Periodicals, Inc.
Sanchez, I; Ortiz-Toquero, S; Blanco, M; Martin, R
Presbyopic contact lens (CL) fittings produce simultaneous vision, providing different retinal images that reduce visual quality and wearers' satisfaction. The purpose of this study was to develop a new method to isolate the multifocality effect of different CL options to manage presbyopia, analysing the impact on binocular visual acuity (VA), stereopsis and contrast sensitivity (CS) and determining the effect of the use of a yellow filter (YF) on visual function. A prospective and double-masked randomized pilot study involving 20 healthy volunteers was conducted. Four multifocal CLs and monovision CLs without far prescription were fitted. All subjects wore their spectacles over the CLs to guarantee optimum VA at distance. Binocular VA, stereopsis and CS were assessed after 20min of CL wear with or without a YF of 455nm. Binocular VA decreased with all multifocal CLs (P<0.05), as did stereopsis (P<0.01). All presbyopia correction reduced CS compared with spectacles (P<0.05), except aspheric designs, at a frequency of 3 cycles/° (P>0.06). Using the YF, visual function improved; better binocular VA was found with all multifocal CLs (statistically significant (P<0.02) with both low-addition designs), and better CS was observed at most spatial frequencies (statistically significant (P<0.02) at low frequencies with all CLs). This pilot study proposes a simple method to analyse the impact of multifocal CL wear on VA, stereopsis and CS while maintaining habitual spectacle correction to assess the patient's short-term opinion and help practitioners and patients make a decision during presbyopia correction with CL fitting. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
González-Méijome, José Manuel; da Silva, Ana Carla; Neves, Helena; Lopes-Ferreira, Daniela; Queirós, António; Jorge, Jorge
To compare the performance of two novel multipurpose disinfecting solutions (MPDS) in preventing silicone hydrogel contact lens dehydration, provide higher scores of subjective comfort and stable optical quality during a month of lens wear in neophyte volunteers. This is a prospective, double-blind, contralateral and randomised study involving the contra lateral use of Complete RevitaLens and Biotrue MPDS. Twenty-five neophytes wore Air Optix Aqua for 1 month. Volunteers were evaluated on day 1 and day 30 at 2 and 10h after lens insertion. Tear film stability using Tearscope Plus (Keeler, UK), whole eye aberrations for 4.5mm pupil size (IRx3, ImaginEyes, France) and subjective comfort (0-10 score) along with the dehydration values obtained with a gravimetric method were collected at each follow-up visit. NIBUT values decreased significantly with both care systems from baseline to 10h visit on day 1 (p=0.032 and 0.016, mean difference=-6.7s and -7.0 s, for Complete Revitalens and Biotrue, respectively). Dehydration rates and ocular aberrations did not change significantly over the month of follow-up (p>0.05, ANOVA with Bonferroni post hoc corrections), nor between visits within the same day (p>0.05, paired sample T-test). End-of-day dryness sensation worsened similarly with both MPDS after 1 month (p=0.021 and 0.005, mean difference=-1.4 and -1.3, for Complete Revitalens and Biotrue, respectively). Regardless of their different chemical compositions in terms of moisture additives both MPDS solutions evaluated performed similarly regarding objective measures of dehydration, tear stability and optical quality but presented significant differences in subjective symptoms. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Arines, Justo; Gargallo, Ana
The training in the use of the slit lamp has always been difficult for students of the degree in Optics and Optometry. Instruments with associated cameras helps a lot in this task, they allow teachers to observe and control if the students evaluate the eye health appropriately, correct use errors and show them how to do it with a visual demonstration. However, these devices are more expensive than those that do not have an integrated camera connected to a display unit. With the aim to improve students' skills in the management of slit lamp, we have adapted USB HD webcams (Microsoft Lifecam HD-5000) to the objectives of the slit lamps available in our contact lenses laboratory room. The webcams are connected to a PC running Linux Ubuntu 11.0; therefore that is a low-cost device. Our experience shows that single method has several advantages. It allows us to take pictures with a good quality of different conditions of the eye health; we can record videos of eye evaluation and make demonstrations of the instrument. Besides it increases the interactions between students because they could see what their colleagues are doing and take conscious of the mistakes, helping and correcting each others. It is a useful tool in the practical exam too. We think that the method supports the training in optometry practice and increase the students' confidence without a huge outlay.
Moro, A; Fagnola, M; Picarazzi, S; Di Dio, A; Pastori, V; Lecchi, M; Tavazzi, S
The aim is discussing the origins of worsening of external eye condition (EEC) and of tear film (TF) instability after wear of silicone-hydrogel contact lenses (CLs) with hydrogen-peroxide (H 2 O 2 ) care system. EEC and TF stability were evaluated before and after 15days of wear combined with different care systems: (1) H 2 O 2 , (2) detergent solution and H 2 O 2 , (3) multipurpose solution (MPS), (4) H 2 O 2 and artificial tears. In-vitro cell mortality tests were performed after 24h cell incubation with CLs treated with H 2 O 2 . Photon correlation spectroscopy (PCS) was carried out on tears of non-wearers and CL wearers who used MPS or H 2 O 2 solution. Worsening of EEC was observed only for the group using H 2 O 2 (group 1). In-vitro, cell mortality was found higher for worn CL than for unworn CLs. Worsening of TF stability was observed regardless of care system and also PCS results on tears of CL wearers were found different compared to non-wearers regardless of care system. The only observed remedy for tear instability of CL wearers was found to be the administration of artificial tears. Worsening of EEC of CL wearers using H 2 O 2 is attributed to H 2 O 2 scarce cleaning efficacy, which can be solved by adding a CL detergent solution. The origin of TF instability is found to be different. A remedy was found to be the administration of artificial tears, whose effect could be attributed either to the role of specific components or to rinsing and replacement of TF during wear. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Fritsche, T R; Gautom, R K; Seyedirashti, S; Bergeron, D L; Lindquist, T D
Free-living and parasitic protozoa are known to harbor a variety of endosymbiotic bacteria, although the roles such endosymbionts play in host survival, infectivity, and invasiveness are unclear. We have identified the presence of intracellular bacteria in 14 of 57 (24%) axenically grown Acanthamoeba isolates examined. These organisms are gram negative and non-acid fast, and they cannot be cultured by routine methodologies, although electron microscopy reveals evidence for multiplication within the amoebic cytoplasm. Examination for Legionella spp. with culture and nucleic acid probes has proven unsuccessful. We conclude that these bacteria are endosymbionts which have an obligate need to multiply within their amoebic hosts. Rod-shaped bacteria were identified in 5 of 23 clinical Acanthamoeba isolates (3 of 19 corneal isolates and 2 of 4 contact lens isolates), 4 of 25 environmental Acanthamoeba isolates, and 2 of 9 American Type Culture Collection Acanthamoeba isolates (ATCC 30868 and ATCC 30871) previously unrecognized as having endosymbionts. Coccus-shaped bacteria were present in one clinical (corneal) isolate and two environmental isolates. There was no statistical difference (P > 0.8) between the numbers of endosymbiont strains originating from clinical (26% positive) and environmental (24% positive) amoebic isolates, suggesting that the presence alone of these bacteria does not enhance amoebic infectivity. Rods and cocci were found in both clinical and environmental isolates from different geographical areas (Seattle, Wash., and Portland, Oreg.), demonstrating their widespread occurrence in nature. Our findings suggest that endosymbiosis occurs commonly among members of the family Acanthamoebidae and that the endosymbionts comprise a diverse taxonomic assemblage. The role such endosymbionts may play in pathogenesis remains unknown, although a variety of exogenous bacteria have been implicated in the development of amoebic keratitis, warranting further
Lin, Meng C; Yeh, Thao N; Graham, Andrew D; Truong, Tan; Hsiao, Carol; Wei, Guan; Louie, Audrey
To determine the effects on corneal epithelial permeability and ocular response of 30 nights of continuous wear (CW) of gas permeable (GP) and silicone hydrogel (SiH) contact lenses. Ninety-one subjects successfully completed 30 days of CW of either GP (n = 42) or SiH (n = 49) contact lenses. Epithelial permeability (P(dc)) was measured by scanning fluorometer at an afternoon (PM) baseline session and again the next morning (AM). One randomly selected eye of each subject was patched overnight and the patch removed immediately before the AM visit. P(dc) measurements and ocular examinations were conducted at baseline and after 30 days of CW. Epithelial permeability increased significantly after 30 days of CW in the patched eyes of the GP group (P = 0.022) and in the unpatched eyes of the SiH group (P = 0.004). The increase was driven primarily by the Asian subjects in each group (GP, P = 0.015; SiH, P = 0.001). There was no significant increase in either lens group in the non-Asian subjects. Multivariate models suggest that the change in AM P(dc) from baseline to 30 days of CW was also related to lens type (P = 0.035), time awake before measurement (P = 0.001), palpebral aperture size (P = 0.003), lens deposits (P = 0.020), and horizontal lens bearing (P = 0.003). Subclinical increases in epithelial permeability can be caused by contact lens CW, despite the elimination of hypoxia. GP lenses permit recovery of the epithelium more quickly than do SiH lenses. Asians appear to be more susceptible to contact lens-induced epithelial changes than do non-Asians.
Topakova, Anastassia A.; Salmin, Vladimir V.; Gar'kavenko, Victor V.; Levchenko, Julia S.; Lazarenko, Victor I.
Fluorimetry of eye is a perspective technique for research and diagnostics in ophthalmology. It is connected to the structural and functional characteristics of eye that is, actually, the optical system allowing transferring the radiation both for excitation and for registration of fluorescence in different eye's compartments: cornea, lens, vitreous body, and fundus of the eye. At present, different models of ophthalmologic fluorophotometers for the analysis of eye fluorescence as well as more advanced models - scanning fluorophotometers - are offered. Assessment of corneal status in persons wearing contact lenses or in patients with pathological changes (i.e. diabetes mellitus) would give us an opportunity to identify the initial manifestations of corneal pathology at the pre-symptomatic phase. In this paper, we present data on the compact spectrofluorimeter with UV LEDs-induced excitation as well as the method for assessing hypoxic alterations in the eye limb zone caused by contact lenses wearing. We demonstrate dependence of autofluorescence spectra on the contact lenses types and duration of their permanent wearing.
Severinsky, Boris; Wajnsztajn, Denise; Frucht-Pery, Joseph
The aim was to the evaluate performance of a novel silicone hydrogel mini-scleral contact lens (SHmS) for optical correction of keratoconus in the early stages after the corneal collagen cross-linking procedure (CXL). We retrospectively analysed the visual acuity improvement and corneal adaptation in the first 10 eyes of nine patients fitted with SHmS lenses one to 3.5 months after corneal collagen cross-linking. The lenses were designed to rest over the patients' sclera and peri-limbal cornea and vault the central cornea with minimal support over it. Visual acuities with manifest refraction and contact lenses, refractive and topographical values (Kmin and Kmax) were evaluated on lens dispensing and after six month of lens wearing. Ocular physiological responses were evaluated using the Institute of Eye Research (IER) grading scales. SHmS fitting was performed 2.1 ± 0.97 (SD) months after collagen cross-linking. Mean follow up was 10.9 ± 4.41 months (range six to 18 months). Mean decimal visual acuity with SHmS was 0.66 ± 0.22 (approximately 6/9 Snellen fraction, range 0.3 to 0.1) or 0.75 ± 0.14 (approximately 6/8.1, range 0.5 to 1.0), when omitting two amblyopic eyes. Nine (90 per cent) eyes were successfully fitted, that is, able to wear the lenses for 10 hours per day or longer. Mean wearing time was 11.7 hours (range six to 14) per day. No corneal neovascularisation or papillary reaction was found in all fitted eyes. SHmS contact lenses provide successful visual rehabilitation shortly after corneal collagen cross-linking. This new soft contact lens design with scleral fixation and minimal apical touch was demonstrated to be safe shortly after collagen cross-linking, as the avoidance of contact with the treated zone minimises contact lens influence on corneal recovery. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.
Rathi, Varsha M; Mandathara, Preeji S; Dumpati, Srikanth
Contact lenses are required for the visual improvement in patients with keratoconus. Various contact lens options, such as rigid gas permeable (RGP) lenses, soft and soft toric lenses, piggy back contact lenses (PBCL), hybrid lenses and scleral lenses are availble. This article discusses about selection of a lens depending on the type of keratoconus and the fitting philosophies of various contact lenses including the starting trial lens. A Medline search was carried out for articles in the English language with the keywords keratoconus and various contact lenses such as Rose k lens, RGP lens, hybrid lens, scleral lens and PBCL. PMID:23925325
Correa, Priscila C; Lui, Aline C F; Silva, Cely B; Gracitelli, Carolina P B; Mimica, Lycia M; Sasagawa, Suzethe M; Netto, Adamo L
To assess the antimicrobial effectiveness of multipurpose solutions in regard to the disinfection of silicone hydrogel contact lenses (CL) using a study of clinical bacterial isolates from ocular material. Three multipurpose solutions (solution A: polyhexamethylene biguanide 0.00025 g/100 mL; solution B: polyquaternary-1 0.001% and myristamidopropyl dimethylamine 0.0006%; and solution C: polyaminopropyl biguanide 0.00013% and polyquaternary 0.0001%) were used as a 3-phase disinfection on silicone hydrogel CL contaminated with bacteria from clinical isolates that were divided into five groups (group 1: Pseudomonas aeruginosa; group 2: Staphylococcus aureus; group 3: Staphylococcus epidermidis; group 4: Streptococcus spp; and group 5: enterobacteria). No differences were observed between the 24- and 48-hr measurements in any of the samples, and the positivity of microorganisms in T0 was 100% for all solutions; it was 0% in T3. Therefore, only steps T1 (rubbing followed by rinsing) and T2 (rubbing followed by rinsing and immersion of CL into solution) were considered for analysis at the 24-hr measurement time. Throughout the phases, a decrease in the number of bacteria was observed, culminating in the elimination (no recovery) of all microorganisms in the three solutions. At the end of the proposed process, the tested solutions were effective.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
Nielsen, Kim; Vorum, Henrik; Ehlers, Niels; Aagaard, Nicolaj; Hjortdal, Jesper; Honoré, Bent
Tear film proteins adhere to the surface of contact lenses (CLs). While the proteins in the tears have been extensively studied with various proteomic techniques, adhered proteins to CLs are less studied. In this pilot study, we have separated proteins with 2D gel electrophoresis prior to the conventional mass spectrometry (MS) in order to analyse the deposited proteins on hydrogel CLs from myopic patients. pHEMA and PVA hydrogel CLs worn by 3 patients for different time lengths were analysed. After wear, the CLs were frozen at -20°C. Proteins were extracted in lysis buffer, separated on 12% polyacrylamide gels and silver-stained. Protein spots were excised and identified with liquid chromatography - tandem MS. Deposited proteins were extracted with a yield of 26-66 μg and separated by 2D gel electrophoresis. The silver-stained gels showed similar protein patterns independent of the patient, hydrogel type and wear time. Seventy-two spots were analysed with MS, representing at least 12 different tear film proteins or protein fragments. Deposited tear film proteins from a single set of CLs worn for 1 day can successfully be analysed first with 2D gel electrophoresis and subsequently with MS, thus making examination of individual patients possible. The protein composition appeared homogeneous between the test persons which is a necessity for additional comparison analysis. The molecular masses of the identified proteins indicate that protein degradation occurs only as a minor event. Myopic patients were investigated in this pilot study, but the combined techniques can easily be applied to other eye diseases. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Kuryan, Jocelyn; Cheema, Anjum; Chuck, Roy S
Background Near-sightedness, or myopia, is a condition in which light rays entering the eye along the visual axis focus in front of the retina, resulting in blurred vision. Myopia can be treated with spectacles, contact lenses, or refractive surgery. Options for refractive surgery include laser-assisted subepithelial keratectomy (LASEK) and laser-assisted in-situ keratomileusis (LASIK). Both procedures utilize a laser to shape the corneal tissue (front of the eye) to correct refractive error, and both create flaps before laser treatment of corneal stromal tissue. Whereas the flap in LASEK is more superficial and epithelial, in LASIK it is thicker and also includes some anterior stromal tissue. LASEK is considered a surface ablation procedure, much like its predecessor, photorefractive keratectomy (PRK). LASEK was developed as an alternative to PRK to address the issue of pain associated with epithelial debridement used for PRK. Assessing the relative benefits and risks/side effects of LASEK and LASIK warrants a systematic review. Objectives To assess the effects of LASEK versus LASIK for correcting myopia. Search methods We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Trials Register (2016, Issue 10); MEDLINE Ovid (1946 to 24 October 2016); Embase.com (1947 to 24 October 2016); PubMed (1948 to 24 October 2016); LILACS (Latin American and Caribbean Health Sciences Literature Database; 1982 to 24 October 2016); the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), last searched 20 June 2014; ClinicalTrials.gov (www.clinicaltrials.gov); searched 24 October 2016; and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 24 October 2016. We did not use any date or language restrictions in the electronic searches for trials. Selection criteria We considered only randomized controlled trials (RCTs) for the purposes of this review
Kuryan, Jocelyn; Cheema, Anjum; Chuck, Roy S
Near-sightedness, or myopia, is a condition in which light rays entering the eye along the visual axis focus in front of the retina, resulting in blurred vision. Myopia can be treated with spectacles, contact lenses, or refractive surgery. Options for refractive surgery include laser-assisted subepithelial keratectomy (LASEK) and laser-assisted in-situ keratomileusis (LASIK). Both procedures utilize a laser to shape the corneal tissue (front of the eye) to correct refractive error, and both create flaps before laser treatment of corneal stromal tissue. Whereas the flap in LASEK is more superficial and epithelial, in LASIK it is thicker and also includes some anterior stromal tissue. LASEK is considered a surface ablation procedure, much like its predecessor, photorefractive keratectomy (PRK). LASEK was developed as an alternative to PRK to address the issue of pain associated with epithelial debridement used for PRK. Assessing the relative benefits and risks/side effects of LASEK and LASIK warrants a systematic review. To assess the effects of LASEK versus LASIK for correcting myopia. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), which contains the Cochrane Eyes and Vision Trials Register (2016, Issue 10); MEDLINE Ovid (1946 to 24 October 2016); Embase.com (1947 to 24 October 2016); PubMed (1948 to 24 October 2016); LILACS (Latin American and Caribbean Health Sciences Literature Database; 1982 to 24 October 2016); the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), last searched 20 June 2014; ClinicalTrials.gov (www.clinicaltrials.gov); searched 24 October 2016; and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en); searched 24 October 2016. We did not use any date or language restrictions in the electronic searches for trials. We considered only randomized controlled trials (RCTs) for the purposes of this review. Eligible RCTs were those in which myopic participants were
Brown, Karl David; Low, Suet; Mariappan, Indumathi; Abberton, Keren Maree; Short, Robert; Zhang, Hong; Maddileti, Savitri; Sangwan, Virender; Steele, David; Daniell, Mark
Extensive damage to the limbal region of the cornea leads to a severe form of corneal blindness termed as limbal stem cell deficiency (LSCD). Whereas most cases of corneal opacity can be treated with full thickness corneal transplants, LSCD requires stem cell transplantation for successful ocular surface reconstruction. Current treatments for LSCD using limbal stem cell transplantation involve the use of murine NIH 3T3 cells and human amniotic membranes as culture substrates, which pose the threat of transmission of animal-derived pathogens and donor tissue-derived cryptic infections. In this study, we aimed to produce surface modified therapeutic contact lenses for the culture and delivery of corneal epithelial cells for the treatment of LSCD. This approach avoids the possibility of suture-related complications and is completely synthetic. We used plasma polymerization to deposit acid functional groups onto the lenses at various concentrations. Each surface was tested for its suitability to promote corneal epithelial cell adhesion, proliferation, retention of stem cells, and differentiation and found that acid-based chemistries promoted better cell adhesion and proliferation. We also found that the lenses coated with a higher percentage of acid functional groups resulted in a higher number of cells transferred onto the corneal wound bed in rabbit models of LSCD. Immunohistochemistry of the recipient cornea confirmed the presence of autologous, transplanted 5-bromo-2'-deoxyuridine (BrdU)-labeled cells. Hematoxylin staining has also revealed the presence of a stratified epithelium at 26 days post-transplantation. This study provides the first evidence for in vivo transfer and survival of cells transplanted from a contact lens to the wounded corneal surface. It also proposes the possibility of using plasma polymer-coated contact lenses with high acid functional groups as substrates for the culture and transfer of limbal cells in the treatment of LSCD.
Brown, Karl David; Low, Suet; Mariappan, Indumathi; Abberton, Keren Maree; Short, Robert; Zhang, Hong; Maddileti, Savitri; Sangwan, Virender; Steele, David
Extensive damage to the limbal region of the cornea leads to a severe form of corneal blindness termed as limbal stem cell deficiency (LSCD). Whereas most cases of corneal opacity can be treated with full thickness corneal transplants, LSCD requires stem cell transplantation for successful ocular surface reconstruction. Current treatments for LSCD using limbal stem cell transplantation involve the use of murine NIH 3T3 cells and human amniotic membranes as culture substrates, which pose the threat of transmission of animal-derived pathogens and donor tissue-derived cryptic infections. In this study, we aimed to produce surface modified therapeutic contact lenses for the culture and delivery of corneal epithelial cells for the treatment of LSCD. This approach avoids the possibility of suture-related complications and is completely synthetic. We used plasma polymerization to deposit acid functional groups onto the lenses at various concentrations. Each surface was tested for its suitability to promote corneal epithelial cell adhesion, proliferation, retention of stem cells, and differentiation and found that acid-based chemistries promoted better cell adhesion and proliferation. We also found that the lenses coated with a higher percentage of acid functional groups resulted in a higher number of cells transferred onto the corneal wound bed in rabbit models of LSCD. Immunohistochemistry of the recipient cornea confirmed the presence of autologous, transplanted 5-bromo-2′-deoxyuridine (BrdU)-labeled cells. Hematoxylin staining has also revealed the presence of a stratified epithelium at 26 days post-transplantation. This study provides the first evidence for in vivo transfer and survival of cells transplanted from a contact lens to the wounded corneal surface. It also proposes the possibility of using plasma polymer-coated contact lenses with high acid functional groups as substrates for the culture and transfer of limbal cells in the treatment of LSCD. PMID:24328453
Gupta, Chirag; Tanaka, Thais Shiota; Elner, Victor M; Soong, H Kaz
To report a case of corneal hydrops with perforation in a patient with ectasia after undergoing laser in situ keratomileusis (LASIK). An observational study with clinical, optical coherence tomographic, and histopathologic findings. A 41-year-old woman had an acute onset of blurry vision, pain, photophobia, tearing, and foreign body sensation in the right eye 10 years after undergoing unilateral LASIK in Jordan. According to her, the surgeon elected not to operate on the left eye because of a "corneal abnormality." On slit-lamp examination, a tear in Descemet membrane with a stromal cleft extending to the overlying LASIK flap interface was noted. The flap was partially dehisced by a diffuse channel of aqueous humor draining from the cleft and streaming out the temporal flap edge. When leakage failed to stop after 2 weeks of treatment with a bandage contact lens, the patient underwent penetrating keratoplasty. Histopathological examination of the host button showed a fluid-filled cleft connecting the flap interface. Slit-lamp examination and corneal topography of the contralateral left eye were consistent with keratoconus. Corneal hydrops with perforation in the setting of post-LASIK ectasia is extremely rare and may be associated with flap dehiscence requiring penetrating keratoplasty.
González-Méijome, José M; López-Alemany, Antonio; Lira, Madalena; Almeida, José B; Oliveira, M Elisabete C D Real; Parafita, Manuel A
The purpose of the present study was to develop mathematical relationships that allow obtaining equilibrium water content and refractive index of conventional and silicone hydrogel soft contact lenses from refractive index measures obtained with automated refractometry or equilibrium water content measures derived from manual refractometry, respectively. Twelve HEMA-based hydrogels of different hydration and four siloxane-based polymers were assayed. A manual refractometer and a digital refractometer were used. Polynomial models obtained from the sucrose curves of equilibrium water content against refractive index and vice-versa were used either considering the whole range of sucrose concentrations (16-100% equilibrium water content) or a range confined to the equilibrium water content of current soft contact lenses (approximately 20-80% equilibrium water content). Values of equilibrium water content measured with the Atago N-2E and those derived from the refractive index measurement with CLR 12-70 by the applications of sucrose-based models displayed a strong linear correlation (r2 = 0.978). The same correlations were obtained when the models are applied to obtain refractive index values from the Atago N-2E and compared with those (values) given by the CLR 12-70 (r2 = 0.978). No significantly different results are obtained between models derived from the whole range of the sucrose solution or the model limited to the normal range of soft contact lens hydration. Present results will have implications for future experimental and clinical research regarding normal hydration and dehydration experiments with hydrogel polymers, and particularly in the field of contact lenses. 2006 Wiley Periodicals, Inc.
Plainis, Sotiris; Ntzilepis, George; Atchison, David A; Charman, W Neil
To evaluate the effects of the wearer's pupil size and spherical aberration on visual performance with centre-near, aspheric multifocal contact lenses (MFCLs). The advantage of binocular over monocular vision was also investigated. Twelve young volunteers, with an average age of 27 ± 5 years, participated in the study. LogMAR Visual Acuity (VA) was measured under cycloplegia for a range of defocus levels (from +3.0 to -3.0 D, in 0.5 D steps) with no correction and with three aspheric MFCLs (Air Optix Aqua Multifocal) with a centre-near design, providing correction for 'Low', 'Med' and 'High' near demands. Measurements were performed for all combinations of the following conditions: (1) artificial pupils of 6 and 3 mm diameter, (2) binocular and monocular (dominant eye) vision. Depth-of-focus (DOF) was calculated from the VA vs defocus curves. Ocular aberrations under cycloplegia were measured using iTrace. VA at -3.0 D defocus (simulating near performance) was statistically higher for the 3 mm than for the 6 mm pupil (p = 0.006), and for binocular rather than for monocular vision (p < 0.001). Similarly, DOF was better for the 3 mm pupil (p = 0.002) and for binocular viewing conditions (p < 0.001). Both VA at -3.0 D defocus and DOF increased as the 'addition' of the MFCL correction increased. Finally, with the centre-near MFCLs a linear correlation was found between VA at -3.0 D defocus and the wearer's ocular spherical aberration (R(2) = 0.20 p < 0.001 for 6 mm data), with the eyes exhibiting the higher positive spherical aberration experiencing worse VAs. By contrast, no correlation was found between VA and spherical aberration at 0.00 D defocus (distance vision). Both near VA and depth-of-focus improve with these MFCLs, with the effects being more pronounced for small pupils and for binocular rather than monocular vision. Coupling of the wearer's ocular spherical aberration with the aberration profiles provided by MFCLs affects their functionality. Ophthalmic
... Health and Consumer Devices Consumer Products Contact Lenses Contact Lens Risks Share Tweet Linkedin Pin it More ... redness blurred vision swelling pain Serious Hazards of Contact Lenses Symptoms of eye irritation can indicate a ...
Ji, Qiuzhi; Yoo, Young-Sik; Alam, Hira; Yoon, Geunyoung
central vision. This trend was found to be less dominant with bifocal SCLs compared to monofocal SCL. Bifocal SCLs have a relatively small impact on myopic shift in peripheral refractive error while DoF is increased significantly. We hypothetically suggest that a mechanism underlying myopia control with these bifocal or multifocal contact lenses is an increase in DoF and a decrease in anisotropy of peripheral optical blur. © 2018 The Authors Ophthalmic & Physiological Optics © 2018 The College of Optometrists.
de Sadeleer, Nicolas
In the light of new case law development, this article examines whether national restrictions on the online sale of pharmaceuticals and medical devices such as contact lenses are consistent either with EU secondary law, either with Article 34 TFEU that prohibits measures having equivalent effect to quantitative restrictions on imports. In particular, this article focuses on an analysis of two judgments on this important issue delivered by the Court of Justice of the European Union in 2003 and 2010, namely the Deutscher Apothekerverband decision and the Ker-Optika decision.
