Sample records for lasik contact lenses

  1. Basics of LASIK Eye Surgery

    MedlinePlus

    ... Vea esta página en español The Basics of LASIK Eye Surgery Share This Page Facebook Twitter Linked- ... Surgery Surgical Alternatives to LASIK For More Information  LASIK Basics If you wear glasses or contact lenses, ...

  2. Types of Contact Lenses

    MedlinePlus

    ... 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, ...

  3. Glasses and Contact Lenses

    MedlinePlus

    ... vision problems; this includes prescribing eyeglasses and contact lenses, but also doing eye surgery for other eye-related problems. An optometrist ... them clean. The most important thing about contact lenses is good hygiene to prevent infections in your eye. But the really fun part of new glasses ...

  4. Contact Lenses in the Laboratory.

    ERIC Educational Resources Information Center

    Kingston, David W.

    1981-01-01

    Summarizes results of a three-item questionnaire returned by 43 Michigan institutions expressing views on wearing contact lenses in chemical laboratories. Questions focused on eye protection, type of protection, and use of contact lenses. (SK)

  5. Contact lenses to slow progression of myopia.

    PubMed

    Sankaridurg, Padmaja

    2017-09-01

    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

  6. [Contact lenses for children. Indications and results].

    PubMed

    Steinbach, P D; Nover, A

    1976-03-18

    If it is necessary to prescribe contact lenses for children, this correction should be made as soon as possible. As a consequence of the development of soft (hydrophile) lenses, the above mentioned group of patients has increased considerably. In any case, a monolateral aphakia as well as a manifest anisometropia should be corrected by a contact lense to avoid amblyopia, heterotropia and loss of stereoscopic vision. Usually soft lenses are well tolerated, so that patients suffering from aphakia as well as hyperopia should always use this type of lense. Nevertheless, the hard lense still has its indication in treating myopia and high astigmatism.

  7. Irregular Corneas: Improve Visual Function With Scleral Contact Lenses.

    PubMed

    de Luis Eguileor, Beatriz; Etxebarria Ecenarro, Jaime; Santamaria Carro, Alaitz; Feijoo Lera, Raquel

    2018-05-01

    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.

  8. Factors influencing bacterial adhesion to contact lenses.

    PubMed

    Dutta, Debarun; Cole, Nerida; Willcox, Mark

    2012-01-01

    The process of any contact lens related keratitis generally starts with the adhesion of opportunistic pathogens to contact lens surface. This article focuses on identifying the factors which have been reported to affect bacterial adhesion to contact lenses. Adhesion to lenses differs between various genera/species/strains of bacteria. Pseudomonas aeruginosa, which is the predominant causative organism, adheres in the highest numbers to both hydrogel and silicone hydrogel lenses in vitro. The adhesion of this strain reaches maximum numbers within 1h in most in vitro studies and a biofilm has generally formed within 24 h of cells adhering to the lens surface. Physical and chemical properties of contact lens material affect bacterial adhesion. The water content of hydroxyethylmethacrylate (HEMA)-based lenses and their iconicity affect the ability of bacteria to adhere. The higher hydrophobicity of silicone hydrogel lenses compared to HEMA-based lenses has been implicated in the higher numbers of bacteria that can adhere to their surfaces. Lens wear has different effects on bacterial adhesion, partly due to differences between wearers, responses of bacterial strains and the ability of certain tear film proteins when bound to a lens surface to kill certain types of bacteria.

  9. Factors influencing bacterial adhesion to contact lenses

    PubMed Central

    Dutta, Debarun; Willcox, Mark

    2012-01-01

    The process of any contact lens related keratitis generally starts with the adhesion of opportunistic pathogens to contact lens surface. This article focuses on identifying the factors which have been reported to affect bacterial adhesion to contact lenses. Adhesion to lenses differs between various genera/species/strains of bacteria. Pseudomonas aeruginosa, which is the predominant causative organism, adheres in the highest numbers to both hydrogel and silicone hydrogel lenses in vitro. The adhesion of this strain reaches maximum numbers within 1h in most in vitro studies and a biofilm has generally formed within 24 h of cells adhering to the lens surface. Physical and chemical properties of contact lens material affect bacterial adhesion. The water content of hydroxyethylmethacrylate (HEMA)-based lenses and their iconicity affect the ability of bacteria to adhere. The higher hydrophobicity of silicone hydrogel lenses compared to HEMA-based lenses has been implicated in the higher numbers of bacteria that can adhere to their surfaces. Lens wear has different effects on bacterial adhesion, partly due to differences between wearers, responses of bacterial strains and the ability of certain tear film proteins when bound to a lens surface to kill certain types of bacteria. PMID:22259220

  10. Tear exchange and contact lenses: A review

    PubMed Central

    Muntz, Alex; Subbaraman, Lakshman N.; Sorbara, Luigina; Jones, Lyndon

    2015-01-01

    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

  11. Contact Lenses for Color Blindness.

    PubMed

    Badawy, Abdel-Rahman; Hassan, Muhammad Umair; Elsherif, Mohamed; Ahmed, Zubair; Yetisen, Ali K; Butt, Haider

    2018-06-01

    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 The Authors. Published by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  12. Scleral contact lenses for the management of complicated ptosis.

    PubMed

    Katsoulos, Konstantinos; Rallatos, Gerasimos Livir; Mavrikakis, Ioannis

    2018-06-01

    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.

  13. Tear exchange and contact lenses: a review.

    PubMed

    Muntz, Alex; Subbaraman, Lakshman N; Sorbara, Luigina; Jones, Lyndon

    2015-01-01

    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. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  14. Do swimming goggles limit microbial contamination of contact lenses?

    PubMed

    Wu, Yvonne T; Tran, Jess; Truong, Michelle; Harmis, Najat; Zhu, Hua; Stapleton, Fiona

    2011-04-01

    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

  15. Halloween Safety: Costumes, Candy, and Colored Contact Lenses

    MedlinePlus

    ... 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 ...

  16. Transmittance of tinted and UV-blocking disposable contact lenses.

    PubMed

    Harris, M G; Haririfar, M; Hirano, K Y

    1999-03-01

    Tinted and ultraviolet (UV)-blocking disposable contact lenses have become increasingly popular over the last decade. Wearers of UV-blocking contact lenses could benefit greatly by protecting their eyes from potential UV radiation damage. A Uvikon 930 dual beam spectrophotometer was used to measure three enhancement-tinted lenses (royal blue, evergreen, and aqua), two types of UV-blocking lenses, and two types of non-UV-blocking lenses. Enhancement-tinted lenses did show a decrease in transmittance at certain wavelengths on the visible spectrum, but they did not reduce the transmittance of UV radiation to the extent of the UV-blocking lenses designed specifically for this purpose.

  17. Salicylate inhibition of acanthamoebal attachment to contact lenses.

    PubMed

    Beattie, Tara K; Tomlinson, Alan; Seal, David V; McFadyen, Angus K

    2011-12-01

    Sodium salicylate has shown potential as a component of contact lens care solutions designed to reduce Acanthamoebal attachment to contact lenses. This study determined the minimum effective concentration required to significantly reduce amoebal attachment. Different concentrations of sodium salicylate (10, 15, and 20 mM) were applied during exposure of unworn or bacterial biofilm-coated hydrogel contact lenses to Acanthamoeba castellanii trophozoites. Salicylate was applied at stage 1 intervention during biofilm formation on lenses, at stage 2 intervention during amoebal exposure, or at both stages. A significant reduction in amoebal attachment was achieved when 10 mM salicylate was included during stage 1 alone; however, 15 mM was required for stage 2 intervention to significantly reduce attachment to clean or biofilm-coated lenses. For stages 1 and 2 combined intervention, 10 mM sodium salicylate produced a significant reduction in amoebal attachment. In situ, within a contact lens case, biofilm formation and amoebal attachment would occur concurrently; therefore, stages 1 and 2 intervention would be closest to the real-life situation, thus indicating that 10 mM of salicylate would be an effective minimum concentration for reducing amoebal attachment to hydrogel contact lenses. Inclusion of components in contact lens care solution, such as sodium salicylate, which reduce Acanthamoebal attachment, has the potential to enhance effectiveness, particularly where amoebicidal efficacy may be limited, thus reducing the risk of contact lens-associated Acanthamoebal infection.

  18. Identification of Microorganisms Isolated From Counterfeit and Unapproved Decorative Contact Lenses.

    PubMed

    Land, Adrian D; Penno, Katie L; Brzezinski, Jennifer L

    2018-03-01

    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.

  19. Plasma surface modification of rigid contact lenses decreases bacterial adhesion.

    PubMed

    Wang, Yingming; Qian, Xuefeng; Zhang, Xiaofeng; Xia, Wei; Zhong, Lei; Sun, Zhengtai; Xia, Jing

    2013-11-01

    Contact lens safety is an important topic in clinical studies. Corneal infections usually occur because of the use of bacteria-carrying contact lenses. The current study investigated the impact of plasma surface modification on bacterial adherence to rigid contact lenses made of fluorosilicone acrylate materials. Boston XO and XO2 contact lenses were modified using plasma technology (XO-P and XO2-P groups). Untreated lenses were used as controls. Plasma-treated and control lenses were incubated in solutions containing Staphylococcus aureus or Pseudomonas aeruginosa. MTT colorimetry, colony-forming unit counting method, and scanning electron microscopy were used to measure bacterial adhesion. MTT colorimetry measurements showed that the optical density (OD) values of XO-P and XO2-P were significantly lower than those of XO and XO2, respectively, after incubation with S. aureus (P < 0.01). The OD value of XO-P was also much lower than that of XO after incubation with P. aeruginosa (P < 0.01). Colony-forming unit counting revealed that a significantly lower number of bacterial colonies attached to the XO-P versus XO lenses and to the XO2-P versus XO2 lenses incubated with S. aureus (P < 0.01). Fewer bacterial colonies attached to the XO-P versus XO lenses incubated with P. aeruginosa (P < 0.01). Further, scanning electron microscopy suggested different bacterial adhesion morphology on plasma-treated versus control lenses. Plasma surface modification can significantly decrease bacterial adhesion to fluorosilicone acrylate contact lenses. This study provides important evidence of a unique benefit of plasma technology in contact lens surface modification.

  20. Direct Laser Writing of Nanophotonic Structures on Contact Lenses.

    PubMed

    AlQattan, Bader; Yetisen, Ali K; Butt, Haider

    2018-04-24

    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.

  1. Microbial adherence to cosmetic contact lenses.

    PubMed

    Chan, Ka Yin; Cho, Pauline; Boost, Maureen

    2014-08-01

    To investigate whether cosmetic contact lenses (CCL) with surface pigments affect microbial adherence. Fifteen brands of CCL were purchased from optical, non-optical retail outlets, and via the Internet. A standardized rub-off test was performed on each CCL (five lenses per brand) to confirm the location of the pigments. The rub-off test comprised gentle rubbing on the surfaces of each CCL with wetted cotton buds for a maximum of 20 rubs per surface. A new set of CCL (five lenses per brand) were incubated in Pseudomonas aeruginosa overnight. Viable counts of adhered bacteria were determined by the number of colony-forming units (CFU) on agar media on each lens. The adherence of P. aeruginosa as well as Staphylococcus aureus and Serratia marcescens to three brands of CCL (A-C) (five lenses per brand) were also compared to their adherences on their clear counterparts. Only two of the 15 brands of CCL tested (brands B and C) had pigments that did not detach with the rub-off test. The remaining 13 brands of CCL all failed the rub-off test and these lenses showed higher P. aeruginosa adherence (8.7 × 10(5)-1.9 × 10(6) CFU/lens). Brands B and C lenses showed at least six times less bacterial adhesion than the other 13 brands. Compared to their clear counterparts, bacterial adherence to brands B and C lenses did not differ significantly, whereas brand A lenses showed significantly higher adherence. Surface pigments on CCL resulted in significantly higher bacterial adherence. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  2. Occlusion properties of prosthetic contact lenses for the treatment of amblyopia.

    PubMed

    Collins, Randall S; McChesney, Megan E; McCluer, Craig A; Schatz, Martha P

    2008-12-01

    The efficacy of opaque contact lenses as occlusion therapy for amblyopia has been established in the literature. Prosthetic contact lenses use similar tints to improve cosmesis in scarred or deformed eyes and may be an alternative in occlusion therapy. To test this idea, we determined the degree of vision penalization elicited by prosthetic contact lenses and their effect on peripheral fusion. We tested 19 CIBA Vision DuraSoft 3 Prosthetic soft contact lenses with varying iris prints, underprints, and opaque pupil sizes in 10 volunteers with best-corrected Snellen distance visual acuity of 20/20 or better in each eye. Snellen visual acuity and peripheral fusion using the Worth 4-Dot test at near were measured on each subject wearing each of the 19 lenses. Results were analyzed with 3-factor analysis of variance. Mean visual acuity through the various lenses ranged from 20/79 to 20/620. Eight lenses allowed preservation of peripheral fusion in 50% or more of the subjects tested. Iris print pattern and opaque pupil size were significant factors in determining visual acuity (p < 0.05). Sufficient vision penalization can be achieved to make occlusion with prosthetic contact lenses a viable therapy for amblyopia. The degree of penalization can be varied and different iris print patterns and pupil sizes, using peripheral fusion, can be preserved with some lenses. Prosthetic contact lenses can be more cosmetically appealing and more tolerable than other amblyopia treatment modalities. These factors may improve compliance in occlusion therapy.

  3. Material properties that predict preservative uptake for silicone hydrogel contact lenses.

    PubMed

    Green, J Angelo; Phillips, K Scott; Hitchins, Victoria M; Lucas, Anne D; Shoff, Megan E; Hutter, Joseph C; Rorer, Eva M; Eydelman, Malvina B

    2012-11-01

    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.

  4. Prescribing prophylactic antibiotics to users of therapeutic contact lenses.

    PubMed

    Colomé-Campos, J; Quevedo-Junyent, L; Godoy-Barreda, N; Martínez-Salcedo, I; Romero-Aroca, P

    2013-03-01

    To describe the benefits and optimum use of prophylactic antibiotics in users of therapeutic contact lenses (TCL). A microbiological study was carried out on samples from 33 patients who continuously wore TCL. The resistance to antibiotics of bacteria isolated in our health region was also reviewed. An assessment was also made on whether there were microorganisms of a higher pathogenic potential in TCL than conventional contact lenses, as reported in the literature. No bacteria were isolated from 17 (52%) of the 33 lenses studied. From the 16 (48%) remaining lenses, coagulase negative Staphylococci were isolated from 10 (62%), Propionibacterium acnes from 4 (25%), and Corynebacterium from 2 (13%). The high number of negative cultures and the presence of saprophytic bacteria indicate that prophylactic antibiotic treatment is not precise. The most frequent pathogenic bacteria found in contact lenses are strongly resistant to the current commercially available antibiotics. Copyright © 2012 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

  5. [What is the role of contact lenses within the scope of electronystagmography?].

    PubMed

    Schmäl, F; Stoll, W

    1997-10-01

    During electronystagmography it is necessary to correct detective vision for calibration, smooth pursuit, and saccadic eye movements. Therefore more and more people use contact lenses instead of normal glasses. Given the lack of detailed information about this phenomenon, in the current literature we decided to investigate the influence of soft contact lenses on electronystagmography. The aim of this study was to find out differences in the results of electronystagmography between using glasses or contact lenses. Our investigation involved 20 vestibular healthy human subjects with myopia. In the first part of the examination they used their contact lenses and in the second part they were wearing normal glasses. After measuring the calibration potential we wanted to see if contact lenses would increase the rate of artifacts in the electronystagmogram. Then we attempted to determine whether contact lenses would an influence on the registration of the optokinetic nystagmus. Induced saccadic eye movements were recorded and analysed. Contact lenses had a negative influence neither on the calibration potential nor on the rate of artifacts. The latency of the saccadic eye movements also showed no differences between both parts of this investigation. Only the velocity of the saccades and the gain value during the optokinetic test were reduced when glasses were used. Contact lenses may stimulate the secretory function of the lacrimal gland and thus decrease friction forces. It is also possible that the reduced image size produced or the reduction-effect of minus by glasses in near sighted persons negatively influences eyeball velocity. In summary, our study demonstrates that contact lenses do not have a negative influence on electronystagmography. Therefore electronystagmographic studies of patients with contact lenses are permissible for purposes of documenting a medical opinion.

  6. [Some special indications for wearing contact lenses (author's transl)].

    PubMed

    Müller, K

    1978-12-01

    The typical distinguishing features of special cases which require contact lenses for satisfactory vision are described. Hence in the first case with anisometria associated with irregular astigmatism of one eye, to which a toric soft contact lens was adapted. In the second case a visual acuity of only 0,6 monocular was attained with the best spectacle lens, however with contact lense the visual acuity was 1.25. Here a verdict from a social court is mentioned, which obliged the sickness insurance to take over the costs for such a case. In the third case the adaptation of contact lenses was undertaken after radical bilateral keratoplasty because of parenchymatous keratitis, and an improvement in visual acuity of at least 400% resulted.

  7. Spectral transmittance of UV-blocking soft contact lenses: a comparative study.

    PubMed

    Rahmani, Saeed; Mohammadi Nia, Mohadeseh; Akbarzadeh Baghban, Alireza; Nazari, Mohammad Reza; Ghassemi-Broumand, Mohammad

    2014-12-01

    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.

  8. Performance evaluation of delefilcon a water gradient daily disposable contact lenses in first-time contact lens wearers.

    PubMed

    Marx, Sebastian; Lauenborg, Bo; Kern, Jami R

    2018-02-06

    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.

  9. An Analysis of Eye Movements with Helmet Mounted Displays

    DTIC Science & Technology

    2014-03-27

    YES/NO Have you had corrective eye surgery ( PRK / LASIK )? YES/NO Have you been diagnosed or treated for any eye injuries or disease(s)? YES...without the use of any type of corrective lenses (glasses or contacts). Those with corrective vision through LASIK or PRK are qualified. Additionally...breast implants? YES/NO Do you wear corrective lenses (glasses/contact lenses)? YES/NO Have you had corrective eye surgery ( PRK / LASIK

  10. Diffusion of Antimicrobials Across Silicone Hydrogel Contact Lenses

    PubMed Central

    Zambelli, Alison M.; Brothers, Kimberly M.; Hunt, Kristin M.; Romanowski, Eric G.; Nau, Amy C.; Dhaliwal, Deepinder K.; Shanks, Robert M. Q.

    2014-01-01

    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

  11. Oxygen permeability of hydrogel contact lenses with organosilicon moieties.

    PubMed

    Compañ, V; Andrio, A; López-Alemany, A; Riande, E; Refojo, M F

    2002-07-01

    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.

  12. Development of Ciprofloxacin-loaded contact lenses using fluorous chemistry

    PubMed Central

    Zhu, Zhiling; Li, Siheng; McDermott, Alison M.

    2017-01-01

    In this work, we developed a simple method to load drugs into commercially available contact lenses utilizing fluorous chemistry. We demonstrated this method using model compounds including fluorous-tagged fluorescein and antibiotic ciprofloxacin. We showed that fluorous interactions facilitated the loading of model molecules into fluorocarbon-containing contact lenses, and that the release profiles exhibited sustained release. Contact lenses loaded with fluorous-tagged ciprofloxacin exhibited antimicrobial activity against Pseudomonas aeruginosa in vitro, while no cytotoxicity towards human corneal epithelial cells was observed. To mimic the tear turnover, we designed a porcine eye infection model under flow conditions. Significantly, the modified lenses also exhibited antimicrobial efficacy against Pseudomonas aeruginosa in the ex vivo infection model. Overall, utilizing fluorous chemistry, we can construct a drug delivery system that exhibits high drug loading capacity, sustained drug release, and robust biological activity. PMID:28188995

  13. Melimine-Coated Antimicrobial Contact Lenses Reduce Microbial Keratitis in an Animal Model.

    PubMed

    Dutta, Debarun; Vijay, Ajay K; Kumar, Naresh; Willcox, Mark D P

    2016-10-01

    To determine the ability of antimicrobial peptide melimine-coated contact lenses to reduce the incidence of microbial keratitis (MK) in a rabbit model of contact lens wear. In vitro antimicrobial activity of melimine-coated contact lenses was determined against Pseudomonas aeruginosa by viable count and a radiolabeled assay. The amount of lipopolysaccharide (LPS) associated with bacteria bound to melimine-coated and control lenses was determined. Ocular swabs from rabbit eyes were collected for assessment of ocular microflora. A rabbit model for MK was developed that used overnight wear of contact lenses colonized by P. aeruginosa in the absence of a corneal scratch. During lens wear, detailed ocular examinations were performed, and the incidence of MK was investigated. Bacteria associated with worn lenses and infected corneas were determined by viable plate count. Inhibition in viable and total P. aeruginosa adhesion by melimine-coated contact lenses was 3.1 log10 and 0.4 log10, respectively. After colonization, the amount of LPS on lenses was approximately the same with or without melimine. Gram-positive bacteria were found in all the ocular swabs followed by fungus (42%). Melimine-coated lens wear was protective and significantly (odds ratio 10.12; P = 0.012) reduced the incidence of P. aeruginosa-driven MK in the rabbit model. The antimicrobial lenses were associated with significantly (P < 0.001) lower ocular scores, indicating improved ocular signs compared with controls. This study showed that contaminated contact lenses can produce MK without corneal epithelial defect in an animal model. Melimine-coated contact lenses reduced the incidence of MK associated with P. aeruginosa in vivo. Development of MK requires viable bacteria adherent to contact lenses, and bacterial debris adherent at the lens surface did not cause keratitis.

  14. Oscillatory squeeze film analysis of soft contact lenses.

    PubMed

    Donnchadha, Éanna Mac; Leal, Cristina; Esmonde, Harry

    2018-04-13

    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.

  15. Can possible toxic effect of ultraviolet-A after corneal cross-linking be prevented? In vitro transmittance study of contact lenses at 370 nm wavelength.

    PubMed

    Bilgihan, Kamil; Yuksel, Erdem; Deniz, Nuriye Gokcen; Yuksel, Nilay

    2015-01-01

    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.

  16. Corneal erosions, bacterial contamination of contact lenses, and microbial keratitis.

    PubMed

    Willcox, Mark D P; Naduvilath, Thomas J; Vaddavalli, Pravin K; Holden, Brien A; Ozkan, Jerome; Zhu, Hua

    2010-11-01

    To estimate the rate of corneal erosion coupled with gram-negative bacterial contamination of contact lenses and compare this with the rate of microbial keratitis (MK) with contact lenses. The rate of corneal erosion and contact lens contamination by gram-negative bacteria were calculated from several prospective trials. These rates were used to calculate the theoretical rate of corneal erosion happening at the same time as wearing a contact lens contaminated with gram-negative bacteria. This theoretical rate was then compared with the rates of MK reported in various epidemiological and clinical trials. Corneal erosions were more frequent during extended wear (0.6-2.6% of visits) compared with daily wear (0.01-0.05% of visits). No corneal erosions were observed for lenses worn on a daily disposable basis. Contamination rates for lenses worn on a daily disposable basis were the lowest (2.4%), whereas they were the highest for low Dk lenses worn on an extended wear basis (7.1%). The estimated rate of corneal erosions occurring at the same time as wearing lenses contaminated with gram-negative bacteria was the lowest during daily wear of low Dk lenses (1.56/10,000 [95% CI: 0.23-10.57]) and the highest during extended wear of high Dk lenses (38.55/10,000 [95% CI: 24.77-60.04]). These rates were similar in magnitude to the rates reported for MK of different hydrogel lenses worn on differing wear schedules. The coincidence of corneal erosions during lens wear with gram-negative bacterial contamination of lenses may account for the relative incidence of MK during lens wear with different lens materials and modes of use.

  17. Candida albicans and Pseudomonas aeruginosa adhesion on soft contact lenses.

    PubMed

    Onurdağ, Fatma Kaynak; Ozkan, Semiha; Ozgen, Selda; Olmuş, Hülya; Abbasoğlu, Ufuk

    2011-04-01

    In this study it was aimed to determine the adherence of Pseudomonas and Candida to contact lens surfaces, and to determine the difference in adherence between five contact lens types. Biofilm-negative control strains were also used to emphasize the difference between biofilm-positive and biofilm-negative strains in adherence. Five different soft contact lenses were used to investigate the adherence of Pseudomonas aeruginosa and Candida albicans strains. P. aeruginosa ATCC 27853, P. aeruginosa ATCC 10145, C.albicans ATCC 10231 standard strains and C. albicans clinical isolate were included in the study. Slime formation was investigated by two methods; modified Christensen macrotube method, and a modified microtiter plate test. P. aeruginosa and C. albicans slime formation on soft contact lenses was studied in adherence and separation phases. Pseudomonas and Candida suspensions were serially diluted and inoculated to blood agar and sabouraud dextrose agar surfaces respectively. After overnight incubation, the colonies were counted. Sterile unworn contact lenses were used as negative controls, and bacterial and fungal culture suspensions were used as positive controls. The experiments were conducted in three parallel series. The number of adherent Pseudomonas was as follows from high to low in polymacon, etafilcon A, hilafilcon, ocufilcon and lotrafilcon contact lenses respectively. However, the number of adherent yeast were determined higher in lotrafilcon and ocufilcon contact lenses, followed by hilafilcon, etafilcon A and polymacon contact lenses. Biofilm-negative Pseudomonas ATCC standard strain and Candida clinical isolate were used to confirm that the number of adherent cells were lower than the biofilm-positive ones. This study demonstrates that in addition to the contact lens properties, the microorganisms themselves and their interactions with the lens material also play an important role in adherence.

  18. In vitro power profiles of daily disposable contact lenses.

    PubMed

    Belda-Salmerón, Lurdes; Madrid-Costa, David; Ferrer-Blasco, Teresa; García-Lázaro, Santiago; Montés-Micó, Robert

    2013-10-01

    To evaluate and compare the distribution of refractive power within the optic zone of different soft contact lenses and to investigate the effect of lens decentration on the power profiles. The Nimo TR1504 instrument was used to measure the optical power across different aperture diameters (from 1.5mm to 5.5mm in steps of 0.5mm) of four daily disposable contact lenses: DAILIES TOTAL1, Proclear 1-Day, SofLens daily disposable and 1-DAY ACUVUE MOIST. Measurements were performed using a wet cell. Power data were evaluated when contact lenses were in its centered position and after inducing different amounts of lens decentration (from 0.2mm to 1.0mm in steps of 0.2mm). All contact lenses showed an increase - more negative - in lens power with distance from the lens center. The amount of change varied depending on the lens. It was about 10% of lens power for DAILIES TOTAL1 (-0.29diopters (D)), SofLens daily disposable (-0.36D), and Proclear 1-Day (-0.32D) whereas 1-DAY ACUVUE MOIST showed a percentage variation of 3.3% (-0.10D). After inducing a lens decentration up to 1mm, the power curves were shifted in the negative direction. However, the change obtained in lens power compared with well-centered position was always lower than a quarter of diopter both for all the lenses and aperture diameters. Our results showed a variation of the refractive power from the lens center, becoming more negative toward the periphery, with a negligible effect of the decentration for all disposable contact lenses studied. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  19. Power profiles of single vision and multifocal soft contact lenses.

    PubMed

    Wagner, Sandra; Conrad, Fabian; Bakaraju, Ravi C; Fedtke, Cathleen; Ehrmann, Klaus; Holden, Brien A

    2015-02-01

    The purpose of this study was to investigate the optical zone power profile of the most commonly prescribed soft contact lenses to assess their potential impact on peripheral refractive error and hence myopia progression. The optical power profiles of six single vision and ten multifocal contact lenses of five manufacturers in the powers -1.00 D, -3.00 D, and -6.00 D were measured using the SHSOphthalmic (Optocraft GmbH, Erlangen, Germany). Instrument repeatability was also investigated. Instrument repeatability was dependent on the distance from the optical centre, manifesting unreliable data for the central 1mm of the optic zone. Single vision contact lens measurements of -6.00 D lenses revealed omafilcon A having the most negative spherical aberration, lotrafilcon A having the least. Somofilcon A had the highest minus power and lotrafilcon A the biggest deviation in positive direction, relative to their respective labelled powers. Negative spherical aberration occurred for almost all of the multifocal contact lenses, including the centre-distance designs etafilcon A bifocal and omafilcon A multifocal. Lotrafilcon B and balafilcon A seem to rely predominantly on the spherical aberration component to provide multifocality. Power profiles of single vision soft contact lenses varied greatly, many having a negative spherical aberration profile that would exacerbate myopia. Some lens types and powers are affected by large intra-batch variability or power offsets of more than 0.25 dioptres. Evaluation of power profiles of multifocal lenses was derived that provides helpful information for prescribing lenses for presbyopes and progressing myopes. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  20. Acanthamoeba keratitis in patients wearing scleral contact lenses.

    PubMed

    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

    2018-06-01

    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 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  1. A Laboratory Assessment of Factors That Affect Bacterial Adhesion to Contact Lenses

    PubMed Central

    Dutta, Debarun; Willcox, Mark DP

    2013-01-01

    Adhesion of pathogenic microbes, particularly bacteria, to contact lenses is implicated in contact lens related microbial adverse events. Various in vitro conditions such as type of bacteria, the size of initial inoculum, contact lens material, nutritional content of media, and incubation period can influence bacterial adhesion to contact lenses and the current study investigated the effect of these conditions on bacterial adhesion to contact lenses. There was no significant difference in numbers of bacteria that adhered to hydrogel etafilcon A or silicone hydrogel senofilcon A contact lenses. Pseudomonas aeruginosa adhered in higher numbers compared to Staphylococcus aureus. Within a genera/species, adhesion of different bacterial strains did not differ appreciably. The size of initial inoculum, nutritional content of media, and incubation period played significant roles in bacterial adhesion to lenses. A set of in vitro assay conditions to help standardize adhesion between studies have been recommended. PMID:24833224

  2. Extended release of hyaluronic acid from hydrogel contact lenses for dry eye syndrome.

    PubMed

    Maulvi, Furqan A; Soni, Tejal G; Shah, Dinesh O

    2015-01-01

    Current dry eye treatment includes delivering comfort enhancing agents to the eye via eye drops, but low residence time of eye drops leads to low bioavailability. Frequent administration leads to incompliance in patients, so there is a great need for medical device such as contact lenses to treat dry eye. Studies in the past have demonstrated the efficacy of hyaluronic acid (HA) in the treatment of dry eyes using eye drops. In this paper, we present two methods to load HA in hydrogel contact lenses, soaking method and direct entrapment. The contact lenses were characterized by studying their optical and physical properties to determine their suitability as extended wear contact lenses. HA-laden hydrogel contact lenses prepared by soaking method showed release up to 48 h with acceptable physical and optical properties. Hydrogel contact lenses prepared by direct entrapment method showed significant sustained release in comparison to soaking method. HA entrapped in hydrogels resulted in reduction in % transmittance, sodium ion permeability and surface contact angle, while increase in % swelling. The impact on each of these properties was proportional to HA loading. The batch with 200-μg HA loading showed all acceptable values (parameters) for contact lens use. Results of cytotoxicity study indicated the safety of hydrogel contact lenses. In vivo pharmacokinetics studies in rabbit tear fluid showed dramatic increase in HA mean residence time and area under the curve with lenses in comparison to eye drop treatment. The study demonstrates the promising potential of delivering HA through contact lenses for the treatment of dry eye syndrome.

  3. Effect of cholesterol deposition on bacterial adhesion to contact lenses.

    PubMed

    Babaei Omali, Negar; Zhu, Hua; Zhao, Zhenjun; Ozkan, Jerome; Xu, Banglao; Borazjani, Roya; Willcox, Mark D P

    2011-08-01

    To examine the effect of cholesterol on the adhesion of bacteria to silicone hydrogel contact lenses. Contact lenses, collected from subjects wearing Acuvue Oasys or PureVision lenses, were extracted in chloroform:methanol (1:1, v/v) and amount of cholesterol was estimated by thin-layer chromatography. Unworn lenses were soaked in cholesterol, and the numbers of Pseudomonas aeruginosa strains or Staphylococcus aureus strains that adhered to the lenses were measured. Cholesterol was tested for effects on bacterial growth by incubating bacteria in medium containing cholesterol. From ex vivo PureVision lenses, 3.4 ± 0.3 μg/lens cholesterol was recovered, and from Acuvue Oasys lenses, 2.4 ± 0.2 to 1.0 ± 0.1 μg/lens cholesterol was extracted. Cholesterol did not alter the total or viable adhesion of any strain of P. aeruginosa or S. aureus (p > 0.05). However, worn PureVision lenses reduced the numbers of viable cells of P. aeruginosa (5.8 ± 0.4 log units) compared with unworn lenses (6.4 ± 0.2 log units, p = 0.001). Similarly, there were fewer numbers of S. aureus 031 adherent to worn PureVision (3.05 ± 0.8 log units) compared with unworn PureVision (4.6 ± 0.3 log units, p = 0.0001). Worn Acuvue Oasys lenses did not affect bacterial adhesion. Cholesterol showed no effect on the growth of any test strain. Although cholesterol has been shown to adsorb to contact lenses during wear, this lipid does not appear to modulate bacterial adhesion to a lens surface.

  4. Drug delivery through soft contact lenses.

    PubMed Central

    Jain, M. R.

    1988-01-01

    Clinical studies were conducted on 466 patients waiting for senile cataract surgery and receiving chloromycetin, gentamicin, or carbenicillin subconjunctivally and through New Sauflon 70 and New Sauflon 85 lenses. The aqueous drug levels were biologically estimated at various time intervals. Soft contact lenses provided significantly higher drug penetration than subconjunctival therapy. Both modes of treatment provided therapeutically effective levels against most of the common ocular pathogens for varying intervals of 2 to 12 hours. PMID:3349016

  5. Release of betaine and dexpanthenol from vitamin E modified silicone-hydrogel contact lenses.

    PubMed

    Hsu, Kuan-Hui; de la Jara, Percy Lazon; Ariyavidana, Amali; Watling, Jason; Holden, Brien; Garrett, Qian; Chauhan, Anuj

    2015-03-01

    To develop a contact lens system that will control the release of an osmoprotectant and a moisturizing agent with the aim to reduce symptoms of ocular dryness. Profiles of the release of osmoprotectant betaine and moisturizing agent dexpanthenol from senofilcon A and narafilcon B contact lenses were determined in vitro under sink conditions. Both types of lenses were also infused with vitamin E to increase the duration of drug release due to the formation of the vitamin E diffusion barriers in the lenses. The release profiles from vitamin E-infused lenses were compared with those from the control lenses. Both dexpanthenol and betaine are released from commercial silicone hydrogel lenses for only about 10 min. Vitamin E loadings into contact lenses at about 20-23% can increase the release times to about 10 h, which is about 60 times larger compared to the control unmodified lenses. Vitamin E-loaded silicone hydrogel contact lenses released betaine and dexpanthenol in a controlled fashion.

  6. Novel Approaches in Formulation and Drug Delivery using Contact Lenses

    PubMed Central

    Singh, Kishan; Nair, Anroop B; Kumar, Ashok; Kumria, Rachna

    2011-01-01

    The success of ocular delivery relies on the potential to enhance the drug bioavailability by controlled and extended release of drug on the eye surface. Several new approaches have been attempted to augment the competence and diminish the intrinsic side effects of existing ocular drug delivery systems. In this contest, progress has been made to develop drug-eluting contact lens using different techniques, which have the potential to control and sustain the delivery of drug. Further, the availability of novel polymers have facilitated and promoted the utility of contact lenses in ocular drug delivery. Several research groups have already explored the feasibility and potential of contact lens using conventional drugs for the treatment of periocular and intraocular diseases. Contact lenses formulated using modern technology exhibits high loading, controlled drug release, apposite thickness, water content, superior mechanical and optical properties as compared to commercial lenses. In general, this review discus various factors and approaches designed and explored for the successful delivery of ophthalmic drugs using contact lenses as drug delivery device PMID:24826007

  7. Hydrogen peroxide mechanosynthesis in siloxane-hydrogel contact lenses.

    PubMed

    Tavazzi, Silvia; Ferraro, Lorenzo; Cozza, Federica; Pastori, Valentina; Lecchi, Marzia; Farris, Stefano; Borghesi, Alessandro

    2014-11-26

    Drug-loaded contact lenses are emerging as the preferred treatment method for several ocular diseases, and efforts are being directed to promote extended and controlled delivery. One strategy is based on delivery induced by environmental triggers. One of these triggers can be hydrogen peroxide, since many platforms based on drug-loaded nanoparticles were demonstrated to be hydrogen-peroxide responsive. This is particularly interesting when hydrogen peroxide is the result of a specific pathophysiological condition. Otherwise, an alternative route to induce drug delivery is here proposed, namely the mechano-synthesis. The present work represents the proof-of-concept of the mechanosynthesis of hydrogen peroxide in siloxane-hydrogel contact lenses as a consequence of the cleavage of siloxane bonds at the interface between the polymer and water in aqueous phase. Their spongy morphology makes contact lenses promising systems for mechanical-to-chemical energy conversion, since the amount of hydrogen peroxide is expected to scale with the interfacial area between the polymer and water. The eyelid pressure during wear is sufficient to induce the hydrogen peroxide synthesis with concentrations which are biocompatible and suitable to trigger the drug release through hydrogen-peroxide-responsive platforms. For possible delivery on demand, the integration of piezoelectric polymers in the siloxane-hydrogel contact lenses could be designed, whose mechanical deformation could be induced by an applied wireless-controlled voltage.

  8. Biological and Clinical Implications of Lysozyme Deposition on Soft Contact Lenses

    PubMed Central

    Omali, Negar Babaei; Subbaraman, Lakshman N.; Coles-Brennan, Chantal; Fadli, Zohra; Jones, Lyndon W.

    2015-01-01

    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

  9. Practitioner Perceptions of Patients Wearing Decorative Contact Lenses Purchased Through Unauthorized Sellers.

    PubMed

    Gaiser, Hilary; Ho, Connie; Janier, Nicole; Wee, Amy; Johnson, Catherine; Watanabe, Ronald

    2017-03-01

    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

  10. Peripheral optics with bifocal soft and corneal reshaping contact lenses.

    PubMed

    Ticak, Anita; Walline, Jeffrey J

    2013-01-01

    To determine whether bifocal soft contact lenses with a distance center design provide myopic defocus to the peripheral retina similar to corneal reshaping contact lenses. Myopic subjects underwent five cycloplegic autorefraction readings centrally and at 10, 20, and 30 degrees temporally, nasally, superiorly, and inferiorly while wearing Proclear Multifocal "D" contact lenses with a +2.00-diopter add power (CooperVision, Fairport, NY) and after wearing Corneal Refractive Therapy (Paragon Vision Sciences, Mesa, AZ) contact lenses for 2 weeks. Fourteen subjects completed the study. Nine (64%) were female, and 12 (86%) were white. The average (± SD) spherical equivalent noncycloplegic manifest refraction for the right eye was -2.84 ± 1.29 diopters. The average logMAR best-corrected, binocular, high-contrast visual acuity was -0.17 ± 0.15 while wearing the bifocal soft contact lenses and -0.09 ± 0.16 after corneal reshaping contact lens wear (analysis of variance, p = 0.27). The orthokeratology contact lens yielded a more myopic peripheral optical profile than the soft bifocal contact lens at 20 and 30 degrees eccentricity (except inferior at 20 degrees); the two modalities were similar at 10 degrees eccentricity. Our data suggest that the two modalities are dissimilar despite the statistical similarities. The corneal reshaping contact lens shows an increase in relative peripheral myopic refraction, a pattern achieved by other studies, but the bifocal lens does not exhibit such a pattern. The low statistical power of the study could be a reason for lack of providing statistical difference in other positions of gaze, but the graphical representation of the data shows a marked difference in the peripheral optical profile between the two modalities. More sophisticated methods of measuring the peripheral optical profile may be necessary to accurately compare the two modalities and to determine the true optical effect of the bifocal soft contact lens on the peripheral

  11. The Use of Contact Lenses in Industrial Environments: An Assessment of Current Research and Policy.

    ERIC Educational Resources Information Center

    Connors, Terry

    2001-01-01

    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…

  12. Research and analysis on new test lenses for calibration of focimeters used for measuring contact lenses

    NASA Astrophysics Data System (ADS)

    Zhang, Jiyan; Wang, Liru; Ma, Zhenya

    2006-11-01

    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.

  13. 16 CFR 456.5 - Rules applicable to prescriptions for contact lenses and related issues.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... contact lenses and related issues. 456.5 Section 456.5 Commercial Practices FEDERAL TRADE COMMISSION TRADE... contact lenses and related issues. Rules applicable to prescriptions for contact lenses and related issues may be found at 16 CFR part 315 (Contact Lens Rule). [69 FR 40511, July 2, 2004] ...

  14. Potential sources of bacteria that are isolated from contact lenses during wear.

    PubMed

    Willcox, M D; Power, K N; Stapleton, F; Leitch, C; Harmis, N; Sweeney, D F

    1997-12-01

    The aim of this paper was to determine the possible contamination sources of contact lenses during wear. Potential sources of the microbiota that colonized hydrogel contact lenses during wear were examined. The microorganisms that colonize contact lenses were grown, identified, and compared to those microorganisms that colonized the lower lid margins, upper bulbar conjunctiva, hands, and contact lens cases of contact lens wearers. In addition, the incidence of contamination of the domestic water supply in the Sydney area was obtained, and this was compared to the incidence of colonization of contact lenses by microorganisms in general and gram-negative bacteria in particular. There was a wide diversity of bacteria that were isolated from each site sampled. Coagulase-negative staphylococci and Propionibacterium spp. were the most common isolates from all ocular sites examined, and constituted the normal ocular microbiota. Other bacteria, including members of the families Enterobacteriaceae and Pseudomonadaceae, were isolated infrequently from all sites, but most frequently from contact lens cases. Statistical analysis revealed that there was a correlation between the isolation of bacteria from the contact lens and the lower lid margin (p < 0.001). Analysis of this correlation revealed that this was true for the normal microbiota. A correlation was also noted between the colonization of contact lenses by gram-negative bacteria and contamination of the domestic water supply. This study has demonstrated that the likely route for the normal ocular microbiota colonizing contact lenses is via the lid margins, whereas colonization by gram-negative bacteria, including potential agents of microbial keratitis, is likely to be from the domestic water supply.

  15. Contact Lenses Wettability In Vitro: Effect of Surface-Active Ingredients

    PubMed Central

    Lin, Meng C.; Svitova, Tatyana F.

    2010-01-01

    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

  16. Management of complications associated with lathe-cut soft contact lenses.

    PubMed

    Freeman, M I

    1979-06-01

    At the present time, nine lathe-cut lenses are FDA approved and commercially available in the United States. Complications of lathe-cut soft contact lenses cover a wide spectrum of problems. Five significant complications of lathe-cut lenses and their prevention and therapeutic management are discussed.

  17. Dexamethasone diffusion across contact lenses is inhibited by Staphylococcus epidermidis biofilms in vitro.

    PubMed

    Brothers, Kimberly M; Nau, Amy C; Romanowski, Eric G; Shanks, Robert M Q

    2014-10-01

    This study was designed to measure the impact of bacterial biofilms on diffusion of an ocular therapeutic through silicone hydrogel bandage lenses in vitro. An assay was designed to study the passage of a commonly used steroid, dexamethasone, through silicone hydrogel soft contact lenses. Diffused dexamethasone was measured using a spectrophotometer over a period of 18 hours and quantified using a standard curve. This assay was performed with control and Staphylococcus epidermidis biofilm-coated contact lenses comprised of lotrafilcon A and methafilcon. Biofilms were formed in brain heart infusion broth supplemented with D-glucose. The presented data validate a simple in vitro model that can be used to measure the penetration of a topical therapeutic through silicone hydrogel soft contact lenses. Using this model, we measured a reduction in dexamethasone diffusion up to 88% through S. epidermidis biofilm-coated silicone hydrogel lenses compared with control lenses. The results of this in vitro study demonstrate that bacterial biofilms impede dexamethasone diffusion through silicone hydrogel contact lenses and warrant future studies regarding the clinical benefit of using ocular therapeutics in the setting of bandage contact lens use for corneal epithelial defects.

  18. Dexamethasone diffusion across contact lenses is inhibited by Staphylococcus epidermidis biofilms in vitro

    PubMed Central

    Brothers, Kimberly M.; Nau, Amy C.; Romanowski, Eric G.; Shanks, Robert M. Q.

    2014-01-01

    Purpose This study was designed to measure the impact of bacterial biofilms on diffusion of an ocular therapeutic through silicone hydrogel bandage lenses in vitro. Methods An assay was designed to study the passage of a commonly used steroid dexamethasone through the silicone hydrogel soft contact lenses. Diffused dexamethasone was measured using a spectrophotometer over a period of 18 hours and quantified using a standard curve. This assay was performed with control and Staphylococcus epidermidis biofilm-coated contact lenses composed of lotrafilcon A and methafilcon. Biofilms were formed in brain heart infusion broth supplemented with D-glucose. Results The presented data validate a simple in vitro model that can be used to measure penetration of a topical therapeutic through silicone hydrogel soft contact lenses. Using this model we measured a reduction of dexamethasone diffusion by up to 88% through S. epidermidis biofilm-coated silicon hydrogel lenses compared to control lenses. Conclusions The results of this in vitro study demonstrate that bacterial biofilms impede dexamethasone diffusion through silicon hydrogel contact lenses, and warrant future studies regarding the clinical benefit of using ocular therapeutics in the setting of bandage contact lens use for corneal epithelial defects. PMID:25090165

  19. The effect of UV-blocking contact lenses as a therapy for canine chronic superficial keratitis.

    PubMed

    Denk, Nora; Fritsche, Jens; Reese, Sven

    2011-05-01

    To evaluate the effect of UV-blocking soft contact lenses in treatment for chronic superficial keratitus (CSK). Twenty six dogs with CSK were treated continuously with UV-blocking contact lenses for 6 months. A contact lens was placed on one eye of each dog; the other eye remained without a lens as a control eye. After this primary study, five of the dogs were further treated and they wore then contact lenses in both eyes. Continuously, all patients were concurrently treated topically with cyclosporine. The contact lenses were changed every 4 weeks and an ophthalmic examination performed. Evaluation criteria included corneal alterations as pigmentation, edema, pannus and vascularization. To determine the transmittance characteristics of the contact lenses before and after use, 32 contact lenses were measured with a UV-vis-NIR spectrophotometer. Pigmentation increased in eyes wearing lenses and in control eyes over the evaluation period of 6 months. Corneal edema increased in the eyes wearing lenses, but remained unaffected in the control eyes. A significant difference in the incidence of pannus and the extent of corneal vascularisation could not be evaluated. Adverse effects were noted in six cases (corneal edema and vascularisation, conjunctivitis, blepharospasm). All new lenses studied reduced UV-radiation to a safe level, whereas used lenses did not maintain their transmittance characteristics. No positive effect of UV-blocking contact lenses could be proven with the study design used. © 2011 American College of Veterinary Ophthalmologists.

  20. Effect of phospholipid deposits on adhesion of bacteria to contact lenses.

    PubMed

    Babaei Omali, Negar; Proschogo, Nicholas; Zhu, Hua; Zhao, Zhenjun; Diec, Jennie; Borazjani, Roya; Willcox, Mark D P

    2012-01-01

    Protein and lipid deposits on contact lenses may contribute to clinical complications. This study examined the effect of phospholipids on the adhesion of bacteria to contact lenses. Worn balafilcon A (n = 11) and senofilcon A (n = 11) were collected after daily wear and phospholipids were extracted in chloroform:methanol. The amount of phospholipid was measured by electrospray ionization mass spectrometry. Unworn lenses soaked in phospholipids were exposed to Pseudomonas aeruginosa and Staphylococcus aureus. After 18 h incubation, the numbers of P. aeruginosa or S. aureus that adhered to the lenses were measured. Phospholipid was tested for possible effects on bacterial growth. A broad range of sphingomyelins (SM) and phosphatidylcholines (PC) were detected from both types of worn lenses. SM (16:0) (m/z 703) and PC (34:2) (m/z 758) were the major phospholipids detected in the lens extracts. Phospholipids did not alter the adhesion of any strain of P. aeruginosa or S. aureus (p > 0.05). Phospholipids (0.1 mg/mL) showed no effect on the growth of P. aeruginosa 6294 or S. aureus 031. Phospholipids adsorb/absorb to contact lenses during wear, however, the major types of phospholipids adsorbed to lenses do not alter bacterial adhesion or growth.

  1. The effects of two different types of bandage contact lenses on the healthy canine eye.

    PubMed

    Braus, Barbara Katharina; Riedler, Daniela; Tichy, Alexander; Spergser, Joachim; Schwendenwein, Ilse

    2018-02-06

    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.

  2. Diamond Nanogel-Embedded Contact Lenses Mediate Lysozyme-Dependent Therapeutic Release

    PubMed Central

    2015-01-01

    Temporarily implanted devices, such as drug-loaded contact lenses, are emerging as the preferred treatment method for ocular diseases like glaucoma. Localizing the delivery of glaucoma drugs, such as timolol maleate (TM), can minimize adverse effects caused by systemic administration. Although eye drops and drug-soaked lenses allow for local treatment, their utility is limited by burst release and a lack of sustained therapeutic delivery. Additionally, wet transportation and storage of drug-soaked lenses result in drug loss due to elution from the lenses. Here we present a nanodiamond (ND)-embedded contact lens capable of lysozyme-triggered release of TM for sustained therapy. We find that ND-embedded lenses composed of enzyme-cleavable polymers allow for controlled and sustained release of TM in the presence of lysozyme. Retention of drug activity is verified in primary human trabecular meshwork cells. These results demonstrate the translational potential of an ND-embedded lens capable of drug sequestration and enzyme activation. PMID:24506583

  3. Latanoprost-Eluting Contact Lenses in Glaucomatous Monkeys.

    PubMed

    Ciolino, Joseph B; Ross, Amy E; Tulsan, Rehka; Watts, Amy C; Wang, Rong-Fang; Zurakowski, David; Serle, Janet B; Kohane, Daniel S

    2016-10-01

    To assess the ability of latanoprost-eluting contact lenses to lower the intraocular pressure (IOP) of glaucomatous eyes of cynomolgus monkeys. Preclinical efficacy study of 3 treatment arms in a crossover design. Female cynomolgus monkeys with glaucoma induced in 1 eye by repeated argon laser trabeculoplasty. Latanoprost-eluting low-dose contact lenses (CLLO) and high-dose contact lenses (CLHI) were produced by encapsulating a thin latanoprost-polymer film within the periphery of a methafilcon hydrogel, which was lathed into a contact lens. We assessed the IOP-lowering effect of CLLO, CLHI, or daily latanoprost ophthalmic solution in the same monkeys. Each monkey consecutively received 1 week of continuous-wear CLLO, 3 weeks without treatment, 5 days of latanoprost drops, 3 weeks without treatment, and 1 week of continuous-wear CLHI. On 2 consecutive days before initiation of each study arm, the IOP was measured hourly over 7 consecutive hours to establish the baseline IOP. Two-tailed Student t tests and repeated-measures analysis of variance were used for statistical analysis. Intraocular pressure. Latanoprost ophthalmic solution resulted in IOP reduction of 5.4±1.0 mmHg on day 3 and peak IOP reduction of 6.6±1.3 mmHg on day 5. The CLLO reduced IOP by 6.3±1.0, 6.7±0.3, and 6.7±0.3 mmHg on days 3, 5, and 8, respectively. The CLHI lowered IOP by 10.5±1.4, 11.1±4.0, and 10.0±2.5 mmHg on days 3, 5, and 8, respectively. For the CLLO and CLHI, the IOP was statistically significantly reduced compared with the untreated baseline at most time points measured. The CLHI demonstrated greater IOP reduction than latanoprost ophthalmic solution on day 3 (P = 0.001) and day 5 (P = 0.015), and at several time points on day 8 (P < 0.05). Sustained delivery of latanoprost by contact lenses is at least as effective as delivery with daily latanoprost ophthalmic solution. More research is needed to determine the optimal continuous-release dose that would be well tolerated

  4. Consequences of wear interruption for discomfort with contact lenses.

    PubMed

    Papas, Eric B; Tilia, Daniel; Tomlinson, Daniel; Williams, Josh; Chan, Eddy; Chan, Jason; Golebiowski, Blanka

    2014-01-01

    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

  5. Ocular Drug Delivery through pHEMA-Hydrogel Contact Lenses Co-Loaded with Lipophilic Vitamins

    NASA Astrophysics Data System (ADS)

    Lee, Dasom; Cho, Seungkwon; Park, Hwa Sung; Kwon, Inchan

    2016-09-01

    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.

  6. Microbiologic study of soft contact lenses after laser subepithelial keratectomy for myopia.

    PubMed

    Hondur, Ahmet; Bilgihan, Kamil; Cirak, Meltem Yalinay; Dogan, Ozgur; Erdinc, Alper; Hasanreisoglu, Berati

    2008-01-01

    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.

  7. Accommodation and Phoria in Children Wearing Multifocal Contact Lenses

    PubMed Central

    Gong, Celia R; Troilo, David; Richdale, Kathryn

    2017-01-01

    Purpose To determine the effect of multifocal contact lenses on accommodation and phoria in children. Methods This was a prospective, non-dispensing, randomized, crossover, single visit study. Myopic children with normal accommodation and binocularity and no history of myopia control treatment were enrolled and fitted with Coopervision Biofinity single vision (SV) and multifocal (MF, +2.50D center distance add) contact lenses. Accommodative responses (photorefraction) and phorias (Modified Thorington) were measured at 4 distances (>3m, 100cm, 40cm, 25cm). Secondary measures included high and low contrast logMAR acuity, accommodative amplitude and facility. Differences between contact lens designs were analyzed using repeated measures regression and paired t-tests. Results A total of 16 subjects, aged 10-15 years, completed the study. There was a small decrease in high (SV: -0.08, MF: +0.01) and low illumination (SV:-0.03, MF: +0.08) (both p<0.01) visual acuity, and contrast sensitivity (SV: 2.0, MF: 1.9 log units, p=0.015) with multifocals. Subjects were more exophoric at 40 cm (SV: -0.41, MF: -2.06 Δ) and 25cm (SV: -0.83, MF: -4.30 Δ) (both p<0.01). With multifocals, subjects had decreased accommodative responses at distance (SV: -0.04; MF: -0.37 D, p=0.02), 100 cm (SV: +0.37; MF: -0.35 D, p<0.01), 40 cm (SV: +1.82; MF: +0.62 D, p<0.01), and 25 cm (SV: +3.38; MF: +1.75 D, p<0.01). There were no significant differences in accommodative amplitude (p=0.66) or facility (p=0.54). Conclusions Children wearing multifocal contact lenses exhibited reduced accommodative responses and more exophoria at increasingly higher accommodative demands than with single vision contact lenses. This suggests that children may be relaxing their accommodation and using the positive addition or increased depth of focus from added spherical aberration of the multifocals. Further studies are needed to evaluate other lens designs, different amounts of positive addition and aberrations, and

  8. Legal responsibilities when fitting minors with contact lenses.

    PubMed

    Harris, M G

    2000-02-01

    Practitioners must understand their legal responsibilities in fitting minors with contact lenses, which include informed consent, contractual obligations, and the Statute of Limitations. Minors are children and teenagers who have not yet reached voting age in their state--generally 18 years of age. Informed consent requires permission from the patient before a practitioner performs any treatment. For these young people, this consent generally can only be given by a parent or legal guardian. Minors can repudiate contracts made with them; therefore, the contractual obligation to pay for a contact lens fitting should be established with a parent or legal guardian. In most states, minors have additional time beyond the usual Statute of Limitations to bring a lawsuit. If practitioners recognize their legal responsibilities in caring for these special patients, fitting youngsters with contact lenses can be a rewarding part of practice.

  9. Comparing goblet cell densities in patients wearing disposable hydrogel contact lenses versus silicone hydrogel contact lenses in an extended-wear modality.

    PubMed

    Lievens, Christopher W; Connor, Charles G; Murphy, Heather

    2003-10-01

    The current study evaluates the response of the ocular surface to extended contact lens wear by comparing a new silicone hydrogel lens to an ACUVUE 2 lens. Twenty subjects with an average age of 28 years were randomly assigned to a fitting with ACUVUE 2 or PureVision lenses. Ocular surface assessment by impression cytology was performed at baseline and for the 6 months after initiation of lens wear. Although goblet cell density significantly increased with wear time, no statistically significant difference was observed between the contact lens groups. The average baseline goblet cell percentages were as follows: ACUVUE 2 group, 1.44; PureVision group, 1.11. The 6-month averages were as follows: ACUVUE 2 group, 3.16; PureVision group, 2.22. It appears that silicone hydrogel lenses may be slightly less irritating to the ocular surface than lenses not containing silicone. This could be a promising indicator for successful 30-day continuous wear.

  10. Oxygen, water, and sodium chloride transport in soft contact lenses materials.

    PubMed

    Gavara, Rafael; Compañ, Vicente

    2017-11-01

    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.

  11. Protein deposition and its effect on bacterial adhesion to contact lenses.

    PubMed

    Omali, Negar Babaei; Zhu, Hua; Zhao, Zhenjun; Willcox, Mark D P

    2013-06-01

    Bacterial adhesion to contact lenses is believed to be the initial step for the development of several adverse reactions that occur during lens wear such as microbial keratitis. This study examined the effect of combinations of proteins on the adhesion of bacteria to contact lenses. Unworn balafilcon A and senofilcon A lenses were soaked in commercially available pure protein mixtures to achieve the same amount of various proteins as found ex vivo. These lenses were then exposed to Pseudomonas aeruginosa and Staphylococcus aureus. Following incubation, the numbers of P. aeruginosa or S. aureus that adhered to the lenses were measured. The possible effect of proteins on bacterial growth was investigated by incubating bacteria in medium containing protein. Although there was a significant (p < 0.003) increase in the total or viable counts of one strain of S. aureus (031) on balafilcon A lenses soaked in the lysozyme/lactoferrin combination, the protein adhered to lenses did not alter the adhesion of any other strains of P. aeruginosa or S. aureus (p > 0.05). Growth of S. aureus 031 (p < 0.0001) but not of P. aeruginosa 6294 was stimulated by addition of lysozyme/lactoferrin combination (2.8/0.5 mg/mL). Addition of lipocalin did not affect the growth of any strains tested (p > 0.05). Adsorption of amounts of lysozyme and lactoferrin or lipocalin equivalent to those extracted from worn contact lenses did not affect the adhesion of most strains of S. aureus or P. aeruginosa to lens surfaces.

  12. Comparison of surface roughness and bacterial adhesion between cosmetic contact lenses and conventional contact lenses.

    PubMed

    Ji, Yong Woo; Cho, Young Joo; Lee, Chul Hee; Hong, Soon Ho; Chung, Dong Yong; Kim, Eung Kweon; Lee, Hyung Keun

    2015-01-01

    To compare physical characteristics of cosmetic contact lenses (Cos-CLs) and conventional contact lenses (Con-CLs) that might affect susceptibility to bacterial adhesion on the contact lens (CL) surface. Surface characteristics of Cos-CLs and Con-CLs made from the same material by the same manufacturer were measured by atomic force microscopy (AFM) and scanning electron microscopy. To determine the extent and rate of bacterial adhesion, Cos-CL and Con-CL were immersed in serum-free Roswell Park Memorial Institute media containing Staphylococcus aureus or Pseudomonas aeruginosa. Additionally, the rate of removal of adherent bacteria was evaluated using hand rubbing or immersion in multipurpose disinfecting solutions (MPDS). The mean surface roughness (root mean square and peak-to-valley value) measured by AFM was significantly higher for Cos-CL than for Con-CL. At each time point, significantly more S. aureus and P. aeruginosa adhered to Cos-CL than to Con-CL, which correlated with the surface roughness of CL. In Cos-CL, bacteria were mainly found on the tinted surface rather than on the noncolored or convex areas. Pseudomonas aeruginosa attached earlier than S. aureus to all types of CL. However, P. aeruginosa was more easily removed from the surface of CL than S. aureus by hand rubbing or MPDS soaking. Increased surface roughness is an important physical factor for bacterial adhesion in Cos-CL, which may explain why rates of bacterial keratitis rates are higher in Cos-CL users in CL physical characteristics.

  13. Aberrations associated with rigid contact lenses.

    PubMed

    Atchison, D A

    1995-10-01

    A rigid contact lens on an eye can produce levels of spherical aberration very different from those produced by a spectacle lens in front of the eye. These levels are considerably affected by contact lens surface asphericity. Change in longitudinal spherical aberration associated with aspherizing a contact lens surface is well predicted by a simple equation for change in sagittal power of the surface. Displacing an aspheric contact lens on the eye can produce considerable defocus, which is well predicted by simple equations for change in sagittal and tangential surface powers. The best refractive correction with contact lenses can be determined only by overrefraction with a patient wearing a contact lens of power and characteristics similar to that which will be prescribed. An aspheric contact lens that moves to a considerable extent on the eye will cause more unstable vision than will a spherical lens that moves to the same extent.

  14. Pseudomonas keratitis associated with daily wear of silicone hydrogel contact lenses.

    PubMed

    Schornack, Muriel M; Faia, Lisa J; Griepentrog, Gregory J

    2008-03-01

    To report two cases of pseudomonas keratitis associated with daily wear of silicone hydrogel contact lenses. Medical records of two patients who developed pseudomonas keratitis while wearing silicone hydrogel lenses on a daily-wear schedule are reviewed and discussed. A 13-year-old girl who wore ACUVUE Advance lenses (Johnson & Johnson Vision Care, Jacksonville, FL) 12 to 14 hours daily developed a paracentral corneal ulcer in her left eye 4 months after beginning contact lens use. Cultures were positive for Pseudomonas aeruginosa. The ulcer responded to fortified antibiotics and resolved in 10 days. Best-corrected visual acuity after resolution of the ulcer was 20/25. A 58-year-old woman with a 30-year history of rigid gas-permeable contact lens wear was refitted with O2 Optix lenses (CIBA Vision, Duluth, GA). Six months later, she had a 4.9 x 4.0 mm epithelial defect with an underlying stromal infiltrate in the right eye. Cultures were positive for P. aeruginosa. The ulcer responded to fortified antibiotics and resolved in 30 days. Best-corrected visual acuity after resolution of the ulcer was 20/30. Increased oxygen permeability associated with silicone hydrogel contact lenses may reduce, but does not eliminate, the risk of pseudomonas keratitis. Studies have yet to quantify the risk of keratitis associated with daily wear of these lens materials. Further study is necessary to identify the risks of complications with daily wear of silicone hydrogel lenses and to determine which factors may contribute to those risks.

  15. Microbial contamination of soft contact lenses & accessories in asymptomatic contact lens users

    PubMed Central

    Thakur, Deeksha V.; Gaikwad, Ujjwala N.

    2014-01-01

    Background & objectives: With increasing use of soft contact lenses the incidence of contact lens induced infections is also increasing. This study was aimed to assess the knowledge of new and existing contact lens users about the risk of microbial contamination associated with improper use and maintenance of contact lenses, type of microbial flora involved and their potential to cause ophthalmic infections. Methods: Four samples each from 50 participants (n=200) were collected from the lenses, lens care solutions, lens care solution bottles and lens cases along with a questionnaire regarding their lens use. The samples were inoculated onto sheep blood agar, Mac Conkey's agar and Sabouraud's dextrose agar. Organisms were identified using standard laboratory protocols. Results: Overall rate of microbial contamination among the total samples was 52 per cent. The most and the least contaminated samples were found to be lens cases (62%) and lens care solution (42%), respectively. The most frequently isolated contaminant was Staphylococcus aureus (21%) followed by Pseudomonas species (19.5%). Majority (64%) of the participants showed medium grade of compliance to lens cleaning practices. Rate of contamination was 100 and 93.75 per cent respectively in those participants who showed low and medium compliance to lens care practices as compared to those who had high level of compliance (43.75%) (P<0.05). Interpretation & conclusions: Lens care practices amongst the participants were not optimum which resulted into high level contamination. Hence, creating awareness among the users about the lens care practices and regular cleaning and replacements of lens cases are required. PMID:25297366

  16. Microbial contamination of soft contact lenses & accessories in asymptomatic contact lens users.

    PubMed

    Thakur, Deeksha V; Gaikwad, Ujjwala N

    2014-08-01

    With increasing use of soft contact lenses the incidence of contact lens induced infections is also increasing. This study was aimed to assess the knowledge of new and existing contact lens users about the risk of microbial contamination associated with improper use and maintenance of contact lenses, type of microbial flora involved and their potential to cause ophthalmic infections. Four samples each from 50 participants (n=200) were collected from the lenses, lens care solutions, lens care solution bottles and lens cases along with a questionnaire regarding their lens use. The samples were inoculated onto sheep blood agar, Mac Conkey's agar and Sabouraud's dextrose agar. Organisms were identified using standard laboratory protocols. Overall rate of microbial contamination among the total samples was 52 per cent. The most and the least contaminated samples were found to be lens cases (62%) and lens care solution (42%), respectively. The most frequently isolated contaminant was Staphylococcus aureus (21%) followed by Pseudomonas species (19.5%). Majority (64%) of the participants showed medium grade of compliance to lens cleaning practices. Rate of contamination was 100 and 93.75 per cent respectively in those participants who showed low and medium compliance to lens care practices as compared to those who had high level of compliance (43.75%) (P<0.05). Lens care practices amongst the participants were not optimum which resulted into high level contamination. Hence, creating awareness among the users about the lens care practices and regular cleaning and replacements of lens cases are required.

  17. Contamination risk of reusing daily disposable contact lenses.

    PubMed

    Boost, Maureen; Poon, Kin-Chiu; Cho, Pauline

    2011-12-01

    This study investigated contamination of saline and daily disposable contact lens (DDCL) stored overnight after use in the original blister pack and the practices of a group of DDCL users. Twenty DDCL wearers placed their lenses after 1 day's use back into the blister pack saline (BPS) and left them overnight before transferring both lens and BPS to a new CL case. The lens and BPS were cultured the following day, and total number of organisms, Staphylococci, and gram negative organisms enumerated. Each subject submitted five pairs of lenses over a 1 month period. Ninety-five percent of subjects had at least one pair of contaminated lenses, and the BPS yielded similar results to the contaminated lenses, with staphylococcal contamination being predominant. Three subjects admitted to not washing their hands before handling their lenses and six to habitual reuse of their lenses with storage in the BPS. There was a higher risk of contamination in male subjects. Reuse of lenses poses an important risk for DDCL users because they are unlikely to have received proper training in cleaning and disinfection of lenses and do not use a lens case or disinfecting solutions. Overnight storage in BPS results in contaminated lenses which if reused increases the infection risk especially with Staphylococci. It is important that practitioners carefully educate their patients in correct use of DDCL and, as cost of lenses is a major factor in willingness to reuse, ensure that DDCL is the most suitable choice when prescribing.

  18. Contact lenses and the rate of evaporation measured in vitro; the influence of wear, squalene and wax.

    PubMed

    Vishnubhatla, Sravya; Borchman, Douglas; Foulks, Gary N

    2012-12-01

    Accelerated evaporation of tears may contribute to dry eye symptoms. It is not clear whether contact lenses decrease or increase the rate of evaporation of tears. In this study, the rates of evaporation through contact lenses (ERTCL) were measured in vitro to gain insight to this question. Contact lenses were equilibrated with various solutions to determine if they influenced ERTCL in vitro. ERTCL was measured gravimetrically. ERTCL measured in vitro for used contact lenses was about 20% faster than for buffer alone suggesting that natural tear components bound to the lenses changed the ERTCL. One natural tear component that binds to contact lenses is waxes. Equilibration of contact lenses with wax increased the ERTCL by about 30% suggesting that waxes might potentially increase ERTCL in vivo. Squalene, found in sebum and possibly meibum was infused into the contact lenses as a step toward decreasing the ERTCL. Squalene decreased ERTCL by over 60% in vitro. Soaking a contact lens in DuraSite(®) with benzalkonium chloride (BAK) did not alter the ERTCL. ERTCL were about 40% higher than the evaporation rate of DuraSite(®) alone or without BAK. In addition to lowering the ERTCL, the squalene in contact lenses could be a source of terpenoids to replace the terpenoids deficient in patients with MGD. If the ERTCL could be minimized in vivo, contact lenses could potentially be used to relieve dry eye symptoms in patients with evaporative dry eye. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  19. A novel procedure for the extraction of protein deposits from soft hydrophilic contact lenses for analysis.

    PubMed

    Keith, D; Hong, B; Christensen, M

    1997-05-01

    A quick, simple, and efficient extraction technique was developed for the removal of protein from soft hydrophilic contact lenses. An extraction solvent consisting of a 50:50 mix of 0.2% trifluoroacetic acid and acetonitrile was used to remove protein from in vitro laboratory-deposited and human-worn contact lenses. The protein removed was analyzed using HPLC, bicinchoninic acid (BCA) analysis, and SDS-PAGE gel electreophoresis. Extraction efficiency for lysozyme from laboratory-deposited Group IV lenses was determined to be approximately 100%. Group IV human-worn contact lenses were extracted and analyzed for lysozyme by HPLC and total protein by bicinchoninic acid (BCA) analysis. Groups I, II, III, and IV contact lenses deposited with an artificial tear protein solution and human-worn lenses were extracted and analyzed by SDS-PAGE gel electreophoresis and micro-BCA. The ACN/TFA procedure offers a simple, quick, and efficient extraction technique for removal of protein from contact lenses for subsequent analysis.

  20. In vitro adhesion of Acanthamoeba castellanii to soft contact lenses depends on water content and disinfection procedure.

    PubMed

    Reverey, Julia F; Fromme, Roland; Leippe, Matthias; Selhuber-Unkel, Christine

    2014-08-01

    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.

  1. On- and off-eye spherical aberration of soft contact lenses and consequent changes of effective lens power.

    PubMed

    Dietze, Holger H; Cox, Michael J

    2003-02-01

    Soft contact lenses produce a significant level of spherical aberration affecting their power on-eye. A simple model assuming that a thin soft contact lens aligns to the cornea predicts that these effects are similar on-eye and off-eye. The wavefront aberration for 17 eyes and 33 soft contact lenses on-eye was measured with a Shack-Hartmann wavefront sensor. The Zernike coefficients describing the on-eye spherical aberration of the soft contact lens were compared with off-eye ray-tracing results. Paraxial and effective lens power changes were determined. The model predicts the on-eye spherical aberration of soft contact lenses closely. The resulting power change for a +/- 7.00 D spherical soft contact lens is +/- 0.5 D for a 6-mm pupil diameter and +/- 0.1 D for a 3-mm pupil diameter. Power change is negligible for soft contact lenses corrected for off-eye spherical aberration. For thin soft contact lenses, the level of spherical aberration and the consequent power change is similar on-eye and off-eye. Soft contact lenses corrected for spherical aberration in air will be expected to be aberration-free on-eye and produce only negligibly small power changes. For soft contact lenses without aberration correction, for higher levels of ametropia and large pupils, the soft contact lens power should be determined with trial lenses with their power and p value similar to the prescribed lens. The benefit of soft contact lenses corrected for spherical aberration depends on the level of ocular spherical aberration.

  2. Ultraviolet radiation-blocking characteristics of contact lenses: relevance to eye protection for psoralen-sensitised patients.