Livi, Stefano; Zeri, Fabrizio; Baroni, Rossella
To assess the compliance of Daily Disposable Contact Lenses (DDCLs) wearers with replacing lenses at a manufacturer-recommended replacement frequency. To evaluate the ability of two different Health Behavioural Theories (HBT), The Health Belief Model (HBM) and The Theory of Planned Behaviour (TPB), in predicting compliance. A multi-centre survey was conducted using a questionnaire completed anonymously by contact lens wearers during the purchase of DDCLs. Three hundred and fifty-four questionnaires were returned. The survey comprised 58.5% females and 41.5% males (mean age 34±12years). Twenty-three percent of respondents were non-compliant with manufacturer-recommended replacement frequency (re-using DDCLs at least once). The main reason for re-using DDCLs was "to save money" (35%). Predictions of compliance behaviour (past behaviour or future intentions) on the basis of the two HBT was investigated through logistic regression analysis: both TPB factors (subjective norms and perceived behavioural control) were significant (p<0.01); HBM was less predictive with only the severity (past behaviour and future intentions) and perceived benefit (only for past behaviour) as significant factors (p<0.05). Non-compliance with DDCLs replacement is widespread, affecting 1 out of 4 Italian wearers. Results from the TPB model show that the involvement of persons socially close to the wearers (subjective norms) and the improvement of the procedure of behavioural control of daily replacement (behavioural control) are of paramount importance in improving compliance. With reference to the HBM, it is important to warn DDCLs wearers of the severity of a contact-lens-related eye infection, and to underline the possibility of its prevention. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Kenyon, Kenneth R; Paz, Helline; Greiner, Jack V; Gipson, Ilene K
To assess the clinical characteristics, incidence, and pathologic correlation of corneal epithelial adhesion abnormalities encountered during LASIK. Prospective noncomparative interventional case series. Five hundred consecutive eyes of 268 patients undergoing primary LASIK procedures by one surgeon utilizing the Moria LSK One microkeratome and VISX Star S-2 excimer laser. Corneal epithelial adhesion was assessed immediately preoperatively using a cellulose surgical sponge (adhesion test), and the incidence, extent, and location of epithelial defects occurring during the microkeratome incision of the corneal flap were recorded. Epithelial specimens from 7 corneas requiring debridement of dysadhesive epithelium were examined by transmission electron microscopy. The characteristics of the study population (age, gender, contact lens use, relevant ocular surface or systemic disease, refractive error, keratometry, pachymetry) and the microkeratome-related variables (head selection and vacuum level) were compared with the results of the preoperative epithelial adhesion test, the development of intraoperative epithelial effects (size and location), and the postoperative outcome. Epithelial defects were sustained by 51 corneas (10.2%), and among these, 31 (6.2%) were microdefects and 20 (4.0%) were macrodefects. The adhesion test was positive (indicative of compromised adhesion of epithelium to stroma) in 20 (64.5%) corneas with microdefects, but false negatives (epithelial defect despite negative adhesion test) occurred in 11 cases (35.4%). The adhesion test was positive in 16 (80%) of corneas having macrodefects, with 4 (20%) false negatives. Thus, the overall positive predictive value of the adhesion test was 59%, and the percentage of positive prediction was 92% (Bayes' theorem). Among all other outcome measures assessed, only corneal flap thickness seemed a potential risk factor, as 40 (78.4%) epithelial defects were associated with the creation of a 180- micro m
Szczotka-Flynn, Loretta B; Debanne, Sara; Benetz, Beth Ann; Wilson, Tawnya; Brennan, Noel
This study hypothesized that a traditional high-water contact lens of moderate oxygen transmissibility (Dk/t) is noninferior to common silicone hydrogel (SH) lenses worn for daily wear with respect to measures of hypoxic stress. Thirty-six habitual contact lens wearers completed wear of three lens types worn in a randomized order: etafilcon A (ACUVUE 2, control), lotrafilcon B (Air Optix Aqua), and comfilcon A (Biofinity). Central corneal thickness (CT) and limbal hyperemia were measured >2 hr after waking and after 6 to 8 hr of wear on days 1 and 7. Endothelial bleb formation was measured on day 1 of each lens type. Noninferiority of etafilcon A, with respect to the other two lens types, was assumed if the following difference margins of equivalence were met: <1.5% for corneal swelling, <0.5 grade for limbal hyperemia, and <1% area of endothelial blebs. Outcomes were modeled using generalized linear mixed modeling techniques. All lenses showed reductions in least-square mean estimates of CT on both days: etafilcon A -0.26% at day 1 and -0.31% at day 7; lotrafilcon B -1.11% at day 1 and -1.06% at day 7; comfilcon A -0.63% at day 1 and -0.84% at day 7. The difference in mean swelling between etafilcon A and lotrafilcon B was 0.85% at day 1 (95% confidence interval [0.4%-1.3%]) and 0.75% at day 7 (0.3%-1.2%). The difference in mean swelling between etafilcon A and comfilcon A was 0.37% at day 1 (-0.1% to 0.8%) and 0.53% at day 7 (0.1%-1.0%). For limbal redness, etafilcon A fell within 0.1 grade of lotrafilcon B and 0.18 grade of comfilcon A. For endothelial bleb formation, etafilcon A fell within 0.45% of lotrafilcon B and 0.23% of comfilcon A. The etafilcon A control lens resulted in corneal deswelling throughout the day as did the SH lens types. Limbal hyperemia and endothelial bleb formation with all lenses were negligible, and noninferiority assumptions were met between the lens types for all outcomes. Equivalence of etafilcon A with respect to the two SH lenses
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Yildirim, Aydin; Cakir, Hanefi; Kara, Necip; Uslu, Hasim
To report the long-term results of intrastromal corneal ring segments (ICRS) for postoperative LASIK ectasia. In this retrospective interventional cases series, 8 eyes of 6 patients who underwent femtosecond laser-assisted ICRS implantation for post-LASIK ectasia were enrolled. Main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), spherical equivalent refraction, and average keratometry (Kavg) values were assessed. Mean±SD follow-up was 67±21 months (range, 36-96 months). The mean UDVA, CDVA, spherical equivalent refraction, and Kavg values were significantly improved at all postoperative visits when compared to baseline values. No serious complications were observed during follow-up. Our long-term findings showed that ICRS yielded improvements in visual acuity, refractive status, and keratometric values without any progression in cases with post-LASIK corneal ectasia. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Lin, Chien-Hong; Cho, Hsien-Lung; Yeh, Yi-Hsing; Yang, Ming-Chien
The surface wettability and anti-protein adsorption of a silicone-based hydrogel that was synthesized by a block copolymer of polydimethylsiloxane (PDMS) and poly (ethylene glycol) methacrylate (PEGMA) was improved via polyelectrolyte multilayer (PEM) immobilization. Polysaccharide PEMs of chitosan (CS, as a positive-charged agent) and hyaluronic acid (HA, as a negative-charged and anti-adhesive agent) were successfully assembled on the PDMS-PU-PEGMA silicone hydrogel in a layer-by-layer (LBL) self-assembly manner. Atomic force microscopy (AFM) and dyeing data verified the progressive buildup of the PEM silicone hydrogel. The results showed that the contact angle of the silicone hydrogel decreased with an increase in the number of PEM grafting layers. Furthermore, after immobilizing five layers of CS/HA, the protein adsorption decreased from 78 ± 11 to 26 ± 4 μg/cm(2) for HSA and from 55 ± 10 to 20 ± 4 μg/cm(2) for lysozymes. This indicates that CS/HA PEM-immobilized silicone hydrogels can resist protein adsorption. Furthermore, these hydrogels were non-cytotoxic according to an in vitro L929 fibroblast assay. Overall, the results demonstrated that the modified silicone hydrogels exhibited hydrophilicity and anti-protein adsorption, as well as relatively high oxygen permeability and optical transparency. Therefore, they would be applicable as a contact lens material. Copyright © 2015 Elsevier B.V. All rights reserved.
Hardten, David R; Chittcharus, Anuwat; Lindstrom, Richard L
PURPOSE: To determine the long-term safety and effectiveness of laser-assisted in situ keratomileusis (LASIK) in the treatment of refractive errors following penetrating keratoplasty. METHODS: A retrospective review was done of 57 eyes of 48 patients with anisometropia or high astigmatism who were unable to wear glasses or a contact lens after penetrating keratoplasty and who underwent LASIK for visual rehabilitation. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BCVA), and corneal transplant integrity were recorded before surgery as well as up to 60 months after LASIK. RESULTS: The mean follow-up after the LASIK was 21.4 +/- 14.2 months (range, 3-60 months). Mean preoperative spherical equivalent (SE) was -4.19 +/- 3.38 diopters (D). Mean preoperative astigmatism was 4.67 +/- 2.18 D. Preoperative BCVA was 20/40 or better in 42 eyes (74%). At 2 years the mean SE was -0.61 +/- 1.81 D and mean astigmatism was 1.94 +/- 1.35 D for the 28 eyes with follow-up. UCVA was 20/40 or better in 12 eyes (43%), and BCVA was 20/40 or better in 24 eyes (86%) at 2 years. A gain in BCVA of one line or more was seen in eight eyes (29%). Two eyes (7%) had loss of two or more lines of BCVA at 2 years. Nine eyes (16%) developed epithelial ingrowth. Five eyes (9%) in this series had repeat corneal transplants. CONCLUSIONS: LASIK is effective for reducing ametropia after penetrating keratoplasty. Proper patient counseling is necessary because the results of LASIK after penetrating keratoplasty are not as good as, and complications are more frequent than, in eyes with naturally occurring myopia and astigmatism. Complications are especially common in patients with mismatch of the donor and host cornea and in those with poor endothelial cell function. PMID:12545688
Pimenta, A F R; Valente, A; Pereira, J M C; Pereira, J C F; Filipe, H P; Mata, J L G; Colaço, R; Saramago, B; Serro, A P
Currently, most in vitro drug release studies for ophthalmic applications are carried out in static sink conditions. Although this procedure is simple and useful to make comparative studies, it does not describe adequately the drug release kinetics in the eye, considering the small tear volume and flow rates found in vivo. In this work, a microfluidic cell was designed and used to mimic the continuous, volumetric flow rate of tear fluid and its low volume. The suitable operation of the cell, in terms of uniformity and symmetry of flux, was proved using a numerical model based in the Navier-Stokes and continuity equations. The release profile of a model system (a hydroxyethyl methacrylate-based hydrogel (HEMA/PVP) for soft contact lenses (SCLs) loaded with diclofenac) obtained with the microfluidic cell was compared with that obtained in static conditions, showing that the kinetics of release in dynamic conditions is slower. The application of the numerical model demonstrated that the designed cell can be used to simulate the drug release in the whole range of the human eye tear film volume and allowed to estimate the drug concentration in the volume of liquid in direct contact with the hydrogel. The knowledge of this concentration, which is significantly different from that measured in the experimental tests during the first hours of release, is critical to predict the toxicity of the drug release system and its in vivo efficacy. In conclusion, the use of the microfluidic cell in conjunction with the numerical model shall be a valuable tool to design and optimize new therapeutic drug-loaded SCLs.
Tabbara, Khalid F; Kotb, Amgad A
To establish a grading system that helps identify high-risk individuals who may experience corneal ectasia after LASIK. Retrospective, comparative, interventional case series. One hundred forty-eight consecutive patients (148 eyes) were included in this study. Thirty-seven patients who underwent LASIK at other refractive centers experienced corneal ectasia in 1 eye after LASIK. One hundred eleven eyes of 111 patients who underwent successful LASIK during the same period were age and gender matched and served as controls. All patients underwent preoperative and postoperative topographic analysis of the cornea. The follow-up period in both groups of patients ranged from 2 to 5 years, with a mean follow-up of 3.6 years. All patients underwent LASIK for myopia (spherical equivalent, -4.00 to -8.00 diopters). Corneal keratometry, oblique cylinder, pachymetry, posterior surface elevation, difference between the inferior and superior corneal diopteric power, and posterior best sphere fit (BSF) over anterior BSF were given a grade of 1 to 3 each. An ectasia grading system was established, and the cumulative risk score was assessed. Patients who had a grade of 7 or less showed no evidence of corneal ectasia, whereas 16 (59%) of 27 patients who had a grade of 8 to 12 had corneal ectasia. Twenty-one (100%) of 21 patients with a grade of more than 12 had corneal ectasia after LASIK (P<0.0001). A risk score may help in the prediction of patients who are at risk of experiencing corneal ectasia after LASIK. A prospective clinical study is needed to assess the validity of these risk factors.
Ye, Ping; Sun, Amy; Weissman, Barry A
Case report on the clinical implications of mini-scleral gas-permeable contact lenses in the treatment of corneal disorders. Three patients with different corneal disorders were fitted with Jupiter design mini-scleral gas-permeable contact lenses. All three patients achieved excellent vision and comfort. The contact lenses were tolerated well, and no complications were observed. Mini-scleral gas-permeable contact lenses provide a good option for patients who require gas-permeable contact lenses for optimal visual function but do not tolerate corneal contact lenses. Mini-scleral lenses are also an excellent therapeutic tool in the treatment of at least some forms of severe dry eyes.
Cardona, Genís; López, Sílvia
To determine working distance, pupil diameter and illumination in real life conditions in a sample of presbyopic participants performing habitual tasks. A total of 59 presbyopic subjects (aged between 45 and 63 years) with different occupational backgrounds participated in the study. Participants were first interviewed regarding their habitual tasks with the aid of an ad hoc questionnaire, following which in-office photopic and mesopic pupil diameter was determined. Pupil diameter was also evaluated while participants conducted each of the self-reported habitual tasks by taking a photograph, which was later submitted to image analysis. In addition, working distance was determined with a measuring tape and the illumination that reached the pupil during each of the different tasks was measured, in lux, with a light meter. The four most common habitual tasks were computer use, reading, sewing and sports. A high intersubject variability was found in pupil diameter, working distance and illumination conditions while conducting the same task. Statistically significant differences were found between the in-office measured photopic and mesopic pupil diameters and those obtained while participants were conducting their habitual tasks in real life conditions (all p<0.001). Potential multifocal contact lens users may present with different ages, different jobs or hobbies and different preferences regarding lighting conditions and working distances. This results in different pupil size, even within the same task. This information may be critical when selecting a particular lens design and add power. Eye care practitioners are therefore advised to assess pupil diameter in real life conditions. Copyright © 2015 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.
NETTUNE, GREGORY R.; PFLUGFELDER, STEPHEN C.
Symptoms of tear dysfunction after laser in situ keratomileusis (LASIK) occur in nearly all patients and resolve in the vast majority. Although dry eye complaints are a leading cause of patient discomfort and dissatisfaction after LASIK, the symptoms are not uniform, and the disease is not a single entity. Post-LASIK tear dysfunction syndrome or dry eye is a term used to describe a spectrum of disease encompassing transient or persistent post-operative neurotrophic disease, tear instability, true aqueous tear deficiency, and neuropathic pain states. Neural changes in the cornea and neuropathic causes of ocular surface discomfort may play a separate or synergistic role in the development of symptoms in some patients. Most cases of early post-operative dry eye symptoms resolve with appropriate management, which includes optimizing ocular surface health before and after surgery. Severe symptoms or symptoms persisting after 9 months rarely respond satisfactorily to traditional treatment modalities and require aggressive management. This review covers current theories of post-LASIK dry eye disease, pathophysiology, risk factors, and management options for this disease spectrum of post-LASIK tear dysfunction and neuropathic pain. PMID:20712970
Casciaro, Bruno; Dutta, Debarun; Loffredo, Maria Rosa; Marcheggiani, Stefania; McDermott, Alison M; Willcox, Mark Dp; Mangoni, Maria Luisa
Contact lens (CL) wear is a risk factor for development of microbial keratitis, a vision threatening infection of the eye. Adverse events associated with colonization of lenses, especially by the multi-drug resistant and biofilm forming bacterium Pseudomonas aeruginosa remain a major safety issue. Therefore, novel strategies and compounds to reduce the onset of CL-associated ocular infections are needed. Recently, the activity of the frog skin-derived antimicrobial peptide Esc(1-21) and its diastereomer Esc(1-21)-1c was evaluated against both planktonic and sessile forms of this pathogen. Furthermore, Esc(1-21) was found to significantly reduce the severity of P. aeruginosa keratitis in a mouse model and preserve antipseudomonal activity in the presence of human basal tears. Here, we have analyzed the activity of the peptides on P. aeruginosa biofilm formed on soft CLs. Microbiological assays and scanning electron microscopy analysis indicated that the peptides were able to disrupt the bacterial biofilm, with the diastereomer having the greater efficacy (up to 85% killing vs no killing at 4 μM for some strains). Furthermore, upon covalent immobilization to the CL, the two peptides were found to cause more than four log reduction in the number of bacterial cells within 20 minutes and to reduce bacterial adhesion to the CL surface (77%-97% reduction) in 24 hours. Importantly, peptide immobilization was not toxic to mammalian cells and did not affect the lens characteristics. Overall, our data suggest that both peptides have great potential to be developed as novel pharmaceuticals for prevention and treatment of CL-associated P. aeruginosa keratitis. © 2017 Wiley Periodicals, Inc.
Said, Ashraf; Hamade, Issam H; Tabbara, Khalid F
To report late onset corneal ectasia following myopic LASIK. A retrospective cohort case series. Nineteen patients with late onset corneal ectasia following LASIK procedure were examined at The Eye Center, Riyadh, Saudi Arabia. Patients underwent LASIK for myopia with spherical equivalent ranging from -1.4 to -13.75 diopters. Age and gender, history of systemic or local diseases, and time of onset of corneal ectasia were recorded. Eye examination and corneal topographical analyses were done before and after LASIK surgery. Nineteen patients (29 eyes) with late onset corneal ectasia were identified from 1998 to 2008 in 13 male and six female patients. The mean follow-up period was 108 ± 23 months (range 72-144 months). No patient had pre-operative identifiable risk factors for corneal ectasia and the mean time of onset was 57 ± 24 months (range 24-120 months after LASIK). The pre-operative values included mean central pachymetry 553 ± 25 μm, mean keratometry reading of 42.9 ± 1.5 diopters, average oblique cylinder of 1.4 ± 1.2 diopters, posterior surface elevation of 26 ± 2.1 diopters, corneal flap thickness of 160 μm, mean spherical equivalent of -5.6 ± 3.6 diopters, and calculated residual corneal stromal bed thickness was 288 ± 35 μm. Three (5 eyes) patients developed ectasia after pregnancy. Three (4 eyes) patients developed corneal ectasia following severe adenoviral keratoconjunctivitis and had positive PCR for adenovirus type 8. Corneal ectasia may develop many years after LASIK surgery and symptoms could go undetected for some time. Pregnancy and adenoviral keratoconjunctivitis occurred post-operatively in six patients.
Li, Jinyang; Zhang, Xiahua; Zheng, Qinxiang; Zhu, Yirui; Wang, Hui; Ma, Huixiang; Jhanji, Vishal; Chen, Wei
To comparatively evaluate the efficacy of a bandage contact lens (BCL) and autologous serum (AS) eye drops in the management of severe dry eye caused by Sjögren syndrome (SS). In this prospective randomized study, 40 patients with SS were enrolled. Patients were divided into 2 treatment groups: BCL and AS. A total of 37 patients were included, 18 patients (35 eyes) in the AS group and 19 patients (36 eyes) in the BCL group. At the end of 6 weeks, the best-corrected visual acuity improved significantly in the BCL group (0.5 ± 0.3 vs. 0.3 ± 0.2, P = 0.003) but not in the AS group (0.4 ± 0.3 vs. 0.3 ± 0.3, P = 0.11). The best-corrected visual acuity remained stable up to 6 weeks after discontinuation of the BCL (0.5 ± 0.3 vs. 0.4 ± 0.2, P = 0.03). Although the Ocular Surface Disease Index scores decreased significantly after treatment in both groups, patients in the BCL group had lower Ocular Surface Disease Index scores than those in the AS group (53.4 vs. 41.8 at week 3, 47.1 vs. 31.0 at week 6, 52.7 vs. 32.0 at week 12; P = 0.014, <0.001, <0.004, respectively). The "faces" scores showed improved quality of life in both groups. Tear break-up time improved significantly in both groups except at 6 weeks after discontinuation of the AS. Patients in the BCL group had lower corneal staining scores than those of the AS group after 6 weeks of treatment and 6 weeks after discontinuation of treatment (P < 0.01). There was no significant change in Schirmer I test scores between or within groups. Balafilcon A silicone hydrogel contact lenses as a BCL were effective in the management of SS-associated dry eye. Clinical Trial Registration—URL: http://www.clinicaltrials.gov. Unique identifier: NCT02147509.
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Moscovici, Bernardo Kaplan; Campos, Mauro
We describe a case of early post-LASIK ectasia detected in the first 6 months after surgery. The patient was treated by means of intrastromal corneal crosslinking under the flap, without de-epithelialization, which resulted in a positive outcome. At the time of writing, 2 years after the procedure, the patient remained free of progression.
Randleman, J Bradley; Su, Johnny P; Scarcelli, Giuliano
To evaluate the biomechanical changes occurring after LASIK flap creation and rapid corneal cross-linking (CXL) measured with Brillouin light microscopy. Porcine eyes (n = 11) were evaluated by Brillouin light microscopy sequentially in the following order: virgin state, after LASIK flap creation, and after rapid CXL. Each eye served as its own control. Depth profile of the Brillouin frequency shift was computed to reveal the depth-dependent changes in corneal stiffness. There was a statistically significant reduction of Brillouin shift (reduced corneal stiffness) after LASIK flap creation compared to virgin corneas across total corneal thickness (-0.035 GHz, P = .0195) and within the anterior stromal region (-0.104 GHz, P = .0039). Changes in the central (-0.029 GHz, P = .0391) and posterior (-0.005 GHz, P = .99) stromal regions were not significant. There was a small increase in Brillouin shift after rapid cross-linking that was not statistically or clinically significant across total corneal thickness (0.006 GHz, P = .4688 for any specific stromal region; 0.002 to 0.009 GHz, P > .46 for all). LASIK flap creation significantly reduced Brillouin shift in the anterior third of the stroma in porcine eyes. Rapid corneal cross-linking had no significant effect on Brillouin shift after LASIK flap creation in porcine eyes. With further validation, non-contact, non-perturbative Brillouin microscopy could become a useful monitoring tool to evaluate the biomechanical impact of corneal refractive procedures and corneal cross-linking protocols. [J Refract Surg. 2017;33(6):408-414.]. Copyright 2017, SLACK Incorporated.
Jacobson, Steven D.
Certain examples provide optical contact micrometers and methods of use. An example optical contact micrometer includes a pair of opposable lenses to receive an object and immobilize the object in a position. The example optical contact micrometer includes a pair of opposable mirrors positioned with respect to the pair of lenses to facilitate viewing of the object through the lenses. The example optical contact micrometer includes a microscope to facilitate viewing of the object through the lenses via the mirrors; and an interferometer to obtain one or more measurements of the object.
Beach, Raymond J. , Benett
A lensing duct to condense (intensify) light using a combination of front surface lensing and reflective waveguiding. The duct tapers down from a wide input side to a narrow output side, with the input side being lens-shaped and coated with an antireflective coating for more efficient transmission into the duct. The four side surfaces are uncoated, preventing light from escaping by total internal reflection as it travels along the duct (reflective waveguiding). The duct has various applications for intensifying light, such as in the coupling of diode array pump light to solid state lasing materials, and can be fabricated from inexpensive glass and plastic.
Beach, R.J.; Benett, W.J.
A lensing duct to condense (intensify) light using a combination of front surface lensing and reflective waveguiding is described. The duct tapers down from a wide input side to a narrow output side, with the input side being lens-shaped and coated with an antireflective coating for more efficient transmission into the duct. The four side surfaces are uncoated, preventing light from escaping by total internal reflection as it travels along the duct (reflective waveguiding). The duct has various applications for intensifying light, such as in the coupling of diode array pump light to solid state lasing materials, and can be fabricated from inexpensive glass and plastic. 3 figures.
Bakaraju, Ravi C; Ehrmann, Klaus; Ho, Arthur
To compare the computed optical performance of prototype lenses designed using deliberate manipulation of higher-order spherical aberrations to extend depth-of-focus (EDOF) with two commercial multifocals. Emmetropic, presbyopic, schematic eyes were coupled with prototype EDOF and commercial multifocal lenses (Acuvue Oasys for presbyopia, AOP, Johnson & Johnson & Air Optix Aqua multifocal, AOMF, Alcon). For each test configuration, the through-focus retinal image quality (TFRIQ) values were computed over 21 vergences, ranging from -0.50 to 2.00D, in 0.125D steps. Analysis was performed considering eyes with three different inherent aberration profiles: five different pupils and five different lens decentration levels. Except the LOW design, the AOP lenses offered 'bifocal' like TFRIQ performance. Lens performance was relatively independent to pupil and aberrations but not centration. Contrastingly, AOMF demonstrated distance centric performance, most dominant in LOW followed by MED and HIGH designs. AOMF lenses were the most sensitive to pupil, aberrations and centration. The prototypes demonstrated a 'lift-off' in the TFRIQ performance, particularly at intermediate and near, without trading performance at distance. When compared with AOP and AOMF, EDOF lenses demonstrated reduced sensitivity to pupil, aberrations and centration. With the through focus retinal image quality as the gauge of optical performance, we demonstrated that the prototype EDOF designs were less susceptible to variations in pupil, inherent ocular aberrations and decentration, compared to the commercial designs. To ascertain whether these incremental improvements translate to a clinically palpable outcome requires investigation through human trials. Copyright © 2017 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.
Said, Ashraf; Hamade, Issam H.; Tabbara, Khalid F.
Purpose To report late onset corneal ectasia following myopic LASIK. Methods A retrospective cohort case series. Nineteen patients with late onset corneal ectasia following LASIK procedure were examined at The Eye Center, Riyadh, Saudi Arabia. Patients underwent LASIK for myopia with spherical equivalent ranging from −1.4 to −13.75 diopters. Age and gender, history of systemic or local diseases, and time of onset of corneal ectasia were recorded. Eye examination and corneal topographical analyses were done before and after LASIK surgery. Results Nineteen patients (29 eyes) with late onset corneal ectasia were identified from 1998 to 2008 in 13 male and six female patients. The mean follow-up period was 108 ± 23 months (range 72–144 months). No patient had pre-operative identifiable risk factors for corneal ectasia and the mean time of onset was 57 ± 24 months (range 24–120 months after LASIK). The pre-operative values included mean central pachymetry 553 ± 25 μm, mean keratometry reading of 42.9 ± 1.5 diopters, average oblique cylinder of 1.4 ± 1.2 diopters, posterior surface elevation of 26 ± 2.1 diopters, corneal flap thickness of 160 μm, mean spherical equivalent of −5.6 ± 3.6 diopters, and calculated residual corneal stromal bed thickness was 288 ± 35 μm. Three (5 eyes) patients developed ectasia after pregnancy. Three (4 eyes) patients developed corneal ectasia following severe adenoviral keratoconjunctivitis and had positive PCR for adenovirus type 8. Conclusions Corneal ectasia may develop many years after LASIK surgery and symptoms could go undetected for some time. Pregnancy and adenoviral keratoconjunctivitis occurred post-operatively in six patients. PMID:23960929
Qin, Vincent; Saad, Alain; Gatinel, Damien
To report a case of iatrogenic unilateral post-LASIK corneal ectasia with contralateral spontaneous ectatic evolution. Case report with preoperative and postoperative measurements including uncorrected visual acuity, corrected distance visual acuity, refraction, slit-scanning topographic and pachymetric maps, and differential maps. Six months after unilateral LASIK, the operated eye progressively developed signs of post-LASIK ectasia with increased inferior corneal steepening and corneal thinning and decrease in corrected distance visual acuity. Five years later, the unoperated eye also developed signs of spontaneous ectatic evolution with increased inferior steepening and corneal thinning. LASIK accelerates occurrence of ectasia in ectasia-susceptible and biomechanically fragile eyes. Copyright 2016, SLACK Incorporated.