    PubMed

    Anstey, A; Taylor, D; Chalmers, I; Ansari, E

    1999-10-01

    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.

  3. Broad spectrum antimicrobial activity of melimine covalently bound to contact lenses.

    PubMed

    Dutta, Debarun; Cole, Nerida; Kumar, Naresh; Willcox, Mark D P

    2013-01-07

    To develop a stable antimicrobial contact lens, which is effective against the International Organization for Standardization (ISO) panel microorganisms, Acanthamoeba castellanii and drug resistant strains of Pseudomonas aeruginosa and Staphylococcus aureus. Melimine was covalently incorporated into etafilcon A lenses. The amount of peptide present on the lens surface was quantified using amino acid analysis. After coating, the heat stability (121°C), lens surface hydrophobicity (by captive bubble), and in vitro cytotoxicity to mouse L929 cells of the lenses were investigated. Antimicrobial activity against the micro-organisms was evaluated by viable plate count and fluorescence microscopy, measuring the proportion of cell death compared with control lenses with no melimine. The most effective concentration was determined to be 152 ± 44 μg lens(-1) melimine on the lens surface. After coating, lenses were relatively hydrophilic and were nontoxic to mammalian cells. The activity remained high after autoclaving (e.g., 3.1, 3.9, 1.2, and 1.0 log inhibition against P. aeruginosa, S. aureus, A. castellanii, and Fusarium solani, respectively). Fluorescence microscopy confirmed significantly reduced (P < 0.001) adhesion of viable bacteria to melimine contact lenses. Viable count confirmed that lenses were active against all the bacteria and fungi from the ISO panel, Acanthamoeba and gave at least 2 log inhibition against all the multidrug resistant S. aureus and P. aeruginosa strains. Melimine may offer excellent potential for development as a broad spectrum antimicrobial coating for contact lenses, showing activity against all the bacterial and fungal ISO panel microorganisms, Acanthamoeba, and antibiotic resistant strains of P. aeruginosa and S. aureus.

  4. Antibacterial activity of contact lenses bearing surface-immobilized layers of intact liposomes loaded with levofloxacin.

    PubMed

    Danion, Anne; Arsenault, Isabelle; Vermette, Patrick

    2007-09-01

    In vitro methods to evaluate antibacterial activity were used with contact lenses bearing levofloxacin-loaded liposomes developed for the prevention and treatment of bacterial ocular infections such as keratitis. Levofloxacin was incorporated into liposomes before these intact liposomes were immobilized onto the surfaces of soft contact lenses using a multilayer immobilization strategy. The release of levofloxacin from contact lenses bearing 2, 5, and 10 layers of liposomes into a saline buffer at 37 degrees C was monitored by fluorescence. The levofloxacin release, as a function of time, was described by a mechanism taking into account two independent first-order kinetic models. The total release of levofloxacin from the contact lenses was completed within 6 days. The release of levofloxacin from contact lenses bearing 10 layers of liposomes and subsequently soaked overnight in a levofloxacin solution was also studied and compare to that of dried contact lenses without any chemical modification rehydrated in a levofloxacin solution. The antibacterial activity of the liposome-coated contact lenses against Staphylococcus aureus was evaluated by measuring (i) the diameters of the inhibition zone on an agar plate and (ii) the optical density using a broth assay. The liposome-coated lenses showed an antibacterial activity both on agar and in broth following 24 h. When initial bacteria inocula were equal or below 10(6) CFU/mL, all the bacteria were inhibited within 2 h. When using initial bacteria inocula of 10(8) CFU/mL, an initial burst release provided by soaking the liposomal lenses was required for the first hours to inhibit bacteria growth. (c) 2007 Wiley-Liss, Inc. and the American Pharmacists Association.

  5. Isolation of coagulase-negative staphylococci from extended-wear soft contact lenses in asymptomatic patients.

    PubMed

    Faghri, Jamshid

    2008-05-01

    Coagulase-negative staphylococci and diphtheroids are normal inhabitants of the outer surface of the human eye. These microorganisms serve as part of the defense mechanism of the ocular anatomy in preventing colonization and infection by pathogenic bacteria. Nevertheless, infections associated with contaminated solutions and cases became serious problems for people who wear soft contact lenses. The aim of this study is to isolate and identify aerobic bacteria, particularly, gram-negative species associated with the use of extended-wear soft contact lenses. Extended-wear contact lenses were collected, using aseptic technique, from the eyes of individuals after 30 days of extended wear (5-7 day intermittent periods) and were examined for adhered aerobic bacteria. Coagulase-negative staphylococci were isolated from 74% of the lenses. Serratia marcescens was found at an incidence of 10% and Pseudomonas aeruginosa at an incidence of 6%. The presence of species of bacteria, including P. aeruginosa and S. marcescens, which have been associated with daily wear soft contact lenses, solutions, and cases also seem to be associated with extended-wear lenses.

  6. Mechanically triggered solute uptake in soft contact lenses.

    PubMed

    Tavazzi, Silvia; Ferraro, Lorenzo; Fagnola, Matteo; Cozza, Federica; Farris, Stefano; Bonetti, Simone; Simonutti, Roberto; Borghesi, Alessandro

    2015-06-01

    Molecular arrangement plays a role in the diffusion of water and solutes across soft contact lenses. In particular, the uptake of solutes in hydrated contact lenses can occur as long as free water is available for diffusion. In this work, we investigated the effect of mechanical vibrations of low frequency (200 Hz) on the solute uptake. Hyaluronan, a polysaccharide of ophthalmic use, was taken as example of solute of interest. For a specific water-hydrated hydrogel material, differential scanning calorimetry experiments showed that a large fraction of the hydration water accounted for loosely-bound water, both before and after one week of daily-wear of the lenses. The size (of the order of magnitude of few hundreds of nanometers) of hyaluronan in aqueous solution was found to be less than the size of the pores of the lens observed by scanning electron microscopy. However, solute uptake in already-hydrated lenses was negligible by simple immersion, while a significant increase occurred under mechanical vibrations of 200 Hz, thus providing experimental evidence of mechanically triggered enhanced solute uptake, which is attributed to the release of interfacial loosely-bound water. Also other materials were taken into consideration. However, the effectiveness of mechanical vibrations for hyaluronan uptake is restricted to lenses containing interfacial loosely-bound water. Indeed, loosely-bound water is expected to be bound to the polymer with bonding energies of the order of magnitude of 10-100 J/g, which are compatible with the energy input supplied by the vibrations. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Power Profiles of Commercial Multifocal Soft Contact Lenses.

    PubMed

    Kim, Eon; Bakaraju, Ravi C; Ehrmann, Klaus

    2017-02-01

    To evaluate the optical power profiles of commercially available soft multifocal contact lenses and compare their optical designs. The power profiles of 38 types of multifocal contact lenses-three lenses each-were measured in powers +6D, +3D, +1D, -1D, -3D, and -6D using NIMO TR1504 (Lambda-X, Belgium). All lenses were measured in phosphate buffered saline across 8 mm optic zone diameter. Refractive index of each lens material was measured using CLR 12-70 (Index Instruments, UK), which was used for converting measured power in the medium to in-air radial power profiles. Three basic types of power profiles were identified: center-near, center-distance, and concentric-zone ring-type designs. For most of the lens types, the relative plus with respect to prescription power was lower than the corresponding spectacle add. For some lens types, the measured power profiles were shifted by up to 1D across the power range relative to their labeled power. Most of the lenses were designed with noticeable amounts of spherical aberration. The sign and magnitude of spherical aberration can either be power dependent or consistent across the power range. Power profiles can vary widely between the different lens types; however, certain similarities were also observed between some of the center-near designs. For the more recently released lens types, there seems to be a trend emerging to reduce the relative plus with respect to prescription power, include negative spherical aberration, and keep the power profiles consistent across the power range.

  8. Colored cosmetic contact lenses: an unsafe trend in the younger generation.

    PubMed

    Singh, Shwetambari; Satani, Dipali; Patel, Amit; Vhankade, Ravinder

    2012-07-01

    To identify the microbiological profile and evaluate the clinical course and outcomes in patients who developed severe infectious keratitis after colored cosmetic contact lens wear. This case series includes 13 patients who developed severe infectious keratitis after colored cosmetic contact lens wear. A detailed history regarding contact lens availability and storage and handling techniques was taken. All patients underwent standard diagnostic microbiological evaluation followed by culture-guided topical antimicrobial therapy. Of 13 patients, 8 were male and 5 were female, with mean age at presentation of 19 ± 3.8 years. All patients were emmetropic, and lenses were worn solely for cosmetic purposes. Seven lenses were dispensed without prescription or fitting from an unlicensed optical shop, 5 patients had shared lenses with friends/relatives, and 1 patient obtained the lens from the garbage. None of the patients followed the recommended contact lens handling and storage techniques. The causative microorganisms included Pseudomonas aeruginosa (54%), Staphylococcus aureus (25%), and Staphylococcus epidermidis (17%), with 1 case of viral keratitis. In 62% of cases, ulcer size was ≥5 × 5 mm and posttreatment corrected visual acuity was 6/24 or less. All patients responded well to topical antimicrobials, and none required surgical intervention. Over-the-counter use of decorative lenses as a cosmetic aid is rapidly increasing. Easy and unmonitored availability of these cosmetic lenses is followed by severe sight-threatening complications in young emmetropic individuals.

  9. In-office microwave disinfection of soft contact lenses

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Harris, M.G.; Rechberger, J.; Grant, T.

    1990-02-01

    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

  10. IgE antibody on worn highly oxygen-permeable silicone hydrogel contact lenses from patients with contact lens-induced papillary conjunctivitis (CLPC).

    PubMed

    Zhao, Zhenjun; Fu, Han; Skotnitsky, Cheryl C; Sankaridurg, Padmaja R; Willcox, Mark D P

    2008-03-01

    To investigate whether the level of IgE is increased in the eyes of patients during general contact lens-induced papillary conjunctivitis (CLPC) events, which involve enlarged papillae across the entire palpebral conjunctiva, or local CLPC events, in which papillae are confined to one or two parts of the area. Worn contact lenses were collected and soaked in phosphate-buffered saline. The levels of eluted IgE and IgE retained on contact lenses were detected by enzyme-linked immunosorbent assay. IgE was detected in 6 of 12 cases of general CLPC, 8 of 21 cases of local CLPC, and none of 14 control contact lenses. The average level of eluted IgE was 0.54 +/- 1.06 IU/contact lens, 0.28 +/- 0.54 IU/contact lens, and 0.04 +/- 0.06 IU/contact lens for general CLPC, local CLPC, and the control group, respectively. The incidences of positive IgE were significantly higher in patients with CLPC (general and local) than in control subjects, but no statistical difference was found between general and local CLPC. Generally higher amounts of retained IgE were detected on contact lenses that had increased levels of eluted IgE. Contact lenses that were collected before or after a CLPC event did not show increased levels of IgE. The level of IgE is increased in the eyes of some patients during an acute event of CLPC. The similar incidence of IgE-positive cases and levels of IgE from general and local CLPC contact lenses suggest that the conditions may share similar causal pathways.

  11. LogMAR and Stereoacuity in Keratoconus Corrected with Spectacles and Rigid Gas-permeable Contact Lenses.

    PubMed

    Nilagiri, Vinay Kumar; Metlapally, Sangeetha; Kalaiselvan, Parthasarathi; Schor, Clifton M; Bharadwaj, Shrikant R

    2018-04-01

    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.

  12. An Investigation and Analysis of the Vestibulo-Ocular Reflex (VOR) in a Vibration Environment

    DTIC Science & Technology

    2013-03-01

    could not have had breast implants. Participants with corrective vision through LASIK , PRK or soft contacts were qualified but individuals requiring...corrective lenses (glasses/contact lenses)? YES/NO Have you had corrective eye surgery ( PRK / LASIK )? YES/NO Have you been diagnosed or...Figure 6. Relative Intensity vs . Forward Current for Everlight 5mm Infrared LED ........ 30 Figure 7. IR LED Circuit

  13. Lathe-cut hydrophilic contact lenses: report of 100 clinical cases.

    PubMed

    Espy, J W

    1978-10-01

    In a review of the literature, it became apparent that there were very few articles describing the advantages, as well as the fitting techniques, of lathe-cut hydrophilic contact lenses. Few practitioners, including those who fit other types of hydrophilic lenses and hard lenses, have had any experience with this lens, and considerable interest has been generated by fragmentary reports of good results. This paper describes in detail the geometry of the first lathe-cut hydrophilic lens approved by the Federal Drug Administration, the fitting methods utilizing trial lenses, and the results of 100 patients successfully fitted.

  14. LASIK

    MedlinePlus Videos and Cool Tools

    ... of this Web site is to provide objective information to the public about LASIK surgery. See other ... undergoing LASIK surgery. This web site also provides information on FDA’s role in LASIK surgery, FDA’s current ...

  15. Contact lens-induced circumlimbal staining in silicone hydrogel contact lenses worn on a daily wear basis.

    PubMed

    Maïssa, Cécile; Guillon, Michel; Garofalo, Renee J

    2012-01-01

    The principal objective of the study was to measure the conjunctival staining produced in the circumlimbal region by silicone hydrogel contact lenses with different edge designs. The secondary objective was to investigate the association between circumlimbal staining and comfort. Four silicone hydrogel contact lenses: ACUVUE OASYS (knife edge design), AIR OPTIX, Biofinity (chisel edge rounded edge combination), and PureVision (rounded edge design), and 1 hydrogel contact lens, ACUVUE 2 (knife edge design), were tested. The study was conducted on a cohort population of 27 established soft contact lens wearers, who wore each contact lens type, in a random order, for a period of 10 (±2) days. Circumlimbal staining was measured in a double-masked fashion through image analysis of digital photographs of lissamine green taken under controlled experimental conditions. The results obtained showed that contact lens edge design was the primary factor controlling circumlimbal staining for silicone hydrogel lenses: a rounded edge away from the ocular surface produced the lowest staining (average, 0.19%) and a knife edge in close apposition to the ocular surface produced the highest staining (average, 1.34%). Contact lens material rigidity was also identified to affect circumlimbal staining and an inverse association between circumlimbal staining and contact lens comfort was demonstrated: the rounded edge design produced the lowest comfort (72 of 100) and the knife edge design produced the highest (87 out of 100). Soft contact lens wear induces circumlimbal staining, the level of staining being influenced by the contact lens edge design. However, high level of circumlimbal staining is not associated with decreased comfort.

  16. Microbiologic Examination of Bandage Contact Lenses Used after Corneal Collagen Cross-linking Treatment.

    PubMed

    Yuksel, Erdem; Yalcin, Nuriye Gokçen; Kilic, Gaye; Cubuk, Mehmet Ozgur; Ozmen, Mehmet Cuneyt; Altay, Aylin; Çağlar, Kayhan; Bilgihan, Kamil

    2016-01-01

    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.

  17. Controlled Release of Multiple Therapeutics from Silicone Hydrogel Contact Lenses.

    PubMed

    White, Charles James; DiPasquale, Stephen Anthony; Byrne, Mark Edward

    2016-04-01

    The majority of contact lens wearers experience a significant level of ocular discomfort associated with lens wear, often within hours of wear, related to dry lenses, inflammation, protein adhesion to the lens surface, etc. Application of controlled drug release techniques has focused on the incorporation and/or release of a single comfort molecule from a lens including high molecular weight comfort agents or pharmaceutical agents. Previous studies have sought to mitigate the occurrence of only single propagators of discomfort. Clinical studies with eye drop solutions have shown that a mixture of diverse comfort agents selected to address multiple propagators of discomfort provide the greatest and longest lasting sensations of comfort for the patient. In this paper, multiple propagators of discomfort are addressed through the simultaneous release of four molecules from a novel contact lens to ensure high level of lens wear comfort. Silicone hydrogel contact lenses were engineered via molecular imprinting strategies to simultaneously release up to four template molecules including hydropropyl methylcellulose (HPMC), trehalose, ibuprofen, and prednisolone. By adjusting the ratio of functional monomer to comfort molecule, a high level of control was demonstrated over the release rate. HPMC, trehalose, ibuprofen, and prednisolone were released at therapeutically relevant concentrations with varying rates from a single lens. The results indicate use as daily disposable lenses for single day release or extended-wear lenses with multiple day release. Imprinted lenses are expected to lead to higher efficacy for patients compared to topical eye drops by improving compliance and mitigating concentration peaks and valleys associated with multiple drops.

  18. Controlled Release of Multiple Therapeutics from Silicone Hydrogel Contact Lenses

    PubMed Central

    White, Charles J.; DiPasquale, Stephen A.; Byrne, Mark E.

    2016-01-01

    Purpose The majority of contact lens wearers experience a significant level of ocular discomfort associated with lens wear, often within hours of wear, related to dry lenses, inflammation, protein adhesion to the lens surface, etc. Application of controlled drug release techniques has focused on the incorporation and/or release of a single comfort molecule from a lens including high molecular weight comfort agents or pharmaceutical agents. Previous studies have sought to mitigate the occurrence of only single propagators of discomfort. Clinical studies with eye drop solutions have shown that a mixture of diverse comfort agents selected to address multiple propagators of discomfort provide the greatest and longest lasting sensations of comfort for the patient. In this paper, multiple propagators of discomfort are addressed through the simultaneous release of four molecules from a novel contact lens to ensure high level of lens wear comfort. Methods Silicone hydrogel contact lenses were engineered via molecular imprinting strategies to simultaneously release up to four template molecules including hydropropyl methylcellulose (HPMC), trehalose, ibuprofen, and prednisolone. Results By adjusting the ratio of functional monomer to comfort molecule, a high level of control was demonstrated over the release rate. HPMC, trehalose, ibuprofen, and prednisolone were released at therapeutically relevant concentrations with varying rates from a single lens. Conclusions The results indicate use as daily disposable lenses for single day release or extended-wear lenses with multiple day release. Imprinted lenses are expected to lead to higher efficacy for patients compared to topical eye drops by improving compliance and mitigating concentration peaks and valleys associated with multiple drops. PMID:26945177

  19. Influence of protein deposition on bacterial adhesion to contact lenses.

    PubMed

    Subbaraman, Lakshman N; Borazjani, Roya; Zhu, Hua; Zhao, Zhenjun; Jones, Lyndon; Willcox, Mark D P

    2011-08-01

    The aim of the study is to determine the adhesion of Gram positive and Gram negative bacteria onto conventional hydrogel (CH) and silicone hydrogel (SH) contact lens materials with and without lysozyme, lactoferrin, and albumin coating. Four lens types (three SH-balafilcon A, lotrafilcon B, and senofilcon A; one CH-etafilcon A) were coated with lysozyme, lactoferrin, or albumin (uncoated lenses acted as controls) and then incubated in Staphylococcus aureus (Saur 31) or either of two strains of Pseudomonas aeruginosa (Paer 6294 and 6206) for 24 h at 37 °C. The total counts of the adhered bacteria were determined using the H-thymidine method and viable counts by counting the number of colony-forming units on agar media. All three strains adhered significantly lower to uncoated etafilcon A lenses compared with uncoated SH lenses (p < 0.05). Lysozyme coating on all four lens types increased binding (total and viable counts) of Saur 31 (p < 0.05). However, lysozyme coating did not influence P. aeruginosa adhesion (p > 0.05). Lactoferrin coating on lenses increased binding (total and viable counts) of Saur 31 (p < 0.05). Lactoferrin-coated lenses showed significantly higher total counts (p < 0.05) but significantly lower viable counts (p < 0.05) of adhered P. aeruginosa strains. There was a significant difference between the total and viable counts (p < 0.05) that were bound to lactoferrin-coated lenses. Albumin coating of lenses increased binding (total and viable counts) of all three strains (p < 0.05). Lysozyme deposited on contact lenses does not possess antibacterial activity against certain bacterial strains, whereas lactoferrin possess an antibacterial effect against strains of P. aeruginosa.

  20. Physicochemical factors influencing bacterial transfer from contact lenses to surfaces with different roughness and wettability.

    PubMed

    Vermeltfoort, Pit B J; van der Mei, Henny C; Busscher, Henk J; Hooymans, Johanna M M; Bruinsma, Gerda M

    2004-11-15

    The aim of this study was to determine the transfer of Pseudomonas aeruginosa No. 3 and Staphylococcus aureus 835 from contact lenses to surfaces with different hydrophobicity and roughness. Bacteria were allowed to adhere to contact lenses (Surevue, PureVision, or Focus Night & Day) by incubating the lenses in a bacterial suspension for 30 min. The contaminated lenses were put on a glass, poly(methylmethacrylate), or silicone rubber substratum, shaped to mimic the eye. After 2 and 16 h, lenses were separated from the substrata and bacteria were swabbed off from the respective surfaces and resuspended in saline. Appropriate serial dilutions of these suspensions were made, from which aliquots were plated on agar for enumeration. Bacterial transfer varied between 4 and 60%, depending on the combination of strain, contact time, contact lens, and substratum surface. For P. aeruginosa No. 3, transfer was significantly higher after 16 h than after 2 h, whereas less increase with time was seen for S. aureus 835. Bacterial transfer from all tested contact lenses was least to silicone rubber, the most hydrophobic and roughest substratum surface included. (c) 2004 Wiley Periodicals, Inc.

  1. The Antibiofilm efficacy of nitric oxide on soft contact lenses.

    PubMed

    Kim, Dong Ju; Park, Joo-Hee; Kim, Marth; Park, Choul Yong

    2017-11-21

    To investigate the antibiofilm efficacy of nitric oxide (NO) on soft contact lenses. Nitrite (NO precursor) release from various concentrations (0-1000 μM) of sodium nitrite (NaNO 2, NO donor) was measured by Griess Assay. Cell viability assay was performed using human corneal epithelial cell under various concentration (0-1000 μM) of NaNO 2 . Biofilm formation on soft contact lenses was achieved by adding Staphylococcus aureus or Pseudomonas aeruginosa to the culture media. Various concentrations of NaNO 2 (0-1000 μM) were added to the culture media, each containing soft contact lens. After incubation in NaNO 2 containing culture media for 1, 3, or 7 days, each contact lens was transferred to a fresh, bacteria-free media without NaNO 2 . The bacteria in the biofilm were dispersed in the culture media for planktonic growth. After reculturing the lenses in the fresh media for 24 h, optical density (OD) of media was measured at 600 nm and colony forming unit (CFU) was counted by spreading media on tryptic soy agar plate for additional 18 h. Nitrite release from NaNO 2 showed dose-dependent suppressive effect on biofilm formation. Most nitrite release from NaNO 2 tended to occur within 30 min. The viability of human corneal epithelial cells was well maintained at tested NaNO 2 concentrations. The bacterial CFU and OD showed dose-dependent decrease in the NaNO 2 treated samples on days 1, 3 and 7 for both Staphylococcus aureus and Pseudomonas aeruginosa. NO successfully inhibited the biofilm formation by Staphylococcus aureus or Pseudomonas aeruginosa on soft contact lenses in dose-dependent manner.

  2. Evaluation of glutaraldehyde and povidone iodine for sterilization of wide-field contact vitrectomy lenses.

    PubMed

    Das, T; Sharma, S; Singh, J; Rao, V; Chalam, K V

    2001-01-01

    Wide-field vitrectomy contact lenses are currently sterilized with ethylene oxide gas, and other lenses with autoclaving. To maintain a large inventory or possibly run the risk of loss of lens quality with repeated autoclaving, glutaraldehyde 2% and povidone iodine 5% solution were evaluated as possible sterilizing agents. Ethylene oxide presterilized lenses were contaminated with known concentrations (10(5) organisms/mL) of bacteria (S. epidemidis, P. aeruginosa, B. subtilis), and fungi (A. flavus, C. albicans) for 5 minutes. The test lenses were treated with glutaraldehyde or povidone iodine for 5, 10, 30, 60, and 120 minutes, and controls with sterilized water for a similar duration. Following treatment, both test and control lenses were sampled with sterile cotton swabs. The swabs were cultured for bacteria (tryptone soya broth 48 hours), and fungi (Saubourd's dextrose broth 5 days). The culture was negative for both glutaraldehyde- and povidone iodine-treated lenses against all organisms at all time points except B subtilis, which needed 120 minutes treatment. Two hours contact time with glutaraldehyde 2% or providone iodine 5% can sterilize vitrectomy contact lenses against common bacteria and fungi without affecting lens quality.

  3. Proteomic analysis of protein deposits on worn daily wear silicone hydrogel contact lenses

    PubMed Central

    Wei, Xiaojia; Aliwarga, Yulina; Carnt, Nicole A.; Garrett, Qian; Willcox, Mark D.P.

    2008-01-01

    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

  4. The Future of Myopia Control Contact Lenses.

    PubMed

    Gifford, Paul; Gifford, Kate Louise

    2016-04-01

    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

  5. Silicone hydrogel contact lenses surface promote Acanthamoeba castellanii trophozoites adherence: qualitative and quantitative analysis.

    PubMed

    Omaña-Molina, Maritza A; González-Robles, Arturo; Salazar-Villatoro, Lizbeth; Bernal-Escobar, Alexander; Durán-Díaz, Angel; Méndez-Cruz, Adolfo René; Martínez-Palomo, Adolfo

    2014-05-01

    To describe the adhesion properties of Acanthamoeba castellanii trophozoites to silicone hydrogel contact lenses of first generation (lotrafilcon A), second generation (galyfilcon A), and third generation (comfilcon A) and correlate the results with their specific surface characteristics, time of interaction, and suspension media. Qualitative and quantitative assessments of the adhesion of 200 trophozoites of A. castellanii on contact lenses in culture medium (Bacto Casitone) and isotonic saline (IS) at different time points (15 minutes and 6 hours) were determined. By scanning electron microscopy, A. castellanii trophozoites were observed firmly adhered to the surface of hydrogel lenses after 15 minutes of interaction. The surface of lotrafilcon A lenses on which amoebae adhere better (16.4±10.2 amoebae/lens section) is rough and folded, which increases the contact surface with trophozoites, allowing acanthopodia to attach firmly. Contrarily, galyfilcon A lenses have a smoother surface, and lower numbers of amoebae were observed adhered to these lenses (4.7±2.9 amoebae/lens section). Even fewer amoebae adhered to the smoother surface of the comfilcon A lens (2.2±1.7 amoebae/lens section). Trophozoites showed similar behavior in both Bacto Casitone medium and IS. A rough surface may contribute to better adhesion of amoebae to silicone hydrogel lenses. Although a reduced numbers of trophozoites adhered to smooth lenses, trophozoites are a risk factor for amoebic keratitis. Isotonic saline facilitated trophozoite survival, suggesting that homemade saline solutions may contribute to the persistence of trophozoites, especially when there is no proper hygiene regimen used with the contact lens cases.

  6. Bilateral corneal erosion due to retail purchase of unfitted prescription contact lenses: a case report.

    PubMed

    Tseng, Santos Shan-Yu; Yang, Winston Wen-Ching; Hsiao, John Ching-Jen

    2008-12-01

    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.

  7. Comfort, Ocular Dryness, and Equilibrium Water Content Changes of Daily Disposable Contact Lenses.

    PubMed

    Insua Pereira, Eduardo; Lira, Madalena

    2017-10-26

    The objective of this investigation was to evaluate the level of comfort and ocular dryness during wear with six daily disposable contact lenses (DDCL) and also determine the changes in contact lens equilibrium water content (EWC) resulting from their wear. In this contralateral open trial, 27 subjects were randomly fitted with six DDCL (stenfilcon A, delefilcon A, nelfilcon A, narafilcon A, nesofilcon A, and omafilcon A). The evaluation of comfort and ocular dryness sensation was recorded by the participants at two moments of the day (11 AM and 5 PM) over a period of 10 days of contact lens wear. The assessment was made with the aid of visual analogue scales (0-10). The refractive index of 54 contact lenses was accessed by a single operator using a digital automated refractometer (CLR 12-70; Index Instruments). The EWC of the lenses was estimated based on its refractive index values. Comfort ratings were slightly higher for delefilcon A (9.56±0.67, P=0.01) and narafilcon A (9.40±0.93, P=0.01) and these lenses wearers also reported less ocular dryness. The results revealed a pronounced water content reduction for omafilcon A (P=0.002), narafilcon A (P=0.008), and nesofilcon A (P=0.003). Although changes in subjective responses and EWC were distinct among the materials analyzed, all the contact lenses performed well during the 10 days of wear.

  8. On-eye optical quality of daily disposable contact lenses for different wearing times.

    PubMed

    Montés-Micó, Robert; Belda-Salmerón, Lurdes; Ferrer-Blasco, Teresa; Albarrán-Diego, César; García-Lázaro, Santiago

    2013-09-01

    To quantify the optical quality of various daily disposable contact lenses in vivo and to ascertain its variation in terms of wearing time by means of objective non-invasive determination of wavefront patterns. The crx1 adaptive-optics system was used to measure the wavefront aberrations in 15 myopic eyes before and at 2-h intervals after contact lens fitting, over a 12-h wearing period. Seven types of contact lenses having different material, water content and lens design were evaluated in this study: Dailies Total1, Dailies AquaComfort Plus, Proclear 1 Day, 1-Day Acuvue TruEye, 1-Day Acuvue moist, SofLens daily disposable and Clariti 1-Day. The aberration data were analysed by fitting Zernike polynomials up to the 5th-order for 3 and 5-mm pupils. The optical quality under each condition and at each point in time was described by means of the Root-Mean-Square (RMS) value of wavefront aberration, Modulation Transfer Function (MTF), Point Spread Function and cut-off spatial frequency. A RMS increase was observed after contact lens fitting as well as over time, both for a 3-mm and a 5-mm pupil. Each type of lens induced a different amount of wavefront aberrations, which vary over time also in a different manner. Dailies Total1 showed the lowest RMS values both at baseline and at the end of the day. In addition, Dailies Total1 provided the best MTF out of all the contact lenses that were assessed. These observations were reflected in higher cut-off spatial frequencies and visual resolution both at baseline and after 12 h of wearing time. Aberrometry makes it possible to analyse accurately and in vivo the optical quality of contact lenses and to assess how lenses having different characteristics - such as material or water content - behave for different wearing times. These variations across contact lenses may result in differences in visual performance. © 2013 The Authors Ophthalmic & Physiological Optics © 2013 The College of Optometrists.

  9. In vitro and in vivo evaluation of ketotifen fumarate-loaded silicone hydrogel contact lenses for ocular drug delivery.

    PubMed

    Xu, Jinku; Li, Xinsong; Sun, Fuqian

    2011-02-01

    The purpose of this work was to evaluate the usefulness of silicone hydrogel contact lenses loaded with ketotifen fumarate for ocular drug delivery. First, silicone contact lenses were prepared by photopolymerization of bitelechelic methacrylated polydimethylsiloxanes macromonomer, 3-methacryloxypropyltris(trimethylsiloxy)silane, and N,N-dimethylacrylamide using ethylene glycol dimethacrylate as a cross-linker and Darocur 1173 as an initiator followed by surface plasma treatment. Then, the silicone hydrogel matrices of the contact lenses were characterized by equilibrium swelling ratio (ESR), tensile tests, ion permeability, and surface contact angle. Finally, the contact lenses were loaded with ketotifen fumarate by pre-soaking in drug solution to evaluate drug loading capacity, in vitro and in vivo release behavior of the silicone contact lenses. The results showed that ESR and ion permeability increase, and the surface contact angle and tensile strength decreased with the increase of DMA component in the silicone hydrogel. The drug loading and in vitro releases were dependent on the hydrogel composition of hydrophilic/hydrophobic phase of the contact lenses. In rabbit eyes, the pre-soaked contact lenses sustained ketotifen fumarate release for more than 24 h, which leads to a more stable drug concentration and a longer mean retention time in tear fluid than that of eye drops of 0.05%.

  10. The effect of protein-coated contact lenses on the adhesion and viability of gram negative bacteria.

    PubMed

    Williams, Timothy J; Schneider, Rene P; Willcox, Mark D P

    2003-10-01

    Gram negative bacterial adhesion to contact lenses can cause adverse responses. During contact lens wear, components of the tear film adsorb to the contact lens. This study aimed to investigate the effect of this conditioning film on the viability of bacteria. Bacteria adhered to contact lenses which were either unworn, worn for daily-, extended- or overnight-wear or coated with lactoferrin or lysozyme. Numbers of viable and total cells were estimated. The number of viable attached cells was found to be significantly lower than the total number of cells on worn (50% for strain Paer1 on daily-wear lenses) or lactoferrin-coated lenses (56% for strain Paer1). Lysozyme-coated lenses no statistically significant effect on adhesion. The conditioning film gained through wear may not inhibit bacterial adhesion, but may act adversely upon those bacteria that succeed in attaching.

  11. Prevention of bacterial colonization of contact lenses with covalently attached selenium and effects on the rabbit cornea.

    PubMed

    Mathews, Steven M; Spallholz, Julian E; Grimson, Mark J; Dubielzig, Richard R; Gray, Tracy; Reid, Ted W

    2006-08-01

    Although silicone hydrogel materials have produced many corneal health benefits to patients wearing contact lenses, bacteria that cause acute red eye or corneal ulcers are still a concern. A coating that inhibits bacterial colonization while not adversely affecting the cornea should improve the safety of contact lens wear. A covalent selenium (Se) coating on contact lenses was evaluated for safety using rabbits and prevention of bacterial colonization of the contact lenses in vitro. Contact lenses coated with Se were worn on an extended-wear schedule for up to 2 months by 10 New Zealand White rabbits. Corneal health was evaluated with slit-lamp biomicroscopy, pachymetry, electron microscopy, and histology. Lenses worn by the rabbits were analyzed for protein and lipid deposits. In addition, the ability of Se to block bacterial colonization was tested in vitro by incubating lenses in a Pseudomonas aeruginosa broth followed by scanning electron microscopy of the contact lens surface. The covalent Se coating decreased bacterial colonization in vitro while not adversely affecting the corneal health of rabbits in vivo. The Se coating produced no noticeable negative effects as observed with slit-lamp biomicroscopy, pachymetry, electron microscopy, and histology. The Se coating did not affect protein or lipid deposition on the contact lenses. The data from this pilot study suggest that a Se coating on contact lenses might reduce acute red eye and bacterial ulceration because of an inhibition of bacterial colonization. In addition, our safety tests suggest that this positive effect can be produced without an adverse effect on corneal health.

  12. Visual performance of four simultaneous-image multifocal contact lenses under dim and glare conditions.

    PubMed

    García-Lázaro, Santiago; Ferrer-Blasco, Teresa; Madrid-Costa, David; Albarrán-Diego, César; Montés-Micó, Robert

    2015-01-01

    To assess and compare the effects of four simultaneous-image multifocal contact lenses (SIMCLs), and those with distant-vision-only contact lenses on visual performance in early presbyopes, under dim conditions, including the effects of induced glare. In this double-masked crossover study design, 28 presbyopic subjects aged 40 to 46 years were included. All participants were fitted with the four different SIMCLs (Air Optix Aqua Multifocal [AOAM; Alcon], PureVision Multifocal [PM; Bausch & Lomb], Acuvue Oasys for Presbyopia [AOP; Johnson & Johnson Vision], and Biofinity Multifocal [BM; CooperVision]) and with monofocal contact lenses (Air Optix Aqua, Alcon). After 1 month of daily contact lens wearing, each subject's binocular distance visual acuity (BDVA) and binocular distance contrast sensitivity (BDCS) were measured using the Functional Visual Analyzer (Stereo Optical Co., Inc.) under mesopic conditions (3 candela [cd]/m) both with no glare and under the 2 levels of induced glare: 1.0 lux (glare 1) and 28 lux (glare 2). Among the SIMCLs, in terms of BDVA, AOAM and PM outperformed BM and AOP. All contact lenses performed better at level without glare, followed by Glare 1, and with the worst results obtained under glare 2. Binocular distance contrast sensitivity revealed statistically significant differences for 12 cycles per degree (cpd). Among the SIMCLs, post hoc multiple comparison testing revealed that AOAM and PM provided the best BDCS at the three luminance levels. In both cases, BDVA and BDCS at 12 cpd, monofocal contact lenses outperformed all SIMCL ones at all lighting conditions. Air Optix Aqua Multifocal and PM provided better visual performance than BM and AOP for distance vision with low addition and under dim conditions, but they all provide worse performance than monofocal contact lenses.

  13. Optimization of ceragenins for prevention of bacterial colonization of hydrogel contact lenses.

    PubMed

    Gu, Xiaobo; Jennings, Jacob D; Snarr, Jason; Chaudhary, Vinod; Pollard, Jacob E; Savage, Paul B

    2013-09-17

    We provided contact lens hydrogels with an antibacterial innate immune function using nonpeptide mimics of endogenous antimicrobial peptides. Antimicrobial peptide mimics, ceragenins, were prepared for either covalent attachment to hydrogels or for controlled elution from lenses. The lipophilicity of the ceragenins was varied incrementally to provide differing levels of association with hydrophobic domains in lenses. Ceragenin-containing lenses were challenged repeatedly with Staphylococcus aureus or Pseudomonas aeruginosa in nutrient media. Bacterial growth and biofilm formation on lenses were quantified. A ceragenin covalently fixed in lenses effectively inhibited S. aureus biofilm formation on lenses in 10% tryptic soy broth (approximately 3-log reduction), but did not reduce biofilm formation in 100% tryptic soy broth. Ceragenins designed to elute from lenses were incorporated at 1% relative to the dry weight of the lenses. The ceragenin with the optimal lipid content, CSA-138, prevented bacterial colonization of lenses for 15 days with P. aeruginosa and for 30 days with S. aureus (daily exchange of growth media and reinoculation with 10⁶ CFU). Measurement of CSA-138 elution showed that concentrations of the ceragenin never exceeded 5 μg/mL in a 24-hour period and that after 4 days of elution, concentrations dropped to <0.5 μg/mL, while maintaining antibacterial activity. Ceragenin CSA-138 appears well suited for providing an innate immune-like function to abiotic hydrogel contact lenses for extended periods of time. Elution of even low concentrations of CSA-138 (<0.5 μg) is sufficient to eliminate inocula of 10⁶ CFU of S. aureus and P. aeruginosa.

  14. Effect of surfactant chain length on drug release kinetics from microemulsion-laden contact lenses.

    PubMed

    Maulvi, Furqan A; Desai, Ankita R; Choksi, Harsh H; Patil, Rahul J; Ranch, Ketan M; Vyas, Bhavin A; Shah, Dinesh O

    2017-05-30

    The effect of surfactant chain lengths [sodium caprylate (C 8 ), Tween 20 (C 12 ), Tween 80 (C 18 )] and the molecular weight of block copolymers [Pluronic F68 and Pluronic F 127] were studied to determine the stability of the microemulsion and its effect on release kinetics from cyclosporine-loaded microemulsion-laden hydrogel contact lenses in this work. Globule size and dilution tests (transmittance) suggested that the stability of the microemulsion increases with increase in the carbon chain lengths of surfactants and the molecular weight of pluronics. The optical transmittance of direct drug-laden contact lenses [DL-100] was low due to the precipitation of hydrophobic drugs in the lenses, while in microemulsion-laden lenses, the transmittance was improved when stability of the microemulsion was achieved. The results of in vitro release kinetics revealed that drug release was sustained to a greater extent as the stability of microemulsion was improved as well. This was evident in batch PF127-T80, which showed sustained release for 15days in comparison to batch DL-100, which showed release up to 7days. An in vivo drug release study in rabbit tear fluid showed significant increase in mean residence time (MRT) and area under curve (AUC) with PF-127-T80 lenses (stable microemulsion) in comparison to PF-68-SC lenses (unstable microemulsion) and DL-100 lenses. This study revealed the correlation between the stability of microemulsion and the release kinetics of drugs from contact lenses. Thus, it was inferred that the stable microemulsion batches sustained the release of hydrophobic drugs, such as cyclosporine from contact lenses for an extended period of time without altering critical lens properties. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. The epidemiology of microbial keratitis with silicone hydrogel contact lenses.

    PubMed

    Stapleton, Fiona; Keay, Lisa; Edwards, Katie; Holden, Brien

    2013-01-01

    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.

  16. [Laboratory study of the cytotoxicity of colored soft contact lenses].

    PubMed

    Almesmary, A A

    1999-01-01

    In the clinical practice we have met with the fact that some patients did not tolerate soft coloured contact lenses even when they used them for a short time. To find whether the cause is the composition of these lenses, mainly the adding of stain, he used the laboratory test to determine cytotoxicity, the test of dynamic observation of cytotoxicity where the cells cultured in vitro are the experimental object. On the basis of the results of this test commonly used for the determination of the cytotoxicity of implantation materials, he thinks that the cause of intolerance of coloured lenses is not their toxicity but other phenomena. An individual hypersensitivity or insufficient care of lenses (the influence of disinfectants) can be among these causes.

  17. pH triggered controlled drug delivery from contact lenses: Addressing the challenges of drug leaching during sterilization and storage.

    PubMed

    Maulvi, Furqan A; Choksi, Harsh H; Desai, Ankita R; Patel, Akanksha S; Ranch, Ketan M; Vyas, Bhavin A; Shah, Dinesh O

    2017-09-01

    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.

  18. Haemophilus influenzae adherent to contact lenses associated with production of acute ocular inflammation.

    PubMed Central

    Sankaridurg, P R; Willcox, M D; Sharma, S; Gopinathan, U; Janakiraman, D; Hickson, S; Vuppala, N; Sweeney, D F; Rao, G N; Holden, B A

    1996-01-01

    Ten episodes of adverse responses to contact lens wear, including contact lens-induced acute red eye (CLARE), in which Haemophilus influenzae was isolated from contact lenses and/or from one of the external ocular sites at the time of the event, are described. All episodes occurred in patients wearing disposable hydrogel lenses on a 6-night extended-wear schedule. Two of the patients had recurrent episodes. H. influenzae was usually isolated in large numbers, and other bacteria or fungi colonizing the contact lens or the external ocular surface were usually present in low numbers. Those patients who were colonized with H. influenzae were more than 100 times as likely to have had a CLARE or infiltrative response than those subjects who were not colonized with this bacterium. H. influenzae colonization of the contact lens and eye may be subsequent to colonization of the nasopharynx because four of the seven patients presented with fever at the time of the event, with concurrent upper respiratory tract infection. Contact lens wearers should be made aware of the potential risk of CLARE associated with the wearing of contact lenses for extended periods during and subsequent to upper respiratory tract infection. PMID:8880493

  19. Controlled Release of Antibiotics From Vitamin E-Loaded Silicone-Hydrogel Contact Lenses.

    PubMed

    Paradiso, Patrizia; Serro, Ana Paula; Saramago, Benilde; Colaço, Rogério; Chauhan, Anuj

    2016-03-01

    Symptoms of bacterial and fungal keratitis are typically treated through the frequent application of antibiotic and antifungal eye drops. The high frequency of half hourly or hourly eye drop administration required to treat these indications is tedious and could reduce compliance. Here, we combine in vitro experiments with a mathematical model to develop therapeutic soft contact lenses to cure keratitis by extended release of suitable drugs. We specifically focus on increasing the release duration of levofloxacin and chlorhexidine from 1-DAY ACUVUE(®) TrueEye™ and ACUVUE OASYS(®) contact lenses by incorporating vitamin E diffusion barriers. Results show that 20% of vitamin E loading in the contact lens increases the release duration of levofloxacin to 100 h and 50 h from 1-DAY ACUVUE(®) TrueEye™ and ACUVUE OASYS(®), respectively, which is a 3- and 6-fold increase, respectively, for the 2 lenses. For chlorhexidine, the increase is 2.5- and 10-fold, for the TrueEye™ and OASYS(®), respectively, to 130 h and 170 h. The mass of drug loaded in the lenses can be controlled to achieve a daily release comparable to the commonly prescribed eye drop therapy. The vitamin E-loaded lenses retain all critical properties for in vivo use. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  20. Omni-focal refractive focus correction technology as a substitute for bi/multi-focal intraocular lenses, contact lenses, and spectacles

    NASA Astrophysics Data System (ADS)

    Ben Yaish, Shai; Zlotnik, Alex; Raveh, Ido; Yehezkel, Oren; Belkin, Michael; Lahav, Karen; Zalevsky, Zeev

    2009-02-01

    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.

  1. Quantitation of total protein deposits on contact lenses by means of amino acid analysis.

    PubMed

    Yan, G; Nyquist, G; Caldwell, K D; Payor, R; McCraw, E C

    1993-04-01

    This study was done to characterize and quantify the protein deposits on worn contact lenses and to measure the residual deposits after extraction in 2% sodium dodecyl sulfate and the total protein deposits on worn vifilcon, atlafilcon, and tefilcon lenses (Food and Drug Administration Types IV, II, and I, respectively). Contact lens extracts were separated with gel electrophoresis, and the amount of protein was estimated after silver staining and densitometry. To determine the residual deposits, the contact lenses were hydrolyzed, and amino acid analysis was carried out by reverse-phase high-performance liquid chromatography after precolumn derivatization with phenylisothiocyanate. Refinement of the hydrolysis conditions was undertaken to minimize interference by the lens polymers. The extraction removed only approximately 25% of the protein deposits. Mild hydrolytic conditions, 20 hr in 6 N HCl at 105 degrees C, were found to cause minimal polymer interference. Of the 350, 10, and 20 micrograms of protein typically determined on whole vifilcon, atlafilcon, and tefilcon lenses, the polymers were estimated to account for 4, 0.5, and less than 0.4 micrograms, respectively. Hydrolysis of worn contact lenses with subsequent amino acid separation can be applied to determine the total protein deposits without the uncertainty inherent in extraction of the deposits.

  2. Descriptive analysis of the type and design of contact lenses fitted according to keratoconus severity and morphology.

    PubMed

    Lunardi, Letícia Helena; Arroyo, Danielle; Andrade Sobrinho, Marcelo Vicente de; Lipener, César; Rosa, Juliana Maria da Silva

    2016-04-01

    Keratoconus is characterized by bilateral asymmetrical corneal ectasia that leads to inferior stromal thinning and corneal protrusion. There is currently a lack of consensus regarding the most efficacious method for fitting contact lenses in patients with keratoconus, given the various topographical patterns and evolution grades observed in affected populations. The purpose of the present study was to evaluate the association between keratoconus evolution grade and topography pattern and the type and design of fitted contact lens. We performed a retrospective analysis of contact lenses fitted in a total of 185 patients with keratoconus (325 eyes). Keratoconus was classified as either grade I, II, III, or IV based on keratometry and cone morphology (nipple, oval, globus, or indeterminate) results. A total of 325 eyes were evaluated in the present study. Of the 62 eyes classified as grade I, 66.1% were fitted with monocurve contact lenses. Of the 162 eyes classified as grade I and II, 51%, 30%, and 19% were fitted with adapted monocurve rigid gas-permeable contact lenses (RGPCL), bicurve lenses, and others lens types, respectively. Bicurve lenses were fitted in 52.1% and 62.2% of eyes classified as grade III and IV, respectively. Of the eyes classified as grade III and IV, monocurve and bicurve RGPCL were fitted in 26% and 55%, respectively. In eyes with oval keratoconus, 45%, 35%, and 20% were fitted with monocurve lenses, bicurve lenses, and other lens types, respectively. In eyes with round cones (nipple morphology), 55%, 30%, and 15% were fitted with bicurve lenses, monocurve lenses, and other lens types, respectively. Monocurve RGPCL were most frequently fitted in patients with mild to moderate keratoconus and oval cones morphology, while bicurve lenses were more frequently fitted in patients with severe and advanced keratoconus. This was probably because bicurve lenses are more appropriate for round cones due to increased corneal asphericity.

  3. The Danger of Using Tap Water with Contact Lenses

    EPA Pesticide Factsheets

    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.

  4. A new method for evaluation of compatibility of contact lenses and lens cases with contact lens disinfecting solutions.

    PubMed

    Mowrey-McKee, Mary; Borazjani, Roya; Collins, Gary; Cook, James; Norton, Susan

    2012-01-01

    The purpose of this article is to describe new methodology, antimicrobial efficacy endpoint methodology to determine compatibility of contact lens solutions, lens cases and hydrogel lenses for disinfection (AEEMC), to evaluate the effect of a contact lens and a lens case on disinfection efficacy, and to present the ring test used to justify the use of the method in multiple laboratories. A prototype solution containing chlorhexidine as the disinfecting agent and four representative lens types (group I and IV hydrogels and two silicone hydrogels) were used in these ring tests. Five laboratories participated in the chemical and microbiologic analyses. The residual chlorhexidine in lens cases containing the contact lenses was determined using high-performance liquid chromatography; uptake by the lenses was then determined by extrapolation. For the microbiologic part of the study, a contact lens was placed in the well of the lens case, inoculated at 10 to 10 cfu (colony forming units) per lens with microorganisms in 10% organic soil. The microorganisms, Pseudomonas aeruginosa, Serratia marcescens, Staphylococcus aureus, Candida albicans, and Fusarium solani, were prepared as in International Organization for Standardization (ISO) 14729. After a 3- to 10-min exposure time, the prototype solution was dispensed into each well. Aliquots of the inoculated solutions were removed at 4 and 24 hrs and 7 and 30 days and cultured in neutralizing media for determination of survivors; lenses were also cultured for survivors. Chemical uptake data confirmed the differences observed in kill of the challenge organisms according to lens type. It was observed that the culturing of the solution provided adequate data to show the effect of a lens on disinfection efficacy of a lens care product. The findings of the ring test indicated that the separate culturing of the contact lenses is not necessary for routine assessment. The methodology in the November 12, 2008, draft standard (AEEMC

  5. Objective assessment of the effect of pupil size upon the power distribution of multifocal contact lenses.

    PubMed

    Papadatou, Eleni; Del Águila-Carrasco, Antonio J; Esteve-Taboada, José J; Madrid-Costa, David; Cerviño-Expósito, Alejandro

    2017-01-01

    To analytically assess the effect of pupil size upon the refractive power distributions of different designs of multifocal contact lenses. Two multifocal contact lenses of center-near design and one multifocal contact lens of center-distance design were used in this study. Their power profiles were measured using the NIMO TR1504 device (LAMBDA-X, Belgium). Based on their power profiles, the power distribution was assessed as a function of pupil size. For the high addition lenses, the resulting refractive power as a function of viewing distance (far, intermediate, and near) and pupil size was also analyzed. The power distribution of the lenses was affected by pupil size differently. One of the lenses showed a significant spread in refractive power distribution, from about -3 D to 0 D. Generally, the power distribution of the lenses expanded as the pupil diameter became greater. The surface of the lens dedicated for each distance varied substantially with the design of the lens. In an experimental basis, our results show how the lenses power distribution is affected by the pupil size and underlined the necessity of careful evaluation of the patient's visual needs and the optical properties of a multifocal contact lens for achieving the optimal visual outcome.

  6. Tonopen XL assessment of intraocular pressure through silicone hydrogel contact lenses.

    PubMed

    Schornack, Muriel; Rice, Melissa; Hodge, David

    2012-09-01

    To assess the accuracy of Tonopen XL measurement of intraocular pressure (IOP) through low-power (-0.25 to -3.00) and high power (-3.25 to -6.00) silicone hydrogel lenses of 3 different materials (galyfilcon A, senofilcon A, and lotrafilcon B). Seventy-eight patients were recruited for participation in this study. All were habitual wearers of silicone hydrogel contact lenses, and none had been diagnosed with glaucoma, ocular hypertension, or anterior surface disease. IOP was measured with and without lenses in place in the right eye only. Patients were randomized to initial measurement either with or without the lens in place. A single examiner collected all data. No statistically significant differences were noted between IOP measured without lenses and IOP measured through low-power lotrafilcon B lenses or high-power or low-power galyfilcon A and senofilcon A lenses. However, we did find a statistically significant difference between IOP measured without lenses and IOP measured through high-power lotrafilcon B lenses. In general, Tonopen XL measurement of IOP through silicone hydrogel lenses may be sufficiently accurate for clinical purposes. However, Tonopen XL may overestimate IOP if performed through a silicone hydrogel lens of relatively high modulus.

  7. Surface chemical structure for soft contact lenses as a function of polymer processing.

    PubMed

    Grobe, G L; Valint, P L; Ammon, D M

    1996-09-01

    The surface chemistry and topography of cast-molded Etafilcon-A and doubled-sided lathed Etafilcon-A soft contact lenses were determined to be significantly different. The variations in surface chemical and morphologic structure between the two lenses were the result of contact lens manufacturing methods. The surface of the cast-molded Etafilcon-A had a consistently less rough surface compared to the doubled sided lathed Etafilcon-A as determined by atomic force microscopy. The surface of the doubled sided lathed Etafilcon-A contained primarily silicone and wax contamination in addition to minute amounts of HEMA. The cast-molded Etafilcon-A had an elemental and chemical content which was consistent with the polymer stoichiometry. Contact angle wettability profiles revealed inherent wettability differences between the two lenses types. The cast-molded Etafilcon-A had an inherently greater water wettability, polarity, and critical surface tension. This means that these two lenses cannot be compared as similar or identical lens materials in terms of surface composition. The manufacturing method used to produce a soft contact lens directly determines the surface elemental and chemical structure as well as the morphology of the finished lens material. These results suggest possible differences in the clinical comfort, spoilage, and lubricity felt during patient wear.

  8. Fungal keratitis and contact lenses: an old enemy unrecognized or a new nemesis on the block?

    PubMed

    Tuli, Sonal S; Iyer, Sandhya A; Driebe, William T

    2007-11-01

    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.

  9. [Profile of medical students from the Universidade Estadual Paulista-UNESP--Botucatu, who wear contact lenses].

    PubMed

    Vidotti, Vanessa Gonçalves; Kamegasawa, Amélia

    2006-01-01

    To analyze the ametropy, way of acquisition, the care and complications related to contact lens wear among medical students from Faculdade de Medicina de Botucatu da Universidade Estadual Paulista-UNESP--Botucatu (SP). Questionnaire applied to students from the 1st to the 6th year of the Medical school of the Faculdade de Medicina de Botucatu da Universidade Estadual Paulista-UNESP--Botucatu (SP), forming an analytical cross-sectional survey. 27.4% of the students use contact lenses, and among them 94.8% use soft contact lenses and 98% have negative degree. 46.9% discard their contact lens monthly. 63.9% have an average daily use of 14 hours, 14.1% acquire the contact lenses from optician stores or at pharmacies and 46.5% of the students clean their contact lenses when they put them on and take them off. Regarding complications, 51.0% reported ocular redness; 44.5%, blurred vision; and 42.6%, foreign body sensation, whereas only 4 students reported "keratitis". We concluded that the inadequate adaptation that occurs even in users knowledgeable about this issue such as medical students, has increased the risk of complications. This fact indicates that more attention must be paid to contact lens care in order to prevent permanent visual deficit.

  10. Multi-centre evaluation of two daily disposable contact lenses.

    PubMed

    Walker, Jon; Young, Graeme; Hunt, Chris; Henderson, Terri

    2007-05-01

    To evaluate the clinical performance of two daily disposable contact lenses: 1-DAY ACUVUE (1DA) (etafilcon A, Johnson & Johnson Vision Care) and FOCUS DAILIES with AquaComfort (FD) (nelfilcon A, CIBA Vision, Inc.), which contains a quickly released moisture enhancing agent, polyvinyl alcohol (PVA). This was a 1-week, daily wear, subject-masked, bilateral, parallel group study with subjects randomly assigned to one of two daily disposable soft contact lenses. Subjects were existing soft contact lens wearers in the age range 18-39 years with a spherical refraction between -0.50 and -6.00 D. Subjects were assessed at baseline and after 1 week. Assessments included both subjective (symptoms, wearing time, vision) and objective (lens fit and ocular health) outcomes. Twenty clinical sites enrolled 282 subjects (74% female) of whom 276 (98%) successfully completed the study. Significantly more 1DA wearers reported higher mean comfort scores than with FD (3.95 versus 3.41, respectively, P<0.0001). End-of-day comfort means were also significantly higher with the 1DA group compared to the FD group (3.3 versus 3.0, P=0.03). The 1DA group reported significantly longer mean overall wearing time (1DA was worn on average 0.66+/-0.30 h longer than FD, P=0.03) and longer mean comfortable wearing time (1DA was worn on average 1.73+/-0.35 h longer than FD, P<0.0001). The 1DA lens generally showed significantly better on-eye fitting in terms of movement in primary (P<0.0001) and upgaze (P<0.0001) and ease of removal from the eye (92% versus 63%, P<0.0001) compared to FD. There was significantly less corneal staining observed with the 1DA wearing eyes compared with the FD wearing eyes (23% versus 45%, respectively, P<0.0001). Finally, there was a weak correlation between corneal staining and comfort for FD (r=0.27, P=0.002, n=136), but not for 1DA (r=-0.11, P=0.18, n=140). Subjective and objective clinical performance differences between two commonly used daily disposable lenses

  11. Adhesion of Pseudomonas aeruginosa and Staphylococcus epidermidis to silicone-hydrogel contact lenses.

    PubMed

    Henriques, Mariana; Sousa, Cláudia; Lira, Madalena; Elisabete, M; Oliveira, Real; Oliveira, Rosário; Azeredo, Joana

    2005-06-01

    The purpose of this study is to compare the adhesion capabilities of the most important etiologic agents of microbial ocular infection to the recently available silicone-hydrogel lenses with those to a conventional hydrogel lens. In vitro static adhesion assays of Pseudomonas aeruginosa 10,145, Staphylococcus epidermidis 9142 (biofilm-positive), and 12,228 (biofilm-negative) to two extended-wear silicone-hydrogel lenses (balafilcon A and lotrafilcon A), a daily wear silicone-hydrogel lens (galyfilcon A) and a conventional hydrogel (etafilcon A) were performed. To interpret the adhesion results, lens surface relative hydrophobicity was assessed by water contact angle measurements. P. aeruginosa and S. epidermidis 9142 exhibited greater adhesion capabilities to the extended wear silicone-hydrogel lenses than to the daily wear silicone- and conventional hydrogel lenses (p < 0.05). No statistical differences were found between the adhesion extent of these strains to galyfilcon A and etafilcon A. The biofilm negative strain of S. epidermidis adhered in larger extents to the silicone-hydrogel lenses than to the conventional hydrogel (p < 0.05), but in much lower amounts than the biofilm-positive strain. The water contact angle measurements revealed that the extended wear silicone-hydrogel lenses are hydrophobic, whereas the daily wear silicone- and conventional hydrogel lenses are hydrophilic. As a result of their hydrophobicity, the extended wear silicone-hydrogel lenses (lotrafilcon A and balafilcon A) may carry higher risk of microbial contamination than both the hydrophilic daily wear silicone-hydrogel lens, galyfilcon A and the conventional hydrogel lens, etafilcon A.

  12. Microbial changes in conjunctival flora with 30-day continuous-wear silicone hydrogel contact lenses.

    PubMed

    Iskeleli, Güzin; Bahar, Hrisi; Eroglu, Ebru; Torun, Muzeyyen Mamal; Ozkan, Sehirbay

    2005-05-01

    To determine the effect of 30-day continuous-wear silicone hydrogel contact lenses on the conjunctival flora in asymptomatic wearers. The authors studied 29 eyes of 15 patients wearing Focus NIGHT & DAY silicone hydrogel contact lenses for up to 30 nights of continuous wear. The average age of the patients was 25.54 +/- 8.98 years. Cultures of the inferior cul-de-sac were taken bilaterally from all eyes, before and after lens wear in asymptomatic patients. The isolation and identification of bacteria were made by standard clinical laboratory methods. The number of eyes whose conjunctival cultures were sterile before using the lenses significantly decreased (P = 0.0005), and the number of eyes with a growth of coagulase-negative staphylococci and diphtheroid rods in their conjunctival cultures significantly increased after using these lenses (P = 0.001 and P = 0.031, respectively). Conversely, a statistically significant difference was not found in the number of eyes that carried Propionibacterium acnes and Fusobacterium nucleatum in their conjunctival cultures before and after using the 30-day continuous-wear silicone hydrogel lenses (P = 0.998 and P = 0.488, respectively). The results suggest that the sterility of the conjunctiva significantly decreased after using 30-day continuous-wear silicone hydrogel contact lenses. In addition, the number of bacteria of the normal conjunctival flora significantly increased after the use of these lenses. Contamination by the bacteria of the eyelids may be a possible colonization factor in this study group. Therefore, it is appropriate to examine the patients who wear these lenses more frequently.

  13. [Investigations on the tolerance and reliability of contact lenses in air and space travel (author's transl)].

    PubMed

    Draeger, J; Schröder, U; Vogt, L

    1980-03-01

    It is still forbidden by German law for cockpit aircrew to wear contact lenses. This is due in particular to experience gathered in the past with older types of contact lenses, especially those made of glass or PMMA. Meanwhile, technological progress has brought improvements in respect of material, size, tolerance and particularly the optical result. Investigations were carried out with regard to the tolerance of contact lenses in condition of low humidity, high g and sudden compression. The results are given and the consequences for cockpit aircrew and passengers are discussed.

  14. The use of contact lenses in low vision rehabilitation: optical and therapeutic applications.

    PubMed

    Vincent, Stephen J

    2017-09-01

    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.

  15. Multifocal rigid gas permeable contact lenses with reduced halo

    NASA Astrophysics Data System (ADS)

    ben Yaish, Shai; Zlotnik, Alex; Limon, Ofer; Lahav Yacouel, Karen; Doron, Ravid; Zalevsky, Zeev

    2014-05-01

    In this communication we present the first dispensing medical trial in which we successfully report on testing of novel extended depth of focus rigid gas permeable (RGP) contact lenses having reduced halo and distinct focal peaks for near and far distance vision.

  16. Bacterial and fungal biofilm formation on contact lenses and their susceptibility to lens care solutions.

    PubMed

    Kackar, Siddharth; Suman, Ethel; Kotian, M Shashidhar

    2017-01-01

    Microbial biofilm formation on contact lenses and lens storage cases may be a risk factor for contact lens-associated corneal infections. Various types of contact lens care solutions are used to reduce microbial growths on lenses. The present study aimed at comparing the growths of biofilms on the different contact lenses and lens cases. The study also aimed at determining the effect of lens care solutions and bacteriophage on these biofilms. One type of hard lens and two types of soft lenses were used for the study. The organisms used were Staphylococcus aureus ATCC 25923, Pseudomonas aeruginosa ATCC 27853, Candida albicans ATCC 60193 and Escherichia coli ATCC 25922. Biofilm production was performed by modified O'Toole and Kolter method and effect of lens cleaning solutions and a crude coliphage on biofilms was also studied. Results were visualised using scanning electron microscopy and quantitated by colony counting method and spectrophotometric measurement of optical density (OD). Statistical analysis was done by SPSS 11.5, Kruskal-Wallis test and Chi-square test. Soft lens cleaning solutions had a significant inhibitory effect (P = 0.020) on biofilm formation on soft lenses and also lens cases (P < 0.001). Soft lens cleaning solution 2 was more efficient than solution 1. However, no such inhibitory effect was observed with regard to hard lens cleaning solution, but for a significant reduction in the OD values (P < 0.001). There was no significant inhibitory effect by bacteriophages. This study showed the importance of selecting the appropriate lens cleaning solution to prevent biofilm production on contact lenses.

  17. Assessing tear film on soft contact lenses with lateral shearing interferometry.

    PubMed

    Szczesna, Dorota H

    2011-11-01

    Evaluating precorneal tear film is one of important clinical measurements for assessing health of anterior eye. Contact lens wear is known to influence the quality of tear film. The aim was to evaluate the applicability of lateral shearing interferometry technique in the noninvasive assessment of the effects of contact lens replacement modality and its water content on tear film stability. Sixteen regular soft contact lens wearers took place in the study. Lateral shearing interferometry measurements, in suppressed blinking conditions, were taken in the mornings and afternoons, after a minimum of 5 hours of lens wear for the daily lenses, and after 2 weeks and 1 month for the fortnightly and monthly lens replacement modalities, respectively. Significant differences (paired bootstrap-based Behrens-Fisher test, P < 0.05) in the tear film surface quality were found between all considered pairs of replacement modalities except for the daily and fortnightly lenses measured in the afternoon of the first day of wear. Significant worsening (paired bootstrap-based Behrens-Fisher test, P < 0.001) of tear film quality was found for the low water content materials. Lateral shearing interferometry is a powerful method for the noninvasive assessment of tear film surface quality on soft contact lenses that may find, in future, its use in the clinical assessment of anterior eye's health.

  18. Visual performance with sport-tinted contact lenses in natural sunlight.

    PubMed

    Erickson, Graham B; Horn, Fraser C; Barney, Tyler; Pexton, Brett; Baird, Richard Y

    2009-05-01

    The use of tinted and clear contact lenses (CLs) in all aspects of life is becoming a more popular occurrence, particularly in athletic activities. This study broadens previous research regarding performance-tinted CLs and their effects on measures of visual performance. Thirty-three subjects (14 male, 19 female) were fitted with clear B&L Optima 38, 50% visible light transmission Amber and 36% visible light transmission Gray-Green Nike Maxsight CLs in an individualized randomized sequence. Subjects were dark-adapted with welding goggles before testing and in between subtests involving a Bailey-Lovie chart and the Haynes Distance Rock test. The sequence of testing was repeated for each lens modality. The Amber and Gray-Green lenses enabled subjects to recover vision faster in bright sunlight compared with clear lenses. Also, subjects were able to achieve better visual recognition in bright sunlight when compared with clear lenses. Additionally, the lenses allowed the subjects to alternate fixation between a bright and shaded target at a more rapid rate in bright sunlight as compared with clear lenses. Subjects preferred both the Amber and Gray-Green lenses over clear lenses in the bright and shadowed target conditions. The results of the current study show that Maxsight Amber and Gray-Green lenses provide better contrast discrimination in bright sunlight, better contrast discrimination when alternating between bright and shaded target conditions, better speed of visual recovery in bright sunlight, and better overall visual performance in bright and shaded target conditions compared with clear lenses.

  19. The effect of fractal contact lenses on peripheral refraction in myopic model eyes.

    PubMed

    Rodriguez-Vallejo, Manuel; Benlloch, Josefa; Pons, Amparo; Monsoriu, Juan A; Furlan, Walter D

    2014-12-01

    To test multizone contact lenses in model eyes: Fractal Contact Lenses (FCLs), designed to induce myopic peripheral refractive error (PRE). Zemax ray-tracing software was employed to simulate myopic and accommodation-dependent model eyes fitted with FCLs. PRE, defined in terms of mean sphere M and 90°-180° astigmatism J180, was computed at different peripheral positions, ranging from 0 to 35° in steps of 5°, and for different pupil diameters (PDs). Simulated visual performance and changes in the PRE were also analyzed for contact lens decentration and model eye accommodation. For comparison purposes, the same simulations were performed with another commercially available contact lens designed for the same intended use: the Dual Focus (DF). PRE was greater with FCL than with DF when both designs were tested for a 3.5 mm PD, and with and without decentration of the lenses. However, PRE depended on PD with both multizone lenses, with a remarkable reduction of the myopic relative effect for a PD of 5.5 mm. The myopic PRE with contact lenses decreased as the myopic refractive error increased, but this could be compensated by increasing the power of treatment zones. A peripheral myopic shift was also induced by the FCLs in the accommodated model eye. In regard to visual performance, a myopia under-correction with reference to the circle of least confusion was obtained in all cases for a 5.5 mm PD. The ghost images, generated by treatment zones of FCL, were dimmer than the ones produced with DF lens of the same power. FCLs produce a peripheral myopic defocus without compromising central vision in photopic conditions. FCLs have several design parameters that can be varied to obtain optimum results: lens diameter, number of zones, addition and asphericity; resulting in a very promising customized lens for the treatment of myopia progression.

  20. IMPACT OF A RINSE STEP ON PROTEIN REMOVAL FROM SILICONE HYDROGEL CONTACT LENSES

    PubMed Central

    Pucker, Andrew D.; Nichols, Jason J.

    2010-01-01

    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

  1. Controlled release of betamethasone from vitamin E-loaded silicone-based soft contact lenses.

    PubMed

    Rad, Maryam Shayani; Sajadi Tabassi, Sayyed Abolghasem; Moghadam, Maryam Hassanpour; Mohajeri, Seyed Ahmad

    2016-11-01

    Betamethasone (BMZ) is an effective drug which is commonly used as an eye drop for the management of ophthalmic inflammations. Due to low ocular bioavailability, it is necessary to prepare and optimize an ocular drug delivery system for BMZ. In this study we tried to use vitamin E diffusion barrier for sustaining BMZ release. Three commercial contact lenses were soaked in vitamin E solutions and swelling percentage, diameter, transmittance, binding capacity and release amount and time were evaluated in comparison with non-vitamin E-loaded pure lenses. The results showed that vitamin E significantly decreased water content of contact lenses whereas, increased the lens diameter in both dry and wet states. It effectively blocked UV radiation which is harmful for the eye surface while had no significant effect on visible transmittance. BMZ loading capacity enhanced and release rate remarkably decreased after using vitamin E as a hydrophobic diffusion barrier. This study revealed that vitamin E can be applied as a hydrophobic diffusion barrier for controlling and sustaining BMZ release from silicone-based soft contact lenses into the lachrymal fluid. It can also protect eye tissues as an antioxidant by blocking the UV radiation.

  2. In vivo performance of melimine as an antimicrobial coating for contact lenses in models of CLARE and CLPU.

    PubMed

    Cole, Nerida; Hume, Emma B H; Vijay, Ajay K; Sankaridurg, Padmaja; Kumar, Naresh; Willcox, Mark D P

    2010-01-01

    One strategy to minimize bacteria-associated adverse responses such as microbial keratitis, contact lens-induced acute red eye (CLARE), and contact lens induced peripheral ulcers (CLPUs) that occur with contact lens wear is the development of an antimicrobial or antiadhesive contact lens. Cationic peptides represent a novel approach for the development of antimicrobial lenses. A novel cationic peptide, melimine, was covalently incorporated into silicone hydrogel lenses. Confirmation tests to determine the presence of peptide and anti-microbial activity were performed. Cationic lenses were then tested for their ability to prevent CLPU in the Staphylococcus aureus rabbit model and CLARE in the Pseudomonas aeruginosa guinea pig model. In the rabbit model of CLPU, melimine-coated lenses resulted in significant reductions in ocular symptom scores and in the extent of corneal infiltration (P < 0.05). Evaluation of the performance of melimine lenses in the CLARE model showed significant improvement in all ocular response parameters measured, including the percentage of eyes with corneal infiltrates, compared with those observed in the eyes fitted with the control lens (P < or = 0.05). Cationic coating of contact lenses with the peptide melimine may represent a novel method of prevention of bacterial growth on contact lenses and consequently result in reduction of the incidence and severity of adverse responses due to Gram-positive and -negative bacteria during lens wear.