Bueno, Juan M.; Berrio, Esther; Artal, Pablo
Imaging polarimetry provides spatially resolved information on the polarization properties of a system. In the case of the living human eye, polarization could be related to the corneal biomechanical properties, which vary from the normal state as a result of surgery or pathologies. We have used an aberro-polariscope, which we recently developed, to determine and to compare the spatially resolved maps of polarization parameters across the pupil between normal healthy and post-LASIK eyes. The depolarization distribution is not uniform across the pupil, with post-surgery eyes presenting larger levels of depolarization. While retardation increases along the radius in normal eyes, this pattern becomes irregular after LASIK refractive surgery. The maps of slow axis also differ in normal and post-surgery eyes, with a larger disorder in post-LASIK eyes. Since these changes in polarization indicate subtle structural modifications of the cornea, this approach can be useful in a clinical environment to follow the biomechanical and optical changes of the cornea after refractive surgery or for the early diagnosis of different corneal pathologies.
In a long line of intellectual triumphs, Einsteinâs theory of general relativity was his greatest and most imaginative. It tells us that what we experience as gravity can be most accurately described as the bending of space itself. This idea leads to consequences, including gravitational lensing, which is caused by light traveling in this curved space. This is works in a way analogous to a lens (and hence the name). In this video, Fermilabâs Dr. Don Lincoln explains a little general relativity, a little gravitational lensing, and tells us how this phenomenon allows us to map out the matter of the entire universe, including the otherwise-invisible dark matter.
SGVU SUBJECT: Professional Presentation Approval 3 MAR2016 1. Your paper, entitled Higher Order Aberrations after Femtosecond LASIK Flap Creation ...of 3 Pagos Higher Order Aberrations After Femtosecond LASIK Flap Creation Jason Croskrey MD, Matthew Caldwell MD, James Townley MD, Douglas Apsey...such as corneal refractive surgery. While studies have previously compared HOA in microkeratome vs. femtosecond corneal flap creation , no studies
Shetty, Rohit; Francis, Mathew; Shroff, Rushad; Pahuja, Natasha; Khamar, Pooja; Girrish, Molleti; Nuijts, Rudy M M A; Sinha Roy, Abhijit
To evaluate transient corneal tissue healing and biomechanical changes between laser in situ keratomileusis (LASIK) and small incision lenticule extraction (SMILE) eyes. In each patient, one eye underwent LASIK and the other underwent SMILE. Optical coherence tomography (OCT) and dynamic Scheimpflug imaging (Corvis-ST) was used to assess tissue healing and biomechanics, respectively. Analyses of OCT scans yielded corneal speckle distribution (CSD) and Bowman's roughness index (BRI). Waveform analyses of deformation amplitude yielded corneal stiffness. Further, corneal force versus corneal deformation data helped compare the two procedures. BRI increased and then decreased transiently after both treatments (P < 0.05). However, SMILE eyes had BRI similar to that of their preoperative state compared to LASIK eyes at 6-month follow-up. CSD indicated a marked increase in the number of bright pixels and a decrease in the number of dark pixels after SMILE (1-month follow-up) and LASIK eyes (3-month follow-up), respectively. CSD returned to near preoperative state thereafter, respectively. Corneal stiffness change from preoperative state was similar between LASIK and SMILE eyes. However, deformation at discrete values of corneal force indicated some recovery of biomechanical strength after SMILE, but not in LASIK eyes. BRI and CSD indicated earlier tissue healing in SMILE eyes than in LASIK. CSD results may indicate delayed cell death in LASIK eyes and increased light scatter due to interface fluid in SMILE eyes. Corneal biomechanical strength remodeled better in SMILE. This may indicate some hydration-related recovery.
Lockington, David; Johnson, Richard; Patel, Dipika V; McGhee, Charles N J
Medical tourism is the practice of travelling overseas for surgery. We describe a patient with low myopia who underwent laser in situ keratomileusis (LASIK) while on holiday in India. She presented to local hospital eye services six weeks post-LASIK with discomfort and reduced vision. She reported three previous LASIK flap lifts in the right eye. Clinical assessment, optical coherence tomography and confocal microscopy demonstrated moderate epithelial ingrowth and reduced visual acuity. Epithelial ingrowth after LASIK may be associated with visual impairment and management is determined by location, magnitude and effect on vision. LASIK tourism may mean patients are less well-informed of risks and lose continuity of professional care. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.
Freeman, J Christopher; Chuck, Roy S
With baby boomers aging, and despite a growing global population, there is a decreasing number of potential laser vision correction patients. Some believe that the worldwide economic downturn of these times will limit the number of potential patients as well. This article highlights looking to an alternative segment of the population to identify potential laser vision correction patients and the limitations of reaching this group. The group known as generation Y contains a large number of individuals who may be candidates for laser vision correction. Traditional marketing efforts present challenges in reaching this particular population segment. Many individuals in this group are already patients of eye doctors for contact lenses and glasses and can be reached by these eye doctors to address candidacy and education of laser vision correction. Generation Y represents a large population segment that contains technology-embracing individuals who, although hard to reach with traditional marketing efforts, may be reached by fellow eye doctors already managing these patients. There are many in this age group who would be good laser vision correction candidates.
Padmanabhan, Prema; Rachapalle Reddi, Sudhir; Sivakumar, Poornima Devi
To report the refractive, topographic, tomographic, and aberrometric characteristics of post-LASIK ectasia; to compare these characteristics with normal post-LASIK controls; and to propose a comprehensive system to grade the severity of post-LASIK ectasia. The refraction, corrected distance visual acuity (CDVA), magnitude, and location of the steepest and thinnest point on the cornea, the highest anterior and posterior surface elevation, the radius of best fit sphere, corneal asphericity, and corneal aberrations were measured in 50 eyes of 29 patients with post-LASIK ectasia. These were compared with corresponding parameters in 50 eyes that did not develop ectasia for more than 1 year after LASIK. A logistic regression analysis was used to create a scoring system to grade the severity. Eyes with post-LASIK ectasia had significantly higher myopia with astigmatism and a lower CDVA than control eyes. Mean topographic toricity was 3.4 ± 1.9D, mean keratometry at the steepest point was 55.32 ± 6.63D, mean highest posterior elevation was 69.72 ± 3 μm, and mean coma was -2.06 ± 1.2 μm. All these parameters were significantly higher than corresponding values in the control group (p < 0.001 in all). Spherical aberration was more negative and the change in asphericity indicated significantly greater prolate shape of the cornea in eyes with post-LASIK ectasia compared to controls. Five parameters, namely, CDVA, spherical equivalent, highest posterior corneal elevation, spherical aberration, and corneal asphericity, were identified as significant predictors of post-LASIK ectasia and used to create a scoring system. Post-LASIK ectasia is characterized by significant changes in refraction, topography, tomography, and aberrometry. The proposed scoring system may be useful in diagnosing, grading, and monitoring post-LASIK ectasia.
Ichijima, Hideji; Karino, Seiko; Sakata, Hiroyuki; Cavanagh, H Dwight
Subjective symptoms and other eye complications were assessed and retrospectively compared in patients belonging to a proprietary membership system who switched from 2-week frequent replacement (2WFR) wear to daily disposable (DD) lens use. Questionnaire responses were completed by all patients for a 5-year interval between October 2008 and September 2013 from 83 wearers in three Japanese clinics (59 female and 24 male; average age: 33.4±10.9 years). Complications were recorded for each patient at times of reexamination. Over the 5-year observation period, the 83 patients wore lenses for more than 26 months. The average duration of use of 2WFR lenses was 14.5±2.7 days/lens (n=83) and subsequently 1.03±0.12 days/lens (n=83) for DD lenses. Compliance with the duration of use was consistently good as monitored by requests for lens resupply in both wearing modalities. The subjective complaint of dryness tended to consistently show improvement by the change to DD wear: 18.1% vs. 30.1% (P=0.10, Fisher exact test). Among eye complications noted in each group, the occurrence of superficial punctate keratitis (SPK) was significantly decreased in DD wear: 9.6% vs. 26.5% (P=0.008, Fisher exact test). The main reasons given by patients for changing to DD wear were (1) "DD lens wear was more hygienic" (78.6%) and (2) "DD lens use is more convenient for travel/business trips" (64.3%). Comments after the switch in wear were (1) "easy and convenient" (95.7%) and (2) "I don't have to worry about expiration dates" on solutions (57.1%). Overall, 95.7% of wearers making the change answered as "satisfied" and "mostly satisfied." In the subscription membership program, which provided free lens replacement and/or reexamination, individual compliance with duration of wear in 2WFR wear cycles was good; however, these patients switching to DD wear tended to have improvement in their subjective complaints of dryness and objectively demonstrated a significant reduction of SPK at follow
Barnett, Melissa; Lien, Vivian; Li, Jennifer Y; Durbin-Johnson, Blythe; Mannis, Mark J
To examine the clinical outcomes of scleral lenses for visual rehabilitation after penetrating keratoplasty (PK). A retrospective review was conducted for 34 patients (48 eyes) who had a history of prior PK and were fit with scleral lenses between October 2009 and December 2013 at the UC Davis Eye Center. The most common initial indication for PK was keratoconus in 27 eyes (56%). Thirty-three eyes (69%) had previously been fit with other types of contact lenses, with small-diameter rigid gas-permeable lenses being the most common. The improvement in best-corrected visual acuity with a scleral lens compared with prior spectacle refraction or other contact lens was a mean of two best-corrected visual acuity lines. Forty-four eyes (91.7%) achieved functional vision with best scleral lens-corrected visual acuities of 20/40 or better. Patients who continued wearing scleral lenses were significantly more likely to report "good" subjective vision compared with patients who abandoned scleral lens wear (P=0.009), although change in objective best-corrected visual acuity did not differ significantly. There were no cases of infectious keratitis. Six eyes (12.5%) developed graft rejection; 3 were able to resume scleral lens wear. Nineteen eyes (39.5%) discontinued scleral lens wear for various reasons, the most common reason for discontinuation of lens wear was difficulty with scleral lens insertion or removal (8 eyes, 42.1%). Scleral lenses are effective and safe in patients who have had PK. There was a mean gain in visual acuity, with the majority of patients achieving 20/40 vision or better. The patient's subjective perception of vision was a significant factor in determining whether scleral lens wear was continued or abandoned.
incidence of (PMMA) lenses . Reported here are the results of contact lens subcontact lens bubble formation under scleral lenses at bubble studies with soft...vision from formation of large bubbles greater than 6,096 m (20,000 It). With soft contact lenses , bubble under their contact lenses . They also found...always located at the limbus and were without sequela to vision or corneal epithelial integrity. scleral lenses used by Jaeckle were permeable to gases
el-Agha, M S; Johnston, E W; Bowman, R W; Cavanagh, H D; McCulley, J P
PURPOSE: To compare the efficacy and safety of photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) in the treatment of spherical hyperopia with use of the VISX STAR S2 excimer laser. METHODS: A review of 15 consecutive patients (22 eyes) receiving PRK and 22 consecutive patients (26 eyes) receiving LASIK (median follow-up, 12 months). RESULTS: Mean age was 52 +/- 7 years for patients receiving PRK and 55 +/- 9 years for patients receiving LASIK. Mean preoperative spherical equivalent was +2.25 +/- 1.16 D for PRK patients and +1.81 +/- 0.92 D for LASIK patients. Mean deviation from intended correction was -0.82 +/- 0.89 D after PRK and +0.19 +/- 0.47 D after LASIK at 1 month (P < .01); +0.16 D +/- 0.37 D after PRK and +0.29 +/- 0.51 D after LASIK at 6 months (P = .906); +0.20 +/- 0.35 D after PRK and +0.37 +/- 0.44 D after LASIK at 1 year (P = .301). At 1 year, 83.3% of PRK eyes and 61.5% of hyperopic LASIK eyes were within +/- 0.50 D of intended correction (P = 1.0). At 1 year, all eyes in both groups had acuity of 20/40 or better uncorrected, and 47.1% of PRK eyes and 54.5% of LASIK eyes had acuity of 20/20 or better uncorrected (P = 1.0). At last follow-up (minimum, 6 months), 2 eyes in each group had lost 2 lines of best spectacle-correct visual acuity, but none had lost more than 2 lines. All PRK patients experienced significant postoperative pain that required systemic medication. LASIK patients had only minor, transient discomfort. CONCLUSION: LASIK and PRK are of comparable efficacy and safety. However, PRK was associated with significant post-operative pain, an initial and temporary myopic overshoot peaking at 1 month, and stability not occurring before 6 months. LASIK was less painful and was associated with more rapid stability (at 1 month) and a trend toward better uncorrected visual acuity, although not statistically significant. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5A FIGURE 5B FIGURE 6A FIGURE 6B PMID:11190041
Schornack, Muriel M; Patel, Sanjay V
To describe the use of Jupiter scleral lenses (Medlens Innovations, Front Royal, VA; and Essilor Contact Lenses, Inc., Dallas, TX) in the management of keratoconus. We performed a single-center retrospective chart review of our initial 32 patients with keratoconus evaluated for scleral lens wear. All patients were referred for scleral lens evaluation after exhausting other nonsurgical options for visual correction. Diagnostic lenses were used in the initial fitting process. If adequate fit could not be achieved with standard lenses, custom lenses were designed in consultation with the manufacturers' specialists. The following measures were evaluated for each patient: ability to tolerate and handle lenses, visual acuity with scleral lenses, number of lenses, and visits needed to complete the fitting process. Fifty-two eyes of 32 patients were evaluated for scleral lens wear. Of these, 12 patients (20 eyes) decided not to pursue scleral lens wear after initial evaluation. One patient (2 eyes) abandoned the fitting process after cataract surgery. The remaining 19 patients (30 eyes) were fit successfully. The average number of lenses ordered per eye was 1.5. The fitting process required an average of 2.8 visits. Standard lenses were prescribed for 23 eyes, and custom designs were needed for 7 eyes. Median best-corrected visual acuity improved from 20/40 (mean, 20/76) before scleral lens fitting to 20/20 (mean, 20/30) after fitting. Follow-up ranged from 3 to 32 months. Jupiter scleral lenses provide acceptable visual acuity and comfort in patients with keratoconus. The availability of diagnostic lenses facilitates the fitting process.
Huang, Guo-Fu; Yang, Bin; Wang, Zheng; Zhang, Xiao-Xiao; Qiu, Ping; Zhou, Sheng
To compare the results of the Q-factor guided LASIK with the conventional LASIK for the correction of myopic astigmatism. Forty-three eyes underwent Q-factor guided LASIK and 41 eyes were received conventional LASIK. The patients were followed up for more than 3 months . Examinations included refraction, distance and near vision, noncontact tonometer, topography (provide Q value), aberrometer, ultrasonic pachymetry, contrast sensitivity function. At 3 months, 97.67% of Q-factor guided LASIK eyes attained UNCVA 1.0 or better and 97.56% eyes in the control group. The mean postoperative SE for Q-factor guided LASIK group was (-0.19 +/- 0.20) diopters (D) at 3 months and (- 0.17 +/- 0.17) diopters (D) in conventional LASIK group. The postoperative Q value of Q-factor guided LASIK was (0.50 +/- 0.28) and (0.82 +/- 0.40) in the conventional LASIK group, significant difference was noted between two groups. Both Q-factor guided LASIK and conventional LASIK significantly increased spherical aberration, the mean RMS of postoperative spherical aberration were (-0.265 +/- 0.156) microm, (-0.487 +/- 0.159) microm respectively, significant difference were noted between two groups at 3 months . Contrast sensitivity was reduced at 1 week and restored at 1 month postoperatively in Q-factor guided LASIK, while in conventional LASIK it was reduced at 1 week, 1 month and restored at 3 months. Corneal topography revealed in Q-factor guided LASIK the diameter of effective optical zone (EOZ) was (5.74 +/- 0.22) mm. However postoperative EOZ of conventional LASIK was (5.34 +/- 0.29) mm in control group. Q-factor guided LASIK is effective, safe and predictable for correction of myopic astigmatism. The postoperative visual quality of Q-factor guided LASIK is better than that of conventional LASIK due to its superiority for correction of spherical aberration.
... disap- pointed. Everyone develops the need to wear reading glasses in their 40s or 50s due to ... corrected for distance with LASIK, you will need reading glasses to correct for presbyopia once it has ...
Ghanem, Ramon C; Ghanem, Marcielle A; Bogoni, Ayla; Ghanem, Vinícius C
To present a case of corneal ectasia after LASIK in a patient with previous arcuate keratotomy. Case report. The patient underwent arcuate keratotomy in both eyes in 1997 for with-the-rule regular hyperopic astigmatism and uneventful bilateral LASIK for residual astigmatism 5 years later. Visual acuity and refraction remained stable for 5 years, when the patient noticed worsening visual acuity. Corneal topography showed progressive inferior steepening, confirming the diagnosis of ectasia. Corneal high-resolution optical coherence tomography revealed a normal LASIK flap. The patient had no risk factors for corneal ectasia other than previous incisional surgery. This case suggests that isolated arcuate keratotomy can be a significant risk factor for the development of corneal ectasia after LASIK. Copyright 2013, SLACK Incorporated.
He, Rui; Qu, Min; Yu, Shun
To compare the visual and refractive outcomes in myopic LASIK between wavefront-guided and traditional treatment. The study included 162 eyes of 81 myopic patients undergoing LASIK by one surgeon. The right eye of each patient underwent customized LASIK with the NIDEK NAVEX laser system (NIDEK, Gamagori, Japan) (study group); the left eye of each patient underwent traditional LASIK with the NIDEK CXII excimer laser system (control group). No significant differences were noted in refractive error, uncorrected visual acuity, and best spectacle-corrected visual acuity after surgery between the two groups (t test, P>.05). Postoperatively, 3.7% of patients in the study group reported glare, which was significantly lower than 12.4% in the control group (chi-square test, .01
LASIK significantly reduces the rate of postoperative glare and induction of higher order aberrations compared to traditional LASIK.
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Blais, B R
Employers' attitudes toward the use of contact lenses at work have become less discriminatory as lenses have improved and numerous studies have demonstrated their safety, provided that additional personal protective equipment is used when necessary. In 1994, the Occupational Safety and Health Administration published its relevant Standard (29 CFR 1910), stating that "contact lenses do not pose additional hazards to the wearer...". Accommodations required by wearers of contact lenses must comply with Title I of the Americans with Disabilities Act. However, many companies still oppose their use. The recently published policy of the American College of Occupational and Environmental Medicine and the American Academy of Ophthalmology on the use of contact lenses should lead to their wider acceptance. Elements of a corporate contact lens policy are outlined. International aspects are summarized as well.
Describes the nature of gradient refractive index (GRIN) lenses, focusing on refraction in these materials, focal length of a thin Wood lens, and on manufacturing of such lenses. Indicates that GRIN lenses of small cross section are in limited production with applications suggested for optical communication and photocopying fields. (JN)
Visser, Esther-Simone; Visser, Rients; van Lier, Henk J J; Otten, Henny M
To evaluate the indications for modern scleral lenses and their clinical performance in patients who were fitted with scleral lenses at the authors' practices. In this cross-sectional survey, all the necessary data were obtained at the first follow-up visit during the 5-month study period. There were four types of scleral lenses: spherical, front-surface toric, back-surface toric, and bitoric. The preformed scleral lens fitting technique developed at Visser Contact Lens Practice was used in all patients. The lenses were cut by precise Sub Micron Lathing from a Boston Equalens II blank at Procornea. Visual acuity and slitlamp findings were recorded. A specially designed classification for scleral lens fitting was used to investigate clinical performance. The largest proportion of the 178 patients (284 eyes) were diagnosed with keratoconus (143 [50.4%] eyes) followed by postpenetrating keratoplasty (56 [19.7%] eyes). The remaining diagnoses were irregular astigmatism, keratitis sicca, corneal dystrophy, and multiple diagnoses. The ratio of spherical to back-surface toric designs was 1:1.1. Clinical examination showed sharp increases in visual acuity (median increase, 0.45) and safe physiologic responses of the anterior eye. All the patients could continue to wear scleral lenses, with 79.2% with the same lens parameters. Several types of corneal abnormality were managed successfully with modern scleral lenses. The main indication was optical correction of an irregular corneal surface. Satisfactory clinical performance meant that all the patients could continue to wear their scleral lenses.
Yokogawa, Hideaki; Kobayashi, Akira; Tagawa, Kosaku; Sugiyama, Kazuhisa
To demonstrate alterations of corneal K-structures (sub-Bowman's fibrous structures) after keratorefractive surgery by in vivo laser confocal microscopy and to look for association of K-structures with fluorescein-stained anterior corneal mosaic (ACM). Five patients (nine eyes) participated in this study. For four patients, one eye was evaluated after laser in situ keratomileusis (LASIK) and the other after epipolis-laser in situ keratomileusis (epi-LASIK). For one patient, the left eye was evaluated after epithelial debridement. A photograph of the ACM was obtained. Central corneal regions were scanned by Heidelberg Retina Tomograph 2 Rostock Cornea Module (Heidelberg Engineering GmbH, Heidelberg, Germany). The ACM and K-structures disappeared in all corneas after epi-LASIK, but not after LASIK and epithelial debridement cornea. The presence of K-structures and ACM may be an index to identify eyes that had a previous refractive surgical procedure (surface ablation or LASIK) and be a health index of Bowman layer and adjacent anterior stroma. Copyright 2010, SLACK Incorporated.
Li, Yan; Shekhar, Raj; Huang, David
Optical coherence tomography (OCT) provides a non-contact and non-invasive means to visualize the corneal anatomy at micron scale resolution. We obtained corneal images from an arc-scanning (converging) OCT system operating at a wavelength of 830nm and a fan-shaped-scanning high-speed OCT system with an operating wavelength of 1310nm. Different scan protocols (arc/fan) and data acquisition rates, as well as wavelength dependent bio-tissue backscatter contrast and optical absorption, make the images acquired using the two systems different. We developed image-processing algorithms to automatically detect the air-tear interface, epithelium-Bowman's layer interface, laser in-situ keratomileusis (LASIK) flap interface, and the cornea-aqueous interface in both kinds of images. The overall segmentation scheme for 830nm and 1310nm OCT images was similar, although different strategies were adopted for specific processing approaches. Ultrasound pachymetry measurements of the corneal thickness and Placido-ring based corneal topography measurements of the corneal curvature were made on the same day as the OCT examination. Anterior/posterior corneal surface curvature measurement with OCT was also investigated. Results showed that automated segmentation of OCT images could evaluate anatomic outcome of LASIK surgery.
Xu, Ye-Sheng; Xie, Wen-Jia; Yao, Yu-Feng
To report surgical management and favorable outcome in a case with delayed repair of traumatic laser in situ keratomileusis (LASIK) flap dislocation with shrinkage and folds. A 30-year-old man with a five-year history of bilateral LASIK experienced blunt trauma to his right eye followed by decreased vision for 5 weeks. The surgical management included initially softening the flap by irrigation with balanced salt solution (BSS). The shrinkage folds were carefully and gently stretched by scraping with a 26-gauge cannula accompanied by BSS irrigation. All of the epithelial ingrowth on the flap inner surface and on the bed was thoroughly debrided by scraping and irrigation. After the flap was repositioned to match its original margin, a soft bandage contact lens was placed. At his initial visit, slit-lamp microscopy and optical coherence tomography (OCT) showed shrinkage of the LASIK flap with an elevated margin approximately 3 mm above the original position. The flap covered half of the pupil and had multiple horizontal folds. Two months after surgery, the flap remained well positioned with only faint streaks in the anterior stroma. The uncorrected visual acuity of the right eye was 20/20 with a manifest refraction of Plano. For delayed repair of traumatically dislocated LASIK flaps, sufficient softening by BSS, stretching the shrinkage folds, and thorough debridement of ingrowth epithelium enable resetting the flap and provide satisfactory results.
The evolution of scleral lenses has led to new formulations of scleral fitting concepts and designs. The diameters of modern scleral lenses have been overhauled too and they are smaller comparing to the original ones. Nowadays, prescription of mini-sclerals supposedly seems in major extension and it appears indeed the necessity of some practitioner to differentiate the smaller mini-scleral lenses from larger mini-scleral lenses empathizing that they are the "smaller" ones. Therefore, it is maybe, necessary a definition of mini-scleral lenses referring to the landing zone width in relation to the horizontal visible iris diameter (HVID) and the limbus extension. The choice of the total diameter is crucial for a successful fitting and it depends majorly on patient's topographic patterns and anatomic factors. However, there are other important criteria for the selection of the scleral lens diameter based on oxygen supply, bubbles formation, mechanical stress on a toric sclera, ocular surface disease protection, entity of the vault over the cornea and distribution of the lens weight on the sclera. The advantages of mini-scleral lenses are various nonetheless in some cases large lenses are necessary. This paper presents a review of the benefits and disadvantages of both mini and large scleral lenses analyzing the conditions in which it may be better to prefer one diameter to another. A suggestion may be that to start fitting the smallest lens as possible, depending on the dimension of HVID and limbus width and consider larger lenses only when issues occur. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
Purpose. To compare the change of anterior corneal higher-order aberrations (HOAs) after laser in situ keratomileusis (LASIK), wavefront-guided LASIK with iris registration (WF-LASIK), femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK), and small incision lenticule extraction (SMILE). Methods. In a prospective study, 82 eyes underwent LASIK, 119 eyes underwent WF-LASIK, 88 eyes underwent FS-LASIK, and 170 eyes underwent SMILE surgery. HOAs were measured with Pentacam device preoperatively and 6 months after surgery. The aberrations were described as Zernike polynomials, and analysis focused on total HOAs, spherical aberration (SA), horizontal coma, and vertical coma over 6 mm diameter central corneal zone. Results. Six months postoperatively, all procedures result in increase of anterior corneal total HOAs and SA. There were no significant differences in the induced HOAs between LASIK and FS-LASIK, while SMILE induced fewer total HOAs and SA compared with LASIK and FS-LASIK. Similarly, WF-LASIK also induced less total HOAs than LASIK and FS-LASIK, but only fewer SA than FS-LASIK (P < 0.05). No significant difference could be detected in the induced total HOAs and SA between SMILE and WF-LASIK, whereas SMILE induced more horizontal coma and vertical coma compared with WF-LASIK (P < 0.05). Conclusion. FS-LASIK and LASIK induced comparable anterior corneal HOAs. Compared to LASIK and FS-LASIK, both SMILE and WF-LASIK showed advantages in inducing less total HOAs. In addition, SMILE also possesses better ability to reduce the induction of SA in comparison with LASIK and FS-LASIK. However, SMILE induced more horizontal coma and vertical coma compared with WF-LASIK, indicating that the centration of SMILE procedure is probably less precise than WF-LASIK. PMID:27818792
Schallhorn, Steve C; Tanzer, David J; Kaupp, Sandor E; Brown, Mitch; Malady, Stephanie E
To compare preoperative and postoperative changes in simulated night driving performance after wavefront-guided (wLASIK) and conventional LASIK (cLASIK) for the treatment of moderate myopia. Retrospective, comparative study. All eyes of subjects with a preoperative manifest spherical equivalent (MSE) between -4.50 and -6.00 who underwent night driving simulator (NDS) testing from 2 clinical trials were entered into the study. This comprised 38 cLASIK patients (62 eyes; mean -5.46 diopters [D] MSE) and 21 wLASIK patients (36 eyes, mean -5.20 D MSE). Patients' records were reviewed from 2 LASIK clinical trials that had similar enrollment criteria. One trial treated patients with conventional LASIK using a bladed microkeratome (cLASIK) and the other treated with a wavefront-guided profile using a femtosecond laser (wLASIK). In both trials, patients with moderate myopia were asked to participate in NDS testing. The detection and identification distances of road hazards were measured with and without a glare source before and 6 months after LASIK. Each eye was tested independently in best-corrected trial frames by a masked operator. In every category, there was a mean reduction in the preoperative to postoperative NDS performance after cLASIK (mean change, -21.3 to -27.9 ft, -6.5 to -8.5 m; 95% confidence interval [CI], -12.0 to -41.3 ft, -3.7 to -12.6 m); there was a corresponding mean improvement after wLASIK (mean change +15.0 to +29.1 ft, +4.6 to +8.9 m; 95% CI, +8.3 to +41.5 ft, +2.5 to +12.6 m). Significant differences between cLASIK and wLASIK NDS performance was observed in every category (P<0.;01, Tukey's honest significant difference for unequal numbers). A clinical relevant loss of NDS performance (>0.5 seconds) was observed in 32% to 38% of cLASIK eyes for all tasks, whereas only 0% to 3% of eyes had this loss after wLASIK. Between 2% and 7% of cLASIK eyes and 11% and 31% of eyes had a significant postoperative improvement in NDS performance in every task
Spadea, Leopoldo; Saviano, Massimo; Di Gregorio, Angela; Di Lodovico, Domenico; De Sanctis, Fabio
To evaluate in a long-term period the effectiveness and safety of topographically guided two-step laser in situ keratomileusis (LASIK) and standard LASIK technique in the correction of refractive errors after successful penetrating keratoplasty (PKP) for keratoconus. At least 2 years after PKP and 6 months after removal of all sutures, 15 eyes of 15 patients (Group 1; mean manifest refraction spherical equivalent (MRSE) -7.23 D -/+ 3.42 SD) were submitted to standard LASIK and 15 eyes of 15 patients (Group 2; mean MRSE -4.37 D -/+ 1.97 SD) to a topographically guided two-step LASIK procedure (first the flap and at least 2 weeks later the laser ablation). In all cases, a superior hinged corneal flap(160 microm/9.5 mm) was created. After a follow-up of 36 months, in Group 1 the mean uncorrected visual acuity (UCVA) was 0.51 logarithm of the minimum angle of resolution (logMAR) -/+ 0.41 SD and the mean best-corrected visual acuity (BCVA) was 0.03 logMAR -/+ 0.05 SD, with a mean MRSE of -1.57 D -/+ 2.65 SD. In Group 2, the mean UCVA was 0.28 logMAR -/+ 0.24 SD and the mean BCVA was 0.01 logMAR -/+ 0.03 SD, with a mean MRSE of -0.07 D -/+ 1.00 SD. In both groups, no complications were observed. After a long follow-up period, both topographically guided two-step LASIK and standard LASIK could be considered effective and safe tools in the correction of refractive errors after successful PKP for keratoconus.