  3. Myopia Control with Bifocal Contact Lenses: A Randomized Clinical Trial.

    PubMed

    Aller, Thomas A; Liu, Maria; Wildsoet, Christine F

    2016-04-01

    Most studies have reported only minimal reductions in myopia progression with bifocal or progressive multifocal spectacles, although somewhat larger, although mostly still clinically insignificant, effects have been reported in children with nearpoint esophoria and/or accommodative dysfunctions. The CONTROL study was a 1-year, prospective, randomized, clinical trial of bifocal contact lenses for control of myopia in children with eso fixation disparities at near. Eighty-six myopic subjects, aged 8 to 18 years, were enrolled in the study after passing the screening examination. Of these, 79 completed lens assignment and 78 completed the study. The mean refractive error of these 79 subjects was -2.69 ± 1.40D (SD), and all had progressed by -0.50D or more since their last examination. All subjects also had eso fixation disparity at near. Subjects were randomly assigned to wear either Vistakon Acuvue 2 (single-vision soft contact lenses [SVSCLs]) or Vistakon Acuvue Bifocal (bifocal soft contact lenses [BFSCLs]). Bifocal adds were selected to neutralize the associated phoria. Treatment outcomes included cycloplegic autorefraction and axial length, assessed in terms of changes after 6 and 12 months of treatment from pretreatment baseline values. The BFSCLs significantly slowed myopia progression, with statistically significant differences between the treatment groups after 6 months. After 12 months of treatment, the SVSCL group had progressed by -0.79 ± 0.43D compared with -0.22 ± 0.34D for the BFSCL group (cycloplegic objective spherical equivalent, average of two eyes). Corresponding axial length changes were 0.24 ± 0.17 mm and 0.05 ± 0.14 mm, respectively. All of these differences were found to be statistically significant (unpaired t-tests, p < 0.001). The distance center bifocal contact lenses tested in this study achieved greater control over myopia progression and axial elongation (>70%) compared with most published results with multifocal spectacles. Further

  4. The use of contact lenses in the civil airman population.

    DOT National Transportation Integrated Search

    1990-09-01

    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...

  5. Adhesion of Stenotrophomonas maltophilia, Delftia acidovorans, and Achromobacter xylosoxidans to Contact Lenses.

    PubMed

    Vijay, Ajay Kumar; Willcox, Mark D P

    2017-09-26

    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.

  6. External ocular surface and lens microbiota in contact lens wearers with corneal infiltrates during extended wear of hydrogel lenses.

    PubMed

    Willcox, Mark; Sharma, Savitri; Naduvilath, Thomas J; Sankaridurg, Padmaja R; Gopinathan, Usha; Holden, Brien A

    2011-03-01

    To determine whether carriage of microbes on the contact lens or ocular surfaces during extended wear (EW) with soft hydroxyethyl methacrylate (HEMA)-based contact lenses predisposes the wearer to adverse events. Participants (non-contact lens wearers) were enrolled in a clinical study involving wear of HEMA-based hydrogel lenses on a six night EW basis with weekly replacement. Type and number of bacteria colonizing the lower lid margins, upper bulbar conjunctiva, and contact lenses during EW after one night, 1 week, 1 month, and thereafter every 3 months for 3.5 years were determined. The association of bacteria with adverse responses was compared between carriers (defined as having significant microbes cultured from two or more samples with 1 year) and noncarriers, and the strength of the association was estimated using multivariate logistic regression. Carriers of gram-positive bacteria on lenses (particularly coagulase negative staphylococci or Corynebacterium spp.) were approximately three and eight times more likely to develop contact lens-induced peripheral ulcers (CLPUs) and asymptomatic infiltrates (AIs), respectively. Staphylococcus aureus was most frequently isolated from lenses during CLPU. Carriers of gram-negative bacteria on lenses were five times more likely to develop contact lens-induced acute red eye (CLARE). Haemophilus influenzae was isolated most frequently from lenses during CLARE and AI events. Bacterial carriage on contact lenses during EW predisposes the wearer to the development of corneal inflammatory events including CLARE, CLPU, and AI.

  7. LASIK eye surgery

    MedlinePlus

    ... Assisted In Situ Keratomileusis; Laser vision correction; Nearsightedness - Lasik; Myopia - Lasik ... cornea (curvature) and the length of the eye. LASIK uses an excimer laser (an ultraviolet laser) to ...

  8. Effect of internal lubricating agents of disposable soft contact lenses on higher-order aberrations after blinking.

    PubMed

    Koh, Shizuka; Maeda, Naoyuki; Hamano, Takashi; Hirohara, Yoko; Mihashi, Toshifumi; Hori, Yuichi; Hosohata, Jun; Fujikado, Takashi; Tano, Yasuo

    2008-03-01

    To investigate whether the polymer composition of disposable soft contact lenses affects sequential changes in higher-order aberrations (HOAs). Fifteen subjects who wore disposable soft contact lenses with dryness-related symptoms and 15 non-contact lens wearers were enrolled in this study. Ocular HOAs were measured for 60 seconds in each subject wearing a disposable etafilcon A lens (conventional lens) or a disposable etafilcon A lens with polyvinyl pyrrolidone (PVP) (lens with PVP) after 1 hour of contact lens wear. During the measurement, subjects were forced to blink every 10 seconds. The aberration data were analyzed in the central 4-mm diameter up to the sixth-order Zernike polynomials. Total HOAs, the fluctuation index (FI), and the stability index (SI) of the total HOAs over time were compared between the two groups. The subjective ocular dryness also was scored. In symptomatic wearers of disposable soft contact lenses, the total HOAs, the FI, and the SI with the lens with PVP were significantly (P=0.013, P=0.014, P=0.019, respectively) lower than with the conventional lens, whereas a significant (P=0.018) difference between the two lenses was observed only in the FI in non-contact lens wearers. Subjective ocular dryness with the lens with PVP significantly decreased compared with the conventional lens in both groups. Sequential measurement of HOAs may be a useful objective method to evaluate the effect of internal lubricating agents of disposable soft contact lenses on optical quality.

  9. In vitro and in vivo evaluation of novel implantation technology in hydrogel contact lenses for controlled drug delivery.

    PubMed

    Maulvi, Furqan A; Lakdawala, Dhara H; Shaikh, Anjum A; Desai, Ankita R; Choksi, Harsh H; Vaidya, Rutvi J; Ranch, Ketan M; Koli, Akshay R; Vyas, Bhavin A; Shah, Dinesh O

    2016-03-28

    Glaucoma is commonly treated using eye drops, which is highly inefficient due to rapid clearance (low residence time) from ocular surface. Contact lenses are ideally suited for controlled drug delivery to cornea, but incorporation of any drug loaded particulate system (formulation) affect the optical and physical property of contact lenses. The objective of the present work was to implant timolol maleate (TM) loaded ethyl cellulose nanoparticle-laden ring in hydrogel contact lenses that could provide controlled drug delivery at therapeutic rates without compromising critical lens properties. TM-implant lenses were developed, by dispersing TM encapsulated ethyl cellulose nanoparticles in acrylate hydrogel (fabricated as ring implant) and implanted the same in hydrogel contact lenses (sandwich system). The TM-ethyl cellulose nanoparticles were prepared by double emulsion method at different ratios of TM to ethyl cellulose. The X-ray diffraction studies revealed the transformation of TM to amorphous state. In vitro release kinetic data showed sustained drug release within the therapeutic window for 168h (NP 1:3 batch) with 150μg loading. Cytotoxicity and ocular irritation study demonstrated the safety of TM-implant contact lenses. In vivo pharmacokinetic studies in rabbit tear fluid showed significant increase in mean residence time (MRT) and area under curve (AUC), with TM-implant contact lenses in comparison to eye drop therapy. In vivo pharmacodynamic data in rabbit model showed sustained reduction in intra ocular pressure for 192h. The study demonstrated the promising potential of implantation technology to treat glaucoma using contact lenses, and could serve as a platform for other ocular diseases. Copyright © 2016 Elsevier B.V. All rights reserved.

  10. In vitro and in vivo evaluation of novel ciprofloxacin-releasing silicone hydrogel contact lenses.

    PubMed

    Hui, Alex; Willcox, Mark; Jones, Lyndon

    2014-07-15

    The purpose of this study was to evaluate ciprofloxacin-releasing silicone hydrogel contact lens materials in vitro and in vivo for the treatment of microbial keratitis. Model silicone hydrogel contact lens materials were manufactured using a molecular imprinting technique to modify ciprofloxacin release kinetics. Various contact lens properties, including light transmission and surface wettability, were determined, and the in vitro ciprofloxacin release kinetics elucidated using fluorescence spectrophotometry. The materials then were evaluated for their ability to inhibit Pseudomonas aeruginosa growth in vitro and in an in vivo rabbit model of microbial keratitis. Synthesized lenses had similar material properties to commercial contact lens materials. There was a decrease in light transmission in the shorter wavelengths due to incorporation of the antibiotic, but over 80% light transmission between 400 and 700 nm. Modified materials released for more than 8 hours, significantly longer than unmodified controls (P < 0.05). In vivo, there was no statistically significant difference between the number of colony-forming units (CFU) recovered from corneas treated with eye drops and those treated with one of two modified contact lenses (P > 0.05), which is significantly less than corneas treated with unmodified control lenses or those that received no treatment at all (P < 0.05). These novel contact lenses designed for the extended release of ciprofloxacin may be beneficial to supplement or augment future treatments of sight-threatening microbial keratitis. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

  11. Trends in the use of silicone hydrogel contact lenses for daily wear.

    PubMed

    Efron, Nathan; Morgan, Philip B

    2008-10-01

    Although the first silicone hydrogel contact lenses introduced onto the world contact lens market in 1999 held approval for both daily wear and extended wear use, the latter modality was promoted much more heavily by the manufacturers. The first silicone hydrogel lenses specifically promoted for daily wear were introduced in 2003. Data that we have gathered from annual contact lens fitting surveys demonstrate an immediate increase in market share whereby this lens type now represents more than one-third of soft lens fits in the United Kingdom. The success of this lens category is attributed to the health and safety benefits of silicone hydrogel materials and the positive impact of lens manufacturers by way of the effective marketing and distribution of these products.

  12. Assessment of ultraviolet B–blocking effects of weekly disposable contact lenses on corneal surface in a mouse model

    PubMed Central

    Lin, David Pei-Cheng; Chang, Han-Hsin; Yang, Li-Chien; Huang, Tzu-Ping; Liu, Hsiang-Jui; Chang, Lin-Song; Lin, Chien-Hsun

    2013-01-01

    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

  13. Wearable smart sensor systems integrated on soft contact lenses for wireless ocular diagnostics

    PubMed Central

    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

    2017-01-01

    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

  14. Wearable smart sensor systems integrated on soft contact lenses for wireless ocular diagnostics.

    PubMed

    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

    2017-04-27

    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.

  15. Wearable smart sensor systems integrated on soft contact lenses for wireless ocular diagnostics

    NASA Astrophysics Data System (ADS)

    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

    2017-04-01

    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.

  16. Drug delivery to the posterior segment of the eye through hydrogel contact lenses.

    PubMed

    Schultz, Clyde; Breaux, Jason; Schentag, Jerome; Morck, Douglas

    2011-03-01

    Despite pharmacological advances, delivery of drugs to the posterior segment of the eye remains problematic. We investigated the ability of hydrogel contact lenses to deliver small-molecule steroids, as well as larger biological molecules to the posterior segment. Release characteristics of steroid-instilled lenses were studied in vitro. Drug delivery to the posterior segment of the eye was evaluated in a rabbit model, in which hydrogel contact lenses treated with diluted steroids (prednisolone or beclomethasone) were placed on rabbit corneas for four hours on days 1, 2, 5, 8 and 10. The amount of drug in plasma, posterior segment tissue and vitreous humour was measured with high-performance liquid chromatography-tandem mass spectrometry. In a further preliminary investigation, two rabbits were treated with ranibizumab. The lenses released prednisolone and beclomethasone in saline over a six-hour period at a declining rate. Prednisolone was found in posterior segment tissue from six of six rabbits at concentrations ranging from 26.8 to 166 ng/g and in vitreous humour from two of six rabbits. Beclomethasone was detected in posterior segment tissue from three rabbits but was not found in the vitreous humour. Ranibizumab was detected in posterior segment tissue in a range from 0.19 ng/mL to 0.5183 ng/mL. Hydrogel contact lenses are a non-invasive, periocular drug delivery device capable of achieving measurable drug levels in posterior segment tissue. © 2010 The Authors. Clinical and Experimental Optometry © 2010 Optometrists Association Australia.

  17. In vitro release of two anti-muscarinic drugs from soft contact lenses

    PubMed Central

    Hui, Alex; Bajgrowicz-Cieslak, Magdalena; Phan, Chau-Minh; Jones, Lyndon

    2017-01-01

    The purpose of this study was to investigate the release of the anti-myopia drugs atropine sulfate and pirenzepine dihydrochloride from commercially available soft contact lenses. Standard ultraviolet (UV) absorbance–concentration curves were generated for atropine and pirenzepine. Ten commercially available contact lenses, including four multifocal lenses, were loaded by soaking in atropine or pirenzepine solutions at two different concentrations (10 mg/mL and 1 mg/mL). The release of the drugs into phosphate-buffered saline was determined over the course of 24 hours at 34°C using UV absorbance. Materials with surface charge released the greatest amount of atropine when loaded with either concentration when compared to the other lens types (p<0.05), releasing upward of 1.026±0.035 mg/lens and 0.979±0.024 mg/lens from etafilcon A and ocufilcon A, respectively. There were no significant differences in the amount of atropine or pirenzepine released from the multifocal and non-multifocal lenses made from the same lens materials. Narafilcon A material demonstrated prolonged release of up to 8 hours when loaded with pirenzepine, although the overall dose delivered from the lens into the solution was among the lowest of the materials investigated. The rest of the lenses reached a plateau within 2 hours of release, suggesting that they were unable to sustain drug release into the solution for long periods of time. Given that no single method of myopia control has yet shown itself to be completely effective in preventing myopia progression, a combination of optical and pharmaceutical devices comprising a drug delivering contact lens presents a novel solution that warrants further investigation. PMID:29213204

  18. Effects of multipurpose solutions on the adhesion of Acanthamoeba to rigid gas permeable contact lenses.

    PubMed

    Lee, Ga-Hyun; Yu, Hak-Sun; Lee, Ji-Eun

    2016-03-01

    To evaluate the effect of multipurpose contact lens care solutions (MPSs) on the adhesion of Acanthamoeba to rigid gas permeable (RGP) contact lenses. Acanthamoeba castellanii (AC) trophozoites were inoculated onto untreated RGP contact lenses (FP, Extra, or Menicon Z), and numbers of trophozoites adhering to lenses were counted under a phase contrast microscope at 18 h post-inoculation (controls). Similarly, adhering trophozoites were counted at 6 h post-inoculation on each of the three RGP lens types with one of three MPSs (Boston Simplus, Menicare Plus, and O2 Care). Scanning electron microscopic examinations were performed to compare lens surfaces. Adhesion of AC trophozoites to untreated FP was greater than to untreated Extra or Menicon Z. Surfaces of Extra and Menicon Z lenses were waxier, smoother, and more homogeneous than those of FP lenses. After treatment with Boston Simplus, adhesion of AC trophozoites was significantly reduced for all lens types as compared with controls (p < 0.0001). Treatments with Menicare Plus or O2 Care reduced the number of adherent AC trophozoites significantly on FP lenses only as compared with controls (p < 0.0001). The adhesion rates of AC trophozoites to RGP lenses depended on lens surfaces. Boston Simplus reduced the adhesion rate of AC trophozoites more than Menicare Plus or O2 Care. Appropriate RGP lens and MPS selection could decrease the prevalence of Acanthamoeba keratitis. © 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.

  19. Noninvasive Continuous Monitoring of Tear Glucose Using Glucose-Sensing Contact Lenses.

    PubMed

    Ascaso, Francisco J; Huerva, Valentín

    2016-04-01

    : 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.

  20. In Vitro Spoilation of Silicone-Hydrogel Soft Contact Lenses in a Model-Blink Cell.

    PubMed

    Peng, Cheng-Chun; Fajardo, Neil P; Razunguzwa, Trust; Radke, Clayton J

    2015-07-01

    We developed an in vitro model-blink cell that reproduces the mechanism of in vivo fouling of soft contact lenses. In the model-blink cell, model tear lipid directly contacts the lens surface after forced aqueous rupture, mirroring the pre-lens tear-film breakup during interblink. Soft contact lenses are attached to a Teflon holder and immersed in artificial tear solution with protein, salts, and mucins. Artificial tear-lipid solution is spread over the air/tear interface as a duplex lipid layer. The aqueous tear film is periodically ruptured and reformed by withdrawing and reinjecting tear solution into the cell, mimicking the blink-rupture process. Fouled deposits appear on the lenses after cycling, and their compositions and spatial distributions are subsequently analyzed by optical microscopy, laser ablation electrospray ionization mass spectrometry, and two-photon fluorescence confocal scanning laser microscopy. Discrete deposit (white) spots with an average size of 20 to 300 μm are observed on the studied lenses, confirming what is seen in vivo and validating the in vitro model-blink cell. Targeted lipids (cholesterol) and proteins (albumin from bovine serum) are identified in the discrete surface deposits. Both lipid and protein occur simultaneously in the surface deposits and overlap with the white spots observed by optical microscopy. Additionally, lipid and protein penetrate into the bulk of tested silicone-hydrogel lenses, likely attributed to the bicontinuous microstructure of oleophilic silicone and hydrophilic polymer phases of the lens. In vitro spoilation of soft contact lenses is successfully achieved by the model-blink cell confirming the tear rupture/deposition mechanism of lens fouling. The model-blink cell provides a reliable laboratory tool for screening new antifouling lens materials, surface coatings, and care solutions.

  1. Extended Ciprofloxacin Release Using Vitamin E Diffusion Barrier From Commercial Silicone-Based Soft Contact Lenses.

    PubMed

    Shayani Rad, Maryam; Mohajeri, Seyed Ahmad

    2017-03-01

    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.

  2. Platelet lysate and chondroitin sulfate loaded contact lenses to heal corneal lesions.

    PubMed

    Sandri, Giuseppina; Bonferoni, Maria Cristina; Rossi, Silvia; Delfino, Alessio; Riva, Federica; Icaro Cornaglia, Antonia; Marrubini, Giorgio; Musitelli, Giorgio; Del Fante, Claudia; Perotti, Cesare; Caramella, Carla; Ferrari, Franca

    2016-07-25

    Hemoderivative tear substitutes contain various ephiteliotrophic factors, such as growth factors (GF), involved in ocular surface homeostasis without immunogenic properties. The aim of the present work was the loading of platelet lysate into contact lenses to improve the precorneal permanence of platelet lysate growth factors on the ocular surface to enhance the treatment of corneal lesions. To this purpose, chondroitin sulfate, a sulfated glycosaminoglycan, which is normally present in the extracellular matrix, was associated with platelet lysate. In fact, chondroitin sulfate is capable of electrostatic interaction with positively charged growth factors, in particular, with bFGF, IGF, VEGF, PDGF and TGF-β, resulting in their stabilization and reduced degradation in solution. In the present work, various types of commercially available contact lenses have been loaded with chondroitin sulfate or chondroitin sulfate in association with platelet lysate to achieve a release of growth factors directly onto the corneal surface lesions. One type of contact lenses (PureVision(®)) showed in vitro good proliferation properties towards corneal cells and were able to enhance cut closure in cornea constructs. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Phosphorylcholine impairs susceptibility to biofilm formation of hydrogel contact lenses.

    PubMed

    Selan, Laura; Palma, Stefano; Scoarughi, Gian Luca; Papa, Rosanna; Veeh, Richard; Di Clemente, Daniele; Artini, Marco

    2009-01-01

    To compare silicone-hydrogel, poly(2-hydroxyethyl methacrylate) (pHEMA), and phosphorylcholine-coated (PC-C) contact lenses in terms of their susceptibility to biofilm formation by Staphylococcus epidermidis and Pseudomonas aeruginosa. Laboratory investigation. Biofilm formation on colonized test lenses was evaluated with confocal microscopy and in vitro antibiotic susceptibility assays. The results of the latter assays were compared with those performed on planktonic cultures of the same organism. For both microorganisms, sessile colonies on silicone-hydrogel and pHEMA lenses displayed lower antibiotic susceptibility than their planktonic counterparts. In contrast, the susceptibility of cultures growing on PC-C lenses was comparable with that for planktonic cultures. In particular, minimum inhibitory concentration for Tazocin (piperacillin plus tazobactam; Wyeth Pharmaceuticals, Aprilia, Italy; S. epidermidis) and gentamicin (P. aeruginosa) was identical, either in the presence of PC-C support or in planktonic cultures (Tazocin, lenses (0.4 mug/ml) with respect to planktonic cultures (0.2 mug/ml). Confocal microscopy of lenses colonized for 24 hours with P. aeruginosa green fluorescent protein-expressing cells revealed a sessile colonization on silicone-hydrogel lens and a few isolated bacterial cells scattered widely over the surface of the PC-C lens. An increase in antibiotic susceptibility of bacterial cultures was associated with diminished bacterial adhesion. Our results indicate that PC-C lenses seem to be more resistant than silicone-hydrogel and pHEMA lenses to bacterial adhesion and colonization. This feature may facilitate their disinfection.

  4. Tear Oxygen Under Hydrogel and Silicone Hydrogel Contact Lenses in Humans

    PubMed Central

    Bonanno, Joseph A.; Clark, Christopher; Pruitt, John; Alvord, Larry

    2011-01-01

    Purpose To determine the tear oxygen tension under a variety of conventional and silicone hydrogel contact lenses in human subjects. Methods 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. Results 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. Conclusions 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. PMID:19609230

  5. Tear oxygen under hydrogel and silicone hydrogel contact lenses in humans.

    PubMed

    Bonanno, Joseph A; Clark, Christopher; Pruitt, John; Alvord, Larry

    2009-08-01

    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.

  6. Demodex sp. as a Potential Cause of the Abandonment of Soft Contact Lenses by Their Existing Users

    PubMed Central

    Tarkowski, Witold; Moneta-Wielgoś, Joanna; Młocicki, Daniel

    2015-01-01

    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

  7. Extended release of high molecular weight hydroxypropyl methylcellulose from molecularly imprinted, extended wear silicone hydrogel contact lenses.

    PubMed

    White, Charles J; McBride, Matthew K; Pate, Kayla M; Tieppo, Arianna; Byrne, Mark E

    2011-08-01

    Symptoms of contact lenses induced dry eye (CLIDE) are typically treated through application of macromolecular re-wetting agents via eye drops. Therapeutic soft contact lenses can be formulated to alleviate CLIDE symptoms by slowly releasing comfort agent from the lens. In this paper, we present an extended wear silicone hydrogel contact lens with extended, controllable release of 120 kDa hydroxypropyl methylcellulose (HPMC) using a molecular imprinting strategy. A commercial silicone hydrogel lens was tailored to release approximately 1000 μg of HPMC over a period of up to 60 days in a constant manner at a rate of 16 μg/day under physiological flowrates, releasing over the entire range of continuous wear. Release rates could be significantly varied by the imprinting effect and functional monomer to template ratio (M/T) with M/T values 0, 0.2, 2.8, 3.4 corresponding to HPMC release durations of 10, 13, 23, and 53 days, respectively. Lenses had high optical quality and adequate mechanical properties for contact lens use. This work highlights the potential of imprinting in the design and engineering of silicone hydrogel lenses to release macromolecules for the duration of wear, which may lead to decreased CLIDE symptoms and more comfortable contact lenses. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Scanning Electron Microscopy Findings With Energy-Dispersive X-ray Investigations of Cosmetically Tinted Contact Lenses

    PubMed Central

    Hotta, Fumika; Imai, Shoji; Miyamoto, Tatsuro; Mitamura-Aizawa, Sayaka; Mitamura, Yoshinori

    2015-01-01

    Objective: To investigate the surfaces and principal elements of the colorants of cosmetically tinted contact lenses (Cos-CLs). Methods: We analyzed the surfaces and principal elements of the colorants of five commercially available Cos-CLs using scanning electron microscopy with energy-dispersive x-ray analysis. Results: In two Cos-CLs, the anterior and posterior surfaces were smooth, and colorants were found inside the lens. One lens showed colorants located to a depth of 8 to 14 μm from the anterior side of the lens. In the other lens, colorants were found in the most superficial layer on the posterior surface, although a coated layer was observed. The colorants in the other three lenses were deposited on either lens surface. Although a print pattern was uniform in embedded type lenses, uneven patterns were apparent in dot-matrix design lenses. Colorants used in all lenses contained chlorine, iron, and titanium. In the magnified scanning electron microscopy images of a certain lens, chlorine is exuded and spread. Conclusions: Cosmetically tinted contact lenses have a wide variety of lens surfaces and colorants. Colorants may be deposited on the lens surface and consist of an element that has tissue toxicity. PMID:25799458

  9. Visual performance after conventional LASIK and wavefront-guided LASIK with iris-registration: results at 1 year

    PubMed Central

    Zhang, Jing; Zhou, Yue-Hua; Li, Rui; Tian, Lei

    2013-01-01

    AIM To compare visual performance of wavefront-guided laser in situ keratomileusis (LASIK) with iris-registration (Wg-LASIK group) and conventional LASIK (LASIK group) one year after surgery and analyze the correlation between wavefront aberrations and visual performance. METHODS Eight hundred and fifty-two myopic eyes of 430 patients were enrolled in this prospective study and divided into two groups: Wg-LASIK group (436 eyes) and LASIK group (416 eyes). A Wavescan Wavefront aberrometer was used to analyze Zernike coefficients and the root-mean-square (RMS) of higher order aberrations, and Optec 6500 visual function instrument was used to measure contrast sensitivity (CS) before and 3, 6, 12 months after surgery. RESULTS The mean spherical equivalent (SE) in Wg-LASIK group was significantly better than those in LASIK group one year after surgery (P=0.024). Wg-LASIK eyes showed better CS values than LASIK eyes at all spatial frequencies with and without glare after surgery (P all<0.01). Moreover, the increase of higher RMS (RMSh), coma, RMS3, RMS4, RMS5 in Wg-LASIK group were significantly lower than those in LASIK group 1 year after surgery (P all<0.05). The increase of coma, spherical aberration (SA), RMS3 and RMS4 in Wg-LASIK and coma and RMS3 in LASIK group were negatively correlated with reduction of contrast sensitivity 1 year after surgery. CONCLUSION A significant better visual performance is got in Wg-LASIK group compared with LASIK group 1 year after surgery, and the Wg-LASIK is particularly suitable for eyes with high-magnitude RMSh. PMID:23991386

  10. Atomic force microscopy and scanning electron microscopy analysis of daily disposable limbal ring contact lenses.

    PubMed

    Lorenz, Kathrine Osborn; Kakkassery, Joseph; Boree, Danielle; Pinto, David

    2014-09-01

    Limbal ring (also known as 'circle') contact lenses are becoming increasingly popular, especially in Asian markets because of their eye-enhancing effects. The pigment particles that give the eye-enhancing effects of these lenses can be found on the front or back surface of the contact lens or 'enclosed' within the lens matrix. The purpose of this research was to evaluate the pigment location and surface roughness of seven types of 'circle' contact lenses. Scanning electron microscopic (SEM) analysis was performed using a variable pressure Hitachi S3400N instrument to discern the placement of lens pigments. Atomic force microscopy (Dimension Icon AFM from Bruker Nano) was used to determine the surface roughness of the pigmented regions of the contact lenses. Atomic force microscopic analysis was performed in fluid phase under contact mode using a Sharp Nitride Lever probe (SNL-10) with a spring constant of 0.06 N/m. Root mean square (RMS) roughness values were analysed using a generalised linear mixed model with a log-normal distribution. Least square means and their corresponding 95% confidence intervals were estimated for each brand, location and pigment combination. SEM cross-sectional images at 500× and 2,000× magnification showed pigment on the surface of six of the seven lens types tested. The mean depth of pigment for 1-DAY ACUVUE DEFINE (1DAD) lenses was 8.1 μm below the surface of the lens, while the remaining lens types tested had pigment particles on the front or back surface. Results of the atomic force microscopic analysis indicated that 1DAD lenses had significantly lower root mean square roughness values in the pigmented area of the lens than the other lens types tested. SEM and AFM analysis revealed pigment on the surface of the lens for all types tested with the exception of 1DAD. Further research is required to determine if the difference in pigment location influences on-eye performance. © 2014 The Authors. Clinical and Experimental

  11. Atomic force microscopy and scanning electron microscopy analysis of daily disposable limbal ring contact lenses

    PubMed Central

    Lorenz, Kathrine Osborn; Kakkassery, Joseph; Boree, Danielle; Pinto, David

    2014-01-01

    Background Limbal ring (also known as ‘circle’) contact lenses are becoming increasingly popular, especially in Asian markets because of their eye-enhancing effects. The pigment particles that give the eye-enhancing effects of these lenses can be found on the front or back surface of the contact lens or ‘enclosed’ within the lens matrix. The purpose of this research was to evaluate the pigment location and surface roughness of seven types of ‘circle’ contact lenses. Methods Scanning electron microscopic (SEM) analysis was performed using a variable pressure Hitachi S3400N instrument to discern the placement of lens pigments. Atomic force microscopy (Dimension Icon AFM from Bruker Nano) was used to determine the surface roughness of the pigmented regions of the contact lenses. Atomic force microscopic analysis was performed in fluid phase under contact mode using a Sharp Nitride Lever probe (SNL-10) with a spring constant of 0.06 N/m. Root mean square (RMS) roughness values were analysed using a generalised linear mixed model with a log-normal distribution. Least square means and their corresponding 95% confidence intervals were estimated for each brand, location and pigment combination. Results SEM cross-sectional images at 500× and 2,000× magnification showed pigment on the surface of six of the seven lens types tested. The mean depth of pigment for 1-DAY ACUVUE DEFINE (1DAD) lenses was 8.1 μm below the surface of the lens, while the remaining lens types tested had pigment particles on the front or back surface. Results of the atomic force microscopic analysis indicated that 1DAD lenses had significantly lower root mean square roughness values in the pigmented area of the lens than the other lens types tested. Conclusions SEM and AFM analysis revealed pigment on the surface of the lens for all types tested with the exception of 1DAD. Further research is required to determine if the difference in pigment location influences on-eye performance. PMID

  12. Oxygen permeability of the pigmented material used in cosmetic daily disposable contact lenses

    PubMed Central

    Galas, Stephen; Copper, Lenora L

    2016-01-01

    Purpose To evaluate the individual contributions of pigment colorant and packing solution containing polyvinyl pyrrolidone (PVP) on the oxygen permeability (Dk) of a cosmetic printed etafilcon A daily disposable contact lens packaged with PVP. Method The oxygen transport of a contact lens is evaluated through the central optical zone of the lens. Cosmetic printed contact lenses contain pigment colorant in the periphery or mid-periphery of the lens. Therefore, to assess the impact of cosmetic print on oxygen permeability, special lenses need to be produced that contain the colorant within the central optical zone. This technique was used to obtain multiple measurements of nonedge-corrected Dk/t of both the center pigmented lens and its nonpigmented equivalent, using a polarographic measurement described in International Organization for Standardization (ISO) 18369-4:2006(E), and the Dk derived for each measurement is corrected for edge effect. In addition, the edge-corrected Dk values of lenses made from the same monomer batch were measured. The lenses were packaged and autoclaved with and without proprietary technology which embeds PVP in the contact lens during autoclaving. The resulting Dk value of the printed lens material was then used with thickness data to generate true Dk/t profiles for a given lens power. Results The edge-corrected Dk of the printed etafilcon A lens with offset pigment colorant was measured to be 19.7×10−11 (cm2/s) (mL O2/mL·mmHg) at 35°C. This was within ±20% tolerance range as specified in ISO 18369-2:2012(E) for the edge-corrected Dk of the nonpigmented etafilcon A control lens evaluated during the same session, 19.5×10−11 (cm2/s) (mL O2/mL·mmHg). The edge-corrected Dk values of the lenses packaged with PVP (mean 20.1, standard deviation [SD] 0.3) were also within the ±20% tolerance range compared to those packaged without PVP (mean 20.0, SD 0.3). Conclusion The pigment colorant and PVP embedded in the contact lens during

  13. Oxygen permeability of the pigmented material used in cosmetic daily disposable contact lenses.

    PubMed

    Galas, Stephen; Copper, Lenora L

    2016-01-01

    To evaluate the individual contributions of pigment colorant and packing solution containing polyvinyl pyrrolidone (PVP) on the oxygen permeability (Dk) of a cosmetic printed etafilcon A daily disposable contact lens packaged with PVP. The oxygen transport of a contact lens is evaluated through the central optical zone of the lens. Cosmetic printed contact lenses contain pigment colorant in the periphery or mid-periphery of the lens. Therefore, to assess the impact of cosmetic print on oxygen permeability, special lenses need to be produced that contain the colorant within the central optical zone. This technique was used to obtain multiple measurements of nonedge-corrected Dk/t of both the center pigmented lens and its nonpigmented equivalent, using a polarographic measurement described in International Organization for Standardization (ISO) 18369-4:2006(E), and the Dk derived for each measurement is corrected for edge effect. In addition, the edge-corrected Dk values of lenses made from the same monomer batch were measured. The lenses were packaged and autoclaved with and without proprietary technology which embeds PVP in the contact lens during autoclaving. The resulting Dk value of the printed lens material was then used with thickness data to generate true Dk/t profiles for a given lens power. The edge-corrected Dk of the printed etafilcon A lens with offset pigment colorant was measured to be 19.7×10 -11 (cm 2 /s) (mL O 2 /mL·mmHg) at 35°C. This was within ±20% tolerance range as specified in ISO 18369-2:2012(E) for the edge-corrected Dk of the nonpigmented etafilcon A control lens evaluated during the same session, 19.5×10 -11 (cm 2 /s) (mL O 2 /mL·mmHg). The edge-corrected Dk values of the lenses packaged with PVP (mean 20.1, standard deviation [SD] 0.3) were also within the ±20% tolerance range compared to those packaged without PVP (mean 20.0, SD 0.3). The pigment colorant and PVP embedded in the contact lens during autoclaving were not found to

  14. Surface interactions on hydrogel contact lenses: scanning electron microscopy (SEM).

    PubMed

    Hart, D E

    1987-12-01

    SEM was used to visualize tear-film/hydrogel polymer surface interactions. Lenses were preserved by fixation including a quaternary ammonium complex to aid in mucin preservation. In less than 2 weeks of continuous wear the anterior surface was completely coated, yet the coating was absent from the posterior lens surface. Tear-film break-up over the deposited lens surface, combined with degradation and deformation at the polymer surface boundary, as well as entrapment of moieties within the polymer matrix, all occurred. These are the likely culprits which can contribute to adverse reactions as well as cause light scatter and diminished vision. Lenses removed directly from the eyes of patients suffering with different forms of conjunctivitis were obtained. Bacterial and viral conjunctivitis can induce a microbially contaminated as well as a heavily deformed and deposited lens. Viable and intact microbes were not typically observed in the mucoprotein layer of hydrogel contact lenses.

  15. The measurement of intraocular pressure over positive soft contact lenses by rebound tonometry.

    PubMed

    Zeri, Fabrizio; De Cusatis, Mario; Lupelli, Luigi; Swann, Peter Graham

    2016-01-01

    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.

  16. Randomized Crossover Trial of Silicone Hydrogel Presbyopic Contact Lenses.

    PubMed

    Sivardeen, Ahmed; Laughton, Deborah; Wolffsohn, James S

    2016-02-01

    To assess the performance of four commercially available silicone hydrogel multifocal monthly contact lens designs against monovision. A double-masked randomized crossover trial of Air Optix Aqua multifocal, PureVision 2 for Presbyopia, Acuvue OASYS for Presbyopia, Biofinity multifocal, and monovision with Biofinity contact lenses was conducted on 35 presbyopes (54.3 ± 6.2 years). After 4 weeks of wear, visual performance was quantified by high- and low-contrast visual acuity under photopic and mesopic conditions, reading speed, defocus curves, stereopsis, halometry, aberrometry, Near Activity Visual Questionnaire rating, and subjective quality of vision scoring. Bulbar, limbal, and palpebral hyperemia and corneal staining were graded to monitor the impact of each contact lens on ocular physiology. High-contrast photopic visual acuity (p = 0.102), reading speed (F = 1.082, p = 0.368), and aberrometry (F = 0.855, p = 0.493) were not significantly different between presbyopic lens options. Defocus curve profiles (p < 0.001), stereopsis (p < 0.001), halometry (F = 4.101, p = 0.004), Near Activity Visual Questionnaire (F = 3.730, p = 0.007), quality of vision (p = 0.002), bulbar hyperemia (p = 0.020), and palpebral hyperemia (p = 0.012) differed significantly between lens types, with the Biofinity multifocal lens design principal (center-distance lens was fitted to the dominant eye and a center-near lens to the nondominant eye) typically outperforming the other lenses. Although ocular aberration variation between individuals largely masks the differences in optics between current multifocal contact lens designs, certain design strategies can outperform monovision, even in early presbyopes.

  17. [Effect of transparent yellow and orange colored contact lenses on color discrimination in the yellow color range].

    PubMed

    Schürer, M; Walter, A; Brünner, H; Langenbucher, A

    2015-08-01

    Colored transparent filters cause a change in color perception and have an impact on the perceptible amount of different colors and especially on the ability to discriminate between them. Yellow or orange tinted contact lenses worn to enhance contrast vision by reducing or blocking short wavelengths also have an effect on color perception. The impact of the yellow and orange tinted contact lenses Wöhlk SPORT CONTRAST on color discrimination was investigated with the Erlangen colour measurement system in a study with 14 and 16 subjects, respectively. In relation to a yellow reference color located at u' = 0.2487/v' = 0.5433, measurements of color discrimination thresholds were taken in up to 6 different color coordinate axes. Based on these thresholds, color discrimination ellipses were calculated. These results are given in the Derrington, Krauskopf and Lennie (DKL) color system. Both contact lenses caused a shift of the reference color towards higher saturated colors. Color discrimination ability with the yellow and orange colored lenses was significantly enhanced along the blue-yellow axis in comparison to the reference measurements without a tinted filter. Along the red-green axis only the orange lens caused a significant reduction of color discrimination threshold distance to the reference color. Yellow and orange tinted contact lenses enhance the ability of color discrimination. If the transmission spectra and the induced changes are taken into account, these results can also be applied to other filter media, such as blue filter intraocular lenses.

  18. 'Contact' in Space Leads to New Lenses

    NASA Technical Reports Server (NTRS)

    2004-01-01

    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.

  19. Power Profiles and In Vitro Optical Quality of Scleral Contact Lenses: Effect of the Aperture and Power.

    PubMed

    Domínguez-Vicent, Alberto; Esteve-Taboada, Jose Juan; Recchioni, Alberto; Brautaset, Rune

    2018-05-01

    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.

  20. Defining the content of patient questionnaires: reasons for seeking laser in situ keratomileusis for myopia.

    PubMed

    Khan-Lim, Doreen; Craig, Jennifer P; McGhee, Charles N J

    2002-05-01

    To determine the relative importance of patients' motives for having laser in situ keratomileusis (LASIK) for myopia. The Corneal Diseases and Excimer Laser Research Unit, University of Dundee, Ninewells Hospital and Medical School, Dundee, Scotland. Twenty-one cards printed with potential reasons for having LASIK and 3 blank cards for respondents to include additional motives were posted to 71 patients who had myopic LASIK. The cards were ranked by each respondent in order of personal importance and returned for analysis. The response rate was 77.5%. The mean age of the 19 male and 37 female respondents was 41.7 years +/- 9.3 (SD) and the mean preoperative spherical equivalent, -9.26 +/- 4.58 diopters. The primary reasons for seeking treatment (percentage of respondents ranking topic within the top 5) were improvement of unaided social vision (69.1%), intolerance to spectacles/contact lenses (65.5%), and freedom from spectacles/contact lenses (61.8%). Almost 70% of respondents ranked 1 of these reasons as the most important. General inconvenience of spectacles/contact lenses and the desire to pursue sports and leisure activities also ranked high (52.7% and 36.4%, respectively). Consistent with previous work, better unaided vision, combined with the inconvenience of or intolerance to spectacles or contact lenses, provided the main incentives to have LASIK for myopia, while improved cosmesis was relatively unimportant (29.1%). The results of this study will allow the design of satisfaction questionnaires that are better directed toward establishing satisfaction of specific, relevant functional and psychological aspects of refractive surgery that are important to patients.

  1. Peripheral Optics with Bifocal Soft and Corneal Reshaping Contact Lenses

    PubMed Central

    Ticak, Anita; Walline, Jeffrey J.

    2012-01-01

    Purpose To determine whether bifocal soft contact lenses with a distance center design provide myopic defocus to the peripheral retina similar to corneal reshaping contact lenses. Methods Myopic subjects underwent five cycloplegic autorefraction readings centrally and at 10, 20, and 30 degrees temporally, nasally, superiorly, inferiorly while wearing a Proclear Multifocal “D” contact lens with a +2.00 D add (CooperVision, Fairport, NY) and after wearing a Corneal Refractive Therapy (Paragon Vision Sciences, Mesa, AZ) contact lens for two weeks Results Fourteen subjects completed the study. Nine (64%) were female, and 12 (86%) were Caucasian. The average (± standard deviation) spherical equivalent non-cycloplegic manifest refraction for the right eye was −2.84 ± 1.29 D. The average logMAR best-corrected, binocular high contrast visual acuity was −0.17 ± 0.15 while wearing the bifocal soft contact lens, and −0.09 ± 0.16 following corneal reshaping contact lens wear (ANOVA, p = 0.27). The orthokeratology contact lens yielded a more myopic peripheral optical profile than the soft bifocal contact lens at 20 and 30 degrees eccentricity (except inferior at 20 degrees); the two modalities were similar at 10 degrees eccentricity. Conclusions Our data suggest that the two modalities are dissimilar despite the statistical similarities. The corneal reshaping contact lens shows an increase in relative peripheral myopic refraction, a pattern achieved by other studies, but the bifocal lens does not exhibit such a pattern. The low statistical power of the study could be a reason for a lack of providing statistical difference in other positions of gaze, but the graphical representation of the data shows a marked difference in peripheral optical profile between the two modalities. More sophisticated methods of measuring the peripheral optical profile may be necessary to accurately compare the two modalities and to determine the true optical effect of the bifocal soft

  2. Predicting success with silicone-hydrogel contact lenses in new wearers.

    PubMed

    Best, Nigel; Drury, Laura; Wolffsohn, James S

    2013-10-01

    to evaluate changes in tear metrics and ocular signs induced by six months of silicone-hydrogel contact lens wear and the difference in baseline characteristics between those who successfully continued in contact lens wear compared to those that did not. Non-invasive Keratograph, Tearscope and fluorescein tear break-up times (TBUTs), tear meniscus height, bulbar and limbal hyperaemia, lid-parallel conjunctival folds (LIPCOF), phenol red thread, fluorescein and lissamine-green staining, and lid wiper epitheliopathy were measured on 60 new contact lens wearers fitted with monthly silicone-hydrogels (average age 36±14 years, 40 females). Symptoms were evaluated by the Ocular Surface Disease Index (OSDI). After six months full time contact lens wear the above metrics were re-measured on those patients still in contact lens wear (n=33). The initial measurements were also compared between the group still wearing lenses after six months and those who had ceased lens wear (n=27). There were significant changes in tear meniscus height (p=0.031), bulbar hyperaemia (p=0.011), fluorescein TBUT (p=0.027), corneal (p=0.007) and conjunctival (p=0.009) staining, LIPCOF (p=0.011) and lid wiper epitheliopathy (p=0.002) after six months of silicone-hydrogel wear. Successful wearers had a higher non-invasive (17.0±8.2s vs 12.0±5.6s; p=0.001) and fluorescein (10.7±6.4s vs 7.5±4.7s; p=0.001) TBUT than drop-outs, although OSDI (cut-off 4.2) was also a strong predictor of success. Silicone-hydrogel lenses induced significant changes in the tear film and ocular surface as well as lid margin staining. Wettability of the ocular surface is the main factor affecting contact lens drop-out. Copyright © 2013 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  3. Ocular physiology and comfort in neophyte subjects fitted with daily disposable silicone hydrogel contact lenses.

    PubMed

    Morgan, Philip B; Chamberlain, Paul; Moody, Kurt; Maldonado-Codina, Carole

    2013-06-01

    To evaluate the performance of a silicone hydrogel daily disposable lens in neophyte subjects over 12 months. Seventy four subjects with no previous contact lens experience were randomised to wear narafilcon A (1 DAY ACUVUE(®) TruEye™) lenses (LW group) or to wear no contact lenses (NLW group) for 12 months. Biomicroscopy (performed by a masked investigator), visual acuity and subjective response scores were recorded at an initial visit and six follow-up visits, in addition to lens fit and surface evaluation for the LW group. Comfort was recorded with SMS messaging. Fifteen of the LW group discontinued before the end of the study, compared with six of the NLW group. Measured visual acuity was about half a line better for the NLW group as these subjects were provided with their full sphero-cylindrical over-refraction, compared to the LW group in their best spherical corrected contact lenses; subjective scores for vision were similar for the two groups. Bulbar conjunctival hyperaemia, limbal hyperaemia, corneal staining, conjunctival staining and papillary conjunctivitis were clinically equivalent for the two groups whereas conjunctival staining was higher in the LW group. Comfort scores assessed by SMS were equivalent for the LW and NLW groups; there was a measurable improvement in comfort during the first month of wear for the LW group. This work has demonstrated that modern soft lenses (narafilcon A daily disposable silicone hydrogel lenses) offer an excellent, comfortable form of vision correction, and are able to exhibit minimal alterations to ocular physiology. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  4. Halos--a problem for all myopes? A comparison between spectacles, contact lenses, and photorefractive keratectomy.

    PubMed

    Lohmann, C P; Fitzke, F W; O'Brart, D; Muir, M K; Marshall, J

    1993-01-01

    After photorefractive keratectomy (PRK) using excimer lasers (193 nm) many patients report the presence of halos around light sources at night. However, halos are not unique to PRK patients, as they are a common observation in myopic contact lens wearers. We present an objective measurement of the halos using a computerized technique. The patient fixated on a red cross within a white circle in the center of a video monitor which served as the halo source. The screen surrounding the circle was not illuminated. The operator controlled the movement of the white spot and moved the spot toward the halo source until the subject indicated when the cursor was at the outer parameter of the halo. Measurements were made at 30 degree intervals around the halo source and expressed as square degrees. The study found that spectacles, soft contact lenses, and excimer laser surgery were superior to hard contact lenses in terms of the size of the halo. A mean value of 2.51 square degrees was obtained for spectacles wearers compared with 3.18 square degrees for soft contact lenses, 3.14 square degrees for excimer laser patients with 4-millimeter ablation zone, 2.76 square degrees for excimer laser patients with a 5-millimeter ablation zone, and 89.5 square degrees for hard contact lenses. It appears that this device is very useful for measuring the halo size after excimer laser PRK. We concluded that halos were not a problem for our patients after excimer laser photorefractive keratectomy.

  5. Deposition of lipid, protein, and secretory phospholipase A2 on hydrophilic contact lenses.

    PubMed

    Mochizuki, Hiroshi; Yamada, Masakazu; Hatou, Shin; Kawashima, Motoko; Hata, Seiichiro

    2008-01-01

    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.

  6. Long-term effects of the extended wear of senofilcon A silicone hydrogel contact lenses on ocular tissues.

    PubMed

    Guillon, Michel; Maïssa, Cécile

    2010-12-01

    The objective of the investigation was to show that, because of their overall properties, Acuvue® Oasys™ with Hydraclear™ Plus brand (senofilcon A) silicone hydrogel contact lenses achieve excellent ocular tissue tolerance during long-term extended wear. The investigation was a 2-year, prospective, extended wear investigation of senofilcon A silicone hydrogel contact lenses worn for up to 6 nights without removal. The 2-year results compared with the subjects' baseline ocular statuses on entering the study revealed: The quantification of the effects on the ocular tissues of 2 years of extended wear of senofilcon A, by mainly previously successful daily soft contact lens wearers, found an excellent biocompatibility. The results support the hypothesis that senofilcon A contact lenses, when worn on a 6-night/7-day extended wear regimen, maintain excellent long-term ocular tissue tolerance. Copyright © 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

  7. Vision of low astigmats through thick and thin lathe-cut soft contact lenses.

    PubMed

    Cho, P; Woo, G C

    2001-01-01

    Distance and near visual acuity of 13 low astigmats were determined in a double-masked experiment through thick and thin (centre thickness 0.12 mm and 0.06 mm, respectively) spherical lathe-cut soft lenses. For each lens type, distance and near LogMAR VA and over-refraction were assessed with different logMAR VA charts. For 70% of the subjects, the residual astigmatism was significantly lower than the refractive astigmatism with thicker lenses. No statistically significant differences in the distance and near logMAR VA was found between the two lens types using any of the charts used, though, in general, logMAR VA obtained through the thicker lens was better than logMAR VA through the thinner lens. The variabilities in distance and near logMAR VA between the two lens types increased with decreased contrast. The variabilities in distance logMAR VA were greater with Chinese charts than with English charts, and LogMAR VA with Chinese charts were significantly worse for both lens types. Based on the results of this study, we concluded that thicker spherical lathe-cut soft lenses provide better vision in low astigmats. The Snellen acuity test is inadequate for vision assessment of soft contact lens wearers. When a patient wearing thin soft contact lenses complains of poor vision in spite of 6/6 or 6/5 Snellen acuity, changing to thicker lenses may be considered.

  8. Bilateral Acanthamoeba ulcer in a user of disposable soft contact lenses: a tragic incident or a consequence of the aggressive policy of soft contact lens trading?

    PubMed

    Sousa, Sidney Júlio de Faria E; Dias, Vanderson Glerian; Marcomini, Luís Antonio Gorla

    2008-01-01

    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?

  9. Bacterial populations on silicone hydrogel and hydrogel contact lenses after swimming in a chlorinated pool.

    PubMed

    Choo, Jennifer; Vuu, Kathy; Bergenske, Peter; Burnham, Kara; Smythe, Jennifer; Caroline, Patrick

    2005-02-01

    A number of reports have indicated an association between swimming with contact lenses and subsequent eye infection. This study tests whether a hydrophilic contact lens worn while swimming accumulates bacteria present in the water. It was of interest to determine whether lens type (silicone hydrogel vs. hydrogel) affected the result. Fifteen healthy noncontact lens wearers swam for 30 minutes with a silicone hydrogel lens (PureVision, Bausch & Lomb, Rochester, NY) on one eye and a hydrogel lens (Acuvue 2, Vistakon Inc., Jacksonville, FL) on the other. Lenses were removed aseptically and placed in sterile vials 10 minutes after the subjects left the water. Microbial growth was enumerated for total numbers of colonies and categorized by species present. Numbers of colonies were compared between the two lens groups and with a water sample taken from the pool at the time of the experiment. Eight of the subjects returned on a different day and wore new lenses for 50 minutes in normal room conditions. Two lenses were lost while swimming. Twenty-seven of the remaining 28 lenses worn while swimming showed colonization, principally with Staphylococcus epidermidis, which was also by far the most common species identified from the water itself. Small numbers of Staphylococcus aureus and Streptococcus salivarius were also present in the water and on the lenses. Numbers of colonies varied among subjects (range, 0 to 230), but no differences were observed between the two lens groups. Lenses removed after 30 minutes of wear without swimming were mostly sterile, with 3 of 16 lenses showing just two colonies each. It appears that wearing a hydrophilic lens while swimming allows accumulation of microbial organisms on or in the lens, regardless of lens material. Swimmers should be advised to wear tight-fitting goggles if lenses are worn while swimming, and thorough disinfection of the lenses before overnight wear seems prudent.

  10. Improvements in Topical Ocular Drug Delivery Systems: Hydrogels and Contact Lenses.

    PubMed

    Ribeiro, Andreza Maria; Figueiras, Ana; Veiga, Francisco

    2015-01-01

    Conventional ophthalmic systems present very low corneal systemic bioavailability due to the nasolacrimal drainage and the difficulty to deliver the drug in the posterior segment of ocular tissue. For these reasons, recent advances have focused on the development of new ophthalmic drug delivery systems. This review provides an insight into the various constraints associated with ocular drug delivery, summarizes recent findings in soft contact lenses (SCL) and the applications of novel pharmaceutical systems for ocular drug delivery. Among the new therapeutic approaches in ophthalmology, SCL are novel continuous-delivery systems, providing high and sustained levels of drugs to the cornea. The tendency of research in ophthalmic drug delivery systems development are directed towards a combination of several technologies (bio-inspired and molecular imprinting techniques) and materials (cyclodextrins, surfactants, specific monomers). There is a tendency to develop systems which not only prolong the contact time of the vehicle at the ocular surface, but also at the same time slow down the clearance of the drug. Different materials can be applied during the development of contact lenses and can be combined with natural inspired strategies of drug immobilization and release, providing successful tools for ocular drug delivery systems.

  11. Influence of day and night wear on surface properties of silicone hydrogel contact lenses and bacterial adhesion.

    PubMed

    Vermeltfoort, Pit B J; Rustema-Abbing, Minie; de Vries, Joop; Bruinsma, Gerda M; Busscher, Henk J; van der Linden, Matthijs L; Hooymans, Johanna M M; van der Mei, Henny C

    2006-06-01

    The aim of this study was to determine the effect of continuous wear on physicochemical surface properties of silicone hydrogel (S-H) lenses and their susceptibility to bacterial adhesion. In this study, volunteers wore 2 pairs of either "lotrafilcon A" or "balafilcon A" S-H contact lenses. The first pair was worn continuously for a week and the second pair for 4 weeks. One lens of each pair was used for surface characterization and the other one for bacterial adhesion experiments. Lens surfaces were characterized by examination of their wettability, roughness, elemental composition, and proteins attached to their surfaces. Adhesion of Staphylococcus aureus 835 and Pseudomonas aeruginosa #3 to a lens was studied using a parallel plate flow chamber. Before use, the lotrafilcon A lens was rougher than the balafilcon A lens and had a lower water contact angle and a higher affinity for S. aureus 835. After wear, both lens types had similar water contact angles, whereas the differences in elemental surface composition decreased as well. S. aureus 835 adhered in higher numbers to worn balafilcon A lenses, whereas the opposite was seen for P. aeruginosa #3. The initial deposition rates of both bacterial strains to lotrafilcon A lenses decreased by wearing and were found to correlate significant (P < 0.001) with the surface roughness of worn lenses. In this study, the differences in surface properties between 2 types of S-H lenses were found to change after 1 week of continuous wear. Generally, bacteria adhered in lower numbers and less tenaciously to worn lenses, except S. aureus 835, adhering in higher numbers to worn balafilcon A lenses.

  12. Comparison of tear osmolarity and ocular comfort between daily disposable contact lenses: hilafilcon B hydrogel versus narafilcon A silicone hydrogel.

    PubMed

    Sarac, Ozge; Gurdal, Canan; Bostancı-Ceran, Basak; Can, Izzet

    2012-06-01

    The aim of this study was to evaluate tear osmolarity and ocular comfort with two different types of hydrogel daily disposable lenses. The right eyes of 15 first-time contact lens users were included in this prospective study. All eyes wore hilafilcon B silicone hydrogel contact lenses for 8 h (group 1). After 1 week without contact lenses, all eyes wore narafilcon A silicone hydrogel contact lenses for 8 h (group 2). Tear osmolarity measurement was performed before and after 4 and 8 h of each contact lens wear. Ocular comfort was assessed after 4 and 8 h of each contact lens wear. In group 1, the mean baseline, 4- and 8-h tear osmolarity values were 293 ± 10.57, 303.00 ± 10.5 mOsm/L (p = 0.023), and 295.0 ± 1.4 mOsm/L (p > 0.05), respectively. In group 2, the mean baseline, 4- and 8-h tear osmolarity values were 294 ± 13.65, 300.9 ± 11.3 mOsm/L (p = 0.007), and 298.80 ± 7.2 mOsm/L (p > 0.05), respectively. In group 1, the mean comfort score was 7.20 ± 0.45 and 8.60 ± 0.45 at 4 and 8 h, respectively (p = 0.038). In group 2, the mean comfort score significantly decreased from 9.80 ± 0.45 to 7.80 ± 0.84 at 4 h (p = 0.039). Both hydrogel and silicone hydrogel daily disposable contact lenses elevated tear osmolarity during 8 h of contact lens wear. The increase in tear osmolarity with both contact lenses was below the cut-off value for dry eye and was not associated with ocular comfort.

  13. The Safety of Soft Contact Lenses in Children

    PubMed Central

    Bullimore, Mark A.

    2017-01-01

    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

  14. Clinical comparison of the (polymacon) spin-cast hydrogel contact lens to the (polymacon) lathe-cut hydrogel lenses.

    PubMed

    Hill, J F

    1980-08-01

    The purpose of this study was to compare the clinical acceptability of polymacon spin-cast to polymacon lathe-cut hydrophilic contact lenses. Ten patients successfully wearing polymacon spin-cast lenses were studied. Each patient had one eye refitted with polymacon lathe-cut lenses. Comparison of the two types of lenses was then made. Objective evaluation included centration, movement, visual acuity, and over-refraction. Subjective criteria were based on patient comfort and stability and quality of vision. Results indicate that lathe-cut lenses can be just as clinically satisfactory as the spincast ones.

  15. Prevention of the adverse photic effects of peripheral light-focusing using UV-blocking contact lenses.

    PubMed

    Kwok, L Stephen; Kuznetsov, Valerian A; Ho, Arthur; Coroneo, Minas T

    2003-04-01

    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

  16. Cosmetic Cleansing Oil Absorption by Soft Contact Lenses in Dry and Wet Conditions.

    PubMed

    Tsukiyama, Junko; Miyamoto, Yuko; Kodama, Aya; Fukuda, Masahiko; Shimomura, Yoshikazu

    2017-09-01

    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.

  17. Simultaneously Load and Extended Release of Betamethasone and Ciprofloxacin from Vitamin E-Loaded Silicone-Based Soft Contact Lenses.

    PubMed

    Rad, Maryam Shayani; Mohajeri, Seyed Ahmad

    2016-09-01

    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.

  18. Traumatic corneal flap displacement after laser in situ keratomileusis (LASIK)

    PubMed Central

    Tsai, Tsung-Han; Peng, Kai-Ling; Lin, Chien-Jen

    2017-01-01

    Background Laser in situ keratomileusis (LASIK) is the most common and popular procedure performed for the correction of refractive errors in the last two decades. We report a case of traumatic flap displacement with flap folding which occurred 3 years after LASIK was performed. Previous literature suggests that vision prognosis would be closely related to proper and prompt management of traumatic flap displacement with flap folding 3 years after LASIK. Case presentation A 23-year-old female presented to our hospital who had undergone uneventful LASIK in both eyes 3 years prior. Unfortunately, she had suffered a blunt trauma in her right eye in a car accident. A late onset of corneal flap displacement was found with upper and lower portion of the flap being folded inside the corneal bed. Surgical intervention for debridement with subsequent reposition of corneal flap was performed as soon as possible in the operating room. A bandage contact lens was placed, and topical antibiotic and corticosteroids were given postoperatively. Two days after the operation, the displaced corneal flap was found to be well attached smoothly on the corneal bed without folds. The best-corrected visual acuity was 6/6 with refraction of −0.75 D to 1.0 D ×175° in her right eye 1 month later. Literature review We reviewed a total of 19 published cases of late-onset traumatic flap dislocations or displacements after LASIK with complete data from 2000 to 2014. Conclusion Traumatic displacement of corneal flaps after LASIK may occur after blunt injury with specific direction of force to the flap margin, especially tangential one. According to the previous literature, late-onset traumatic flap displacement may happen at any time after LASIK and be caused by various types of injuries. Fortunately, good visual function could mostly be restored with immediate and proper management. PMID:28458585

  19. Traumatic corneal flap displacement after laser in situ keratomileusis (LASIK).

    PubMed

    Tsai, Tsung-Han; Peng, Kai-Ling; Lin, Chien-Jen

    2017-01-01

    Laser in situ keratomileusis (LASIK) is the most common and popular procedure performed for the correction of refractive errors in the last two decades. We report a case of traumatic flap displacement with flap folding which occurred 3 years after LASIK was performed. Previous literature suggests that vision prognosis would be closely related to proper and prompt management of traumatic flap displacement with flap folding 3 years after LASIK. A 23-year-old female presented to our hospital who had undergone uneventful LASIK in both eyes 3 years prior. Unfortunately, she had suffered a blunt trauma in her right eye in a car accident. A late onset of corneal flap displacement was found with upper and lower portion of the flap being folded inside the corneal bed. Surgical intervention for debridement with subsequent reposition of corneal flap was performed as soon as possible in the operating room. A bandage contact lens was placed, and topical antibiotic and corticosteroids were given postoperatively. Two days after the operation, the displaced corneal flap was found to be well attached smoothly on the corneal bed without folds. The best-corrected visual acuity was 6/6 with refraction of -0.75 D to 1.0 D ×175° in her right eye 1 month later. We reviewed a total of 19 published cases of late-onset traumatic flap dislocations or displacements after LASIK with complete data from 2000 to 2014. Traumatic displacement of corneal flaps after LASIK may occur after blunt injury with specific direction of force to the flap margin, especially tangential one. According to the previous literature, late-onset traumatic flap displacement may happen at any time after LASIK and be caused by various types of injuries. Fortunately, good visual function could mostly be restored with immediate and proper management.

  20. LASIK and dry eye.

    PubMed

    Toda, Ikuko

    2007-01-01

    Dry eye is one of the most common complications after laser-assisted in situ keratomileusis (LASIK). The clinical signs of post-LASIK dry eye include positive vital staining of ocular surface, decreased tear film breakup time and Schirmer test, reduced corneal sensitivity, and decreased functional visual acuity. The symptoms and signs last at least 1 month after LASIK. Although the mechanisms for developing post-LASIK dry eye are not completely understood, loss of corneal innervation by flap-making may affect the reflex loops of the corneal-lacrimal gland, corneal-blinking, and blinking-meibomian gland, and blinking-meibomian gland, resulting in decreased aqueous and lipid tear secretion and mucin expression. As LASIK enhancement by flap-lifting induces less dry eye symptoms and signs than first surgery, it is suggested that other factors rather than loss of neurotrophic effect may be involved in the mechanisms of post-LASIK dry eye. The treatments of dry eye include artificial tears, topical cyclosporine, hot compress, punctal plugs, and autologous serum eye drops. For patients with severe preoperative dry eye, a combination of punctal plugs and serum eye drops is required to be used before surgery.

  1. Objective and subjective responses in patients refitted to daily-wear silicone hydrogel contact lenses.

    PubMed

    Dumbleton, Kathryn; Keir, Nancy; Moezzi, Amir; Feng, Yunwei; Jones, Lyndon; Fonn, Desmond

    2006-10-01

    Silicone hydrogel (SiH) lenses offer many physiological advantages for daily wear (DW) in addition to the continuous-wear modality for which they were originally developed. The purpose of this study was to investigate the clinical performance and physiological responses in a group of successful long-term wearers of conventional hydrogel lenses when refitted with DW SiH contact lenses. Eighty-seven successful soft lens wearers (8.4+/-4.7 years of prior lens wear) participated in this study. Bulbar and limbal hyperemia were subjectively graded and digitally photographed for subsequent masked objective evaluation. Subjective symptoms were scored using visual analog scales. In addition, refractive error, corneal curvature, and corneal thickness were measured. All subjects were refitted with Focus Night & Day (lotrafilcon A) SiH lenses; however, to reduce the potential for bias, they were informed that they were being randomly assigned to wear either low oxygen permeability (Dk) lenses or high Dk SiH lenses and were "masked" as to their lens assignment. Subjects returned after 1 week, 1 month, and 2 months of DW, at which time all gradings, photographs, and measurements were repeated. End-of-day subjective symptoms were also graded periodically during the study. Ninety-three percent of subjects were successfully refitted. Both objective and subjective evaluations showed that bulbar and limbal hyperemia decreased significantly in all quadrants during the study (p<0.001), particularly for those subjects with greater baseline hyperemia (p<0.001). Subjects reported a concurrent reduction in end-of-day dryness and improved end-of-day comfort compared with their habitual lenses (p<0.001). No significant changes in refractive error, tarsal papillary response, corneal curvature, or corneal thickness were found during the study. Hyperemia in contact lens wearers may be attributed to a number of factors, including hypoxia. Refitting existing low Dk lens wearers with SiH lenses on

  2. Microbial keratitis secondary to unintended poor compliance with scleral gas-permeable contact lenses.

    PubMed

    Zimmerman, Aaron B; Marks, Amanda

    2014-01-01

    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.

  3. Power profiles and short-term visual performance of soft contact lenses.

    PubMed

    Papas, Eric; Dahms, Anne; Carnt, Nicole; Tahhan, Nina; Ehrmann, Klaus

    2009-04-01

    To investigate the manner in which contemporary soft contact lenses differ in the distribution of optical power within their optic zones and establish if these variations affect the vision of wearers or the prescribing procedure for back vertex power (BVP). By using a Visionix VC 2001 contact lens power analyzer, power profiles were measured across the optic zones of the following contemporary contact lenses ACUVUE 2, ACUVUE ADVANCE, O2OPTIX, NIGHT & DAY and PureVision. Single BVP measures were obtained using a Nikon projection lensometer. Visual performance was assessed in 28 masked subjects who wore each lens type in random order. Measurements taken were high and low contrast visual acuity in normal illumination (250 Cd/m), high contrast acuity in reduced illumination (5 Cd/m), subjective visual quality using a numerical rating scale, and visual satisfaction rating using a Likert scale. Marked differences in the distribution of optical power across the optic zone were evident among the lens types. No significant differences were found for any of the visual performance variables (p > 0.05, analysis of variance with repeated measures and Friedman test). Variations in power profile between contemporary soft lens types exist but do not, in general, result in measurable visual performance differences in the short term, nor do they substantially influence the BVP required for optimal correction.

  4. Risk factors for microbial bioburden during daily wear of silicone hydrogel contact lenses.

    PubMed

    Jiang, Ying; Jacobs, Michael; Bajaksouzian, Saralee; Foster, Altreisha N; Debanne, Sara M; Bielefeld, Roger; Garvey, Matt; Raghupathy, Sangeetha; Kern, Jami; Szczotka-Flynn, Loretta B

    2014-05-01

    To assess risk factors associated with substantial microbial bioburden of lids, conjunctivae, contact lenses, and storage cases during daily wear of silicone hydrogel contact lenses. Two hundred eighteen patients were fit to lotrafilcon A lenses, randomized to use either a multipurpose solution or a hydrogen peroxide care system, and followed up for 1 year. Lenses, lens transport saline, lids, conjunctivae, and storage cases were cultured and considered to have substantial microbial bioburden when they harbored high levels of commensal or pathogenic organisms. Univariate and multivariate logistic regression analyses were conducted to examine which demographic covariates were associated with significant bioburden at each location while controlling for solution use. In multivariate analyses, smoking trended toward an association with lens bioburden (odds ratio [OR]=2.15, 95% confidence interval [CI]: 0.95-4.88). Clerical occupations were found to be associated with more frequent overall storage case contamination (OR=3.51, 95% CI: 1.15-10.70) and, specifically, higher gram-positive storage case contamination (OR=5.57, 95% CI: 1.82-17.06). The peroxide system was associated with more frequent storage case contamination (OR=7.6, 95% CI: 3.79-15.19). Coagulase-negative staphylococci (CNS) were the most frequently cultured organisms within storage cases, and in multivariate analyses, CNS were more frequently found in storage cases of peroxide users (OR=6.12, 95% CI: 2.91-13.09). Clerical occupations were associated with increased microbial bioburden of storage cases during daily wear of silicone hydrogel lenses. Smoking may increase the risk of lens contamination. Storage cases are most frequently contaminated with normal skin flora, and peroxide cases were associated with more frequent contamination. However, the solution type was not associated with lid or lens contamination nor with corneal infiltrative events in this study.

  5. A Randomized Trial of Soft Multifocal Contact Lenses for Myopia Control: Baseline Data and Methods.

    PubMed

    Walline, Jeffrey J; Gaume Giannoni, Amber; Sinnott, Loraine T; Chandler, Moriah A; Huang, Juan; Mutti, Donald O; Jones-Jordan, Lisa A; Berntsen, David A

    2017-09-01

    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.

  6. Long-term effects of the daily wear of senofilcon A silicone hydrogel contact lenses on corneal and conjunctival tissues.

    PubMed

    Guillon, Michel; Maïssa, Cécile

    2010-12-01

    The objective of the investigation was to show that, because of their overall properties, Acuvue® Oasys™ with Hydraclear® Plus brand (senofilcon A) silicone hydrogel contact lenses achieve excellent ocular tissue tolerance during long-term daily wear. The 2-year investigation was a prospective daily wear analysis of Acuvue® Oasys™ with Hydraclear® Plus (senofilcon A) silicone hydrogel contact lenses replaced every 2 weeks and used in conjunction with a representative range of care systems. The 2-year results compared with the subjects' baseline ocular status on entering the study revealed: The quantification of the effects on the ocular tissues of 2 years of daily wear of senofilcon A, by mainly previously successful daily soft contact lens wearers, showed an excellent biocompatibility. The results support the hypothesis that senofilcon A contact lenses, when worn on a 2-week daily wear regimen, maintain excellent long-term ocular tissue tolerance. Copyright © 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

  7. The impact of cellular debris on Pseudomonas aeruginosa adherence to silicone hydrogel contact lenses and contact lens storage cases.

    PubMed

    Burnham, Geoffrey W; Cavanagh, H Dwight; Robertson, Danielle M

    2012-01-01

    To evaluate neutrophil-enhanced Pseudomonas aeruginosa (PA) biofilm formation on silicone hydrogel contact lenses and to determine the effect of epithelial biodebris on PA adherence in contact lens storage cases. A fully invasive PA corneal isolate stably conjugated to green fluorescent protein was used. Unworn lotrafilcon A contact lenses were incubated at various ratios of PA to polymorphonuclear neutrophil (PMN) for 24 hours at 37°C. Lens-associated PA was evaluated using laser scanning confocal microscopy and nonviable PA were visualized using propidium iodide. Viable bacteria were enumerated by colony-forming unit (CFU) analysis. For acute epithelial cell studies, PA viability was determined after coincubation with freeze-thaw epithelial cell lysates in 96-well polystyrene plates. Levels of residual cellular debris and bacterial viability were further assessed in used contact lens storage cases. Laser scanning confocal microscopy demonstrated that cotreatment with PMA-stimulated neutrophils increased PA adherence over 24 hours to lens surfaces with a striking alteration of PA architecture. Propidium iodide staining showed that the adherent bacteria consisted of a mixture of viable and nonviable PA; a PMN-associated increase in viable PA was confirmed by CFU (PA:PMN 0.1:1, P = 0.025; PA:PMN 1:1, P = 0.005). Acute epithelial cell debris studies revealed a significant increase in viable PA in 96-well plates in the presence of epithelial freeze-thaw lysates (PA:debris 1:1, P = 0.002; PA:debris 100:1, P = 0.002). Crystal violet staining of used lens storage cases revealed residual cellular debris at all time points, which was independent of microbial contamination; all lens cases used for periods of 9 months or more were uniformly associated with high levels of viable microorganisms. These results demonstrate that prolonged corneal inflammation with the presence of PMNs when confronted with simultaneous PA challenge in extended contact lens wear has the potential

  8. Bacterial Colonization of Disposable Soft Contact Lenses Is Greater during Corneal Infiltrative Events than during Asymptomatic Extended Lens Wear

    PubMed Central

    Sankaridurg, Padmaja R.; Sharma, Savitri; Willcox, Mark; Naduvilath, Thomas J.; Sweeney, Deborah F.; Holden, Brien A.; Rao, Gullapalli N.