Parkhurst, Gregory D
Purpose The aim of this study was to evaluate and compare night vision and low-luminance contrast sensitivity (CS) in patients undergoing implantation of phakic collamer lenses or wavefront-optimized laser-assisted in situ keratomileusis (LASIK). Patients and methods This is a nonrandomized, prospective study, in which 48 military personnel were recruited. Rabin Super Vision Test was used to compare the visual acuity and CS of Visian implantable collamer lens (ICL) and LASIK groups under normal and low light conditions, using a filter for simulated vision through night vision goggles. Results Preoperative mean spherical equivalent was −6.10 D in the ICL group and −6.04 D in the LASIK group (P=0.863). Three months postoperatively, super vision acuity (SVa), super vision acuity with (low-luminance) goggles (SVaG), super vision contrast (SVc), and super vision contrast with (low luminance) goggles (SVcG) significantly improved in the ICL and LASIK groups (P<0.001). Mean improvement in SVaG at 3 months postoperatively was statistically significantly greater in the ICL group than in the LASIK group (mean change [logarithm of the minimum angle of resolution, LogMAR]: ICL =−0.134, LASIK =−0.085; P=0.032). Mean improvements in SVc and SVcG were also statistically significantly greater in the ICL group than in the LASIK group (SVc mean change [logarithm of the CS, LogCS]: ICL =0.356, LASIK =0.209; P=0.018 and SVcG mean change [LogCS]: ICL =0.390, LASIK =0.259; P=0.024). Mean improvement in SVa at 3 months was comparable in both groups (P=0.154). Conclusion Simulated night vision improved with both ICL implantation and wavefront-optimized LASIK, but improvements were significantly greater with ICLs. These differences may be important in a military setting and may also affect satisfaction with civilian vision correction. PMID:27418804
Wichmann, Matthias; Scherger, Benedikt; Schumann, Steffen; Lippert, Sina; Scheller, Maik; Busch, Stefan F; Jansen, Christian; Koch, Martin
Typical lenses suffer from Fresnel reflections at their surfaces, reducing the transmitted power and leading to interference phenomena. While antireflection coatings can efficiently suppress these reflections for a small frequency window, broadband antireflection coatings remain challenging. In this paper, we report on the simulation and experimental investigation of Brewster lenses in the THz-range. These lenses can be operated under the Brewster angle, ensuring reflection-free transmission of p-polarized light in an extremely broad spectral range. Experimental proof of the excellent focusing capabilities of the Brewster lenses is given by frequency and spatially resolved focus plane measurements using a fiber-coupled THz-TDS system.
Childs, Andre; Li, Hao; Lewittes, Daniella M.; Dong, Biqin; Liu, Wenzhong; Shu, Xiao; Sun, Cheng; Zhang, Hao F.
Contact lenses are increasingly used in laboratories for in vivo animal retinal imaging and pre-clinical studies. The lens shapes often need modification to optimally fit corneas of individual test subjects. However, the choices from commercially available contact lenses are rather limited. Here, we report a flexible method to fabricate customized hydrogel contact lenses. We showed that the fabricated hydrogel is highly transparent, with refractive indices ranging from 1.42 to 1.45 in the spectra range from 400 nm to 800 nm. The Young’s modulus (1.47 MPa) and hydrophobicity (with a sessile drop contact angle of 40.5°) have also been characterized experimentally. Retinal imaging using optical coherence tomography in rats wearing our customized contact lenses has the quality comparable to the control case without the contact lens. Our method could significantly reduce the cost and the lead time for fabricating soft contact lenses with customized shapes, and benefit the laboratorial-used contact lenses in pre-clinical studies.
Jacobs, Deborah S
Scleral rigid gas-permeable lenses play an important and underappreciated role in the treatment of corneal disease. This review provides an update on scleral rigid gas-permeable lenses for the visual rehabilitation of ectasia and irregular astigmatism, and an update on scleral rigid gas-permeable lenses in the therapy of ocular surface disease. Several series and one case report present advances in the treatment of ocular surface disease with scleral rigid gas-permeable lenses. In addition, there are two reports describing one center's consecutive case experience using modern scleral lens design, predominantly in patients with ectasia and postkeratoplasty astigmatism. Finally, a comprehensive article reviewing the history and principles behind current scleral rigid gas-permeable lenses, with particular attention to the use of scleral rigid gas-permeable lenses in the management of ocular surface disorders was published. Clinicians who treat patients with ocular surface disease should be aware of scleral rigid gas-permeable lenses as a therapeutic option for their patients. Advances in lens design make scleral rigid gas-permeable lenses a practical option for an increasing number and variety of patients with corneal disease.
Deflection of light by gravity was predicted by General Relativity and observationally confirmed in 1919. In the following decades, various aspects of the gravitational lens effect were explored theoretically. Among them were: the possibility of multiple or ring-like images of background sources, the use of lensing as a gravitational telescope on very faint and distant objects, and the possibility of determining Hubble's constant with lensing. It is only relatively recently, (after the discovery of the first doubly imaged quasar in 1979), that gravitational lensing has became an observational science. Today lensing is a booming part of astrophysics. In addition to multiply-imaged quasars, a number of other aspects of lensing have been discovered: For example, giant luminous arcs, quasar microlensing, Einstein rings, galactic microlensing events, arclets, and weak gravitational lensing. At present, literally hundreds of individual gravitational lens phenomena are known. Although still in its childhood, lensing has established itself as a very useful astrophysical tool with some remarkable successes. It has contributed significant new results in areas as different as the cosmological distance scale, the large scale matter distribution in the universe, mass and mass distribution of galaxy clusters, the physics of quasars, dark matter in galaxy halos, and galaxy structure. Looking at these successes in the recent past we predict an even more luminous future for gravitational lensing. Supplementary material is available for this article at 10.12942/lrr-1998-12.
Jeweler, Sue; Barnes-Robinson, Linda
When parents and teachers help gifted kids use the metaphor "learning through different lenses," amazing things happen: Horizons open up. Ideas are focused. Thoughts are magnified and clarified. They see the big picture. Metaphoric thinking offers new and exciting ways to see the world. Viewing the world through different lenses provides…
Dürsteler, Juan Carlos
A review of the use of aspherics in the last decades, understood in a broad sense as encompassing single-vision lenses with conicoid surfaces and free-form and progressive addition lenses (PALs) as well, is provided. The appearance of conicoid surfaces to correct aphakia and later to provide thinner and more aesthetically appealing plus lenses and the introduction of PALs and free-form surfaces have shaped the advances in spectacle lenses in the last three decades. This document basically considers the main target optical aberrations, the idiosyncrasy of single lenses for correction of refractive errors and the restrictions and particularities of PAL design and their links to science vision and perception.
Wu, Ying; Chu, Renyuan; Zhou, Xingtao; Dai, Jinhui; Qu, Xiaomei
Corneal refractive surgery results in nerve damage. Nerve regeneration is a complex process that involves nerve growth factor (NGF). Here, a comparative study was conducted to determine the NGF level in the central cornea after laser in situ keratomileusis (LASIK) and epipolis laser in situ keratomileusis (epi-LASIK) treatment. Twenty-four New Zealand white rabbits underwent randomly assigned epi-LASIK treatment on 1 eye and LASIK treatment on the other eye. Experimental animals were sacrificed 1 day, 3 days, 7 days, and 1 month after treatment, and the NGF level was determined by immunohistochemistry and Western blot analyses. Statistical analyses were performed using a Student t test (P < 0.05). Immunohistochemical staining demonstrated a weak NGF signal in the cornea of control and LASIK-treated rabbit eyes. After epi-LASIK treatment, the level of NGF increased significantly in the epithelial layer at the 1- and 3-day time point, and returned to control levels 7 days after treatment. Western blot analyses showed that the NGF level was significantly lower after LASIK treatment as compared to epi-LASIK treatment, 1 day and 3 days after treatment (t = -6.50, -5.85; P = 0.023, 0.028), with no significant difference between the two groups at the 7-day and 1-month time points (P > 0.05). This study demonstrates for the first time that the NGF level in the central corneal epithelial layer of rabbit eyes is significantly increased early after epi-LASIK treatment in contrast to LASIK treatment, and decreased to control levels 1 week after treatment.
In a 1944 study, Jaeckle evaluated scleral lenses in an attempt to answer the question, "Can contact lenses be used practicably in planes at the...subsequently decreases.(9) Subcontact lens bubble formation was first reported by Jaeckle in 1944, who noted bubbles forming under scleral contact lenses at...215 iv LIST OF TABLES TABLE PAGE 1. Advantages of contact lenses ..................... 147 2. Disadvantages of contact
Twa, Michael D; Nichols, Jason J; Joslin, Charlotte E; Kollbaum, Pete S; Edrington, Timothy B; Bullimore, Mark A; Mitchell, G Lynn; Cruickshanks, Karen J; Schanzlin, David J
There are numerous reports of corneal ectasia after laser in situ keratomileusis (LASIK) for myopia without a consistent definition of this condition or a definitive etiology. We conducted a retrospective analysis of published case reports to describe common characteristics of this postoperative event and compared them with findings from a group of successful LASIK patients. A MEDLINE search for "LASIK" and "ectasia" yielded 21 relevant articles published before May 2003 (n = 86 eyes, 59 patients). A comparison group (n = 103 eyes, 63 patients) was selected from a clinic-based sample of successful LASIK patients with 12 months of follow-up after treatment. Descriptive statistics are reported as median and interquartile range. Comparisons were performed using the Wilcoxon rank sum, Wilcoxon signed rank, and chi-square tests. Time to diagnosis of ectasia after LASIK was 13 months (6 to 20 months). Residual myopia in the ectasia group was -3.69 D (-6.00 to -2.13 D) and was significantly greater than the comparison group, -0.38 D (-0.75 to 0.00 D), P < 0.001. After surgery, eyes with ectasia had increased corneal toricity 2.87 D (2.00 to 4.9 D) with increased oblique astigmatism 1.3 D (0.23 to 2.89 D) relative to eyes in the comparison group 0.00 D (0.00 to 0.08 D), and a loss of 2 lines (-0.5 to -6 lines) of best spectacle-corrected visual acuity (all P < 0.001). Thirty-five percent of reported cases resulted in subsequent corneal transplantation. Preoperative characteristics of corneal ectasia include worse visual acuity, less corneal thickness, greater residual myopia, and greater corneal toricity than nonectatic eyes. Treatment factors associated with corneal ectasia after LASIK are greater stromal ablation and less residual stromal bed thickness. Postoperative characteristics of corneal ectasia are myopic refractive error with increased astigmatism, worse spectacle-corrected visual acuity, increased corneal toricity with topographic abnormality, and progressive
Riaz, Kamran M; Feder, Robert S; Srivastava, Arth; Rosin, Jonathan; Basti, Surendra
To describe the clinical stages and management of Achromobacter xylosoxidans keratitis with post-LASIK epithelial ingrowth in two patients. Retrospective chart review. Both patients had been treated with topical antibiotics and corticosteroids for several weeks prior to presentation. Examination at presentation revealed significant areas of epithelial ingrowth without signs of acute inflammation, prompting an erroneous initial diagnosis of recurrent corneal erosion. A corneal infiltrate was eventually observed and A. xylosoxidans was cultured from both patients. Clinical resolution occurred with treatment consisting of topical fortified antibiotics. In one patient, the flap was lifted to obtain cultures and irrigate the stromal bed with fortified antibiotics. Post-LASIK epithelial ingrowth may have served as a risk factor for A. xylosoxidans infection. Classic signs of infectious keratitis were absent, delaying the diagnosis. Three clinical stages described herein may assist the clinician with diagnosis and customized management obviating the need for penetrating keratoplasty. Copyright 2013, SLACK Incorporated.
Romero-Diaz-de-Leon, Lorena; Serna-Ojeda, Juan Carlos; Navas, Alejandro; Graue-Hernández, Enrique O.; Ramirez-Miranda, Arturo
Purpose: To report the rate of flap-related complications in LASIK surgery performed by in-training ophthalmology residents and to analyze the risk factors for these complications. Methods: We analyzed 273 flap dissections in 145 patients from March 2013 to February 2014. We included all LASIK surgeries performed by 32 ophthalmology residents using a Moria M2 microkeratome. All the flap-related complications were noted. Comparison between both groups with and without complications was performed with an independent Student's t-test and relative risks were calculated. Results: There were 19 flap-related complications out of the 273 flap dissections (6.95%). The most common complication was incomplete flap dissection (n = 10; 3.66%), followed by free-cap (n = 5; 1.83%), and flap-buttonhole (n = 2; 0.73%). There was no significant difference between the complicated and uncomplicated cases in terms of the right versus the left eye, pachymetry results, white-to-white diameter, and spherical equivalent. But this difference was significant for mean keratometry (P = 0.008), K-min (P = 0.01), and K-max (P = 0.03) between these groups. Final visual acuity after rescheduling laser treatment was similar in both groups. Relative risks for flap-related complications were 2.03 for the first LASIK surgery (CI 95% 0.64 to 6.48; P = 0.22) and 1.26 (CI 95% 0.43 to 3.69; P = 0.66) for the surgeon's flap-related complications. Female gender presented an odds ratio of 2.48 (CI 95% 0.68 to 9.00; P = 0.16) for complications. Conclusion: Flap-related complications are common intraoperative event during LASIK surgery performed by in-training ophthalmologists. Keratometries and surgeon's first procedure represent a higher probability for flap related complications than some other biometric parameters of patient's eye. PMID:27621782
Dai, Ma-Li; Wang, Qin-Mei; Lin, Zu-Shun; Yu, Ye; Huang, Jin-Hai; Savini, Giacomo; Zhang, Jia; Wang, Ling; Xu, Chen-Chen
To evaluate the posterior corneal surface differences between non-laser in situ keratomileusis (LASIK) and 10-year post-LASIK myopic eyes. The study included 130 eyes from 65 patients, who were treated with myopic LASIK 10 years ago. In addition, 130 eyes from 65 unoperated myopic patients of matching present age and preoperative refraction were divided into control group. Data on the posterior corneal surface and anterior chamber were obtained from Pentacam software and compared between the groups. Postoperative visual acuity (VA) and refractive error were also analysed. The mean preoperative spherical equivalent (SE) was -6.99 ± 1.78 dioptre (D) in the LASIK group. Ten years after surgery, the mean SE was -0.45 ± 1.22 D, the efficacy index was 0.98, and the safety index was 1.01. The posterior corneal elevations of the LASIK group at 2 mm corneal diameter were significantly lower than those of the control group. However, posterior corneal elevations at 6 mm corneal diameter were higher in the LASIK group than the controls (p < 0.01 for all). The mean Q-values of posterior corneal surface demonstrated significant positive direction compared to that of control eyes at 6 and 7 mm corneal diameters (p < 0.05 for both). At the thinnest point of the cornea, the anterior chamber depths were shallower in the LASIK group than in controls. Meanwhile, the anterior chamber volumes (ACV) were smaller in the LASIK group than in the control group. Our results demonstrated that the posterior corneal surface tends to show signs of central flattening and peripheral steepening 10 years after myopic LASIK surgery compared to that of non-operated myopic eyes. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
Ramos-Esteban, Jerome C; Servat, Juan Javier; Tauber, Shachar; Bia, Frank
To report the history and clinical presentation of a 23-year-old man who developed delayed onset lamellar keratitis in his right eye 2 weeks after uneventful LASIK for correction of myopia. Initial clinical presentation suggested an infectious etiology, which led to therapeutic elevation of the LASIK flap and further microbiologic investigation with bacterial cultures. Bacterial cultures revealed Bacillus megaterium, which was sensitive to all antibiotics against which it was tested. Twenty-four hours after initiating aggressive topical and oral antibiotic therapy, symptomatic relief occurred in the affected eye. The patient's uncorrected final visual acuity at 1-year follow-up was 20/15 in the right eye, and the stromal bed developed a faint peripheral non-visually significant scar. This case is an unusual presentation and course for microbial keratitis following LASIK, which occurred despite aseptic technique and fluoroquinolone antibiotic prophylaxis. Following refractive surgery one should be prepared to culture the lamellar interface in cases of suspected microbial keratitis and begin aggressive antibiotic therapy.
Srivannaboon, Sabong; Chansue, Ekktet
To investigate intraoperative perception and sensation during Laser in situ Keratomileusis (LASIK). Sixty patients with uneventful LASIK were included. All procedures were performed by one surgeon with one technique. Any patient with intra-operative complications was excluded. The patients were asked to fill in the subjective evaluation form regarding their perception and sensation during the operation. Twenty-nine patients (48%) reported no pain and twenty-six patients (43%) reported no burning sensation during the surgery. Nineteen patients (32%) reported no light perception during the suction period of microkeratome. There was no correlation between duration of the suction and no light perception (R2 0.01). Thirty-four patients (56%) reported no trouble in maintaining visual fixation at the red light during the laser treatment. Ten patients (16%) reported they could clearly see the movement during the surgery and 5 out of 10 patients (50% of 16%) reported visual frightening. Fifty cases (84%) reported no visual frightening during the surgery after reassurance of the visual experience by the surgeon before the surgery. Patients undergoing LASIK may experience different visual perceptions. Reassurance of the intraoperative perception and sensation before the surgery can reduce the visual frightening.
Friehmann, Asaf; Mimouni, Michael; Nemet, Arie Y; Sela, Tzahi; Munzer, Gur; Kaiserman, Igor
To analyze the incidence and risk factors associated with epithelial ingrowth following uncomplicated microkeratome-assisted LASIK. All patients who underwent microkeratome-assisted LASIK between January 2006 and December 2014 in a single surgical center were reviewed. Epithelial ingrowth cases were identified and associated factors were assessed. Overall, 149 (0.49%) of 30,574 cases developed epithelial ingrowth. The epithelial ingrowth group was older compared to controls (35.3 ± 12.3 vs 31.7 ± 10.3 years, P = .001) and had a higher percentage of moderate to high hyperopia (13.7% vs 5.3%, P < .001), early postoperative flap slippage requiring flap repositioning (9.4% versus 2.8%, P < .001), or flap lifting for enhancement (48.6% vs 4.3%, P < .001), were treated with a smaller optic zone (6 mm) (37.7% vs 15.2%, P < .001), with a Moria M2 microkeratome (Moria SA, Antony, France) (70.1% vs 55.5%, P = .02), by low volume surgeons (n < 1,000) (5.8% vs 1.3%, P < .001), in a lower operating room temperature (22.3 ± 1.8 vs 22.8 ± 1.6, P = .005), and with a greater maximum ablation depth (67.3 ± 29.7 vs 57.3 ± 30.3, P < .001). There was a high incidence of epithelial ingrowth in the enhancement group compared to primary LASIK (4.8% vs 0.2%, P < .001). The time between treatments (primary and enhanced LASIK) was significantly greater in the epithelial ingrowth group (mean: 1,110 ± 870 vs 626 ± 662 days, P < .001). There was a significant rise in epithelial ingrowth rates as time between primary and enhancement LASIK increased, peaking at 4 to 5 years (P < .001). In multivariate analysis, flap lifting for enhancement (odds ratio [OR] = 19.5, P < .001), 6-mm optic zone (OR = 2.2, P < .001), moderate to severe hyperopia (OR = 2.4, P = .005), greater ablation depth (OR = 1.005, P < .001), and low volume surgeon (OR = 3.9, P = .01) were associated with epithelial ingrowth (total R 2 = 15.4). The potential risk factors described above may forewarn surgeons as to which
Cox, Daniel J; Banton, Thomas; Record, Steven; Grabman, Jesse H; Hawkins, Ronald J
Driving is a vision-based activity of daily living that impacts safety. Because visual disruption can compromise driving safety, contact lens wearers with astigmatism may pose a driving safety risk if they experience residual blur from spherical lenses that do not correct their astigmatism or if they experience blur from toric lenses that rotate excessively. Given that toric lens stabilization systems are continually improving, this preliminary study tested the hypothesis that astigmats wearing toric contact lenses, compared with spherical lenses, would exhibit better overall driving performance and driving-specific visual abilities. A within-subject, single-blind, crossover, randomized design was used to evaluate driving performance in 11 young adults with astigmatism (-0.75 to -1.75 diopters cylinder). Each participant drove a highly immersive, virtual reality driving simulator (210 degrees field of view) with (1) no correction, (2) spherical contact lens correction (ACUVUE MOIST), and (3) toric contact lens correction (ACUVUE MOIST for Astigmatism). Tactical driving skills such as steering, speed management, and braking, as well as operational driving abilities such as visual acuity, contrast sensitivity, and foot and arm reaction time, were quantified. There was a main effect for type of correction on driving performance (p = 0.05). Correction with toric lenses resulted in significantly safer tactical driving performance than no correction (p < 0.05), whereas correction with spherical lenses did not differ in driving safety from no correction (p = 0.118). Operational tests differentiated corrected from uncorrected performance for both spherical (p = 0.008) and toric (p = 0.011) lenses, but they were not sensitive enough to differentiate toric from spherical lens conditions. Given previous research showing that deficits in these tactical skills are predictive of future real-world collisions, these preliminary data suggest that correcting low to moderate
Biomedical Optical Company of America's (BOCA) suntiger lenses, similar in principle to natural filters in the eyes of hawks and eagles, bar 99 percent of potentially harmful wavelengths, while allowing visually useful colors of light (red, orange, green) to pass through. They also improve visual acuity, night vision and haze or fog visibility. The lenses evolved from work done by James B. Stephens and Dr. Charles G. Miller of the Jet Propulsion Laboratory. They developed a formula and produced a commercial welding curtain that absorbs, filters, and scatters light. This research led to protective glasses now used by dentists, workers in hazardous environments, CRT operators and skiers.
Mirshahi, Alireza; Kohnen, Thomas
To study the effect of microkeratome suction on ocular structures during LASIK. Observational, prospective case series. Twenty-one eyes of 11 patients with myopia or astigmatic myopia (8 females, 3 males) were included. The mean patient age was 36.3 years (median, 37 years; range, 24-48 years), and the mean spherical equivalent was -5.03 diopters (D) (median, -4.63 D; range, -2.38 to -8.38 D). We performed preoperative and intraoperative A-scan ultrasonography during application of suction using the Hansatome microkeratome (Bausch & Lomb Surgical, Munich, Germany) to create corneal flaps during LASIK. We also performed preoperative and postoperative B-scan ultrasonography of the posterior ocular segment with special attention to the presence and size of posterior vitreous detachment (PVD). We measured changes in the axial length, anterior chamber depth, lens thickness, and vitreous distance (distance from the posterior lens capsule to the posterior pole) during application of the microkeratome suction ring and recorded new occurrences of or increases in the size of the PVD after surgery. The lens thickness decreased (mean change, -0.20 mm; P = 0.001; 95% confidence interval [CI], -0.11 to -0.30) in 18 eyes during application of the suction ring. The vitreous distance increased (mean change, 0.20 mm; P = 0.004; 95% CI, 0.08-0.32) in 16 eyes. No statistically significant changes were found in the anterior chamber depth (P = 0.75) or axial length (P = 0.51). After surgery, 3 of 14 eyes (21.4%) experienced PVD that did not have echographic signs of PVD before surgery. Of 7 eyes with preoperative PVD, the PVD enlarged in 1 eye (14.3%). During application of microkeratome suction, the lens thickness decreases, whereas the vitreous distance increases, suggesting anterior traction on the posterior segment. The relationship between the observed PVD and LASIK merits further investigation.
Strong gravitational lensing has now developed into a mature tool for investigating galactic structure and dynamics as well as cosmological models. In this lecture the phenomenon of strong gravitational lensing, its history and applications are reviewed with an emphasis on the recent ideas developed by the author. Expected massive discoveries of strong lensing galactic scale systems in forthcoming projects like Euclid or LSST herald the bright future of gravitational lensing in cosmology.
Bower, Kraig S.; Sia, Rose K.; Ryan, Denise S.; Mines, Michael J.; Dartt, Darlene A.
Purpose To evaluate dry eye manifestations following photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) and determine the incidence and predictive factors of chronic dry eye using a set of dry eye criteria. Setting Walter Reed Army Medical Center, Washington, DC, USA Methods This is a prospective non-randomized clinical study of 143 active duty U.S. Army personnel aged 29.9±5.2 years with myopia or myopic astigmatism (manifest spherical equivalent −3.83±1.96 diopters) undergoing either PRK or LASIK. Dry eye evaluation was performed pre- and postoperatively. Main outcome measures included dry eye manifestations, incidence, and predictive factors of chronic dry eye. Results Schirmer scores, corneal sensitivity, ocular surface staining, surface regularity index (SRI), and responses to dry eye questionnaire significantly changed over time after PRK. After LASIK, significant changes were observed in tear breakup time, corneal sensitivity, ocular surface staining, and responses to questionnaire. At twelve months postoperatively, 5.0% of PRK and 0.8% of LASIK participants developed chronic dry eye. Regression analysis showed preoperatively lower Schirmer score will significantly influence development of chronic dry eye after PRK whereas preoperatively lower Schirmer score or higher ocular surface staining score will significantly influence the occurrence of chronic dry eye after LASIK. Conclusions Chronic dry eye is uncommon after PRK and LASIK. Ocular surface and tear film characteristics during preoperative examination may help predict chronic dry eye development in PRK and LASIK. PMID:26796443
Özyol, Pelin; Özyol, Erhan; Karel, Fatih
The performance of an intraocular lens is determined by several factors such as the surgical technique, surgical complications, intraocular lens biomaterial and design, and host reaction to the lens. The factor indicating the biocompatibility of an intraocular lens is the behavior of inflammatory and lens epithelial cells. Hence, the biocompatibility of intraocular lens materials is assessed in terms of uveal biocompatibility, based on the inflammatory foreign-body reaction of the eye against the implant, and in terms of capsular biocompatibility, determined by the relationship of the intraocular lens with residual lens epithelial cells within the capsular bag. Insufficient biocompatibility of intraocular lens materials may result in different clinical entities such as anterior capsule opacification, posterior capsule opacification, and lens epithelial cell ongrowth. Intraocular lenses are increasingly implanted much earlier in life in cases such as refractive lens exchange or pediatric intraocular lens implantation after congenital cataract surgery, and these lenses are expected to exhibit maximum performance for many decades. The materials used in intraocular lens manufacture should, therefore, ensure long-term uveal and capsular biocompatibility. In this article, we review the currently available materials used in the manufacture of intraocular lenses, especially with regard to their uveal and capsular biocompatibility, and discuss efforts to improve the biocompatibility of intraocular lenses.