    2000-01-01

    Microorganisms, especially gram-negative bacteria, are considered to play a role in the etiology of certain corneal infiltrative events (CIEs) observed during soft contact lens wear. This study explored the possibility of microbial colonization of soft contact lenses as a risk factor leading to CIEs. In a clinical trial conducted from March 1993 to January 1996, 330 subjects wore disposable soft contact lenses on a 6-night extended-wear and disposal schedule. During this period, 4,321 lenses (118 during CIEs; 4,203 during asymptomatic lens wear) were recovered aseptically and analyzed for microbial colonization. A greater percentage of lenses were free from microbial colonization during asymptomatic wear than during CIEs (42 versus 23%; P < 0.0001). The incidence of gram-positive bacteria, gram-negative bacteria and fungi was greater during CIEs than during asymptomatic lens wear (P < 0.05). During asymptomatic lens wear, gram-positive bacteria were isolated most frequently and were usually normal external ocular microbiota. Of the gram-positive bacteria, the incidence of Streptococcus pneumoniae was greater during CIE than during asymptomatic wear (7.6 versus 0.6%; P < 0.0001). While gram-negative bacteria were seen in few cases during asymptomatic wear, their incidence during CIE in comparison to asymptomatic wear was substantial and significant (23.7 versus 3.8%; P < 0.0001). Also, the level of colonization was high. Of CIEs, events of microbial keratitis, contact lens acute red eye, and asymptomatic infiltrative keratitis were associated with lens colonization with gram-negative bacteria or S. pneumoniae. Colonization of soft contact lenses with pathogenic bacteria, especially gram-negative bacteria and S. pneumoniae, appears to be a significant risk factor leading to CIE. PMID:11101574

  9. Co-delivery of timolol and hyaluronic acid from semi-circular ring-implanted contact lenses for the treatment of glaucoma: in vitro and in vivo evaluation.

    PubMed

    Desai, Ankita R; Maulvi, Furqan A; Pandya, Mihir M; Ranch, Ketan M; Vyas, Bhavin A; Shah, Shailesh A; Shah, Dinesh O

    2018-05-29

    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.

  10. Composition of incubation solution impacts in vitro protein uptake to silicone hydrogel contact lenses

    PubMed Central

    Heynen, Miriam; Luensmann, Doerte; Jones, Lyndon

    2012-01-01

    Purpose To determine the impact of incubation solution composition on protein deposition to silicone hydrogel (SH) contact lenses using a simplistic and a complex model of the tear film. Methods Three SH materials – senofilcon A (SA), lotrafilcon B (LB), and balafilcon A (BA) – were incubated in two different solutions; Solution A was a simplistic augmented buffered saline solution containing a single protein, whereas Solution B was a complex artificial tear solution (ATS), containing the augmented buffered saline solution in addition to proteins, lipids, and mucins (pH=7.4). The proteins of interest (lysozyme, lactoferrin, albumin) were radiolabeled with Iodine-125 (2% protein of interest) and the accumulation of the conjugated protein to the lens materials was determined after 1, 7, 14, and 28 days of incubation. Protein deposition was measured using a gamma counter and the raw data were translated into absolute amounts (µg/lens) via extrapolation from standards. Results After 28 days, lysozyme uptake was significantly lower on BA lenses when incubated in Solution A (33.7 μg) compared to Solution B (56.2 μg), p<0.001. SA lenses deposited similar amounts of lysozyme when incubated in either Solution A (2.6 μg) or Solution B (4.1 μg), p>0.05. LB lenses also deposited similar amounts of lysozyme for both solutions (Solution A: 5.0 μg, Solution B: 4.7 μg, p>0.05). After 28 days, BA lenses accumulated approximately twice the amount of lactoferrin than the other lens materials, with 30.3 μg depositing when exposed to Solution A and 22.0 μg with Solution B. The difference between the two solutions was statistically significant (p<0.001). LB materials deposited significantly greater amounts of lactoferrin when incubated in Solution A (16.6 μg) compared to Solution B (10.3 μg), p<0.001. Similar amounts of lactoferrin were accumulated onto SA lenses regardless of incubation solution composition (Solution A: 8.2 μg, Solution B: 11.2 μg, p>0.05). After 28

  11. Post-LASIK dry eye

    PubMed Central

    Shtein, Roni M

    2011-01-01

    Laser-assisted in situ keratomileusis (LASIK) is a frequently performed corneal refractive surgery with excellent refractive outcomes. The most common complication of LASIK is dry eyes, with virtually all patients developing some degree of dryness in the immediate postoperative period. Identifying preoperative dry eyes, and conscientious attention and treatment in the perioperative time period, can lead to enhanced patient satisfaction and more accurate visual outcomes. Improved understanding of the development of dry eyes after LASIK will advance our understanding of the complex pathophysiology of dry eye disease. PMID:22174730

  12. Microbial contamination of contact lenses after scaling and root planing using ultrasonic scalers with and without protective eyewear: A clinical and microbiological study.

    PubMed

    Afzha, Rooh; Chatterjee, Anirban; Subbaiah, Shobha Krishna; Pradeep, Avani Rangaraju

    2016-01-01

    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. 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. 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. 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.

  13. Biocompatibility and light transmission of liposomal lenses.

    PubMed

    Danion, Anne; Doillon, Charles J; Giasson, Claude J; Djouahra, Saliha; Sauvageau, Patrick; Paradis, Renée; Vermette, Patrick

    2007-10-01

    To validate the biocompatibility and transmittance properties of contact lenses bearing intact liposomes. These liposomal lenses loaded with therapeutics can be used as ophthalmic drug delivery systems. The biocompatibility of soft contact lenses, coated with liposomes was evaluated through in vitro direct and indirect cytocompatibility assays on human corneal epithelial cells, on reconstructed human corneas and on ex vivo rabbit corneas. The direct and indirect transmission spectra of liposome-covered lenses were also evaluated to test if they transmit all wavelengths of the ultraviolet-visible spectrum, to thereby fulfill their optical function, without gross alteration of the colors perception and with a minimum of light dispersion. Contact lenses bearing layers of stable liposomes did not induce any significant changes in cell viability and in cell growth, compared with lenses bearing no liposome. Elution assays revealed that no cytotoxic compound leaks from the lenses whether bearing liposomes or not. Histological analyses of reconstructed human corneas and ex vivo rabbit corneas directly exposed to liposomal lenses revealed neither alteration to the cell nor to the tissue structures. Contact lenses bearing layers of liposomes did not significantly affect light transmission compared with control lenses without liposome at the wavelength of maximal photopic sensitivity, i.e., 550 nm. In addition, the contact lenses afford more eye protection in the ultraviolet spectrum, compared with the control lenses. Liposomal contact lenses are biocompatible and their transmittance properties are not affected in the visible light range.

  14. Barriers, motivators and enablers for dispensing multifocal contact lenses in Mumbai, India

    PubMed Central

    Thite, Nilesh; Shah, Ukti; Mehta, Jasmin; Jurkus, Janice

    2015-01-01

    Purpose To understand the potential barriers, motivators and enablers in dispensing multifocal contact lenses (MFCL). Method 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. Results 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). Conclusion 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. PMID:25563404

  15. Barriers, motivators and enablers for dispensing multifocal contact lenses in Mumbai, India.

    PubMed

    Thite, Nilesh; Shah, Ukti; Mehta, Jasmin; Jurkus, Janice

    2015-01-01

    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.

  16. Operational Use Of Contact Lenses By Military Aircrew (L’Utilisation Operationnelle des Lentilles de Contact)

    DTIC Science & Technology

    1992-10-01

    Astigmatism 1 I Accommodation and Convergence 12 Advantages and Disadvantages of Contact Lenses 12 Optical Performance 12 Compliance 13 Supervision 13...absence of parallel tear lens, especially advantages of dealing with only one type of lens and accompanying astigmatism ) support system. - discomfort...Polcon I low. provides an explanation for the failure of high Dk Potycon 1I 8 a materials in fitting a cornea with astigmatism and the Si-02-•• ex need

  17. Thickness and topographic inspection of RPG contact lenses by optical triangulation

    NASA Astrophysics Data System (ADS)

    Costa, Manuel F. M.

    2001-06-01

    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.

  18. Efficacy of Toric Contact Lenses in Fitting and Patient-Reported Outcomes in Contact Lens Wearers.

    PubMed

    Cox, Stephanie M; Berntsen, David A; Bickle, Katherine M; Mathew, Jessica H; Powell, Daniel R; Little, B Kim; Lorenz, Kathrine Osborn; Nichols, Jason J

    2018-06-05

    To assess whether patient-reported measures are improved with soft toric contact lenses (TCLs) compared with soft spherical contact lenses (SCLs) and whether clinical time needed to fit TCL is greater than SCL. Habitual contact lens wearers with vertexed spherical refraction +4.00 to +0.25 D or -0.50 to -9.00 D and cylinder -0.75 to -1.75 DC were randomly assigned to be binocularly fitted into a TCL or SCL, and masked to treatment assignment. Time to successful fit was recorded. After 5 days, the National Eye Institute Refractive Error Quality of Life Instrument (NEI-RQL-42) and modified Convergence Insufficiency Symptom Survey (CISS) were completed. After washout, subjects were fit into the alternative lens design (TCL or SCL). Outcomes were evaluated using linear mixed models for the time to fit and CISS score, generalized linear model for the successful fit, and Wilcoxon tests for the NEI-RQL-42. Sixty subjects (71.7% women, mean age [±SD] = 27.5±5.0 years) completed the study. The mean time to fit the TCL was 10.2±4.3 and 9.0±6.5 min for the SCL (least square [LS] mean difference (TCL-SCL)=1.2, P=0.22). Toric contact lens scored better than SCL in global NEI-RQL-42 score (P=0.006) and the clarity of vision (P=0.006) and satisfaction with correction subscales (P=0.006). CISS showed a 15% reduction in symptoms (LS mean difference [TCL-SCL]=-2.20, P=0.02). TCLs are a good option when trying to improve the vision of patients with low-to-moderate astigmatism given the subjective improvements in outcomes.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.

  19. Mechanistic modeling of ophthalmic drug delivery to the anterior chamber by eye drops and contact lenses.

    PubMed

    Gause, Samuel; Hsu, Kuan-Hui; Shafor, Chancellor; Dixon, Phillip; Powell, Kristin Conrad; Chauhan, Anuj

    2016-07-01

    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

  20. Microbial contamination of contact lenses after scaling and root planing using ultrasonic scalers with and without protective eyewear: A clinical and microbiological study

    PubMed Central

    Afzha, Rooh; Chatterjee, Anirban; Subbaiah, Shobha Krishna; Pradeep, Avani Rangaraju

    2016-01-01

    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

  1. Microbiological study of therapeutic soft contact lenses used in the treatment of recurrent corneal erosion syndrome.

    PubMed

    Park, Young Min; Kwon, Han Jo; Lee, Jong Soo

    2015-03-01

    To determine the bacteriological spectrum of the removed therapeutic soft contact lenses (TSCLs) and to establish efficacy of prophylactic antibiotics on TSCLs used for 2 weeks for treatment of patients with recurrent corneal erosion syndrome (RCES). This study included idiopathic RCES treated using highly oxygen-permeable silicone hydrogel contact lenses (CLs), and treated 4 times per day with topical tobramycin 3% for 2 weeks. After TSCLs were applied for 2 weeks, the lenses were removed with sterile forceps under which a speculum was inserted, and placed on blood agar with the inner face down. The TSCLs were analyzed for bacterial colonization, and antibiotic susceptibility tests were performed for the isolates, using disk diffusion. Of the 40 lenses analyzed, 9 (22.5%) yielded positive cultures. Staphylococcus epidermidis was the most commonly isolated microorganism; there were five methicillin-sensitive coagulase-negative staphylococci and two methicillin-resistant coagulase-negative staphylococci. Furthermore, we found two lenses that were colonized by Enterobacter gergoviae and Citrobacter freundii. All cultured bacteria showed intermediate or complete sensitivity to ciprofloxacin, tigecycline, and tobramycin. Despite bacterial colonization in 9 CLs, no clinical signs of infectious keratitis were found in any of the patients with prophylactic topical tobramycin 3%. In case of using TSCLs for 2 weeks, tobramycin or ciprofloxacin may be useful as prophylactic topical antibiotics for preventing secondary corneal infections. Considering currently growing incidence of ciprofloxacin-resistant ocular isolates, tobramycin seems to be a reasonable prophylactic topical antibiotic susceptible broad spectrum of bacteria in clinics.

  2. Quantity of protein deposited on hydrogel contact lenses and its relation to visible protein deposits.

    PubMed

    Myers, R I; Larsen, D W; Tsao, M; Castellano, C; Becherer, L D; Fontana, F; Ghormley, N R; Meier, G

    1991-10-01

    The purposes of this study were to determine if the quantity of protein deposited (QPD) upon hydrogel lenses was affected by enzymatic cleaning and to test the potential relation between QPD and visible protein deposition (VPD) and change. Seventy-four contact lens patients classified as "heavy depositors" wore new lenses for an average of 80 (SD = 32) days. Cleaning and disinfection solutions varied. One lens was cleaned weekly by a papain enzymatic treatment. The distribution of QPD measurements was bimodal and was related to the FDA material for nonionic, low water content lenses (FDA Materials Group no. 1). The mean deposition was 45 micrograms/cm2 (N = 112) compared with that of ionic, high water content lenses (FDA Materials Group no. 4), which was 1010 micrograms/cm2 (N = 30). VPD distributions were the same for the FDA Group no. 1 and no. 4 lenses. Enzymatic treatment did not significantly reduce QPD; however, enzymatic treatment did reduce VPD. Thus QPD and VPD are independent phenomena and possible reasons for this are given.

  3. Effect of Masking on Subjective Responses to Daily Disposable Contact Lenses.

    PubMed

    Keir, Nancy; Luensmann, Doerte; Woods, Craig A; Bergenske, Peter; Fahmy, Mary; Fonn, Desmond

    2016-08-01

    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.

  4. Can UV radiation-blocking soft contact lenses attenuate UV radiation to safe levels during summer months in the southern United States?

    PubMed

    Walsh, James E; Bergmanson, Jan P G; Saldana, Gerardo; Gaume, Amber

    2003-01-01

    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.

  5. Influence of Amphibian Antimicrobial Peptides and Short Lipopeptides on Bacterial Biofilms Formed on Contact Lenses

    PubMed Central

    Maciejewska, Magdalena; Bauer, Marta; Neubauer, Damian; Kamysz, Wojciech; Dawgul, Malgorzata

    2016-01-01

    The widespread use of contact lenses is associated with several complications, including ocular biofilm-related infections. They are very difficult to manage with standard antimicrobial therapies, because bacterial growth in a biofilm is associated with an increased antibiotic resistance. The principal aim of this study was to evaluate the efficacy of antimicrobial peptides (AMPs) in eradication of bacterial biofilms formed on commercially available contact lenses. AMPs were synthesized according to Fmoc/tBu chemistry using the solid-phase method. Minimum inhibitory concentration (MIC) and minimum biofilm eradication concentration (MBEC) of the compounds were determined. Anti-biofilm activity of the antimicrobial peptides determined at different temperatures (25 °C and 37 °C) were compared with the effectiveness of commercially available contact lens solutions. All of the tested compounds exhibited stronger anti-biofilm properties as compared to those of the tested lens solutions. The strongest activity of AMPs was noticed against Gram-positive strains at a temperature of 25 °C. Conclusions: The results of our experiments encourage us toward further studies on AMPs and their potential application in the prophylaxis of contact lens-related eye infections. PMID:28773992

  6. Antimicrobial Efficacy of Multipurpose Disinfecting Solutions in the Presence of Contact Lenses and Lens Cases.

    PubMed

    Gabriel, Manal M; McAnally, Cindy; Bartell, John

    2018-03-01

    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.

  7. Antimicrobial Efficacy of Multipurpose Disinfecting Solutions in the Presence of Contact Lenses and Lens Cases

    PubMed Central

    McAnally, Cindy; Bartell, John

    2018-01-01

    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

  8. The influence of surface treatment on hydrophobicity, protein adsorption and microbial colonisation of silicone hydrogel contact lenses.

    PubMed

    Santos, Lívia; Rodrigues, Diana; Lira, Madalena; Oliveira, M Elisabete C D Real; Oliveira, Rosário; Vilar, Eva Yebra-Pimentel; Azeredo, Joana

    2007-07-01

    To evaluate the influence of surface treatment of silicone-hydrogel CL on lens hydrophobicity, protein adsorption and microbial colonisation by studying several silicone hydrogel contact lenses (CL) with and without surface treatment. The lenses used in this study were Balafilcon A, Lotrafilcon A, Lotrafilcon B and Galyfilcon A. A conventional hydrogel CL (Etafilcon A) was also tested. Hydrophobicity was determined through contact angle measurement using the advancing type technique on air. The type and quantity of proteins adsorbed were assessed through SDS-PAGE and fluorescence spectroscopy, respectively. Microbial colonisation was studied by removing the microbes from the lenses through sonication, and counting the colony-forming units on agar plates. Regarding hydrophobicity, both surface and non-surface-treated silicone hydrogel CL were found to be hydrophobic, and the conventional hydrogel CL was found to be hydrophilic. Concerning protein adsorption, different protein profiles were observed on the several lenses tested. Nevertheless, the presence of proteins with the same molecular weight as lysozyme and lactoferrin was common to all lenses, which is probably related to their abundance in tears. In terms of total protein adsorption, silicone hydrogel CL did not exhibit any differences between themselves. However, the conventional hydrogel Etafilcon A adsorbed a larger amount of proteins. Regarding microbial colonisation, Balafilcon A exhibited the greatest amount of colonising microbes, which can be due to its superior hydrophobicity and higher electron acceptor capacity. This study suggests that silicone hydrogel lenses adsorb a lower amount of proteins than the conventional hydrogel lenses and that this phenomenon is independent of the presence of surface treatment. Concerning microbial colonisation, the surface treated Balafilcon A, exhibited a greater propensity, a fact that may compromise the lens wearer's ocular health.

  9. Applicability of contact angle techniques used in the analysis of contact lenses, part 1: comparative methodologies.

    PubMed

    Campbell, Darren; Carnell, Sarah Maria; Eden, Russell John

    2013-05-01

    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.

  10. [Fitting Monocurve and Bicurve (Soper-McGuire design) rigid gas-permeable contact lenses in keratoconus patients: a prospective randomized comparative clinical trial].

    PubMed

    Coral-Ghanem, Cleusa; Alves, Milton Ruiz

    2008-01-01

    To evaluate the clinical performance of Monocurve and Bicurve (Soper-McGuire design) rigid gas-permeable contact lens fitting in patients with keratoconus. A prospective and randomized comparative clinical trial was conducted with a minimum follow-up of six months in two groups of 63 patients. One group was fitted with Monocurve contact lenses and the other with Bicurve Soper-McGuire design. Study variables included fluoresceinic pattern of lens-to-cornea fitting relationship, location and morphology of the cone, presence and degree of punctate keratitis and other corneal surface alterations, topographic changes, visual acuity for distance corrected with contact lenses and survival analysis for remaining with the same contact lens design during the study. During the follow-up there was a decrease in the number of eyes with advanced and central cones fitted with Monocurve lenses, and an increase in those fitted with Soper-McGuire design. In the Monocurve group, a flattening of both the steepest and the flattest keratometric curve was observed. In the Soper-McGuire group, a steepening of the flattest keratometric curve and a flattening of the steepest keratometric curve were observed. There was a decrease in best-corrected visual acuity with contact lens in the Monocurve group. Survival analysis for the Monocurve lens was 60.32% and for the Soper-McGuire was 71.43% at a mean follow-up of six months. This study showed that due to the changes observed in corneal topography, the same contact lens design did not provide an ideal fitting for all patients during the follow-up period. The Soper-McGuire lenses had a better performance than the Monocurve lenses in advanced and central keratoconus.

  11. Robert Mandell: a pioneer and giant in the art and science of contact lenses.

    PubMed

    Polse, Kenneth A

    2008-10-01

    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.

  12. Silicone hydrogel mini-scleral contact lenses in early stage after corneal collagen cross-linking for keratoconus: a retrospective case series.

    PubMed

    Severinsky, Boris; Wajnsztajn, Denise; Frucht-Pery, Joseph

    2013-11-01

     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.

  13. From Reading Stones, Glasses and Contact Lenses to Intraocular Lenses & Ophthalmic Lasers--A Short Overview over the History of Visual Aids.

    PubMed

    Scholtz, Sibylle K; Auffarth, Gerd U

    2012-01-01

    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.

  14. Computational Sensing of Staphylococcus aureus on Contact Lenses Using 3D Imaging of Curved Surfaces and Machine Learning.

    PubMed

    Veli, Muhammed; Ozcan, Aydogan

    2018-03-27

    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.

  15. Effect of plasma treatment on the performance of two drug-loaded hydrogel formulations for therapeutic contact lenses.

    PubMed

    Paradiso, Patrizia; Chu, Virginia; Santos, Luís; Serro, Ana Paula; Colaço, Rogério; Saramago, Benilde

    2015-07-01

    Although the plasma technology has long been applied to treat contact lenses, the effect of this treatment on the performance of drug-loaded contact lenses is still unclear. The objective of this work is to study the effect of nitrogen plasma treatment on two drug-loaded polymeric formulations which previously demonstrated to be suitable for therapeutic contact lenses: a poly-hydroxyethylmethacrylate (pHEMA) based hydrogel loaded with levofloxacin and a silicone-based hydrogel loaded with chlorhexidine. Modifications of the surface and the optical properties, and alterations in the drug release profiles and possible losses of the antimicrobial activities of the drugs induced by the plasma treatment were assessed. The results showed that, depending on the system and on the processing conditions, the plasma treatment may be beneficial for increasing wettability and refractive index, without degrading the lens surface. From the point of view of drug delivery, plasma irradiation at moderate power (200 W) decreased the initial release rate and the amount of released drug, maintaining the drug activity. For lower (100 W) and higher powers (300 W), almost no effect was detected because the treatment was, respectively, too soft and too aggressive for the lens materials. © 2014 Wiley Periodicals, Inc.

  16. Adhesive capabilities of Staphylococcus aureus and Pseudomonas aeruginosa isolated from tears of HIV/AIDS patients to soft contact lenses.

    PubMed

    Ajayi, B O; Kio, F E; Otajevwo, F D

    2012-01-01

    Fifty conjunctival swab samples collected from ELISA confirmed HIV/AIDS seropositive patients who were referred to the HIV/AIDS laboratories of the University of Benin Teaching Hospital and Central Hospital both based in Benin City, Nigeria were aseptically cultured on appropriate media by standard methods. The resulting isolates/strains, after identification by standard methods, were tested for their ability to adhere to two hydrophobic non-ionic daily wear silicone hydrogel soft contact lenses (i.e. lotrafilcon B, WC 33% and polymacon, WC 38%) as well as to two hydrophilic ionic conventional extended wear silicone hydrogel soft contact lenses (i.e. methafilcon A, WC 55% and omafilcon A, WC 60%) by the adhesiveness/slime production modified vortex/Robin device method. Evidence of adhesiveness/slime production was indicated by presence of a visible stained film lining the surface of the contact lens which was measured and recorded as strong or weak according to the density of the adhered bacterial film. Fourteen (28.0%) Staphylococcus aureus strains and 10 (20.0%) Pseudomonas aeruginosa strains were obtained among other organisms. Staphylococcus aureus strains adhered in decreasing order to lotrafilcon B (55.4 ± 4.7), polymacon (46.4 ± 8.4), methfilcon A (46.4 ± 8.4) and omafilcon A (25.0 ± 6.4) with no significant difference in adhesive strengths of individual strains (P > 0.05). Pseudomonas aeruginosa strains also recorded decreasing adhesive strengths to lotrafilcon B (37.5 ± 8.2), polymacon (28.6 ± 6.3), methafilcon A (26.8 ± 5.5) and omafilcon A (23.2 ± 5.5) also with no significant difference in adhesive strengths of individual strains (P > 0.05). Attachment strengths of Staph. aureus strains to all four contact lenses were higher than those of Pseudomonas aeruginosa strains. Both organisms adhered most to hydrophobic lotrafilcon B and least to hydrophilic omafilcon A. This invitro adhesion studies revealed that daily wear silicone hydrogel low water

  17. Adhesive Capabilities of Staphylococcus Aureus and Pseudomonas Aeruginosa Isolated from Tears of HIV/AIDS Patients to Soft Contact Lenses

    PubMed Central

    B. O., Ajayi; F.E., Kio; F.D., Otajevwo

    2012-01-01

    Fifty conjunctival swab samples collected from ELISA confirmed HIV/AIDS seropositive patients who were referred to the HIV/AIDS laboratories of the University of Benin Teaching Hospital and Central Hospital both based in Benin City, Nigeria were aseptically cultured on appropriate media by standard methods. The resulting isolates/strains, after identification by standard methods, were tested for their ability to adhere to two hydrophobic non-ionic daily wear silicone hydrogel soft contact lenses (i.e. lotrafilcon B, WC 33% and polymacon, WC 38%) as well as to two hydrophilic ionic conventional extended wear silicone hydrogel soft contact lenses (i.e. methafilcon A, WC 55% and omafilcon A, WC 60%) by the adhesiveness/slime production modified vortex/Robin device method. Evidence of adhesiveness/slime production was indicated by presence of a visible stained film lining the surface of the contact lens which was measured and recorded as strong or weak according to the density of the adhered bacterial film. Fourteen (28.0%) Staphylococcus aureus strains and 10 (20.0%) Pseudomonas aeruginosa strains were obtained among other organisms. Staphylococcus aureus strains adhered in decreasing order to lotrafilcon B (55.4 ± 4.7), polymacon (46.4 ± 8.4), methfilcon A (46.4 ± 8.4) and omafilcon A (25.0 ± 6.4) with no significant difference in adhesive strengths of individual strains (P > 0.05). Pseudomonas aeruginosa strains also recorded decreasing adhesive strengths to lotrafilcon B (37.5 ± 8.2), polymacon (28.6 ± 6.3), methafilcon A (26.8 ± 5.5) and omafilcon A (23.2 ± 5.5) also with no significant difference in adhesive strengths of individual strains (P > 0.05). Attachment strengths of Staph. aureus strains to all four contact lenses were higher than those of Pseudomonas aeruginosa strains. Both organisms adhered most to hydrophobic lotrafilcon B and least to hydrophilic omafilcon A. This invitro adhesion studies revealed that daily wear silicone hydrogel low water

  18. In vivo laser confocal microscopic analysis of corneal K-structures after keratorefractive surgery (LASIK and epi-LASIK).

    PubMed

    Yokogawa, Hideaki; Kobayashi, Akira; Tagawa, Kosaku; Sugiyama, Kazuhisa

    2010-01-01

    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.

  19. Corneo-scleral contact lenses in an uncommon case of keratoconus with high hyperopia and astigmatism.

    PubMed

    Porcar, Esteban; Montalt, Juan Carlos; España-Gregori, Enrique; Peris-Martínez, Cristina

    2017-10-01

    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.

  20. Detachment of trophozoites of Acanthamoeba species from soft contact lenses with BEN22 detergent, BioSoak, and Renu multi-purpose solutions.

    PubMed

    Raali, E; Vaahtoranta-Lehtonen, H H; Lehtonen, O P

    2001-07-01

    BEN22 detergent was studied for its ability to detach Acanthamoeba from soft contact lenses without mechanical cleaning or separate cleaning agents. Trophozoites of Acanthamoeba castellanii and A. polyphaga were adhered onto nonionic, high water content soft contact lenses. The lenses were immersed for 2 hours in contact lens care solutions and the remaining trophozoites were counted microscopically. The counts were compared to the counts on the same lens before treatment. BEN22 (50:50 mixture of L-alpha-L-rhamnopyranosyl-beta-hydroxydecanoyl-beta-hydroxydecanoate and 2-O-alpha-L-rhamnopyranosyl-alpha-L-rhamnopyranosyl-beta-hydroxydecanoyl-beta-hydroxydecanoate) (Kassell Industries, Inc., Wisconsin Dells, WI) in a concentration of 0.05% detached the trophozoites to a statistically significant greater extent than saline, but commercial ReNu Multi-Purpose Solution (Bausch & Lomb, Italy) and BioSoak (Finnsusp Ltd., Finland) did so as well. ReNu Multi-Purpose Solution was more effective than 0.005% BEN22 in detaching the trophozoites of both of the Acanthamoeba strains. After the 2 hour immersion period, a maximum of 97% of the initial trophozoites were detached. The variation between individual lenses was significantly greater than that within the different areas of one lens. BEN22 had no reliable detaching effect on Acanthamoeba. The variation between lenses was great, and the rate of detachment was low with all the agents tested indicating that immersion and rinsing in the solutions tested cannot be considered as a safe substitute for proper disinfection against Acanthamoeba in contact lens care.

  1. Extended Latanoprost Release from Commercial Contact Lenses: In Vitro Studies Using Corneal Models

    PubMed Central

    Mohammadi, Saman; Jones, Lyndon; Gorbet, Maud

    2014-01-01

    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

  2. Adhesion of Acanthamoeba on Cosmetic Contact Lenses

    PubMed Central

    2017-01-01

    Background This study aimed to evaluate the adhesion of Acanthamoeba trophozoites on cosmetic contact lenses (CLs) with and without CL care multipurpose solution (MPS) treatment. Methods Acanthamoeba lugdunensis L3a trophozoites were inoculated onto disks trimmed from CLs: 1-day Acuvue moist, 1-day Acuvue define, Acuvue 2, and Acuvue 2 define. After 18-hour inoculation, the number of adherent trophozoites was counted under phase contrast microscopy. The effects of MPS, Opti-Free Express, soaking CLs for 6 hours, on Acanthamoeba adhesion were analyzed. Scanning electron microscopic examination was performed for assessment of Acanthamoeba attached on the lens surface. Results Acanthamoeba trophozoites showed greater adhesion to cosmetic CL (P = 0.017 for 1-day CL and P = 0.009 for 2-week CL) although there was no significant difference between the types of cosmetic CL. On all lenses, the number of adherent Acanthamoeba was significantly reduced after treatment with MPS (P < 0.001 for 1-day Acuvue moist, P = 0.046 for 1-day Acuvue define, P < 0.001 for Acuvue 2, and P = 0.015 for Acuvue 2 define), but there was still significant difference between conventional and cosmetic CLs (P = 0.003 for 1-day CL and P < 0.001 for 2-week CL, respectively). More attachment of Acanthamoeba was observed on colored area and the acanthopodia of Acanthamoeba was placed on the rough surface of colored area. Conclusion Acanthamoeba showed a greater affinity for cosmetic CL and mostly attached on colored area. Although MPS that contained myristamidopropyl dimethylamine reduced the adhesion rate, there was a significant difference between conventional and cosmetic CLs. PMID:29318793

  3. A prospective comparison of phakic collamer lenses and wavefront-optimized laser-assisted in situ keratomileusis for correction of myopia

    PubMed Central

    Parkhurst, Gregory D

    2016-01-01

    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

  4. A prospective comparison of phakic collamer lenses and wavefront-optimized laser-assisted in situ keratomileusis for correction of myopia.

    PubMed

    Parkhurst, Gregory D

    2016-01-01

    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). 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. 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). 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.

  5. Posterior corneal surface differences between non-laser in situ keratomileusis (LASIK) and 10-year post-LASIK myopic eyes.

    PubMed

    Dai, Ma-Li; Wang, Qin-Mei; Lin, Zu-Shun; Yu, Ye; Huang, Jin-Hai; Savini, Giacomo; Zhang, Jia; Wang, Ling; Xu, Chen-Chen

    2018-03-01

    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.

  6. Facts about Myopia

    MedlinePlus

    ... retina. Contact lenses can cause complications (e.g., dry eye, corneal distortion, immunologic reaction, infection), but may be ... study, up to 28 percent of people experienced dry eye symptoms after LASIK. 6 In the same study, ...

  7. Bacterial contaminants of bandage contact lenses used after laser subepithelial or photorefractive keratectomy.

    PubMed

    Liu, Xiaowei; Wang, Peng; Kao, Andrew A; Jiang, Yang; Li, Ying; Long, Qin

    2012-07-01

    To compare the locations and types of bacterial contamination of bandage disposable soft contact lenses after laser subepithelial keratectomy (LASEK) and photorefractive keratectomy (PRK). Bandage disposable soft contact lenses were collected with sterile forceps from 30 eyes of 15 consecutive patients treated with LASEK (LASEK group) and 30 eyes of 15 consecutive patients who underwent PRK (PRK group) to correct myopia. Immediately after collection, each lens was cut in two parts with sterile scissors and placed onto chocolate agar with one piece outer face down and the inner face down for the other piece. The lenses were analyzed for bacterial colonization and evaluated for the amount of growth on the inner face and outer face, respectively. The antibiotic susceptibility tests were performed for the isolates using disk diffusion. Five positive cultures (16.7%) were found in LASEK group: 4 appeared in the inner face of the lens and1 appeared in the outer face. In PRK group, 2 of the 30 contact lenses (6.67%) had positive cultures; both of them appeared in the outer face of the lens. The difference of positive culture rate in the two groups was not statistically significant (χ=1.46, P=0.228). When comparing the positive colonization rate in location, the positive culture rate in the inner face of LASEK group was statistically significantly higher than that of PRK group (13.3% vs. 0%, χ=4.29, P=0.038); however, no clinical finding of infection was noted. In both groups, methicillin-sensitive coagulase-negative staphylococci (MSSCoN) were the most common isolate. Besides MSSCoN, the growth of methicillin-resistant coagulase-negative staphylococci, Corynebacterium, and Micrococcus were also present in this study. All the microorganisms were sensitive to tobramycin, which was used in conjunction with dexamethasone to treat the cases. Previous literature reports that the risk of infectious keratitis after LASEK or PRK is relatively low. However, within this study, the

  8. Investigation of biofilm formation on contact eye lenses caused by methicillin resistant Staphylococcus aureus.

    PubMed

    Khalil, M A; Sonbol, F I

    2014-01-01

    The objective was to investigate the biofilm-forming capacity of methicillin resistant Staphylococcus aureus (MRSA) isolated from eye lenses of infected patients. A total of 32 MRSA isolated from contact lenses of patients with ocular infections were screened for their biofilm-forming capacity using tube method (TM), Congo red agar (CRA), and microtiter plate (MtP) methods. The effect of some stress factor on the biofilm formation was studied. The biofilm-forming related genes, icaA, icaD and 10 microbial surface components that recognize adhesive matrix molecule (MSCRAMM), of the selected MRSA were also detected using polymerase chain reaction. Of 32 MRSA isolates, 34.37%, 59.37%, and 81.25% showed positive results using CRA, TM or MtP, respectively. Biofilm production was found to be reduced in the presence of ethanol or ethylenediaminetetraacetic acid and at extreme pH values. On the other hand, glucose or heparin leads to a concentration dependent increase of biofilm production by the isolates. The selected biofilm producing MRSA isolate was found to harbor the icaA, icaD and up to nine of 10 tested MSCRAMM genes, whereas the selected non biofilm producing MRSA isolate did not carry any of the tested genes. The MtP method was found to be the most effective phenotypic screening method for detection of biofilm formation by MRSA. Furthermore, the molecular approach should be taken into consideration for the rapid and correct diagnosis of virulent bacteria associated with contact eye lenses.