Özyol, Pelin; Özyol, Erhan; Karel, Fatih
The performance of an intraocular lens is determined by several factors such as the surgical technique, surgical complications, intraocular lens biomaterial and design, and host reaction to the lens. The factor indicating the biocompatibility of an intraocular lens is the behavior of inflammatory and lens epithelial cells. Hence, the biocompatibility of intraocular lens materials is assessed in terms of uveal biocompatibility, based on the inflammatory foreign-body reaction of the eye against the implant, and in terms of capsular biocompatibility, determined by the relationship of the intraocular lens with residual lens epithelial cells within the capsular bag. Insufficient biocompatibility of intraocular lens materials may result in different clinical entities such as anterior capsule opacification, posterior capsule opacification, and lens epithelial cell ongrowth. Intraocular lenses are increasingly implanted much earlier in life in cases such as refractive lens exchange or pediatric intraocular lens implantation after congenital cataract surgery, and these lenses are expected to exhibit maximum performance for many decades. The materials used in intraocular lens manufacture should, therefore, ensure long-term uveal and capsular biocompatibility. In this article, we review the currently available materials used in the manufacture of intraocular lenses, especially with regard to their uveal and capsular biocompatibility, and discuss efforts to improve the biocompatibility of intraocular lenses. PMID:28845327
Greenslade, Thomas B., Jr.
One of the rewards of walking up the scores of steps winding around the inside of the shaft of a lighthouse is turning inward and examining the glass optical system. This arrangement of prisms, lenses, and reflectors is used to project the light from a relatively small source in a beam that can be seen far at sea.
Seider, Michael I.; McLeod, Stephen D.; Porco, Travis C.; Schallhorn, Steven C.
Objective To determine if procedure room temperature and humidity during LASIK affects refractive outcomes in a very large patient sample. Design Retrospective cohort study. Participants 202,394 eyes of 105,712 patients aged 18 to 75 years old who underwent LASIK at an Optical Express, Inc. location in their United Kingdom and Ireland centers from January 1, 2008 to June 30, 2011 who met inclusion criteria. Methods Patient age, gender, pre- and one month post-LASIK manifest refraction and flap creation technique were recorded as well as the ambient temperature and humidity during LASIK. Effect size determination, in addition to univariate and multivariate analysis was performed to characterize the relationships between LASIK procedure room temperature and humidity and post-operative refractive outcome. Main Outcome Measures One month post-LASIK manifest refraction. Results No clinically significant effect of procedure room temperature or humidity was found on LASIK refractive outcomes. When considering all eyes in our population, an increase of one degree Celsius during LASIK was associated with a 0.003 diopter more hyperopic refraction one month post-operatively and an increase in one percent humidity was associated with a 0.0004 more myopic refraction. These effect sizes were the same or similar when considering only myopic eyes, only hyperopic eyes and subgroups of eyes stratified by age and pre-operative refractive error. Conclusions Procedure room temperature or humidity during LASIK was found to have no clinically significant relationship with post-operative manifest refraction in our population. PMID:23769199
Rayer, Mathieu; Mansfield, Daniel
A chromatic confocal microscope is a single point non-contact distance measurement sensor. For three decades the vast majority of the chromatic confocal microscope use refractive-based lenses to code the measurement axis chromatically. However, such an approach is limiting the range of applications. In this paper the performance of refractive, diffractive and Hybrid aspheric diffractive are compared. Hybrid aspheric diffractive lenses combine the low geometric aberration of a diffractive lens with the high optical power of an aspheric lens. Hybrid aspheric diffractive lenses can reduce the number of elements in an imaging system significantly or create large hyper- chromatic lenses for sensing applications. In addition, diffractive lenses can improve the resolution and the dynamic range of a chromatic confocal microscope. However, to be suitable for commercial applications, the diffractive optical power must be significant. Therefore, manufacturing such lenses is a challenge. We show in this paper how a theoretical manufacturing model can demonstrate that the hybrid aspheric diffractive configuration with the best performances is achieved by step diffractive surface. The high optical quality of step diffractive surface is then demonstrated experimentally. Publisher's Note: This paper, originally published on 5/10/14, was replaced with a corrected/revised version on 5/19/14. If you downloaded the original PDF but are unable to access the revision, please contact SPIE Digital Library Customer Service for assistance.
Lam, Kay; Rootman, Dan B; Lichtinger, Alejandro; Rootman, David S
Corneal ectasia is a serious complication of laser in situ keratomileusis (LASIK). We report the case of a 29-year-old man who underwent LASIK in both eyes and in whom corneal ectasia developed in the left eye 3 years after surgery. He was treated sequentially with intraocular pressure-lowering medication, intrastromal corneal ring segment (ICRS) implants, and collagen cross-linking. Vision improved and the ectasia stabilized following treatment. Combined ICRS implantation and collagen cross-linking should be considered early in the management of post-LASIK ectasia.
Schumacher, S.; Sander, M.; Stolte, A.; Doepke, C.; Baumgaertner, W.; Lubatschowski, H.
Rapid development of new laser technologies enabled the application of ultra short lasers in refractive surgery. Focused ultra short laser pulses in near-infrared spectral range can generate a laser induced breakdown (LIB) in the cornea, which will disrupt the tissue. Cutting depth and position can be established by varying the laser focus. The fs-LASIK technique allows both flap and lenticule to be formed by using fs-pulses without the presence of any mechanical impact. During the cutting process not all of the pulse energy is deposited into the cornea; approximately half of the remaining energy propagates through the eye and reaches the retina. Though defocused, the transmitted energy can still induce damage to the retina due to absorption by the retinal pigment epithelium and the transfer of thermal energy to surrounding tissue. The fs-LASIK process was simulated with two laser systems; one continous-wave and one in the fs-regime. For the simulation the exposure time and focusing numerical aperature which defines the retinal spot size were varied. The Damage thresholds of the laser beam exposed eyes were determined in terms of ophthalmoscopic and histopathologic observations.
Park, Jung Hyun; Song, Nang Hee; Koh, Jae Woong
To report on Achromobacter xylosoxidans keratitis in two healthy patients who had worn contact lenses foran extended period of time. A 36-year-old female and a 21-year-old female visited our hospital with ocular pain and blurred vision. Both patients had a history of wearing soft contact lenses for over fve years with occasional overnight wear. At the initial presentation, a slit lamp examination revealed corneal stromal infiltrations and epithelial defects with peripheral neovascularization in both patients. Microbiological examinations were performed from samples of corneal scrapings, contact lenses, contact lens cases, and solution. The culture resulting from the samples taken from the contact lenses, contact lens cases, and solution were all positive for Achromobacter xylosoxidans. Confrming that the direct cause of the keratitis was the contact lenses, the frst patient was prescribed ceftazidime and amikacin drops sensitive to Achromobacter xylosoxidans. The second patient was treated with 0.3% gatifoxacin and fortifed tobramycin drops. After treatment, the corneal epithelial defects were completely healed, and subepithelial corneal opacity was observed. Two cases of Achromobacter xylosoxidans keratitis were reported in healthy young females who wore soft contact lenses. Achromobacter xylosoxidans should be considered a rare but potentially harmful pathogen for lens-induced keratitis in healthy hosts.
Learning unit: Thin lenses "Why objects seen through lenses are sometimes upright and sometimes reversed" Nita Laura Simona National College of Arts and Crafts "Constantin Brancusi", Craiova, Romania 1. GEOMETRIC OPTICS. 13 hours Introduction (models, axioms, principles, conventions) 1. Thin lenses (Types of lenses. Defining elements. Path of light rays through lenses. Image formation. Required physical quantities. Lens formulas). 2. Lens systems (Non-collated lenses. Focalless systems). 3. Human eye (Functioning as an optical system. Sight defects and their corrections). 4. Optical instruments (Characteristics exemplified by a magnifying glass. Paths of light rays through a simplified photo camera. Path of light rays through a classical microscope) (Physics curriculum for the IXth grade/ 2011). This scenario exposes a learning unit based on experimental sequences (defining specific competencies), as a succession of lessons started by noticing a problem whose solution assumes the setup of an experiment under laboratory conditions. Progressive learning of theme objectives are realised with sequential experimental steps. The central cognitive process is the induction or the generalization (development of new knowledge based on observation of examples or counterexamples of the concept to be learnt). Pupil interest in theme objectives is triggered by problem-situations, for example: "In order to better see small objects I need a magnifying glass. But when using a magnifier, small object images are sometimes seen upright and sometimes seen reversed!" Along the way, pupils' reasoning will converge to the idea: "The image of an object through a lens depends on the relative distances among object, lens, and observer". Associated learning model: EXPERIMENT Specific competencies: derived from the experiment model, in agreement with the following learning unit steps I. Evoking - Anticipation: Size of the problem, formulation of hypotheses and planning of experiment. II
Sander, M.; Minet, O.; Zabarylo, U.; Müller, M.; Tetz, M. R.
The femtosecond-laser in situ keratomileusis (fs-LASIK) technique has successfully entered the refractive surgery market to correct ametropia by cutting transparent corneal tissue with ultra-short laser pulses based on photodisruption. The laser pulses in the near infrared range (NIR) generate a laser-induced breakdown (LIOB) in the cornea. By propagating through the eye, a certain amount of the pulse is deposited in the cornea and the remaining energy interacts with the strong absorbing tissue behind. Due to the absorption by the retinal pigment epithelium and the transfer of the thermal energy to surrounding tissue, the transmitted energy can induce damage to the retina. The aim of this project was to find out the threshold influences concerning the tissue and the correlation between the results of the macroscopical appraisal and the fundus oculi pigmentation by simulating the fs-LASIK procedure with two various laser systems in the continuous wave (CW) and fs-regime. Therefore ex-vivo determinations were carried out macroscopically and histopathologically on porcine tissue.
Padmanabhan, N.; Seljak, U.; Pen, U. L.
We present a survey of the cosmological applications of the next generation of weak lensing surveys, paying special attention to the computational challenges presented by the number of galaxies, Ngal˜10 5. We focus on optimal methods with no pixelisation and derive a multigrid P3M algorithm that performs the relevant computations in O( Ngal log Ngal) time. We test the algorithm by studying three applications of weak lensing surveys—convergence map reconstruction, cluster detection and E and B power spectrum estimation using realistic 1°×1° simulations derived from N-body simulations. The map reconstruction is able to reconstruct large scale features without artifacts. Detecting clusters using only weak lensing is difficult because of line-of-sight contamination and noise, with low completeness if one desires low contamination of the sample. A power spectrum analysis of the convergence field is more promising and we are able to reconstruct the convergence spectrum with no loss of information down to the smallest scales. The numerical methods used here can be applied to other data sets with same O( N log N) scaling and can be generalised to a sphere.
contact 10-1 ’ .. . - w r" -,lSflZ.1,’y..,’.,L mp p,, tp. -,- ’’..r • %- 4o- Figure 1. Scleral contact lenses . 4.eN -.. r-4- Figure 2. Corneal... contact lens, Soft contact lens, Keratoconus, Aphakia * ABSTRACT (Contnue on reverse if necessary and identify by block number) ontact lenses are an...alternative method to spectacles for correcting refractive errors, but he U.S. Air Force prohibits the wearing of contact lenses by all aircrew
Mackool, Richard J; Monsanto, Vivian R
We describe a surgical technique to manage persistent corneal striae after laser in situ keratomileusis (LASIK). The sequential lift and suture technique reduces the time required for LASIK, eliminates the need to fixate the flap with forceps during suturing, and increases the accuracy of suture placement. The results in 10 eyes (9 patients) showed complete resolution of striae with improvement in subjective symptoms (glare and blurred vision) and best corrected visual acuity.
Hondur, Ahmet; Bilgihan, Kamil; Hasanreisoglu, Berati
To compare the clinical and confocal microscopic results of mechanical (epi-LASIK) versus alcohol-assisted laser epithelial keratomileusis (LASEK) for the correction of myopia. Twenty-five patients with myopia received epi-LASIK in one eye and LASEK in the other. The difference of spherical equivalent refraction of myopia and astigmatism was less than 1.00 diopter (D) in two eyes of each case. Mechanical separation of the epithelium was performed with the Lasitome epithelial separator and alcohol-assisted separation with 25 second application of 18% alcohol. Ablation was performed with the ESIRIS laser. Patients were seen daily until epithelial closure, and at 1, 3, 6, and 12 months. Time to epithelial healing, uncorrected visual acuity (UCVA), manifest refraction, haze, and grey scale value in confocal microscopy were recorded. Preoperative myopic spherical equivalent refraction was -3.95+/-1.49 D in the epi-LASIK and -3.91+/-1.39 D in the LASEK-treated eyes. The mean time to epithelial healing was slightly longer after epi-LASIK (4.86+/-0.64 vs 4.18+/-0.58 days). Of both epi-LASIK and LASEK-treated eyes, 92% achieved 20/20 or better UCVA and were within +/-0.50 D of emmetropia at 12 months. The grade of haze and mean grey scale value in confocal microscopy were similar in epi-LASIK and LASEK-treated eyes at all postoperative periods. One eye treated with epi-LASIK suffered a minor stromal cut. Epi-LASIK and LASEK offer effective correction of myopia with comparable results at 1 year.
Yuksel, Nilay; Bilgihan, Kamil; Hondur, Ahmet M; Yildiz, Burcin; Yuksel, Erdem
To evaluate the long term clinical and confocal results of mechanical (Epi-LASIK) versus alcohol-assisted laser epithelial keratomileusis (LASEK) for correction of myopia. Gazi University Medical School, Department of Ophthalmology, Ankara, Turkey. Retrospective study. Twenty-two eyes treated with LASEK and twenty eyes treated with Epi-LASIK were evaluated with a mean follow-up duration of 45 months. Mechanical separation of the epithelium was performed with Lasitome epithelial separator, and alcohol-assisted separation with 25s application of 18% alcohol. Laser ablation was performed with the ESIRIS laser. All patients were examined daily until epithelial closure; at 1, 3, 6, and 12 months; and every year subsequently. Main outcome measures were uncorrected visual acuity (UCVA), manifest refraction, haze, and gray scale value in confocal microscopy, efficacy and safety indexes. Preoperative myopic spherical equivalent refraction was -4.65 ± 1.74 D in the LASEK and -3.87 ± 1.30 D in the Epi-LASIK-treated eyes (p=0.36). Of both LASEK and Epi-LASIK-treated eyes, 95% achieved 20/25 or better final UCVA. The grade of haze and mean gray scale value in confocal microscopy were similar in LASEK and Epi-LASIK-treated eyes at all postoperative periods. The efficacy index was 0.94 in LASEK group and 0.96 in Epi-LASIK group (p=0.44). The safety index was 1.01 in LASEK group and 1.02 in Epi-LASIK group (p=0.42). Both LASEK and Epi-LASIK offer safe and effective correction of myopia in the long term. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.
Allen, F. G.; Yue, A. S.; Yu, J. G.
Method enables use of crystal or semiconductor materials with selective spectral-response characteristics (ultraviolet, visible, or infrared wavelengths) in fabrication of contact lenses, reading glasses, and photographic processing equipment.
Treu, Tommaso; Marshall, Philip J.; Clowe, Douglas
This Resource Letter provides a guide to a selection of the literature on gravitational lensing and its applications. Journal articles, books, popular articles, and websites are cited for the following topics: foundations of gravitational lensing, foundations of cosmology, history of gravitational lensing, strong lensing, weak lensing, and microlensing.
Frings, Andreas; Richard, Gisbert; Steinberg, Johannes; Druchkiv, Vasyl; Linke, Stephan Johannes; Katz, Toam
Purpose To analyze the refractive and keratometric stability in hyperopic astigmatic laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) during the first 6 months after surgery. Patients and methods This retrospective cross-sectional study included 97 hyperopic eyes; 55 were treated with LASIK and 42 with PRK. Excimer ablation for all eyes was performed using the ALLEGRETTO excimer laser platform using a mitomycin C for PRK and a mechanical microkeratome for LASIK. Keratometric and refractive data were analyzed during three consecutive follow-up intervals (6 weeks, 3 months, and 6 months). The corneal topography was obtained using Scheimpflug topography, and subjective refractions were acquired by expert optometrists according to a standardized protocol. Results After 3 months, mean keratometry and spherical equivalent were stable after LASIK, whereas PRK-treated eyes presented statistically significant (P<0.001) regression of hyperopia. In eleven cases, hyperopic regression of >1 D occurred. The optical zone diameter did not correlate with the development of regression. Conclusion After corneal laser refractive surgery, keratometric changes are followed by refractive changes and they occur up to 6 months after LASIK and for at least 6 months after PRK, and therefore, caution should be applied when retreatment is planned during the 1st year after surgery because hyperopic refractive regression can lead to suboptimal visual outcome. Keratometric and refractive stability is earlier achieved after LASIK, and therefore, retreatment may be independent of late regression. PMID:27099463
Zhang, F J; Sun, M S
With the development of excimer laser and femtosecond laser equipment, application of diversified and customized surgical decision in modern corneal refractive surgery has been an inevitable trend. However, how to make a personalized decision with an accurate surgical design to achieve better visual quality becomes the main focus in clinical applications. Small-incision lenticule extraction (SMILE) and femtosecond assisted laser in situ keratomileusis (FS-LASIK) have been commonly acknowledged as the mainstream of corneal refractive surgery for ametropia correction nowadays. Both methods have been verified by clinical practice for many years. This article compares and elaborates the different characteristics with advantages and disadvantages of the two methods so as to provide some reasonable treatment options for refractive surgery. (Chin J Ophthalmol, 2018, 54: 7-10) .
Schlichting, Katja; Novak, Tobias; Heinrich, Andreas
Individual additive manufacturing of optical systems based on 3D Printing offers varied possibilities in design and usage. In addition to the additive manufacturing procedure, the usage of tunable lenses allows further advantages for intelligent optical systems. Our goal is to bring the advantages of additive manufacturing together with the huge potential of tunable lenses. We produced tunable lenses as a bundle without any further processing steps, like polishing. The lenses were designed and directly printed with a 3D Printer as a package. The design contains the membrane as an optical part as well as the mechanical parts of the lens, like the attachments for the sleeves which contain the oil. The dynamic optical lenses were filled with an oil. The focal length of the lenses changes due to a change of the radius of curvature. This change is caused by changing the pressure in the inside of the lens. In addition to that, we designed lenses with special structures to obtain different areas with an individual optical power. We want to discuss the huge potential of this technology for several applications. Further, an appropriate controlling system is needed. Wéll show the possibilities to control and regulate the optical power of the lenses. The lenses could be used for illumination tasks, and in the future, for individual measurement tasks. The main advantage is the individuality and the possibility to create an individual design which completely fulfills the requirements for any specific application.
Farris, R L
Tear analysis in contact lens wearers was compared with tear analysis in aphakics without contact lens wear and normal phakic patients. Subjects were divided into five groups: group 1, aphakic without contact lens; group 2, phakic with daily-wear hard contact lens; group 3, phakic with daily-wear soft contact lens; group 4, phakic with extended-wear soft contact lens; and group 5, aphakic with extended-wear soft contact lens. The experimental groups were compared with age- and sex-matched control groups for statistical analysis of tear variables by means of the Student's t-test. The variables measured were tear osmolarity, tear albumin, and lysozyme and lactoferrin concentrations in basal and reflex tears. Highly significant elevations of tear osmolarity were found in aphakic subjects without contact lenses. Less significant differences in tear osmolarity were found in phakic subjects with hard daily-wear lenses or with extended-wear soft lenses. Tear albumin, lysozyme, and lactoferrin in basal and reflex tears were not significantly different in the different groups of contact lens wearers or in the group of aphakic subjects without contact lenses compared with their control groups. Individual variations in tear albumin, lysozyme, and lactoferrin appeared to be responsible for the inability to demonstrate significant differences in tear composition in association with the wearing of different types of contact lenses. Older and aphakic patients demonstrated a tendency to have increased concentrations of proteins in the tears compared with younger, phakic contact lens wearers and normal controls without contact lenses. PMID:3914131
Guillon, Michel; Dumbleton, Kathy; Theodoratos, Panagiotis; Patel, Trisha; Karkkainen, Tom; Moody, Kurt
Contact lens wearers of Asian descent may be predisposed to experience microtrauma of the ocular surface as a result a thinner post-lens tear film and higher eyelid tension, and these effects would be anticipated to be most marked in an older population. The objective of this study was to quantify the mechanical effects of the study contact lenses on the ocular surface in a population of presbyopic contact lens wearers of Asian descent. Twenty established presbyopic contact lens wearers (hydrogel n=5, none habitual wearers of etafilcon A lenses; silicone hydrogel n=15) of Asian descent were refitted with etafilcon A multifocal daily disposable contact lenses (1-DAY ACUVUE MOIST MULTIFOCAL) for a period of 1 month of daily lens wear. The habitual modalities of wear were 45% daily disposable and 55% planned replacement. Digital photographs of the upper lid margins, nasal and temporal conjunctiva, and superior cornea were taken after 6 hr of wear of the participants' habitual contact lenses, after 1 day without contact lens wear, and after 6 hr of wear of the study contact lenses at the end of the 1-month period. The photographs were masked according to study visit and the staining extent measured using proprietary software. Lid margin staining was significantly lower with the study contact lenses (2.0±1.0 mm) than with the participants' own contact lenses (3.2±3.0 mm) after 6 hr of wear, representing a mean staining decrease of 38% (P=0.010). Lid margin staining after 6 hr of wear of the study contact lenses was not different from that measured after 1 day without contact lenses (P=0.507). Limbal staining was also significantly less with the study contact lenses than with the participants' own contact lenses after 6 hr of wear (P=0.009). There was minimal upper corneal staining, and the degree was similar with the study and habitual lenses. Etafilcon A material, worn under a daily disposable modality, was shown to reduce upper lid margin and limbal staining in
Parminder, Amy; Jacobs, Deborah S
The last two decades have brought advances in materials and manufacturing of large diameter rigid gas-permeable contact lenses, and a greater appreciation of the role of scleral lenses for therapeutic indications. The purpose of this review is to provide an update on the use of rigid gas-permeable scleral lenses in the management of patients with complications after refractive surgery. There are recent reports on clinical experience with specific scleral lens designs from single institutions in cohorts that include patients who have undergone refractive surgery. Typically, these are patients with 'irregular corneas' after radial keratotomy or LASER assisted in-situ keratomileusis, but patients with keratectasia, dry eye syndrome, and corneal neuralgia are also reported. Visual outcomes and wearing success rates are high in these reports, although outcomes for refractive surgery patients are not reported separately. Clinicians who encounter patients with complications after corneal refractive surgery should be aware of advances in scleral lenses. Scleral lenses are an alternative to surgical intervention in patients who might otherwise be considered poor contact lens candidates.
Bernstein, Gary M.; Armstrong, Robert
We derive an estimator of weak gravitational lensing shear from background galaxy images that avoids noise-induced biases through a rigorous Bayesian treatment of the measurement. The derived shear estimator disposes with the assignment of ellipticities to individual galaxies that is typical of previous approaches to galaxy lensing. Shear estimates from the mean of the Bayesian posterior are unbiased in the limit of large number of background galaxies, regardless of the noise level on individual galaxies. The Bayesian formalism requires a prior, describing the (noiseless) distribution of the target galaxy population over some parameter space; this prior can be constructed from low-noise images of a subsample of the target population, attainable from long integrations of a fraction of the survey field. We find two ways to combine this exact treatment of noise with rigorous treatment of the effects of the instrumental point spread function (PSF) and sampling. The Bayesian model-fitting (BMF) method assigns a likelihood of the pixel data to galaxy models (e.g. Sérsic ellipses), and requires the unlensed distribution of galaxies over the model parameters as a prior. The Bayesian Fourier domain (BFD) method compresses the pixel data to a small set of weighted moments calculated after PSF correction in Fourier space. It requires the unlensed distribution of galaxy moments as a prior, plus derivatives of this prior under applied shear. A numerical test using a simplified model of a biased galaxy measurement process demonstrates that the Bayesian formalism recovers applied shears to <1 part in 103 accuracy as well as providing accurate uncertainty estimates. BFD is the first shear measurement algorithm that is model free and requires no approximations or ad hoc assumptions in correcting for the effects of PSF, noise, or sampling on the galaxy images. These algorithms are good candidates for attaining the part-per-thousand shear inference required for hemisphere-scale weak
Beach, Raymond J.; Honea, Eric C.; Bibeau, Camille; Mitchell, Scott; Lang, John; Maderas, Dennis; Speth, Joel; Payne, Stephen A.
A hollow lensing duct to condense (intensify) light using a combination of focusing using a spherical or cylindrical lens followed by reflective waveguiding. The hollow duct tapers down from a wide input side to a narrow output side, with the input side consisting of a lens that may be coated with an antireflective coating for more efficient transmission into the duct. The inside surfaces of the hollow lens duct are appropriately coated to be reflective, preventing light from escaping by reflection as it travels along the duct (reflective waveguiding). The hollow duct has various applications for intensifying light, such as in the coupling of diode array pump light to solid state lasing materials.
Akhtar, Saeed; Alkatan, Hind; Kirat, Omar; Almubrad, Turki
Post-laser in situ keratomileusis (LASIK) corneal ectasia is a serious late postoperative complication. Here, we report the ultrastructural features of the post-LASIK cornea of two patients. Two normal corneas (age 24 and 37 years old) and two post-LASIK ectaic corneas from two patients (A and B) were studied. The "patient A" (age 27 years) underwent penetrating keratoplasty and "patient B" (age 31 years) underwent deep-anterior lamellar keratoplasty. The excised corneas were processed for light and electron microscopy. A total of 120 images for three-dimensional (3D) reconstruction were taken by using the software "Recorder" and using a bottom mounted camera "Quemesa" attached to a JOEL 1400 transmission electron microscope. The 3D images were constructed using "Visual Kai" software. In the post-LASIK cornea, the hemidesmosomes, the basement membrane, and Bowman"s layer were abnormal. The stromal lamellae were thin and disorganized. The collagen fibrils (CFs) diameter and interfibrillar spacing had decreased. Aggregated microfibrils were present in the Bowman's layer and all parts of the stroma. A large number of microfilaments were present at the detachment end of the flap and residual stroma. The 3D images showed the presence of collagen microfibrils and proteoglycans (PGs) within the CF of the normal and post-LASIK cornea. The collagen microfibrils and PGs within the CFs had degenerated in the post-LASIK cornea. Collagen microfibrils and PGs within the CFs were degenerated, leading to the degeneration of CFs, followed by the disorganization of lamellae in post-LASIK cornea. The CFs diameter and interfibrillar spacing decreased. Copyright © 2013 Wiley Periodicals, Inc.
Nelson, C. A.; Cook, K. H.; Popowski, P.; Drake, A. J.; Marshall, S. L.; Griest, K.; Vandehei, T.; Alcock, C.; Allsman, R. A.; Axelrod, T. S.; Freeman, K. C.; Peterson, B. A.; Alves, D. R.; Becker, A. C.; Stubbs, C. W.; Tomaney, A. B.; Bennett, D. P.; Geha, M.; Lehner, M. J.; Minniti, D.; Pratt, M. R.; Quinn, P. J.; Sutherland, W.; Welch, D.; MACHO Collaboration
There are two principle geometrical arrangements which may explain Large Magellanic Cloud (LMC) microlensing: a) halo-lensing, in which the lensed object is part of the Milky Way galactic halo and b) self-lensing, in which the lensed object is part of the LMC. Self-lensing in turn may be broken into two categories: LMC-LMC self-lensing, in which both the source and the lens reside in the LMC and background self-lensing, in which the lens is a star in the LMC and the source star is drawn from some population behind the LMC. Models suggest the contribution of LMC-LMC self-lensing is small, so the nature of LMC microlensing may be estimated from the location of the microlensing source stars. If the source stars are in the LMC then microlensing is dominated by halo-lensing; conversely if the source stars are located behind the LMC then microlensing is dominated by self-lensing. Since background populations reside behind the LMC, we expect them to be both redder and fainter then the average population of the LMC. We attempt to determine if the MACHO source stars come from such a background population by comparing the HST color-magnitude diagram (CMD) of source stars to the CMD of the average population of the LMC and looking for the effects of extra reddening and extinction. The microlensing source stars are identified by deriving accurate centroids in the ground-based MACHO images using difference image analysis (DIA) and then transforming the DIA coordinates to the HST frame. Preliminary results suggest that halo-lensing accounts for ≳ 40% of the observed microlensing results. Support provided by NASA, DOE, NSF and NPSC.
Papas, Eric; Tilia, Daniel; McNally, John; de la Jara, Percy Lazon
To investigate if contact lens-related discomfort is a function of the time of day at which lenses are worn. This was a randomized, crossover, open-label clinical trial where subjective responses, with and without contact lenses, were assessed every 2 hours during five stages (A to E). Each stage began at the time when subjects would normally have inserted their contact lenses (T0). During stage A, no lenses were worn, whereas in stage B, lenses were worn continuously for 12 hours. In stages C to E, lenses were worn for only 4 hours. Contact lenses were inserted at T0 for stage C, but for stages D and E, lenses were not inserted until T0 + 4 and T0 + 8 hours, respectively. Mixed linear models were used for statistical analysis. In the absence of contact lenses, ocular comfort and dryness remained reasonably constant throughout the observation period. Ocular comfort and dryness decreased during 12 hours of continuous lens wear and became significantly worse from the 8-hour time onward compared with insertion (p < 0.023). There were no significant differences in terms of ocular comfort and dryness between any of the 4-hour lens wear stages (p < 0.82). During each 4-hour stage, both comfort and dryness behaved in a similar fashion (p > 0.05) to the first 4 hours of continuous contact lens wear. Comparing the scores of each of these stages with the no-lens response at the corresponding time showed no significant differences for comfort (p > 0.23) or dryness (p > 0.37). Short periods of wear can be experienced at any time of day without significant change in ocular discomfort and dryness. This suggests that subjective responses at the end of the day are determined by the length of time lenses are in contact with the eye, rather than the time of day at which lenses are worn.
Gravitational lensing distorts cosmic shear maps and Cosmic Microwave Background (CMB) anisotropies maps. We derive the correlation functions of the lensing-induced shear and the reconstructed deflection angle. We investigate the applications of those correlations in determining cosmological parameters: (1) The reconstructed lensing potential enhances the detectability of CMB tensor B-mode anisotropy which completes all required initial conditions to explain the primordial universe. (2) The cross-correlation between the lensed CMB maps and Far Infrared Radiation Background (FIRB) anisotropy maps is studied to understand the nature of FIRB sources and their relation to the distribution of dark matter. (3) CMB lensing and cosmic shear can be used to probe massive neutrinos collapsing into the gravitational wells when they become non-relativistic. (4) The cosmological parameters related to cosmic acceleration can be precisely determined by cosmic shear maps. We study how to generalise those parameters and how to discriminate different models.
Tessore, Nicolas; Bellagamba, Fabio; Metcalf, R. Benton
Robust modelling of strong lensing systems is fundamental to exploit the information they contain about the distribution of matter in galaxies and clusters. In this work, we present LENSED, a new code which performs forward parametric modelling of strong lenses. LENSED takes advantage of a massively parallel ray-tracing kernel to perform the necessary calculations on a modern graphics processing unit (GPU). This makes the precise rendering of the background lensed sources much faster, and allows the simultaneous optimization of tens of parameters for the selected model. With a single run, the code is able to obtain the full posterior probability distribution for the lens light, the mass distribution and the background source at the same time. LENSED is first tested on mock images which reproduce realistic space-based observations of lensing systems. In this way, we show that it is able to recover unbiased estimates of the lens parameters, even when the sources do not follow exactly the assumed model. Then, we apply it to a subsample of the Sloan Lens ACS Survey lenses, in order to demonstrate its use on real data. The results generally agree with the literature, and highlight the flexibility and robustness of the algorithm.
Wu, Ying; Wang, Li-qiang
This was a prospective controlled clinical trial. 48 myopia patients (96 eyes) were included in this study. After LASIK, accelerated corneal collagen cross-linking (ACXL) was used for myopia treatment. During 6-month follow-up, the results of LASIK-ACXL treatment were studied and compared to the LASIK-only procedure. The results showed that no statistically significant differences in UDVA, CDVA, MRSE, K mean, pachymetry, or ECD were found between the two groups at the visit after 6 months of follow-up (all P > 0.05). At 6 months postoperatively, 2 eyes lost one or more lines of visual acuity in the LASIK-ACXL group, whereas all LASIK-only treated eyes had a stable CDVA. In vivo confocal microscopy showed a decrease of keratocyte density and appearance of honeycomb-like structures in the anterior residual stroma bed; the changes were similar but more pronounced following LASIK-only. None of the cases in both groups developed signs of significant keratitis, regression, or ectasia during the 6-month follow-up. LASIK-ACXL can effectively correct refractive error in patients with myopia, with no significant complications during 6-month follow-up, indicating stability and morphologic change similar to those with LASIK-only treatment. PMID:27689082
Mohamed-Noriega, Karim; Riau, Andri K; Lwin, Nyein C; Chaurasia, Shyam S; Tan, Donald T; Mehta, Jodhbir S
We compared early corneal nerve changes after small incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK). A total of 12 rabbits underwent LASIK in one eye and SMILE in the fellow eye. Baseline and follow-up evaluations at 1, 2, and 4 weeks postoperatively were performed with in vivo confocal microscopy to evaluate 5 different areas within the treated zone: center, superior, inferior, nasal, and temporal. Cryosections of the corneas and whole mount of the extracted SMILE lenticules were analyzed with immunostaining of βIII-tubulin. One week after SMILE and LASIK, a decrease in nerve length and density was observed in all evaluated areas. A trend toward greater subbasal nerve length and density (SLD), more eyes with subbasal nerves (ESN), more eyes with subbasal nerves longer than 200 μm (SNL), and higher mean number of subbasal nerves by frame (NSN) in SMILE than in LASIK groups was observed at subsequent follow-up time points. Only the SMILE group showed a recovery of SLD, ESN, and NSN by week 4 (P > 0.05). A trend toward more eyes with sprouting subbasal nerves and greater mean number of sprouting nerves was observed in LASIK than in SMILE, indicating that more subbasal nerves were disrupted and undergoing regeneration after LASIK. Immunostaining at postoperative week 4 revealed a faster stromal nerve recovery in post-SMILE eyes compared to post-LASIK eyes. Our findings suggest that SMILE results in less nerve damage and faster nerve recovery than LASIK.
Ortega-Usobiaga, J; Llovet-Osuna, F; Djodeyre, M R; Llovet-Rausell, A; Beltran-Sanz, J; Baviera-Sabater, J
A study is made on the incidence of corneal ectasia after laser in situ keratomileusis (LASIK) in patients with large differences in mean keratometry (MK) readings between both eyes (OU). Visual outcomes were also evaluated. The medical records of 164,603 patients (315,259 eyes) who underwent LASIK from January 2003 to December 2011 were reviewed in order to identify patients with a difference in MK of ≥ 1.25 D between OU. The main outcome measures were incidence of ectasia after LASIK, and visual outcome. A total of 35 eyes that met the inclusion criteria were found. Functional and visual results were those expected for myopia studies. After a minimum follow-up of 2 years, no corneal ectasia was found in 3 eyes (2 patients). The possibility of finding a patient with an asymmetry in MK and normal topography is low (0.021%), and it does not seem to be a contraindication of LASIK. Although no corneal ectasia was found in this case series, and as it is a potentially sight-threatening complication, patients with very different MK between OU should be studied carefully before undergoing LASIK. Copyright © 2013 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.
Liu, Siqi; Pen, Ue-Li; Macquart, J.-P.; Brisken, Walter; Deller, Adam
We test the inclined sheet pulsar scintillation model (Pen & Levin) against archival very long baseline interferometry (VLBI) data on PSR 0834+06 and show that its scintillation properties can be precisely reproduced by a model in which refraction occurs on two distinct lens planes. These data strongly favour a model in which grazing-incidence refraction instead of diffraction off turbulent structures is the primary source of pulsar scattering. This model can reproduce the parameters of the observed diffractive scintillation with an accuracy at the percent level. Comparison with new VLBI proper motion results in a direct measure of the ionized interstellar medium (ISM) screen transverse velocity. The results are consistent with ISM velocities local to the PSR 0834+06 sight-line (through the Galaxy). The simple 1-D structure of the lenses opens up the possibility of using interstellar lenses as precision probes for pulsar lens mapping, precision transverse motions in the ISM, and new opportunities for removing scattering to improve pulsar timing. We describe the parameters and observables of this double screen system. While relative screen distances can in principle be accurately determined, a global conformal distance degeneracy exists that allows a rescaling of the absolute distance scale. For PSR B0834+06, we present VLBI astrometry results that provide (for the first time) a direct measurement of the distance of the pulsar. For most of the recycled millisecond pulsars that are the targets of precision timing observations, the targets where independent distance measurements are not available. The degeneracy presented in the lens modelling could be broken if the pulsar resides in a binary system.
Picot, C; Gauthier, A-S; Campolmi, N; Delbosc, B
To evaluate the contribution of scleral lenses in terms of improving the quality of life in the treatment of astigmatism after penetrating keratoplasty or in keratoconus. We conducted an observational retrospective study, evaluating quality of life (QOL) of patients who failed to adapt to RPG lenses, fitted with SPOT(®) scleral lenses between October 2007 and March 2011 in the University Hospital of Besançon Department of Ophthalmology. QOL was assessed before and after scleral lens adaptation with the French version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ 25). We included 47 patients (83 eyes) fitted with scleral lenses on one or both eyes: 56 eyes with keratoconus and 27 post-keratoplasty eyes. The average duration of wearing scleral lenses was 18±10months and the average wearing time was 14±3hours per day. The rate of participation in the survey was 86.5% (41 patients). Visual acuity in the better eye progressed from 0.68±0.46 to 0.15±0.17 logMAR at the 6th month after scleral lens adaptation (P<0.0001). The average scores on the NEI-VFQ 25 questionnaire of patients fitted with scleral lenses for at least 6 months were significantly higher than those without scleral lenses, with a global score of 80.2/100 with, versus 48.1/100 without, scleral lenses (P<0.0001). The global score increased by an average of 32.1±4.6 points (-28, 82) (P<0.0001). Statistical analysis found no significant difference in global score between patients in the keratoconus and keratoplasty groups (P>0.05). Scleral lenses showed a significant improvement in quality of life for patients who had failed or are intolerant to conventional rigid gas permeable contact lenses. In our two main optical indications, keratoconus and keratoplasty, they represent an alternative or a step prior to surgery. Copyright © 2015 Elsevier Masson SAS. All rights reserved.
Asena, Leyla; Altınörs, Dilek Dursun
To report the clinical outcomes of scleral Misa ® lenses (Microlens Contactlens Technolgy, Arnhem, Netherlands) for visual rehabilitation in patients with pellucid marginal degeneration (PMD). In this prospective interventional case series, 24 eyes of 12 PMD patients were fitted with scleral Misa ® lenses. Patients were followed regularly for continuous daily wearing time (CDWT), contact lens handling issues, visual acuity, and any subjective or objective contact lens related complications. The mean patient age was 35.0±13.8 years (range, 23-47 years). The average length of follow-up was 14.1±3.7 months (range, 8.5-18 months). All eyes were fit with mini Misa ® scleral lenses with a diameter of 16.5 or 17mm. The mean Snellen best-corrected visual acuity (BCVA) before scleral lenses with spectacle correction was 0.42±0.15 (range, 0.2-0.6). With scleral lenses, mean BCVA was 0.75±0.15 (range, 0.5-0.9), (p=0.003) with a mean gain of 3.3 lines of BCVA. More than half (16 eyes, 67%) reported wearing their scleral lenses for 8h or more on a daily basis. Three patients (6 eyes, 25%) abandoned scleral lens wear. Patients who abandoned the scleral lens wear tended to have a better spectacle corrected visual acuity and less gain of lines. Scleral lenses can be used succesfully in patients with PMD who are intolerant to other types of contact lenses. Patients who have a low spectacle BCVA and a higher gain of visual acuity with scleral lenses are good candidates for scleral lens use. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.
In the coming Large Synoptic Survey Telescope era, we will observe O(100) of lensed supernovae (SNe). In this paper, we investigate the possibility for predicting time and sky position of an SN using strong lensing. We find that it will be possible to predict the time and position of the fourth image of SNe which produce four images by strong lensing, with combined information from the three previous images. It is useful to perform multimessenger observations of the very early phase of SN explosions including the shock breakout.
Barreira, Alexandre; Li, Baojiu; Jennings, Elise; ...
In this study, we determine the concentration–mass relation of 19 X-ray selected galaxy clusters from the Cluster Lensing and Supernova Survey with Hubble survey in theories of gravity that directly modify the lensing potential. We model the clusters as Navarro–Frenk–White haloes and fit their lensing signal, in the Cubic Galileon and Nonlocal gravity models, to the lensing convergence profiles of the clusters. We discuss a number of important issues that need to be taken into account, associated with the use of non-parametric and parametric lensing methods, as well as assumptions about the background cosmology. Our results show that the concentrationmore » and mass estimates in the modified gravity models are, within the error bars, the same as in Λ cold dark matter. This result demonstrates that, for the Nonlocal model, the modifications to gravity are too weak at the cluster redshifts, and for the Galileon model, the screening mechanism is very efficient inside the cluster radius. However, at distances ~ [2–20] Mpc/h from the cluster centre, we find that the surrounding force profiles are enhanced by ~ 20–40% in the Cubic Galileon model. This has an impact on dynamical mass estimates, which means that tests of gravity based on comparisons between lensing and dynamical masses can also be applied to the Cubic Galileon model.« less
Stapleton, Fiona; Versace, Patrick
Objectives To determine the effect of hyperopic laser in situ keratomileusis (H-LASIK) on corneal integrity, by investigating relationships between proportionate corneal tissue ablated and refractive outcomes at 3 months. Methods 18 eyes of 18 subjects treated with H-LASIK by Technolas 217c Excimer Laser were included in the study. Orbscan II Topography System was used to determine corneal volume and pachymetry 3mm temporally (3T). The volume of corneal tissue ablated was determined from the laser nomogram. Univariate associations between age, treatment, corneal volume, overall proportion of tissue removed, proportion of tissue removed at 3T, residual bed thickness at 3T and refractive outcomes 3 months post-LASIK were examined and independent factors associated with refractive outcomes determined using linear regression models. Results At 3 months post-LASIK, the mean difference to expected refractive outcome was -0.20 ± 0.64 (Range -2.00 to +1.00). In univariate analysis, difference to expected refractive outcome was associated with proportion of tissue removed at 3T (P<0.01, r = -0.605) and total number of pulses (P< 0.05, r = -0.574). In multivariable analysis, difference to expected refractive outcome was associated with the proportion of tissue removed at 3T only. Conclusion Subjects undergoing H-LASIK, may present as either over or under-corrected at 3 months. The proportion of tissue removed at 3T was the single significant determinant of this outcome, suggesting unexpected biomechanical alterations resulting in corneal steepening. Future hyperopic LASIK procedures could consider proportionate volume of corneal tissue removed at 3T in addition to laser nomograms to achieve improved refractive outcomes. PMID:28151939
Pietilä, Juhani; Huhtala, Anne; Mäkinen, Petri; Uusitalo, Hannu
The aim of this paper is to present the accuracy, predictability, and safety outcomes of LASIK enhancements performed with the FEMTO LDV femtosecond laser (Ziemer Ophthalmic Systems, Port, Switzerland) and the Allegretto Wave Concerto 500 Hz excimer laser (Wavelight AG, Erlangen, Germany), following previous LASIK treatments. FEMTO LDV was used for flap creation in 85 previously LASIK-treated eyes of 62 patients. The intended flap thickness was 90 μm in 81 eyes and 140 μm in 4 eyes. The size of the suction ring was 9.0 mm in 72 eyes and 9.5 mm in 13 eyes. Flap dimensions were measured and correlated to preoperative characteristics. With the intended flap thickness of 90 μm in previously LASIK-treated eyes, the actual flap thickness was 90.2 ± 6.6 μm (range 80-122), and the flap diameter was 9.2 ± 0.2 mm (range 8.7-9.9). The mean hinge length was 4.0 ± 0.2 mm (range 3.0-4.8). Flap thickness correlated positively with patient age and hinge length. Complications were reported in 12 eyes (14.1 %). Most of the complications were very mild, and none of them prevented further refractive laser treatment. One eye lost two Snellen lines of best spectacle-corrected visual acuity. Femtosecond LASIK enhancement is warranted only in rare cases. Surgical experience is needed and special caution must be practiced. For cases of a primary free cap, femtosecond LASIK is not recommended.
Dong, Zixian; Zhou, Xingtao; Wu, Jihong; Zhang, Zhehuan; Li, Tao; Zhou, Zimei; Zhang, Shenghai; Li, Gang
Aim To evaluate and compare early corneal wound healing and inflammatory responses after small incision lenticule extraction (SMILE) versus femtosecond laser laser in situ keratomileusis (LASIK). Methods Thirty-six eyes of 36 rabbits underwent SMILE, while another 36 eyes of 36 rabbits were treated with femtosecond laser LASIK. All the eyes were subjected to the same refractive correction of −6.00 DS/−1.00 DC. Twelve eyes that had no surgery were included for control. After euthanisation, corneal tissue sections were evaluated with terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick-end labelling (TUNEL) assay to detect apoptosis at postoperative 4 and 24 h, immunocytochemistry for Ki67 to detect keratocyte proliferation at postoperative day 3, week 1 and month 1, and immunocytochemistry for CD11b to detect inflammation at postoperative day 1, day 3 and week 1, respectively. Results No adverse effects were noted after SMILE or LASIK. Corneal healing postoperatively was uneventful in all cases. There were significantly fewer TUNEL-positive corneal stromal cells after the SMILE procedure at 4 and 24 h postoperatively (p<0.01) compared with the LASIK procedure. In addition, immunocytochemistry showed significantly fewer Ki67-positive cells in the SMILE group than those in the femtosecond laser LASIK group at day 3 and week 1 postoperatively (p<0.05), but there was little expression of Ki67 at month 1 postoperatively in both groups. The CD11b-positive cells were significantly fewer in the SMILE group at day 1, day 3 and week 1 postoperatively (p<0.01). Conclusions SMILE induces less keratocyte apoptosis, proliferation and inflammation compared with femtosecond laser LASIK. PMID:24227802
Rathaus, Ben; Itzhaki, Nissan
We study the CMB lensing signature of a pre-inationary particle (PIP), assuming it is responsible for the giant rings anomaly that was found recently in the WMAP data. Simulating Planck-like data we find that generically the CMB lensing signal to noise ratio associated with such a PIP is quite small and it would be difficult to cross correlate the temperature giant rings with the CMB lensing signal. However, if the pre-inationary particle is also responsible for the bulk flow measured from the local large scale structure, which happens to point roughly at the same direction as the giant rings, then the CMB lensing signal to noise ratio is fairly significant.
The NASA Hubble Space Telescope serendipitous survey of the sky has uncovered exotic patterns, rings, arcs and crosses that are all optical mirages produced by a gravitational lens, nature's equivalent of having giant magnifying glass in space. Shown are the top 10 lens candidates uncovered in the deepest 100 Hubble fields. Hubble's sensitivity and high resolution allow it to see faint and distant lenses that cannot be detected with ground-based telescopes whose images are blurred by Earth's atmosphere. [Top Left] - HST 01248+0351 is a lensed pair on either side of the edge-on disk lensing galaxy. [Top Center] - HST 01247+0352 is another pair of bluer lensed source images around the red spherical elliptical lensing galaxy. Two much fainter images can be seen near the detection limit which might make this a quadruple system. [Top Right] - HST 15433+5352 is a very good lens candidate with a bluer lensed source in the form of an extended arc about the redder elliptical lensing galaxy. [Middle Far Left] - HST 16302+8230 could be an 'Einstein ring' and the most intriguing lens candidate. It has been nicknamed the 'the London Underground' since it resembles that logo. [Middle Near Left] - HST 14176+5226 is the first, and brightest lens system discovered in 1995 with the Hubble telescope. This lens candidate has now been confirmed spectroscopically using large ground-based telescopes. The elliptical lensing galaxy is located 7 billion light-years away, and the lensed quasar is about 11 billion light-years distant. [Middle Near Right] - HST 12531-2914 is the second quadruple lens candidate discovered with Hubble. It is similar to the first, but appears smaller and fainter. [Middle Far Right] - HST 14164+5215 is a pair of bluish lensed images symmetrically placed around a brighter, redder galaxy. [Bottom Left] - HST 16309+8230 is an edge-on disk-like galaxy (blue arc) which has been significantly distorted by the redder lensing elliptical galaxy. [Bottom Center] - HST 12368
Mediavilla, Evencio; Muñoz, Jose A.; Garzón, Francisco; Mahoney, Terence J.
Contributors; Participants; Preface; Acknowledgements; 1. Lensing basics Sherry H. Suyu; 2. Exoplanet microlensing Andrew Gould; 3. Case studies of microlensing Veronica Motta and Emilio Falco; 4. Microlensing of quasars and AGN Joachim Wambsganss; 5. DM in clusters and large-scale structure Peter Schneider; 6. The future of strong lensing Chris Fassnacht; 7. Methods for strong lens modelling Charles Keeton; 8. Tutorial on inverse ray shooting Jorge Jimenez-Vicente.
Li, Meiyan; Zhou, Zimei; Shen, Yang; Knorz, Michael C; Gong, Lan; Zhou, Xingtao
To compare the impact on corneal sensation after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (femto-LASIK) in patients with myopia. In this prospective, nonrandomized comparative study, 71 subjects were enrolled. Thirty-eight eyes of 38 patients underwent SMILE and 33 eyes of 33 patients underwent femto-LASIK. Corneal sensation was tested with Cochet-Bonnet esthesiometry in five corneal areas preoperatively and at 1 week and 1, 3, and 6 months postoperatively. Comparison of corneal sensation was performed for the SMILE and femto-LASIK groups. Additionally, the correlations were evaluated between the postoperative corneal sensation, preoperative spherical equivalent, and ablation depth. All tested areas within the cap or flap demonstrated corneal hypoesthesia immediately after both surgeries. SMILE-treated eyes showed less compromised corneal sensation than femto-LASIK-treated eyes at all postoperative visits in the central, inferior, nasal, and temporal areas at the 1-week and 1-month visits. In the SMILE group, the inferior, nasal, and temporal quadrants recovered faster than other areas. In the femto-LASIK group, the sensation over the flap did not recover to preoperative levels by postoperative 6 months. There was no correlation between postoperative corneal sensation, preoperative spherical equivalent, and ablation depth in both groups. The impairment of corneal sensation was less significant in the SMILE group than in the femto-LASIK group and was independent of preoperative spherical equivalent or ablation depth. Copyright 2014, SLACK Incorporated.
Chynn, E W; Lopez, M A; Pavan-Langston, D; Talamo, J H
To identify potential differences in time to diagnosis and final visual outcome between contact lens and noncontact lens users with Acanthamoeba keratitis. Prior studies have shown early diagnosis and therapy to be related to outcome but have not analyzed differences among patients with and without contact lenses. A retrospective analysis of 11 consecutive cases (involving 13 eyes) of Acanthamoeba keratitis diagnosed at one institution over a 3-year period. Mean time to diagnosis was significantly longer in noncontact lens users versus those who wore contact lenses (mean, 5.8 versus 3.3 weeks). Fifty percent of patients who did not wear contact lenses had a poor outcome (visual acuity worse than 20/40 or penetrating keratoplasty) versus 14% of patients who wore contact lenses. Diagnoses were made later in patients without contact lenses, and these patients had a worse visual outcome than those with Acanthamoeba keratitis who wore contact lenses. All patients with unresponsive microbial keratitis, even those without contact lens use, should be evaluated for Acanthamoeba.
Schornack, Muriel M; Baratz, Keith H; Patel, Sanjay V; Maguire, Leo J
To describe the use of the Jupiter scleral contact lens (Medlens Innovations, Front Royal, VA or Essilor Contact Lens, Inc., Dallas, TX) in the management of ocular manifestations of chronic graft versus host disease (cGVHD). This study is a retrospective case series. Five consecutive patients with severe keratoconjunctivitis sicca (KCS) associated with cGVHD that could not be adequately managed with conventional therapy were evaluated for scleral contact lens wear between January and December 2007. All patients were evaluated with lenses from the standard 18.2 mm Jupiter B diagnostic fitting set. If lenses of standard design failed to provide adequate fit, custom lenses were designed. Three outcome measures were evaluated: the patient's ability to tolerate and successfully handle the lenses, improvement in symptoms of KCS, and improvement in visual acuity. All 5 patients (10 eyes) were successfully fit with Jupiter scleral lenses. Six eyes of 3 patients were successfully fit with lenses of standard design. Standard parameters were altered to achieve adequate fit in 4 eyes of 2 patients. All patients reported subjective improvements in comfort with Jupiter scleral lenses, and best-corrected vision improved in 7 of the 10 eyes fit within the first several months of contact lens wear. The remaining 3 eyes maintained the visual acuity measured before scleral lens wear (20/20 in 2 eyes, 20/40 in 1 eye). Duration of follow-up ranged from 4 to 14 months. Jupiter scleral lenses can relieve symptoms of KCS and may improve vision in patients with cGVHD.
Schallhorn, Steven C; Farjo, Ayad A; Huang, David; Boxer Wachler, Brian S; Trattler, William B; Tanzer, David J; Majmudar, Parag A; Sugar, Alan
To describe wavefront-guided (WFG) LASIK for the primary treatment of low to moderate levels of myopia and astigmatism and to examine the evidence on the safety and effectiveness of the procedure in comparison with conventional LASIK. Literature searches conducted in 2004, 2005, 2006, and 2007 retrieved 209 unique references from the PubMed and Cochrane Library databases. The panel selected 65 articles to review, and of these, chose 45 articles that they considered to be of sufficient clinical relevance to submit to the panel methodologist for review. During the review and preparation of this assessment, an additional 2 articles were included. A level I rating was assigned to properly conducted, well-designed, randomized clinical trials; a level II rating was assigned to well-designed cohort and case-controlled studies; and a level III rating was assigned to case series, case reports, and poorly designed prospective and retrospective studies. In addition, studies that were conducted by laser manufacturers before device approval (premarket approval) were reviewed as a separate category of evidence. The assessment describes studies reporting results of WFG LASIK clinical trials, comparative trials, or both of WFG and conventional LASIK that were rated level II and level III. There were no studies rated as level I evidence. Four premarket approval studies conducted by 4 laser manufacturers were included in the assessment. The assessment did not compare study results or laser platforms because there were many variables, including the amount of follow-up, the use of different microkeratomes, and the level of preoperative myopia and astigmatism. There is substantial level II and level III evidence that WFG LASIK is safe and effective for the correction of primary myopia or primary myopia and astigmatism and that there is a high level of patient satisfaction. Microkeratome and flap-related complications are not common but can occur with WFG LASIK, just as with
Liesenborgs, J.; de Rijcke, S.; Dejonghe, H.; Bekaert, P.
Gravitational lenses are a spectacular astrophysical phenomenon, a cosmic mirage caused by the gravitational deflection of light in which multiple images of a same background object can be seen. Their beauty is only exceeded by their usefulness, as the gravitational lens effect is a direct probe of the total mass of the deflecting object. Furthermore, since the image configuration arising from the gravitational lens effect depends on the exact gravitational potential of the deflector, it even holds the promise of learning about the distribution of the mass. In this presentation, a method for extracting the information encoded in the images and reconstructing the mass distribution is presented. Being a non-parametric method, it avoids making a priori assumptions about the shape of the mass distribution. At the core of the procedure lies a genetic algorithm, an optimization strategy inspired by Darwin's principle of ``survival of the fittest''. One only needs to specify a criterion to decide if one particular trial solution is deemed better than another, and the genetic algorithm will ``breed'' appropriate solutions to the problem. In a similar way, one can create a multi-objective genetic algorithm, capable of optimizing several fitness criteria at the same time. This provides a very flexible way to incorporate all the available information in the gravitational lens system: not only the positions and shapes of the multiple images are used, but also the so-called ``null space'', i.e. the area in which no such images can be seen. The effectiveness of this approach is illustrated using simulated data, which allows one to compare the reconstruction to the true mass distribution.
Cooke, Matthew D; Koenig, Steven B
To describe a case of acute corneal hydrops in a patient with corneal ectasia after laser in situ keratomileusis (LASIK). An observational study presenting clinical, slit-lamp, and optical coherence tomographic findings. A 66-year-old man with a history of moderate myopic astigmatism presented with a sudden loss of vision in his left eye 11 years after undergoing LASIK. He underwent a single enhancement in his left eye and was subsequently diagnosed with ectasia 9 years later. Slit-lamp examination demonstrated a small tear in the Descemet membrane with a large fluid-filled cleft separating the LASIK flap and extending to the flap edge. Because no aqueous humor leakage was detected, the patient was managed conservatively with eventual resolution of the fluid-filled cleft and return of 20/30 visual acuity. Acute corneal hydrops is a rare complication of post-LASIK corneal ectasia. In the absence of flap dehiscence and wound leak, such patients may be managed with simple observation.
Martins, Suy Anne Rebouças; Campos, Mauro Q.; Vidal, Benedicto C.; Berto, Alessandra G. A.; Aguiar, Jair A. K.
Purpose To evaluate the acute effects of laser in situ keratomileusis (LASIK) upon the synthesis of proteoglycans (PGs) and collagen fibril organization in human corneal explants. Methods Human corneas that had been rejected for transplants were obtained at Banco de Olhos of Hospital São Paulo. For each eye pair, one cornea was submitted to refractive surgery, and the other was used as its matched control. After surgery, the corneas were excised from the eyes and immediately placed in a Ham F-12 nutrient mixture containing 35S-sulfate for the metabolic labeling of PGs. After 24 h incubation, PGs were extracted and identified by a combination of agarose gel electrophoresis and enzymatic degradation with protease and specific glycosaminoglycan lyases. Histopathological and birefringence analysis were performed in fixed tissue slices. Results A marked decrease in 35S-sulfate incorporation in PGs was observed in corneal explants that received LASIK, especially concerning dermatan sulfate-PGs, with keratan sulfate- and heparan sulfate-PG synthesis reduced to a lower degree. Only low molecular weight PGs were present in the corneas, both before and 24 h after LASIK. No sign of wound healing processes were observed, but a marked change in corneal birefringence was seen following LASIK treatment. Conclusions Laser application led to decreased PG biosynthesis in human corneal explants, with marked changes in the collagen fibril organization, as revealed by changes in the tissue birefringence. PMID:17293778
Munshi, Dipak; Valageas, Patrick
Weak gravitational lensing is responsible for the shearing and magnification of the images of high-redshift sources due to the presence of intervening mass. Since the lensing effects arise from deflections of the light rays due to fluctuations of the gravitational potential, they can be directly related to the underlying density field of the large-scale structures. Weak gravitational surveys are complementary to both galaxy surveys and cosmic microwave background observations as they probe unbiased nonlinear matter power spectra at medium redshift. Ongoing CMBR experiments such as WMAP and a future Planck satellite mission will measure the standard cosmological parameters with unprecedented accuracy. The focus of attention will then shift to understanding the nature of dark matter and vacuum energy: several recent studies suggest that lensing is the best method for constraining the dark energy equation of state. During the next 5 year period, ongoing and future weak lensing surveys such as the Joint Dark Energy Mission (JDEM; e.g. SNAP) or the Large-aperture Synoptic Survey Telescope will play a major role in advancing our understanding of the universe in this direction. In this review article, we describe various aspects of probing the matter power spectrum and the bi-spectrum and other related statistics with weak lensing surveys. This can be used to probe the background dynamics of the universe as well as the nature of dark matter and dark energy.
Schornack, Muriel M
To present a comprehensive review of current and historical literature on scleral lenses. A comprehensive search of several databases from each database's earliest inception to May 23, 2014 was conducted by an experienced librarian with input from the author to locate articles related to scleral lens design, fabrication, prescription, and management. A total of 899 references were identified, 184 of which were directly related to scleral lenses. References of interest were organized by date, topic, and study design. Most of articles published before 1983 presented lens design and fabrication techniques or indications for scleral lens therapy. Case reviews published after 1983 identified major indications for scleral lenses (corneal ectasia, ocular surface disease, and refractive error) and visual and functional outcomes of scleral lens wear. Statistically significant improvements in visual acuity, vision-related quality of life, and ocular surface integrity were reported. Reviews of ocular and systemic conditions suggested that comprehensive management strategies for these conditions could include scleral lenses. Early work investigating scleral lens fitting characteristics, optical qualities, and potential physiological impact on anterior ocular structures have been published in the past 5 years. Indications for scleral lens wear are well-established. Developing areas of research on the physiologic impact of scleral lens wear on the ocular surface, the use of technology to improve scleral lens vision and fit, and the impact of these devices on the quality of life should further enhance our understanding of scleral lenses in the future.
Elandt, Ryan B; Shakeri, Mostafa; Alam, Mohammad-Reza
Here we show that a nonlinear resonance between oceanic surface waves caused by small seabed features (the so-called Bragg resonance) can be utilized to create the equivalent of lenses and curved mirrors for surface gravity waves. Such gravity wave lenses, which are merely small changes to the seafloor topography and therefore are surface noninvasive, can focus or defocus the energy of incident waves toward or away from any desired focal point. We further show that for a broadband incident wave spectrum (i.e., a wave group composed of a multitude of different-frequency waves), a polychromatic topography (occupying no more than the area required for a monochromatic lens) can achieve a broadband lensing effect. Gravity wave lenses can be utilized to create localized high-energy wave zones (e.g., for wave energy harvesting or creating artificial surf zones) as well as to disperse waves in order to create protected areas (e.g., harbors or areas near important offshore facilities). In reverse, lensing of oceanic waves may be caused by natural seabed features and may explain the frequent appearance of very high amplitude waves in certain bodies of water.
Alió, Jorge L; Montés-Mico, Robert
To assess efficacy, safety, predictability, stability, and changes in higher-order aberrations (HOAs) and contrast sensitivity (CS) after wavefront-guided and standard LASIK enhancement for the correction of residual refractive errors. Prospective, randomized, comparative clinical study. Twenty eyes of 20 consecutive patients (spherical equivalent [SE], -2.01+/-1.36 diopters [D]) treated with wavefront-guided Zyoptix Ablation Refinement software (ZAR) LASIK and 20 eyes of 20 consecutive patients (SE, -1.81+/-1.21 D) treated with standard Planoscan LASIK, both for residual refractive error enhancement. Efficacy, safety, predictability, stability, HOAs, and CS were evaluated before and after enhancement at 6 months' follow-up. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), manifest refraction, CS by means of the Functional Acuity Contrast Test, and HOAs by means of Zywave aberrometry were evaluated preoperatively and 6 months after retreatment. At 6 months postoperatively, UCVA was 20/25 or better in 100% of the eyes. Efficacy indexes were 1.09 for ZAR patients and 0.95 for Planoscan patients. No eyes lost > or =1 line of BCVA; in the ZAR group, 2 eyes gained 1 line and 6 eyes gained > or =2 lines; in the Planoscan group, 3 eyes gained 1 line. The ZAR group showed a percentage of eyes (94.4%) within the 0.5-D range in SE higher than that shown by the Planoscan group (88.8%). After 6 months, the HOA root mean square (RMS) increased on average by a factor of 1.44 for the Planoscan group (P = 0.003). No change or reduction in HOA RMS was found in the ZAR group (factor of 0.96; P>0.01). Contrast sensitivity was reduced in the Planoscan group only at the highest spatial frequency (18 cycles per degree; P<0.01). There was a significant reduction of CS as a function of HOA increase for the Planoscan group (P<0.0001). No changes were observed for the ZAR group at any spatial frequency (1.5-18 cycles per degree; P>0.01). Wavefront-guided LASIK using
Settas, George; Settas, Clare; Minos, Evangelos; Yeung, Ian Yl
Hyperopia, or hypermetropia (also known as long-sightedness or far-sightedness), is the condition where the unaccommodating eye brings parallel light to a focus behind the retina instead of on it. Hyperopia can be corrected with both non-surgical and surgical methods, among them photorefractive keratectomy (PRK) and laser assisted In situ keratomileusis (LASIK). There is uncertainty as to whether hyperopic-PRK or hyperopic-LASIK is the better method. The objectives of this review were to determine whether PRK or LASIK leads to more reliable, stable and safe results when correcting a hyperopic refractive error. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 2), MEDLINE (January 1950 to February 2012), EMBASE (January 1980 to February 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to February 2012), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the WHO International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). There were no date or language restrictions in the electronic searches for trials. The electronic databases were last searched on 17 February 2012. When trials are included in the review we will search the reference lists of the studies included in the review for information about further trials. We will use the Science Citation Index to search for papers that cite any studies included in this review. We did not handsearch journals or conference proceedings specifically for this review. We planned to include only randomised controlled trials (RCTs) comparing PRK against LASIK for correction of hyperopia and then perform a sensitivity analysis of pre- and post-millennial trials since this is the mid-point in the history of both PRK and LASIK. We did not identify any studies that met the inclusion criteria for this review. As no studies met the
Settas, George; Settas, C; Minos, E; Yeung, Ian Y L
Hyperopia, or hypermetropia (also known as long-sightedness or far-sightedness), is the condition where the unaccommodating eye brings parallel light to a focus behind the retina instead of on it. Hyperopia can be corrected with both non-surgical and surgical methods, among them photorefractive keratectomy (PRK) and laser assisted In situ keratomileusis (LASIK). There is uncertainty as to whether hyperopic-PRK or hyperopic-LASIK is the better method. The objectives of this review were to determine whether PRK or LASIK leads to more reliable, stable and safe results when correcting a hyperopic refractive error. We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2008), MEDLINE (January 1950 to January 2009), EMBASE (January 1980 to January 2009) and LILACS (January 1982 to January 2009). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 13 January 2009. We also searched the reference lists of the studies included in the review for information about further trials and used the Science Citation Index to search for papers that cite any studies included in this review. We did not handsearch journals or conference proceedings specifically for this review. We planned to include only randomised controlled trials (RCTs) comparing PRK against LASIK for correction of hyperopia and then perform a sensitivity analysis of pre- and post-millennial trials since this is the mid-point in the history of both PRK and LASIK. We did not identify any studies that met the inclusion criteria for this review. As no studies met the inclusion criteria for this review, we discussed the results of non-randomised trials comparing hyperopic-PRK with hyperopic-LASIK. No robust, reliable conclusions could be reached, but the non-randomised trials reviewed appear to be in agreement that hyperopic-PRK and hyperopic-LASIK are of comparable efficacy. High quality, well-planned open RCTs are
Povedano-Montero, Francisco Javier; Álvarez-Peregrina, Cristina; Hidalgo Santa Cruz, Fernando; Villa-Collar, César; Sánchez Valverde, José
To analyze the state of scientific publications in the field of scleral lenses applying a bibliometric study. The database used in this bibliometric study was SCOPUS, the largest abstract and citation database of peer-reviewed literature: scientific journals, books, and conference proceedings. Using remote download techniques, articles published between 1962 (year of first registrations) and 2015 were selected by entering the main descriptors: "scleral contact lenses" and "scleral lenses," limiting the field for the article, keywords, and abstract, linked with the OR tab. We applied the following bibliometric indicators: Price index, doubling time and annual growth rate, Price transience index, Lotka law of scientific productivity, and Bradford zones. The authors recovered 361 contributions (articles, reviews, letters to the editor, etc.) for 1962 to 2016. The distribution for five-year periods shows a significant increase in 2012 to 2016, with a growth of 222.22% in comparison with the previous period 2012 to 2016. The countries with the highest production are the United states with 135 contributions, United Kingdom with 46, and India with 19. The most productive institutions are Harvard Medical school, Boston Foundation for Sight, and Moorfields Eye Hospital National Health Service Foundation Trust. Classification of authors based on productivity is strongly concentrated in small producers, with a transient index of 59.03. The total number of authors is 891, representing a coauthor index of 2.47 for the 361 documents retrieved. The authors with the highest productivity are Kenneth W. Pullum, Perry Rosenthal, and Deborah S. Jacobs, with an h-index between 12 and 19 documents. The number of documents published on scleral lenses shows a significant increase in the last 5 years, and currently, they represent only 1.44% of all publications on contact lenses. Bibliometric studies have become essential tools for evaluating scientific activity, allowing an overview of
Lam, Andrew K C; Tse, Jimmy S H
This study compared the measurements of intraocular pressure (IOP) and ocular pulse amplitude (OPA) using the Dynamic Contour Tonometry (DCT) over silicone hydrogel contact lenses of different modulus. Corneal biomechanics were also measured using the Ocular Response Analyzer (ORA). Forty-seven young (mean age 22.3 years, standard deviation 1.2 years) subjects had IOP, OPA, corneal hysteresis (CH) and corneal resistance factor (CRF) measured without lens and with two brands of silicone hydrogel contact lenses. Each eye wore one brand followed by another, randomly assigned, and then the lenses switched over. Difference and agreement of IOP and OPA with and without silicone hydrogel contact lens were studied. The right and left eyes had similar corneal curvatures, central corneal thicknesses, IOP, OPA and corneal biomechanics at baseline. No significant difference was found in CH and CRF when they were measured over different contact lenses. IOP demonstrated a greater difference (95% limits of agreement: 2.73mmHg) compared with no lens when it was measured over high modulus silicone hydrogel lenses. Agreement improved over low lens modulus silicone hydrogel lenses (95% limits of agreement: 2.2-2.4mmHg). 95% limits of agreement were within 1.0mmHg for OPA. This study demonstrated the feasibility of DCT over silicone hydrogel lenses. Low lens modulus silicone hydrogel contact lens in situ has no clinical effect on DCT. Copyright © 2013 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.
The refractive surgery includes a lot of procedures for changing the refraction of the eye to obtain a better visual acuity with no glasses or contact lenses. LASIK is the most commonly performed laser refractive surgery today. The goal is to present the postoperative evolution of the refraction and visual acuity after LASIK for Mixed and Hyperopic Astigmatism. The results show that LASIK is safe and predictible if we have well performed interventions and well-selected patients.
Sun, Chi-Chin; Chang, Chao-Kai; Ma, David Hui-Kang; Lin, Yi-Fang; Chen, Kuan-Jen; Sun, Ming-Hui; Hsiao, Ching-Hsi; Wu, Pei-Hsuan
Dry eye is the most common complication after LASIK procedure and is associated with corneal denervation. We conducted the study to compare dry eye parameters and corneal sensitivity (CS) after laser in situ keratomileusis (LASIK) with a femtosecond laser (FS) or microkeratome (MK). In this prospective, nonrandomized, comparative study, 87 consecutive patients with myopia were assigned to receive either LASIK surgery with an FS (n = 44) or MK-assisted LASIK surgery (n = 43). The groups were age and sex matched. Corneal sensitivity, Schirmer testing, tear breakup time (TBUT), conjunctival and corneal stainings, and a subjective questionnaire (Ocular Surface Disease Index [OSDI]) were evaluated preoperatively, at 1 week, and at 1, 3, and 6 months postoperatively. Preoperative spherical equivalent and sphere, calculated ablation depth, and suction time differed significantly between the two groups (p < 0.01, all comparisons). Postoperatively, CS decreased in both groups and gradually recovered. Schirmer test values were not significantly different throughout the postoperative time points between the groups. Laser in situ keratomileusis-induced corneal epitheliopathy was also increased after operation in both groups. However, there was no significant difference between the groups in corneal and conjunctival staining scores. The OSDI scores were increased postoperatively in both groups. After adjustment for the calculated ablation depth, TBUT was the only parameter that was statistically higher in the FS group than in the MK group (p = 0.03). Both FS- and MK-assisted LASIK reduced CS and TBUT and increased corneal staining and OSDI scores. However, TBUT was significantly higher in the FS group than in the MK group after operation.
Daftarian, Narsis; Dehghan, Mohammad-Hossein; Ahmadieh, Hamid; Soheilian, Masoud; Karkhaneh, Reza; Lashay, Alireza; Mirshahi, Ahmad; Parhizkar, Hamid; Kazemimoghadam, Mohsen; Modarreszadeh, Mehdi; Hashemi, Masih; Fadaei, Mojtaba; Entezari, Morteza
Purpose To describe the clinical features and surgical outcomes of rhegmatogenous retinal detachment (RRD) following myopic laser in situ keratomileusis (LASIK). Methods In a retrospective, non-comparative case series, 46 eyes that had undergone vitreoretinal surgery for management of RRD following myopic LASIK were identified. Data was reviewed with emphasis on characteristics of the RRD, employed surgical techniques, and anatomic and visual outcomes. Results Mean pre-LASIK myopia was −9.7±3.9 (range −4.00 to −18.00) diopters (D). Mean interval between LASIK and development of RRD was 11.6±11.2 months. Posterior vitreous detachment was present in 44 eyes (95.6%). The retinal breaks included flap tears in 36 (78.3%) eyes, giant tears in 8 (17.4%) eyes and atrophic holes in 2 (4.3%) eyes. In eyes with flap tears, the breaks were multiple, large or posterior to the equator in 24(66.7%) eyes. Retinal breaks were related to lattice degeneration in 20 (43.5%) eyes of which, three had history of prophylactic barrier laser photocoagulation. Scleral buckling was performed as the initial procedure in 32 (69.6%) eyes and primary vitrectomy was undertaken in 14 (30.4%) eyes. The initial surgical procedure failed in 14 (30.4%) eyes due to proliferative vitreoretinopathy (PVR). Retinal reattachment was finally achieved in 43 (93.4%) eyes. Postoperative visual acuity ≥20/40 and ≥20/200 was achieved in 16 (34.8%) and 25 (54.3%) eyes, respectively. Conclusion Post-LASIK retinal detachment has a complex nature in eyes with moderate to high myopia. The retinal detachment is complex in terms of size, number and location of retinal breaks, is associated with a high rate of PVR and entails unfavorable visual outcomes. PMID:23198065
Clinch, Thomas E.
Purpose: The aim of the study was to evaluate the safety of besifloxacin ophthalmic suspension 0.6% as antibacterial prophylaxis in the surgical setting. Methods: Two prospective safety surveillance studies were conducted—one in the cataract surgery setting and the other in the laser-assisted in situ keratomileusis (LASIK) surgery setting. Cases from patients aged 18 years and above were eligible for inclusion. In both surveillance studies, data were collected from consecutive cases of routine primary cataract surgery and LASIK surgery, respectively, in which besifloxacin ophthalmic suspension 0.6% or moxifloxacin ophthalmic solution 0.5% was used as the topical perioperative prophylactic antibacterial medication as part of the clinician's routine standard of care. The primary safety endpoint was the incidence of treatment-emergent adverse events (TEAEs). Results: The cataract surgery surveillance study included 485 cases/eyes (besifloxacin, n = 333; moxifloxacin, n = 152), whereas the LASIK surveillance study included 456 cases/eyes (besifloxacin, n = 344; moxifloxacin, n = 112). In the cataract study, only 1 TEAE was reported in a besifloxacin case (mild hypersensitivity/allergic reaction considered possibly related to besifloxacin). No TEAEs were reported in the LASIK study. In both studies, surgical outcomes were similar with both treatments. The frequency of preoperative and/or postoperative dosing was generally lower for besifloxacin than that for moxifloxacin. Conclusions: In prospective safety surveillance studies of patients undergoing cataract extraction or LASIK, TEAEs associated with prophylactic use of besifloxacin ophthalmic suspension 0.6% were rare, and surgical outcomes with besifloxacin were similar to those with moxifloxacin ophthalmic solution 0.5%. PMID:24637269
Majmudar, Parag A; Clinch, Thomas E
The aim of the study was to evaluate the safety of besifloxacin ophthalmic suspension 0.6% as antibacterial prophylaxis in the surgical setting. Two prospective safety surveillance studies were conducted-one in the cataract surgery setting and the other in the laser-assisted in situ keratomileusis (LASIK) surgery setting. Cases from patients aged 18 years and above were eligible for inclusion. In both surveillance studies, data were collected from consecutive cases of routine primary cataract surgery and LASIK surgery, respectively, in which besifloxacin ophthalmic suspension 0.6% or moxifloxacin ophthalmic solution 0.5% was used as the topical perioperative prophylactic antibacterial medication as part of the clinician's routine standard of care. The primary safety endpoint was the incidence of treatment-emergent adverse events (TEAEs). The cataract surgery surveillance study included 485 cases/eyes (besifloxacin, n = 333; moxifloxacin, n = 152), whereas the LASIK surveillance study included 456 cases/eyes (besifloxacin, n = 344; moxifloxacin, n = 112). In the cataract study, only 1 TEAE was reported in a besifloxacin case (mild hypersensitivity/allergic reaction considered possibly related to besifloxacin). No TEAEs were reported in the LASIK study. In both studies, surgical outcomes were similar with both treatments. The frequency of preoperative and/or postoperative dosing was generally lower for besifloxacin than that for moxifloxacin. In prospective safety surveillance studies of patients undergoing cataract extraction or LASIK, TEAEs associated with prophylactic use of besifloxacin ophthalmic suspension 0.6% were rare, and surgical outcomes with besifloxacin were similar to those with moxifloxacin ophthalmic solution 0.5%.
Tong, Jessica Y; Viswanathan, Deepa; Hodge, Christopher; Sutton, Gerard; Chan, Colin; Males, John J
Post laser-assisted in situ keratomileusis (LASIK) ectasia is a rare and unpredictable complication after LASIK. Corneal collagen crosslinking (CXL) has emerged as a promising technique to address this complication. Our study evaluates the long-term efficacy of CXL for post-LASIK ectasia in an Australian setting. Retrospective review of post-LASIK ectasia patients referred to and treated at 3 corneal refractive surgery institutions in Sydney, Australia. Eleven patients (14 eyes; mean age, 39.7 ± 12.6 years) underwent epithelium-off CXL with follow-up ranging from 12-78 months. Best spectacle-corrected visual acuity (BSCVA), simulated keratometry, corneal topography indices, and higher-order aberrations (HOAs) [mean ± standard error of the mean (SEM)] were measured with a rotating Scheimpflug camera (Pentacam, Oculus). Comparisons between baseline measurements and postoperative outcomes were performed using paired t test analysis. At last follow-up, BSCVA improved significantly by 0.2 ± 0.06 logMAR (P = 0.01), and 12 of 14 eyes showed no keratometric deterioration. Of the corneal topography indices, index of height asymmetry showed a trend toward a significant improvement (P = 0.05). There was no progression of corneal HOAs. Central corneal thickness was not significantly altered (P = 0.6). No major postoperative complications were observed. In the Australian setting, CXL has proven effective at stabilizing the progression of post-LASIK ectasia, inducing corneal regularity, and improving visual acuity. Copyright 2017 Asia-Pacific Academy of Ophthalmology.
Toda, Ikuko; Ide, Takeshi; Fukumoto, Teruki; Tsubota, Kazuo
To evaluate the visual performance of two customized ablation systems (wavefront-guided ablation and topography-guided ablation) in LASIK. In this prospective, randomized clinical study, 68 eyes of 35 patients undergoing LASIK were enrolled. Patients were randomly assigned to wavefront-guided ablation using the iDesign aberrometer and STAR S4 IR Excimer Laser system (Abbott Medical Optics, Inc., Santa Ana, CA) (wavefront-guided group; 32 eyes of 16 patients; age: 29.0 ± 7.3 years) or topography-guided ablation using the OPD-Scan aberrometer and EC-5000 CXII excimer laser system (NIDEK, Tokyo, Japan) (topography-guided group; 36 eyes of 19 patients; age: 36.1 ± 9.6 years). Preoperative manifest refraction was -4.92 ± 1.95 diopters (D) in the wavefront-guided group and -4.44 ± 1.98 D in the topography-guided group. Visual function and subjective symptoms were compared between groups before and 1 and 3 months after LASIK. Of seven subjective symptoms evaluated, four were significantly milder in the wavefront-guided group at 3 months. Contrast sensitivity with glare off at low spatial frequencies (6.3° and 4°) was significantly higher in the wavefront-guided group. Uncorrected and corrected distance visual acuity, manifest refraction, and higher order aberrations measured by OPD-Scan and iDesign were not significantly different between the two groups at 1 and 3 months after LASIK. Both customized ablation systems used in LASIK achieved excellent results in predictability and visual function. The wavefront-guided ablation system may have some advantages in the quality of vision. It may be important to select the appropriate system depending on eye conditions such as the pattern of total and corneal higher order aberrations. [J Refract Surg. 2016;32(11):727-732.]. Copyright 2016, SLACK Incorporated.
... solutions used, for example, to clean, disinfect, wet, lubricate, rinse, soak, or store contact lenses and... for use with contact lenses, e.g., for cleaning, disinfecting, wetting, lubricating, rinsing, soaking... bottle with a shrink band could say “For your protection, this bottle has an imprinted seal around the...
... solutions used, for example, to clean, disinfect, wet, lubricate, rinse, soak, or store contact lenses and... for use with contact lenses, e.g., for cleaning, disinfecting, wetting, lubricating, rinsing, soaking... bottle with a shrink band could say “For your protection, this bottle has an imprinted seal around the...
... solutions used, for example, to clean, disinfect, wet, lubricate, rinse, soak, or store contact lenses and... for use with contact lenses, e.g., for cleaning, disinfecting, wetting, lubricating, rinsing, soaking... bottle with a shrink band could say “For your protection, this bottle has an imprinted seal around the...
This paper reviews a phenomenological approach to the gravitational lensing by exotic objects such as the Ellis wormhole lens, where the exotic lens objects may follow a non-standard form of the equation of state or may obey a modified gravity theory. A gravitational lens model is proposed in the inverse powers of the distance, such that the Schwarzschild lens and exotic lenses can be described in a unified manner as a one parameter family. As observational implications, the magnification, shear, photo-centroid motion and time delay in this lens model are discussed.
Lo, Yat Hei; Leonhardt, Rainer
We present novel designs for aspheric lenses used in terahertz (THz) imaging. As different surfaces result in different beam shaping properties and in different losses from reflection and absorption, the resultant imaging resolution (i.e. the focal spot size) depends critically on the design approach. We evaluate the different lens designs using Kirchhoff's scalar diffraction theory, and test the predictions experimentally. We also show that our lenses can achieve sub-wavelength resolution. While our lens designs are tested with THz radiation, the design considerations are applicable also to other regions of the electro-magnetic spectrum.
Pecego, Mariana; Barnett, Melissa; Mannis, Mark J; Durbin-Johnson, Blythe
The aim of this study was to evaluate both the indications for and results of fitting the Jupiter Scleral Lens in patients with corneal abnormalities. This was a retrospective case review of 63 patients (107 eyes) fitted with scleral lenses between October 2009 and March 2011 at the UC Davis Eye Center. Sixty-three percent of 107 eyes were in patients with keratoconus. Other conditions included high postkeratoplasty astigmatism and corneal scarring. The improvement in best-corrected visual acuity compared with previous contact lens or glasses correction was a mean gain of 3.5 Snellen lines (SD=2.6). Seventy-eight percent of patients found the scleral lenses to be comfortable or comfortable. Twenty-five eyes discontinued the wear after at least 3 months. Jupiter Scleral lenses are a good alternative for patients with corneal abnormalities and for those who failed other types of lens rehabilitation. Seventy-seven percent of eyes fit with Jupiter Scleral Lenses were still wearing after a follow-up of 3 months.
Siganos, Dimitrios S; Papastergiou, Georgios I; Moedas, Carlos
To assess the performance of the Pascal dynamic contour tonometer (PDCT) (Swiss Microtechnology AG) by comparing it to Goldmann applanation tonometry (GAT) and noncontact air tonometry (NCT) before and after laser in situ keratomileusis (LASIK). Vlemma Eye Institute, Athens, Greece. Intraocular pressure was measured in 118 eyes before and 1 and 4 weeks after LASIK using GAT, NCT, and the PDCT, which allows direct, digital, transcorneal measurement of intraocular pressure. Preoperatively, central corneal thickness (CCT) correlated with GAT and NCT measurements but not with PDCT measurements. After LASIK, the mean reduction in CCT ranged from -3.0 to -171.0 microm (median 78 microm). The mean GAT measurement dropped by -4.9 mm Hg +/- 2.7 (SD) at 1 week and was -5.4 +/- 3.0 mm Hg at 4 weeks. Similar drops were observed in NCT measurements. The observed post-LASIK changes in GAT and NCT IOP measurements were not directly proportional to the change in CCT, refractive error, or mean keratometric readings. The preoperative and postoperative PDCT measurements did not differ significantly. The structural corneal changes induced by LASIK appeared to influence GAT and NCT measurements but not PDCT measurements. Therefore, PDCT may be better suited for monitoring IOP in unoperated eyes and in eyes that have had LASIK.
Higuchi, Yuichi; Inoue, Kaiki Taro
The cosmic microwave background (CMB) has non-Gaussian features in the temperature fluctuations. An anomalous cold spot surrounded with a hot ring, called the Cold Spot, is one of such features. If a large underdense region (supervoid) resides towards the Cold Spot, we would be able to detect a systematic shape distortion in the images of background source galaxies via weak lensing effect. In order to estimate the detectability of such signals, we used the data of N-body simulations to simulate full-sky ray-tracing of source galaxies. We searched for a most prominent underdense region using the simulated convergence maps smoothed at a scale of 20° and obtained tangential shears around it. The lensing signal expected in a concordant Λ cold dark matter model can be detected at a signal-to-noise ratio S/N ˜ 3. If a supervoid with a radius of ˜200 h-1 Mpc and a density contrast δ0 ˜ -0.3 at the centre resides at a redshift z ˜ 0.2, on-going and near-future weak gravitational lensing surveys would detect a lensing signal with S/N ≳ 4 without resorting to stacking. From the tangential shear profile, we can obtain a constraint on the projected mass distribution of the supervoid.
Ros, Rosa M.
It is not common to introduce current astronomy in school lessons. This article presents a set of experiments about gravitational lenses. It is normal to simulate them by means of computers, but it is very simple to simulate similar effects using a drinking glass full of liquid or using only the glass base. These are, of course, cheap and easy…
Ivanov, Dragia; Nikolov, Stefan
In this paper we consider the main properties of cylindrical lenses and propose several demonstrational experiments that can be performed with them. Specifically we use simple glasses full of water to demonstrate some basic geometrical optics principles and phenomena. We also present some less standard experiments that can be performed with such…
Kobashi, Hidenaga; Kamiya, Kazutaka; Shimizu, Kimiya
To compare postoperative ocular surface integrity and innervation between small incision lenticule extraction (SMILE) and femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK). The Cochrane Central Register of Controlled Trials, PubMED, and EMBASE were searched for prospective comparative studies. Trials meeting the selection criteria were quality appraised, and the data were extracted by 2 independent authors. The weighted mean differences (WMDs) and 95% confidence intervals (CIs) were used to compare dry eye examinations and corneal subbasal nerve density (SMILE-FS-LASIK). The study covered 5 trials. No significant difference was found in the Schirmer test score between both groups (WMD = -1.91 and 0.27; 95% CI, -5.02 to 1.20 and -0.99 to 1.54; P = 0.23 and 0.67 at 1- and 6-month follow-ups, respectively). Tear breakup time in the SMILE group significantly exceeded that in the FS-LASIK group (WMD = 0.65 and 1.14; 95% CI, 0.20-1.10 and 0.18-2.10; P = 0.004 and 0.02, at 1- and 6-month follow-ups, respectively). Ocular surface disease index scores were significantly better in the SMILE group 6 months postoperatively (WMD = -10.12, 95% CI, -16.07 to -4.18, P = 0.0008). No significant difference was found in tear osmolarity between both groups (WMD = -5.19 and -6.37; 95% CI, -17.15 to 6.76 and -22.74 to 10.00; P = 0.39 and 0.45 at 1- and 6-month follow-ups, respectively). Higher corneal sensitivity was observed in the SMILE group 1 and 6 months postoperatively (WMD = 11.35 and 3.49; 95% CI, 7.29-15.40 and 1.76-5.21; P < 0.00001 and <0.0001, at 1- and 6-month follow-ups, respectively). Corneal subbasal nerve density was also significantly higher in SMILE-treated eyes than it was in FS-LASIK-treated eyes 1 month postoperatively (WMD = 4.72, 95% CI, 1.10-8.34, P = 0.01). According to this meta-analysis, the SMILE procedure has fewer negative impacts on the ocular surface and corneal innervation than does FS-LASIK. Furthermore, SMILE shows superiority over FS-LASIK
Gravitational lensing emerged as an observational field following the 1979 discovery of a doubly imaged quasar lensed by a foreground galaxy. In the 1980s and '90s dozens of other multiply imaged systems were observed, as well as time delay measurements, weak and strong lensing by galaxies and galaxy clusters, and the discovery of microlensing in our galaxy. The rapid pace of advances has continued into the new century. Lensing is currently one of best techniques for finding and mapping dark matter over a wide range of scales, and also addresses broader cosmological questions such as understanding the nature of dark energy. This focus issue of New Journal of Physics presents a snapshot of current research in some of the exciting areas of lensing. It provides an occasion to look back at the advances of the last decade and ahead to the potential of the coming years. Just about a decade ago, microlensing was discovered through the magnification of stars in our galaxy by invisible objects with masses between that of Jupiter and a tenth the mass of the Sun. Thus a new component of the mass of our galaxy, dubbed MACHOs, was established (though a diffuse, cold dark matter-like component is still needed to make up most of the galaxy mass). More recently, microlensing led to another exciting discovery—of extra-solar planets with masses ranging from about five times that of Earth to that of Neptune. We can expect many more planets to be discovered through ongoing surveys. Microlensing is the best technique for finding Earth mass planets, though it is not as productive overall as other methods and does not allow for follow up observations. Beyond planet hunting, microlensing has enabled us to observe previously inaccessible systems, ranging from the surfaces of other stars to the accretion disks around the black holes powering distant quasars. Galaxies and galaxy clusters at cosmological distances can produce dramatic lensing effects: multiple images of background galaxies
Dermatitis - contact; Allergic dermatitis; Dermatitis - allergic; Irritant contact dermatitis; Skin rash - contact dermatitis ... There are 2 types of contact dermatitis. Irritant dermatitis : This ... It is not caused by an allergy, but rather the skin's reaction ...
Watanabe, R; Ishibashi, Y; Hommura, S; Ishii, K
Acanthamoeba keratitis seems to be associated with wearing contact lenses. As controls, we surveyed contact lens wearers without keratitis. Contact lens solutions of 93 persons were examined in order to identify risk factors for contamination by Acanthamoeba. Therefore, the contact lens disinfection system and storage schedules were studied in each case. Acanthamoeba organisms were isolated from 4 specimens (4.3%). The incidence of Acanthamoeba was higher in specimens of soft contact lens solution than in those of hard contact lens solution, and all the Acanthamoeba positive cases had been using tap water.
Alió, Jorge; Galal, Ahmed; Montalbán, Raúl; Piñero, David
To investigate the safety and efficacy of customized corneal wavefront-guided retreatment in symptomatic patients with highly aberrated corneas following LASIK. This prospective study included 75 eyes of 59 patients with significant visual symptoms who underwent LASIK for the correction of residual refractive error. Ablation profiles were calculated using CSO corneal topography and ESIRIS/Schwind laser platform. Eyes were divided into two groups: those with significant night vision symptoms (37 eyes; night symptoms group) and those with decentration, irregular ablation profile, and flap complications (38 eyes; corneal complications group). Corneal topography and aberrations, visual acuity, point spread function (PSF), refractive outcome, and subjective symptoms were evaluated preoperatively, and 1, 3, and 6 months postoperatively. Mean uncorrected visual acuity was 20/32 preoperatively and 20/25 at 6 months postoperatively in the night symptoms group and 20/40 preoperatively and 20/30 at 6 months postoperatively in the corneal complications group. Mean best spectacle-corrected visual acuity was 20/25 both preoperatively and 6 months postoperatively in both groups (t test, P = .219 and P = .149 for the night symptoms and corneal complications groups, respectively). Safety index was 1.1 in both groups, and efficacy index was 0.93 and 0.92, respectively. Statistically significant improvement of total corneal higher order aberrations, tilt, and improvement of spherical aberrations and coma were observed, with corresponding improvement of PSF. Corneal wavefront-guided LASIK retreatment with CSO topography, ORK-W software, and ESIRIS/Schwind laser platform is safe and effective for treating symptomatic patients affected by corneal higher order aberrations or corneal irregularities following LASIK surgery.
Kanellopoulos, A John; Pe, Lawrence H
To describe our clinical experience in wavefront-guided LASIK enhancements using the WaveLight ALLEGRETTO system (WaveLight Technologie AG, Erlangen, Germany) for symptomatic eyes previously treated with standard LASIK. Twenty-six eyes of 20 patients with residual myopia, hyperopia, or mixed astigmatism and/or night vision symptoms after primary standard LASIK were considered for wavefront-guided customized retreatment using the WaveLight ALLEGRETTO WAVE 200 Hz excimer laser system (model 106). Preoperative best spectacle-corrected visual acuity (BSCVA), uncorrected visual acuity, topography with the ALLEGRETTO Topolyzer, wavefront analysis using the ALLEGRETTO WAVE Tscherning Analyzer, and contrast sensitivity were compared to postoperative (enhancement) measurements. Twenty-two of the original 26 eyes underwent wavefront-guided enhancement, 4 were excluded because they did not meet wavefront-guided treatment inclusion guidelines of this study. Mean follow-up was 8 months (range: 6 to 13 months, standard deviation [SD] 2). All patients were within +/- 0.50 diopters (manifest refraction) of intended postoperative refraction. The mean preoperative BSCVA improved from 20/25 (SD +/- 0.12) to 20/18 (SD +/- 0.1) postoperatively. All patients gained at least one line of BSCVA, and a maximum of three lines. There was no loss of BSCVA in any patient. The total amount of high order aberrations (RMSH) decreased from an average of 1.04 (SD +/- 0.22) to 0.46 (SD +/- 0.14) microm. Patients also had a mean improvement in low contrast sensitivity of 59%. Based on this small series, customized wavefront-guided enhancements using the WaveLight ALLEGRETTO system in patients who underwent previous LASIK appear to be safe and effective in correcting residual refractive error, reducing high order aberrations, and improving visual symptoms when reliable and reproducible measurements are achieved.
Richoz, Olivier; Mavrakanas, Nikolaos; Pajic, Bojan; Hafezi, Farhad
To report the long-term results of corneal collagen cross-linking (CXL) in ectasia after LASIK and photorefractive keratectomy (PRK). Retrospective, interventional cases series. Twenty-six eyes of 26 patients (18 male, 8 female) with postoperative ectasia after LASIK (23 eyes) and PRK (3 eyes) were included with a mean age of 35 ± 9 years at the time of treatment and a mean follow-up of 25 months (range, 12-62 months). All consecutive patients treated with CXL for progressive ectasia after LASIK or PRK at the Institute for Refractive and Ophthalmic Surgery, Zurich, Switzerland between 2004 and 2010 were included. Corrected distance visual acuity (CDVA), maximum keratometry readings (K(max)), minimum radius of curvature (R(min)), and 6 corneal topography indices were assessed in this study. Mean CDVA before CXL was 0.5 logarithm of the minimum angle of resolution (logMAR) units, which improved to a mean of 0.3 logMAR units (P<0.001). Corrected distance visual acuity improved 1 line or more in 19 cases and remained unchanged in 7 patients. Mean K(max) after CXL of 50.9 ± 4.9 diopters (D) was significantly lower (P<0.001) than mean pre-CXL K(max) of 52.8 ± 5 D. The R(min) after CXL was increased significantly (P = 0.006), whereas the index of surface variance (P = 0.03), the index of vertical asymmetry (P = 0.04), the keratoconus index (P = 0.03), and the central keratoconus index (P = 0.016) were reduced significantly. Ectasia after LASIK and PRK was arrested by CXL with stabilization or improvement of CDVA and K(max) after a mean follow-up of 25 months. There were improvements in 4 topography indices, suggesting a more regular corneal surface. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.
Santhiago, Marcony R; Smadja, David; Wilson, Steven E; Krueger, Ronald R; Monteiro, Mario L R; Randleman, J Bradley
To investigate the association of the percent tissue altered (PTA) with the occurrence of ectasia after LASIK in eyes with suspicious preoperative corneal topography. This retrospective comparative case-control study compared associations of reported ectasia risk factors in 129 eyes, including 57 eyes with suspicious preoperative Placido-based corneal topography that developed ectasia after LASIK (suspect ectasia group), 32 eyes with suspicious topography that remained stable for at least 3 years after LASIK (suspect control group), and 30 eyes that developed ectasia with bilateral normal topography (normal topography ectasia group). Groups were subdivided based on topographic asymmetry into high- or low-suspect groups. The PTA, preoperative central corneal thickness (CCT), residual stromal bed (RSB), and age (years) were evaluated in univariate and multivariate analyses. Average PTA values for normal topography ectasia (45), low-suspect ectasia (39), high-suspect ectasia (36), low-suspect control (32), and high-suspect control (29) were significantly different from one another in all comparisons (P < .003) except high- and low-suspect ectasia groups (P = .033), and presented the highest discriminative capability of all variables evaluated. Age was only significantly different between the high-suspect ectasia and normal topography ectasia groups, and CCT was not significantly different between any groups. Stepwise logistic regression revealed the PTA as the most significant independent variable (P < .0001), with RSB the next most significant parameter. There remains a significant correlation between PTA values and ectasia risk after LASIK, even in eyes with suspicious corneal topography. Less tissue alteration, or a lower PTA value, was necessary to induce ectasia in eyes with more remarkable signs of topographic abnormality, and PTA provided better discriminative capabilities than RSB for all study populations. Copyright 2015, SLACK Incorporated.
Konomi, Keiko; Chen, Li-Li; Tarko, Rachel S; Scally, Amy; Schaumberg, Debra A; Azar, Dimitri; Dartt, Darlene A
To determine whether measurable preoperative characteristics predispose patients to chronic dry eye after laser in situ keratomileusis (LASIK). The study consisted of 24 eyes of 24 patients who underwent LASIK. Tear breakup time, Schirmer testing with and without anesthesia, rose bengal staining, central corneal sensitivity, nucleus-to-cytoplasmic ratio, and goblet cell density were evaluated 2 weeks before and 1 week, 3 months, and 9 months after surgery. Patients were classified into two outcome groups, the nondry-eye group (NDEG) and the chronic dry-eye group (CDEG), on the basis of dry eye status 9 months after surgery. The authors tested whether preoperative values of each parameter were associated with the development of chronic dry eye. All parameters, except rose bengal staining, deteriorated significantly after surgery but returned to preoperative levels within 3 to 9 months. The CDEG had significantly lower preoperative Schirmer test values with and without anesthesia and were delayed in recovery after surgery in goblet cell density, rose bengal staining, Schirmer test values without anesthesia, and tear breakup time. Results of preoperative Schirmer tests without anesthesia positively correlated with tear breakup time 9 months after surgery. Preoperative tear volume may affect recovery of the ocular surface after LASIK and may increase the risk for chronic dry eye.
Mularoni, Alessandro; Laffi, Gian Luca; Bassein, Leona; Tassinari, Giorgio
To assess the efficacy, predictability, stability, and safety of a two-step LASIK procedure using topography-guided ablation to correct astigmatism after penetrating keratoplasty. Fifteen eyes of 15 patients underwent a two-step LASIK procedure at the Maggiore Hospital of Bologna, Italy. In the first step, a flap was created using the Hansatome microkeratome. In the second step, topography-guided ablation using the LaserSight LSX was planned with interactive software (CIPTA) once topographical and refractive stabilization had been obtained. Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), cylindrical correction, gain of lines of BSCVA, spherical equivalent refraction, and complications were analyzed. Minimum follow-up was 12 months (range: 12 to 30 months). Uncorrected visual acuity improved in all 15 (100%) eyes. At the last postoperative examination, 11 (73%) eyes had UCVA > or = 20/40. Nine (60%) eyes were within 1.0 diopter (D) of the attempted correction. Mean postoperative astigmatism was -1.67 (range: -3.5 to 0; standard deviation: 1.26). Index of success of astigmatic correction was 0.26. No patient lost Snellen lines of BSCVA. Intraoperative complications included two buttonhole flaps, and postoperative complications included one flap retraction. No further laser treatment was needed. The two-step LASIK procedure using topography-guided ablation reduces spherical and cylindrical refractive error due to penetrating keratoplasty. Topography-guided ablation also proved to be effective in correcting irregular astigmatism.
Frings, Andreas; Linke, Stephan J; Bauer, Eva L; Druchkiv, Vasyl; Katz, Toam; Steinberg, Johannes
Purpose This study was initiated to evaluate biomechanical changes using the Corvis ST tonometer (CST) on the cornea after laser in situ keratomileusis (LASIK). Setting University Medical Center Hamburg-Eppendorf, Germany, and Care Vision Refractive Centers, Germany. Design Retrospective cohort study. Methods This retrospective study included 37 eyes of 37 refractive patients. All CST measurements were performed 1 day before surgery and at the 1-month follow-up examination. The LASIK procedure included mechanical flap preparation using a Moria SBK microkeratome and an Allegretto excimer laser platform. Results Statistically significant differences were observed for mean first applanation length, mean first and second deflection lengths, mean first and second deflection amplitudes, radius of curvature, and peak distance. Significant positive correlations were found between the change (Δ) of radius of curvature and manifest refraction spherical equivalent (MRSE), ablation depth, and Δintraocular pressure as well as between AD and ΔHC-time. Each diopter of myopic correction in MRSE resulted in an increase in Δradius of curvature of 0.2 mm. Conclusion Several CST parameters were statistically significantly altered by LASIK, thereby indicating that flap creation, ablation, or both, significantly change the ability of the cornea to absorb or dissipate energy. PMID:25709393
Pasquali, Theodore A; Aufderheide, Adam; Brinton, Jason P; Avila, Michele R; Stahl, Erin D; Durrie, Daniel S
To investigate whether dilute brimonidine (0.025%) reduces patient discomfort, subconjunctival hemorrhage, and injection after LASIK without a significant increase in the rate of flap complications or surgical enhancements. This randomized, double-blind, prospective study enrolled 180 patients (360 eyes) in a contralateral eye comparison of topical dilute brimonidine, naphazoline/pheniramine, or Systane Ultra (Alcon Laboratories, Inc., Fort Worth, TX) administered shortly before LASIK for any indication. Patients were evaluated for subconjunctival hemorrhage, injection, and flap dislocation 1 hour and 1 day postoperatively. Patient questionnaires measuring patient comfort and ocular symptoms were administered at these same follow-up visits. Patients were examined for 3 months to determine similar outcomes for standard indices of safety, predictability, efficacy, and enhancement rates. Scores of patient discomfort, subconjunctival hemorrhage, and injection were significantly lower in eyes treated with dilute brimonidine at the 1 hour and 1 day postoperative examinations. Refloats for mild-flap edge wrinkling were required in 3 brimonidine eyes (2.5%), 1 naphazoline/pheniramine eye (0.8%), and no control eyes, but this difference did not reach statistical significance (P = .18). There was no significant difference between eyes at 3 months in terms of visual acuity, refractive error, corrected distance visual acuity, or rate of enhancement. Use of dilute brimonidine before LASIK reduces subconjunctival hemorrhage and injection and improves patient comfort after surgery. Flap edge wrinkling requiring refloat may still be a complication with dilute brimonidine. Copyright 2013, SLACK Incorporated.
Vahdati, Ali; Seven, Ibrahim; Mysore, Naveen; Randleman, J Bradley; Dupps, William J
To develop a computational approach to corneal biomechanical risk analysis in refractive surgery and to investigate its utility in an enigmatic case of unilateral ectasia after bilateral LASIK. Preoperative corneal elevation datasets from both eyes of a patient who developed unilateral post-LASIK ectasia were used to construct geometrically patient-specific, microstructurally motivated finite element models. Models were assessed before and after implementation of case-specific treatment parameters for interocular differences in corneal geometry and strain behavior under physiological loading conditions. Standard clinical predictors of post-LASIK ectasia risk were similar for the affected and contralateral eyes, and no risk factor asymmetry was identified in tomographic screening that included posterior corneal elevation analysis. However, differences in the magnitude and distribution of strain and stress were observed that are consistent with greater predisposition to biomechanical instability in the affected eye. Load testing with simulated intraocular pressure increases provoked opposite trends in curvature change in the preoperative models representing affected and unaffected eyes, with steepening in the ectatic eye and flattening in the clinically stable eye. Patient-specific computational analyses revealed differences in intrinsic biomechanical behaviors that may predispose a cornea to instability after refractive surgery. Strain and stress analyses elucidated differential risk not ascertained with current refractive surgery screening paradigms. This pilot study illustrates a risk analysis approach that implicitly considers the entire corneal three-dimensional geometry and can be performed a priori in a screening setting. [J Refract Surg. 2016;32(12):811-820.]. Copyright 2016, SLACK Incorporated.
Taneri, Suphi; Kiessler, Saskia; Rost, Anika; Dick, H Burkhard
To report a case of unilateral corneal ectasia following LASIK surgery combined with prophylactic corneal cross-linking (CXL) in a young patient. Case report. Preoperative topography was unremarkable in both eyes with a minimum corneal thickness of 554 μm in the right eye and 546 μm in the left eye. Preoperative corrected distance visual acuity (CDVA) was 1.0 (20/20 Snellen) in both eyes with a refraction of +1.25 -2.75 × 10 in the right eye and +0.50 -2.00 × 163 in the left eye. LASIK combined with CXL was uneventful. After 12 months, postoperative topography was unremarkable with an uncorrected distance visual acuity (UDVA) of 1.0 in both eyes. Two years after surgery, the patient presented with a loss of vision (UDVA 0.25) and an inferior steepening on topography in the left eye. Standard CXL was performed to arrest further progression. This report illustrates that the currently used prophylactic CXL protocol in combination with LASIK may not be effectively preventing corneal ectasia in every case. [J Refract Surg. 2017;33(1):50-52.]. Copyright 2017, SLACK Incorporated.
Frings, Andreas; Linke, Stephan J; Bauer, Eva L; Druchkiv, Vasyl; Katz, Toam; Steinberg, Johannes
This study was initiated to evaluate biomechanical changes using the Corvis ST tonometer (CST) on the cornea after laser in situ keratomileusis (LASIK). University Medical Center Hamburg-Eppendorf, Germany, and Care Vision Refractive Centers, Germany. Retrospective cohort study. This retrospective study included 37 eyes of 37 refractive patients. All CST measurements were performed 1 day before surgery and at the 1-month follow-up examination. The LASIK procedure included mechanical flap preparation using a Moria SBK microkeratome and an Allegretto excimer laser platform. Statistically significant differences were observed for mean first applanation length, mean first and second deflection lengths, mean first and second deflection amplitudes, radius of curvature, and peak distance. Significant positive correlations were found between the change (Δ) of radius of curvature and manifest refraction spherical equivalent (MRSE), ablation depth, and Δintraocular pressure as well as between AD and ΔHC-time. Each diopter of myopic correction in MRSE resulted in an increase in Δradius of curvature of 0.2 mm. Several CST parameters were statistically significantly altered by LASIK, thereby indicating that flap creation, ablation, or both, significantly change the ability of the cornea to absorb or dissipate energy.
Caster, Andrew I; Hoff, James L; Ruiz, Roman
To compare outcomes after LASIK surgery using the conventional LADARVision4000 laser and the wavefront-guided LADARWave CustomCornea wavefront system. A prospective study was performed involving 140 myopic eyes receiving conventional or CustomCornea LASIK between May and October 2003. The preoperative manifest spherical equivalent refraction was limited to myopia < or = -7.00 diopters (D). The preoperative manifest cylinder was limited to < or = -2.50 D of astigmatism. Patients were evaluated for 3 months following surgery. Results evaluated were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity, manifest refraction, dilated wavefront measurements, contrast sensitivity, and patient responses to subjective questionnaires. For the CustomCornea eyes at 3 months, 80% (70/87) had UCVA > or = 20/20 and 95% (83/87) had UCVA > or = 20/25. For the conventional eyes at 3 months, 45% (9/20) had UCVA > or = 20/20 and 80% (16/20) had UCVA > or = 20/25. At the 3-month postoperative visit, 85% (74/87) of the CustomCornea eyes and 55% (11/20) of the conventional eyes were within +/- 0.50 D of their intended correction. At 1 and 3 months, the CustomCornea treated eyes had a statistically significant lower mean increase in higher order aberrations than conventionally treated eyes (P < .05). CustomCornea wavefront-guided LASIK surgery appears safe and effective and provides clinical benefits that appear to exceed those of conventional LADARVision surgery.
Donaldson, Kendall E; Fishler, Jane
To review the case of a 41-year-old woman who underwent bariatric surgery in 2000. She subsequently underwent laser in situ keratomileusis (LASIK) surgery in 2008 and complained of dry eye since the LASIK surgery. In November 2010, she was diagnosed with a corneal melt and was treated with aggressive lubrication, followed by eventual amniotic membrane placement and a tarsorrhaphy. She then presented for consultation at the Bascom Palmer Eye Institute when she developed a corneal infiltrate. She was diagnosed with fungal keratitis with corneal xerosis. At that time, vitamin A levels were measured and were less than 2 μ/dL. The patient admitted noncompliance with nutritional supplements. Case report. The patient was treated with aggressive lubrication and natamycin. Vitamin supplements were restarted, and the patient experienced dramatic improvement in symptoms with resolution of the infection. A central corneal scar with corneal thinning remains. The patient underwent a penetrating keratoplasty for visual rehabilitation. Patient education with emphasis on compliance with nutritional supplements is essential after bariatric surgery. Consider vitamin A deficiency in the differential diagnosis of dry eye after LASIK surgery.
Farooqui, Mansoor A; Al-Muammar, Abdul Rahman
To evaluate the difference in visual acuity, subjective night vision glare, and higher order aberrations in eyes with myopia with or without astigmatism operated with topography-guided customized corneal LASIK and conventional LASIK. This contralateral study includes 46 eyes (23 patients) that underwent topography-guided corneal customized LASIK using the customized aspheric treatment zone (CATz) ablation profile in one eye and conventional LASIK using the NIDEK EC-5000 Advanced Vision Excimer laser system (NAVEX) in the other eye for myopia with or without astigmatism. Patients were masked to which eye underwent topography-guided CATz or conventional LASIK. Postoperative glare and root-mean-square (RMS) values for total higher order aberrations were measured at 1 and 3 months and compared between the two eyes. No significant difference was noted in uncorrected visual acuity between the two groups at 1 and 3 months postoperatively. Of all patients, 81% stated glare was higher in conventionally treated eyes than in the CATz-treated eyes at 1 and 3 months postoperatively. The RMS values for total coma (0.2385 vs 0.1522) and spherical aberration (0.2381 vs 0.1058) in conventionally treated and CATz-treated eyes were significantly higher in conventionally treated eyes (P=.029 and P=.004, respectively) at 3-month follow-up. Topography-guided corneal customized LASIK with the CATz profile gave better night vision quality as compared to conventional LASIK with expanded treatment zone. Better night vision quality was associated with less induced spherical aberrations and coma postoperatively in the CATz treatment group.