  9. Estimation of the refractive index of rigid contact lenses on the basis of back vertex power measurements.

    PubMed

    Pearson, Richard

    2011-03-01

    To assess the possibility of estimating the refractive index of rigid contact lenses on the basis of measurements of their back vertex power (BVP) in air and when immersed in liquid. First, a spreadsheet model was used to quantify the magnitude of errors arising from simulated inaccuracies in the variables required to calculate refractive index. Then, refractive index was calculated from in-air and in-liquid measurements of BVP of 21 lenses that had been made in three negative BVPs from materials with seven different nominal refractive index values. The power measurements were made by two operators on two occasions. Intraobserver reliability showed a mean difference of 0.0033±0.0061 (t = 0.544, P = 0.59), interobserver reliability showed a mean difference of 0.0043±0.0061 (t = 0.707, P = 0.48), and the mean difference between the nominal and calculated refractive index values was -0.0010±0.0111 (t = -0.093, P = 0.93). The spreadsheet prediction that low-powered lenses might be subject to greater errors in the calculated values of refractive index was substantiated by the experimental results. This method shows good intra and interobserver reliabilities and can be used easily in a clinical setting to provide an estimate of the refractive index of rigid contact lenses having a BVP of 3 D or more.

  10. Development of optoelectronic hardware: program complex for the analysis of hypoxia in the anterior eye camera in persons wearing contact lenses

    NASA Astrophysics Data System (ADS)

    Topakova, Anastassia A.; Salmin, Vladimir V.; Gar'kavenko, Victor V.; Levchenko, Julia S.; Lazarenko, Victor I.

    2016-04-01

    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.

  11. Corneal and conjunctival sensory function: the impact on ocular surface sensitivity of change from low to high oxygen transmissibility contact lenses.

    PubMed

    Golebiowski, Blanka; Papas, Eric B; Stapleton, Fiona

    2012-03-09

    Deprivation of oxygen to the ocular surface during contact lens wear has been implicated in the alteration of sensory function. This study investigates whether increasing oxygen availability through discontinuation of contact lens wear or transfer into highly oxygen transmissible (high Dk/t) lenses leads to a change in corneal or conjunctival sensitivity. Twenty-seven long-term extended wearers of low Dk/t soft contact lenses ceased lens wear for 1 week and were refitted with high Dk/t silicone hydrogel lenses. A control group of 25 nonwearers matched for age and sex was also recruited. Central corneal and inferior conjunctival sensitivity were measured using an air-jet aesthesiometer. Threshold was determined using a staircase technique. Measurements were taken during low Dk/t lens wear; after 1 week of no wear; and after 1, 3, 6, and 12 months of high Dk/t lens wear. Measurements were carried out on one occasion on the nonwearers. Corneal sensitivity decreased 1 week after discontinuation of low Dk/t lenses and no further change in sensitivity occurred with high Dk/t lens wear. Conjunctival sensitivity did not change over the same time frame. Ocular surface sensitivity in long-term low Dk/t soft lens wearers was similar to that of nonwearers. Sensitivity was higher in females than males in the nonwearers, but not in the lens-wearing group. An interaction of sex on change in conjunctival threshold was found in the lens wearers. These findings indicate that factors other than oxygen availability alone determine sensitivity of the ocular surface. Silicone hydrogel contact lenses appear to have only a minor impact on ocular surface sensitivity in previous lens wearers.

  12. Outcomes of LASIK and PRK in previous penetrating corneal transplant recipients.

    PubMed

    Kovoor, Timmy A; Mohamed, Engy; Cavanagh, H Dwight; Bowman, R Wayne

    2009-09-01

    To evaluate the safety and efficacy of excimer laser refractive surgery in correcting refractive error in eyes that have undergone previous penetrating keratoplasty (PK). Twenty-three keratorefractive procedures on 16 eyes from 16 consecutive subjects were evaluated between 2002 and 2008. Each patient presented a previous history of a PK with subsequent postoperative myopia and astigmatism. Keratometric value, manifest refraction, best-corrected visual acuity, uncorrected visual acuity, and complications were determined. There were a total of 14 photorefractive keratectomy (PRK) procedures performed on 11 eyes and 9 laser in situ keratomileusis (LASIK) procedures performed on 5 eyes. In the PRK group, the preoperative post-PK manifest refractive spherical equivalent and cylindrical error were -6.22 +/- 6.23 diopter and 5.23 +/- 2.26 D, respectively. The PRK postoperative manifest refractive spherical equivalent and cylindrical error were -3.61 +/- 4.23 D (P=0.25) and 3.21 +/- 1.78 D (P=0.02), respectively. In the LASIK group, the preoperative post-PK manifest refractive spherical equivalent and cylindrical error were -3.05 +/- 3.29 D and 4.11 +/- 2.38 D, respectively. The LASIK postoperative manifest refractive spherical equivalent and cylindrical error were -1.51 +/- 2.02 D (P=0.24) and 2.08 +/- 1.26 D (P=0.03), respectively. There was a 2-line or greater improvement of uncorrected visual acuity in 8 of the 14 PRK treatments and 5 of the 9 LASIK treatments. There were two episodes of acute graft rejection. One of the episodes resolved with topical and oral corticosteroids, and the other episode required a repeat corneal transplantation. PRK and LASIK are effective tools in reducing surgically induced astigmatism after penetrating corneal transplantation in most patients in this case series. The reduction of astigmatism may allow improved contact lens or spectacle fitting to achieve best-corrected binocular visual acuity.

  13. Optical contact micrometer

    DOEpatents

    Jacobson, Steven D.

    2014-08-19

    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.

  14. In vitro drug release and in vivo safety of vitamin E and cysteamine loaded contact lenses.

    PubMed

    Dixon, Phillip; Fentzke, Richard C; Bhattacharya, Arnab; Konar, Aditya; Hazra, Sarbani; Chauhan, Anuj

    2018-06-15

    Cystinosis is an orphan disease caused by a genetic mutation that leads to deposition of cystine crystals in many organs including cornea. Ophthalmic manifestation of the disease can be treated with hourly instillation of cysteamine eye drops. The hourly eye drop instillation is tedious to the patients leading to poor compliance and additionally, significant degradation of the drug occurs within one week of opening the bottle, which further complicates this delivery approach. This paper focuses on designing a contact lens to treat the disease with improved efficacy compared to eye drops, and also exploring safety of the drug eluding contact lens in an animal model. Our goal is to design a lens that is safe and that can deliver a daily therapeutic dose of cysteamine to the cornea while retaining drug stability. We show that cysteamine diffuses out rapidly from all lenses due to its small size. Vitamin E incorporation increases the release duration of both ACUVUE ® OASYS ® and ACUVUE ® TruEye TM but the effect is more pronounced in TruEye TM likely due to the low solubility of vitamin E in the lens matrix and higher aspect ratio of the barriers. The barriers are not effective in hydrogel lenses, which along with the high aspect ratio in silicone hydrogels suggests that barriers could be forming at the interface of the silicone and hydrogel phases. The presence of vitamin E has an additional beneficial effect of reduction in the oxidation rates, likely due to a transport barrier between the oxygen diffusing through the silicone channels and drug located in the hydrogel phase. Based on this study, both Acuvue ® OASYS ® and ACUVUE ® TruEye TM can be loaded with vitamin E to design a cysteamine eluting contact lenses for effective therapy of cystinosis. The lenses must be worn for about 4-5 hr. each day, which is less than the typical duration of daily-wear. The vitamin E and cysteamine loaded lenses did not exhibit any toxicity in a rabbit model over a period of 7

  15. Microbial adhesion to silicone hydrogel lenses: a review.

    PubMed

    Willcox, Mark D P

    2013-01-01

    Microbial adhesion to contact lenses is believed to be one of the initiating events in the formation of many corneal infiltrative events, including microbial keratitis, that occur during contact lens wear. The advent of silicone hydrogel lenses has not reduced the incidence of these events. This may partly be related to the ability of microbes to adhere to these lenses. The aim of this study was to review the published literature on microbial adhesion to contact lenses, focusing on adhesion to silicone hydrogel lenses. The literature on microbial adhesion to contact lenses was searched, along with associated literature on adverse events that occur during contact lens wear. Particular reference was paid to the years 1995 through 2012 because this encompasses the time when the first clinical trials of silicone hydrogel lenses were reported, and their commercial availability and the publication of epidemiology studies on adverse events were studied. In vitro studies of bacterial adhesion to unworn silicone hydrogel lens have shown that generally, bacteria adhere to these lenses in greater numbers than to the hydroxyethyl methacrylate-based soft lenses. Lens wear has different effects on microbial adhesion, and this is dependent on the type of lens and microbial species/genera that is studied. Biofilms that can be formed on any lens type tend to protect the bacteria and fungi from the effects on disinfectants. Fungal hyphae can penetrate the surface of most types of lenses. Acanthamoeba adhere in greater numbers to first-generation silicone hydrogel lenses compared with the second-generation or hydroxyethyl methacrylate-based soft lenses. Microbial adhesion to silicone hydrogel lenses occurs and is associated with the production of corneal infiltrative events during lens wear.

  16. Fine lattice lines on the corneal surface after laser in situ keratomileusis (LASIK).

    PubMed

    Carpel, E F; Carlson, K H; Shannon, S

    2000-03-01

    To present an example of a pattern of lines resembling fine lattice on the corneal surface subsequent to laser in situ keratomileusis (LASIK). This subtle phenomenon may be relatively common and may affect visual outcome. Case report. A 41-year-old year old man with high myopia and best-corrected visual acuity of 20/20 +2 in each eye underwent laser in situ keratomileusis (LASIK). No operative or postoperative complications occurred. No striae were evident on slit-lamp examination with direct illumination and retroillumination at the time of surgery or in the postoperative period. Postoperative uncorrected visual acuity was 20/25 with a best-corrected spectacle correction of 20/25 in both eyes. Fine lines in a lattice pattern were seen only with fluorescein dye in the precorneal tear film as areas of "negative stain" within the LASIK flap. With tear film supplementation, the lines were less evident and visual acuity improved. One year postoperatively, his uncorrected visual acuity was 20/25 in both eyes. The best-corrected spectacle visual acuity was RE: 20/20 -2, LE: 20/25. The fine lines were still present within the flap. A soft contact lens improved visual acuity to 20/20 in both eyes. Although all four puncta were occluded, he had no epiphora. Fine lines in a lattice pattern that may represent folds in the epithelium or Bowman layer may be present within the flap after LASIK and may adversely affect visual acuity. They may be visible as areas of negative stain with fluorescein dye in the precorneal tear film in the absence of any striae visible in the flap. These superficial lines have been seen more in patients with high degrees of correction and in patients with dry eye. If visual acuity is affected, it may be improved with punctal occlusion, tear supplements, or a contact lens.

  17. Comparison Between Bandage Contact Lenses and Pressure Patching on the Erosion Area and Pain Scale in Patients With Corneal Erosion.

    PubMed

    Triharpini, Ni Nyoman; Gede Jayanegara, I Wayan; Handayani, Ariesanti Tri; Widiana, I Gde Raka

    2015-01-01

    Corneal erosion is common in eye emergency cases. Extensive corneal erosions result in severe pain and prolonged healing time. This study aimed to compare bandage contact lenses with pressure patching in terms of reducing the size of the erosion area, pain scale in patients with corneal erosion and its complications. A randomized open-label clinical trial was conducted. Subjects with mechanical corneal erosion were selected to use either bandage contact lenses or pressure patching. All subjects received antibiotic eye drops and 0.5% tropicamide eye drops. Evaluations were done 24 and 72 hours after treatment. The size of the corneal erosion area, pain scale, and complications were assessed. A total of 32 eyes (16 eyes in each group) were studied. The change in the size of the corneal erosion area was greater in the bandage contact lens group than in the pressure patching group, although there was no significant difference. In the bandage contact lens group, 56.25% of the eyes were healed at 24 hours and 43.75% were healed at 72 hours. In the pressure patching group, 62.50% were healed at 24 hours and 12.50% were healed at 72 hours. The change in pain scale was significantly greater in the bandage contact lens group than in the pressure patching group. No complications were found in both groups. Bandage contact lenses are an effective alternative to treating mechanical corneal erosion because of their effect in reducing pain without causing any complications.

  18. Clinical Evaluation of Large Diameter Rigid-Gas Permeable Versus Soft Toric Contact Lenses for the Correction of Refractive Astigmatism. A MultiCenter Study.

    PubMed

    Michaud, Langis; Bennett, Edward S; Woo, Stephanie L; Reeder, Renee; Morgan, Bruce W; Dinardo, Amy; Harthan, Jennifer S

    2018-05-01

    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.

  19. Wear effects on microscopic morphology and hyaluronan uptake in siloxane-hydrogel contact lenses.

    PubMed

    Tavazzi, Silvia; Tonveronachi, Martina; Fagnola, Matteo; Cozza, Federica; Ferraro, Lorenzo; Borghesi, Alessandro; Ascagni, Miriam; Farris, Stefano

    2015-07-01

    The purpose of this study was a comparison between new and worn siloxane-hydrogel contact lenses in terms of microscopic structure, surface morphology, and loading of hyaluronan. The analyses were performed by scanning electron microscopy, with the support of the freeze-drying technique, and by fluorescence confocal microscopy. Along the depth profile of new lenses, a thin porous top layer was observed, which corresponds to the region of hyaluronan penetration inside well-defined channels. The time evolution was followed from one day to two weeks of daily wear, when a completely different scenario was found. Clear experimental evidence of a buggy surface was observed with several crests and regions of swelling, which could be filled by the hyaluronan solution. The modifications are attributed to the progressive relaxation of the structure of the polymeric network. © 2014 Wiley Periodicals, Inc.

  20. Dynamic simulation of the effect of soft toric contact lenses movement on retinal image quality.

    PubMed

    Niu, Yafei; Sarver, Edwin J; Stevenson, Scott B; Marsack, Jason D; Parker, Katrina E; Applegate, Raymond A

    2008-04-01

    To report the development of a tool designed to dynamically simulate the effect of soft toric contact lens movement on retinal image quality, initial findings on three eyes, and the next steps to be taken to improve the utility of the tool. Three eyes of two subjects wearing soft toric contact lenses were cyclopleged with 1% cyclopentolate and 2.5% phenylephrine. Four hundred wavefront aberration measurements over a 5-mm pupil were recorded during soft contact lens wear at 30 Hz using a complete ophthalmic analysis system aberrometer. Each wavefront error measurement was input into Visual Optics Laboratory (version 7.15, Sarver and Associates, Inc.) to generate a retinal simulation of a high contrast log MAR visual acuity chart. The individual simulations were combined into a single dynamic movie using a custom MatLab PsychToolbox program. Visual acuity was measured for each eye reading the movie with best cycloplegic spectacle correction through a 3-mm artificial pupil to minimize the influence of the eyes' uncorrected aberrations. Comparison of the simulated acuity was made to values recorded while the subject read unaberrated charts with contact lenses through a 5-mm artificial pupil. For one study eye, average acuity was the same as the natural contact lens viewing condition. For the other two study eyes visual acuity of the best simulation was more than one line worse than natural viewing conditions. Dynamic simulation of retinal image quality, although not yet perfect, is a promising technique for visually illustrating the optical effects on image quality because of the movements of alignment-sensitive corrections.

  1. 25G compared with 20G vitrectomy under Resight non-contact wide-angle lenses for Terson syndrome.

    PubMed

    Mao, Xinbang; You, Zhipeng

    2017-08-01

    The aim of the present study was to compare the effectiveness of 25G vitrectomy to standard 20G vitrectomy for treatment of Terson syndrome under Resight non-contact wide-angle lenses. This was a case-control study of 20 patients with Terson syndrome (study group) that underwent 25G vitrectomy under Resight non-contact wide-angle lenses, with those of 20 matched patients that underwent 20G vitrectomy (control group). Medical records were reviewed from between July 2011 and October 2013. Data included results of the Early Treatment Diabetic Retinopathy Study examination, ophthalmology B-scan ultrasonography and fundus photography. The mean age, follow-up time, the preoperative visual acuity of LogMAR and the preoperative intraocular pressure (IOP) were all comparable in the two groups (all P>0.05). There were statistically significant differences in postoperative visual acuity of LogMAR compared with preoperative visual acuity (P<0.001) in both groups, but no difference between the groups (P=0.845). However, the operative times (13.5 min in study group vs. 42 min in control group) and post-operative IOP at day 1 (13.5 vs. 20 mmHg) were significantly reduced in the study group compared to the control group (P<0.001). Therefore, the present findings suggest that 25G Vitrectomy for Terson syndrome under Resight non-contact wide-angle lenses can achieve a significantly shorter operative time and lower post-operative IOP compared with 20G Vitrectomy.

  2. Iris registration in wavefront-guided LASIK to correct mixed astigmatism.

    PubMed

    Khalifa, Mounir; El-Kateb, Mohamed; Shaheen, Mohamed Shafik

    2009-03-01

    To investigate the predictability, safety, and efficiency of wavefront-guided laser in situ keratomileusis (LASIK) with iris-registration technology to correct mixed astigmatism. Vision correction center, Alexandria, Egypt. This retrospective double-blind study included randomly selected patients with mixed astigmatism who sought laser refractive surgery. Patients were divided equally into 3 groups and treated with conventional LASIK and manual marking, wavefront-guided LASIK and manual marking, or wavefront-guided LASIK with iris registration (LASIK+IR group). Eyes were analyzed preoperatively and up to 3 months postoperatively. The LASIK+IR group had better postoperative uncorrected visual acuity (100% 20/30 or better; 90% 20/20 or better; 20% 20/16 or better) than the other groups and did not lose preoperative best spectacle-corrected visual acuity, unlike the other groups. This group also had the highest percentage of eyes that gained lines of acuity (20% 1 line; 10% 2 lines). The LASIK+IR group had the highest predictability of spherical refraction (80% within +/-0.50 diopter [D]; 100% within +/-1.00 D [P<.05] and the highest predictability of cylinder refraction. The LASIK+IR eyes had a significantly smaller increase postoperatively in coma, trefoil, and secondary astigmatism. There was no significant difference between groups in spherical aberration or quadrafoil. The LASIK-IR group had the most improvement in scotopic contrast sensitivity (P<.05). Wavefront-guided LASIK with iris registration was more predictable, safe, and efficient than conventional or wavefront-guided LASIK with manual marking in correcting mixed astigmatism. Further studies are needed to confirm these results.

  3. Contact Lens Risks

    MedlinePlus

    ... 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 ...

  4. Fabricating customized hydrogel contact lens

    NASA Astrophysics Data System (ADS)

    Childs, Andre; Li, Hao; Lewittes, Daniella M.; Dong, Biqin; Liu, Wenzhong; Shu, Xiao; Sun, Cheng; Zhang, Hao F.

    2016-10-01

    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.

  5. Fabricating customized hydrogel contact lens

    PubMed Central

    Childs, Andre; Li, Hao; Lewittes, Daniella M.; Dong, Biqin; Liu, Wenzhong; Shu, Xiao; Sun, Cheng; Zhang, Hao F.

    2016-01-01

    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. PMID:27748361

  6. Outcome after treatment of ametropia with implantable contact lenses.

    PubMed

    Lackner, Birgit; Pieh, Stefan; Schmidinger, Gerald; Hanselmayer, Georg; Dejaco-Ruhswurm, Irene; Funovics, Martin A; Skorpik, Christian

    2003-11-01

    To evaluate long-term results after insertion of implantable contact lenses (ICLs) in phakic eyes. Prospective, noncomparative, interventional case series. Seventy-five phakic eyes (65 myopic, 10 hyperopic eyes) of 45 patients aged 21.7 to 60.6 years were included. STAAR Collamer Implantable Contact Lenses (STAAR Surgical Inc., Nidau, Switzerland) were implanted for correction of high myopia and hyperopia. Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were determined. Presence of lens opacification and the distance between the ICL and the crystalline lens were assessed by slit-lamp examination before surgery and at 1, 3, 6 months, and yearly after lens implantation. Preoperative mean spherical equivalent was -16.23+/-5.29 diopters (D) for myopic eyes and +7.88 +/-1.46 D for hyperopic eyes. After ICL implantation, mean residual refractive error was -1.77+/-2.17 D in myopic patients and +0.44+/-0.69 D in hyperopic patients. Preoperative mean UCVA was Snellen 0.03+/-0.03 for myopic patients and Snellen 0.12+/-0.16 for hyperopic patients. Preoperative mean BCVA was Snellen 0.49+/-0.23 for myopic patients and Snellen 0.82+/-0.23 for hyperopic patients. After ICL implantation, mean UCVA up to the end of individual observation time was Snellen 0.36+/-0.36 for myopic patients and Snellen 0.58+/-0.28 for hyperopic patients. Mean BCVA was Snellen 0.73+/-0.26 for myopic and Snellen 0.80+/-0.24 for hyperopic patients. Mean preoperative IOP was 14.2+/-2.7 mmHg, and mean postoperative IOP was 13.46+/-2.1 mmHg over all follow-up investigations. The main complication was the development of subcapsular anterior opacifications of the crystalline lens in 25 eyes (33.3%), 2 of which showed direct contact to the ICL. Eleven eyes (14.7%) were stable in opacification and 14 eyes (18.7%) had progressive opacifications. The median time to opacification was 27.1 months. In 8 patients (10.7%), the subjective visual impairment mandated

  7. Contact lens induced papillary conjunctivitis with silicone hydrogel lenses.

    PubMed

    Sorbara, L; Jones, L; Williams-Lyn, D

    2009-04-01

    To describe the refitting of a soft lens wearer into a silicone hydrogel lens due to neovascularization. This change, in turn, caused contact lens induced papillary conjunctivitis (CLPC) and a further refitting was necessary. The patient was refit into a high Dk surface treated silicone hydrogel with a high modulus value. A second refitting was undertaken into a lower Dk silicone hydrogel contact lens with a lower modulus value which had no surface treatment but incorporated an internal wetting agent. A high Dk/t lens was used to resolve existing neovascularization and chronic hyperaemia. Subsequently, CLPC response occurred, possibly due to a combination of factors, resulting in irritation of the palpebral conjunctiva. This resulted in temporary lens discontinuation. A second silicone hydrogel lens was fit, along with the use of a non-preserved care system, which led to improvement and eventual resolution of the condition. High Dk silicone hydrogel lenses have shown excellent efficacy in resolving hypoxic complications such as neovascularization and hyperaemia. However, attention needs to be paid to their potential effect on the upper tarsal plate. More than one silicone hydrogel lens may be needed to help resolve these issues.

  8. A comparison of in-air and in-saline focimeter measurement of the back vertex power of spherical soft contact lenses.

    PubMed

    Pearson, Richard M; Evans, Bruce J W

    2012-11-01

    To compare the repeatability and validity of measurements of the back vertex power (BVP) of spherical soft contact lenses made in-air using the method specified in the International Standard (ISO 18369-3:2006) with the corresponding values when BVP was calculated from measurements made using a wet cell and focimeter method that is not approved by this Standard. The BVP of 20 hydrogel and 20 silicone hydrogel lenses, with labelled powers ranging from +8.00 to -12.00 D, were measured with a focimeter by two operators on two occasions in-air in accordance with the relevant International Standard. Equivalent sets of measurements were made with the lenses immersed in-saline within a wet cell and their BVPs in-air were calculated. The validity of each method was assessed by comparing their results with an instrument that used the Hartmann method. The reliability results were generally a little better for the in-saline measurements than for the in-air measurements, although all reliability data demonstrated absolute values of mean errors (inter-operator and inter-session) that were <0.05 D for hydrogel lenses and <0.07 D for silicone hydrogel lenses. The in-air 95% confidence intervals were <0.45 D and <0.40 D for hydrogel and silicone hydrogel lenses, respectively and in-saline <0.39 and <0.31 D for hydrogel and silicone hydrogel lenses, respectively. The validity data revealed a relationship between measurement error and BVP for the in-air data (the focimeter overestimates the power of high plus and high minus lenses compared with the Hartmann instrument) and possibly a more complex relationship for the in-saline data. The 95% limits of agreement indicate better agreement for the in-saline validity data (-0.55 to +0.48 D for hydrogel lenses and -0.42 to +0.54 D for silicone hydrogel lenses) than those obtained in-air (-0.64 to +0.68 D for hydrogel lenses and -0.57 to +0.44 D for silicone hydrogel lenses). Using equipment readily available in a clinical setting, the wet

  9. Adjuvant corneal crosslinking to prevent hyperopic LASIK regression

    PubMed Central

    Aslanides, Ioannis M; Mukherjee, Achyut N

    2013-01-01

    Purpose To report the long term outcomes, safety, stability, and efficacy in a pilot series of simultaneous hyperopic laser assisted in situ keratomileusis (LASIK) and corneal crosslinking (CXL). Method A small cohort series of five eyes, with clinically suboptimal topography and/or thickness, underwent LASIK surgery with immediate riboflavin application under the flap, followed by UV light irradiation. Postoperative assessment was performed at 1, 3, 6, and 12 months, with late follow up at 4 years, and results were compared with a matched cohort that received LASIK only. Results The average age of the LASIK-CXL group was 39 years (26–46), and the average spherical equivalent hyperopic refractive error was +3.45 diopters (standard deviation 0.76; range 2.5 to 4.5). All eyes maintained refractive stability over the 4 years. There were no complications related to CXL, and topographic and clinical outcomes were as expected for standard LASIK. Conclusion This limited series suggests that simultaneous LASIK and CXL for hyperopia is safe. Outcomes of the small cohort suggest that this technique may be promising for ameliorating hyperopic regression, presumed to be biomechanical in origin, and may also address ectasia risk. PMID:23576861

  10. Adjuvant corneal crosslinking to prevent hyperopic LASIK regression.

    PubMed

    Aslanides, Ioannis M; Mukherjee, Achyut N

    2013-01-01

    To report the long term outcomes, safety, stability, and efficacy in a pilot series of simultaneous hyperopic laser assisted in situ keratomileusis (LASIK) and corneal crosslinking (CXL). A small cohort series of five eyes, with clinically suboptimal topography and/or thickness, underwent LASIK surgery with immediate riboflavin application under the flap, followed by UV light irradiation. Postoperative assessment was performed at 1, 3, 6, and 12 months, with late follow up at 4 years, and results were compared with a matched cohort that received LASIK only. The average age of the LASIK-CXL group was 39 years (26-46), and the average spherical equivalent hyperopic refractive error was +3.45 diopters (standard deviation 0.76; range 2.5 to 4.5). All eyes maintained refractive stability over the 4 years. There were no complications related to CXL, and topographic and clinical outcomes were as expected for standard LASIK. This limited series suggests that simultaneous LASIK and CXL for hyperopia is safe. Outcomes of the small cohort suggest that this technique may be promising for ameliorating hyperopic regression, presumed to be biomechanical in origin, and may also address ectasia risk.

  11. Development of ocular drug delivery systems using molecularly imprinted soft contact lenses.

    PubMed

    Tashakori-Sabzevar, Faezeh; Mohajeri, Seyed Ahmad

    2015-05-01

    Recently, significant advances have been made in order to optimize drug delivery to ocular tissues. The main problems in ocular drug delivery are poor bioavailability and uncontrollable drug delivery of conventional ophthalmic preparations (e.g. eye drops). Hydrogels have been investigated since 1965 as new ocular drug delivery systems. Increase of hydrogel loading capacity, optimization of drug residence time on the ocular surface and biocompatibility with the eye tissue has been the main focus of previous studies. Molecular imprinting technology provided the opportunity to fulfill the above-mentioned objectives. Molecularly imprinted soft contact lenses (SCLs) have high potentials as novel drug delivery systems for the treatment of eye disorders. This technique is used for the preparation of polymers with specific binding sites for a template molecule. Previous studies indicated that molecular imprinting technology could be successfully applied for the preparation of SCLs as ocular drug delivery systems. Previous research, particularly in vivo studies, demonstrated that molecular imprinting is a versatile and effective method in optimizing the drug release behavior and enhancing the loading capacity of SCLs as new ocular drug delivery systems. This review highlights various potentials of molecularly imprinted contact lenses in enhancing the drug-loading capacity and controlling the drug release, compared to other ocular drug delivery systems. We have also studied the effects of contributing factors such as the type of comonomer, template/functional monomer molar ratio, crosslinker concentration in drug-loading capacity, and the release properties of molecularly imprinted hydrogels.

  12. Reliability of power profiles measured on NIMO TR1504 (Lambda-X) and effects of lens decentration for single vision, bifocal and multifocal contact lenses.

    PubMed

    Kim, Eon; Bakaraju, Ravi C; Ehrmann, Klaus

    2016-01-01

    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.

  13. A Rabbit Model of Acanthamoeba Keratitis: Use of Infected Soft Contact Lenses After Corneal Epithelium Debridement With a Diamond Burr.

    PubMed

    Ortillés, Ángel; Goñi, Pilar; Rubio, Encarnación; Sierra, Marta; Gámez, Ekaterina; Fernández, María T; Benito, María; Cristóbal, José Á; Calvo, Begoña

    2017-02-01

    To develop a rabbit model of Acanthamoeba keratitis (AK) as the best method to reproduce the natural course of this disease. To induce AK, infected contact lenses (1000 amoebae/mm2, 90% trophozoites) were placed over the previously debrided corneal surface, in combination with a temporary tarsorrhaphy. Environmental and clinical strains of Acanthamoeba spp. (genotype T4) were used. Three groups (1L, n = 32; 2L-21d, n = 5; 2L-3d, n = 23) were established according to the number of contact lenses used (1L, 1 lens; 2L-21d and 2L-3d, 2 lenses) and the placement day of these (1L, day 1; 2L-21d, days 1 and 21; 2L-3d, days 1 and 3). The infection was quantified by a clinical score system and confirmed using corneal cytology and culture, polymerase chain reaction and histopathologic analysis. The infection rate obtained was high (1L, 87.5%; 2L-21d, 100%; 2L-3d, 82.6%), although no clinical signs were observed in the 50% of the infected animals in group 1L. Among groups, group 2L-3d showed more cases of moderate and severe infection. Among strains, no statistically significant differences were found in the infection rate. In the control eyes, cross infection was confirmed when a sterile contact lens was placed in the previously debrided corneas but not if the eye remained intact. The combination of two infected contact lenses after corneal debridement seems to be an alternative model, clinically and histopathologically similar to its human counterpart, to induce the different AK stages and reproduce the course of the disease in rabbits.

  14. LASIK versus photorefractive keratectomy for high myopic (> 3 diopter) astigmatism.

    PubMed

    Katz, Toam; Wagenfeld, Lars; Galambos, Peter; Darrelmann, Benedikt Große; Richard, Gisbert; Linke, Stephan Johannes

    2013-12-01

    To compare the efficacy, safety, predictability, and vector analysis indices of LASIK and photorefractive keratectomy (PRK) for correction of high cylinder of greater than 3 diopters (D) in myopic eyes. The efficacy, safety, and predictability of LASIK or PRK performed in 114 consecutive randomly selected myopic eyes with an astigmatism of greater than 3 D were retrospectively analyzed at the 2- to 6-month follow-up visits. Vector analysis of the cylindrical correction was compared between the treatment groups. A total of 57 eyes receiving PRK and 57 eyes receiving LASIK of 114 refractive surgery candidates were enrolled in the study. No statistically significant difference in efficacy [efficacy index = 0.76 (±0.32) for PRK vs 0.74 (±0.19) for LASIK (P = .82)], safety [safety index = 1.10 (±0.26) for PRK vs 1.01 (±0.17) for LASIK (P = .121)], or predictability [achieved astigmatism < 1 D in 39% of PRK- and 54% of LASIK-treated eyes, and < 2 D in 88% of PRK- and 89% of LASIK-treated eyes (P = .218)] was demonstrated. Using Alpins vector analysis, the surgically induced astigmatism and difference vector were not significantly different between the surgery methods, whereas the correction index showed a slight and significant advantage of LASIK over PRK (1.25 for PRK and 1.06 for LASIK, P < .001). LASIK and PRK are comparably safe, effective, and predictable procedures for excimer laser correction of high astigmatism of greater than 3 D in myopic eyes. Predictability of the correction of the cylindrical component is lower than that of the spherical equivalent. Copyright 2013, SLACK Incorporated.

  15. Biomechanical Changes After LASIK Flap Creation Combined With Rapid Cross-Linking Measured With Brillouin Microscopy.

    PubMed

    Randleman, J Bradley; Su, Johnny P; Scarcelli, Giuliano

    2017-06-01

    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.

  16. Simulation of the Effect of Different Presbyopia-Correcting Intraocular Lenses With Eyes With Previous Laser Refractive Surgery.

    PubMed

    Camps, Vicente J; Miret, Juan J; García, Celia; Tolosa, Angel; Piñero, David P

    2018-04-01

    To simulate the optical performance of three presbyopia-correcting intraocular lenses (IOLs) implanted in eyes with previous laser refractive surgery. A simulation of the through-focus modulation transfer function (MTF) was performed for three presbyopia-correcting IOLs (Mplus, Oculentis GmbH, Berlin, Germany; Symfony, Johnson & Johnson Vision, Santa Ana, CA; and Mini Well, SIFI S.p.A., Lavinaio, Italy) in one eye with previous myopic LASIK and another with hyperopic LASIK. Real topographic data and the wavefront aberration profile of each IOL obtained with a Hartmann-Shack sensor were used. In the eye with myopic LASIK, all IOLs lost optical quality at near and intermediate distances for 4- and 4.7-mm pupil size. For 3-mm pupil size, the Mini Well IOL showed the best intermediate and near MTF and maintained the far focus independently of the pupil. In the eye with hyperopic LASIK, the Mini Well IOL showed an intermediate, distance, and -4.00-diopter (D) foci for all pupils. The Symfony IOL showed a depth of focus at far and intermediate distance for 3-mm and a focus at -2.50 D in the rest. The Mplus showed a focus of -4.50 and -3.00 D for the 3- and 4-mm pupil, respectively. The Mini Well and Symfony IOLs seem to work better than the Mplus IOL in eyes with previous myopic LASIK. With previous hyperopic LASIK, the Mini Well IOL seems to be able to provide acceptable near, intermediate, and far foci for all pupil sizes. These findings should be confirmed in future clinical studies. [J Refract Surg. 2018;34(4):222-227.]. Copyright 2018, SLACK Incorporated.

  17. Defining the physiologically normal coating and pathological deposit: an analysis of sulfur-containing moieties and pellicle thickness on hydrogel contact lenses.

    PubMed

    Hart, D E; Plociniak, M P; Grimes, G W

    1998-04-01

    Historically, biochemical studies of the interaction between tears and hydrogel contact lenses have not been coordinated with the study of the morphological ultrastructure of the phenomena. Moreover, terms that have distinct and different meanings--pellicle, coating, deposit, and biofilm--have been used interchangeably and often incorrectly when applied within the context of the general field of contact lens biotechnology to describe the tear-polymer interaction. We describe our elucidation of morphological and elemental characteristics of the normal pellicle that forms on the lens surface and urge standard use of the word "pellicle" to specify this entity. Fourteen worn hydrogel lenses (8 Group 1 and 6 Group 4 lenses according to the FDA classification) were rinsed, quartered, and fixed or dried, depending on the analysis to be performed. Scanning electron microscopy (SEM) was used to examine the morphology of the pellicle and quantify its thickness. X-ray analysis was used to detect elements associated with the anterior, central, and posterior portions of the lenses and their relative distribution. A distinctive morphological pellicle ranging from 0.1 to 8.6 microns was present on 12 of the 14 lenses. The pellicle was thicker on the Group 4 lenses than on the Group 1 lenses (P < 0.003). However, the pellicle on Group 1 lenses became thicker with increasing lens age (P < 0.02), but not as thick as on Group 4 lenses. Morphologically distinct lipid or jelly bump deposits were observed at the surface of both lenses from a single patient wearing 2 week old Group 4 lenses. Eleven lenses had sulfur-bearing tear components on the anterior zone. Sulfur was deposited within the matrix of nine lenses. The sulfur containing moieties were more prevalent on Group 4 lenses (P < 0.002). More sulfur was assayed on older lenses (P < 0.004). The anterior lens zone had more sulfur-bearing tear components than did the posterior or center zones (P < 0.05). The physiologically normal

  18. Drug loading optimization and extended drug delivery of corticoids from pHEMA based soft contact lenses hydrogels via chemical and microstructural modifications.

    PubMed

    García-Millán, Eva; Koprivnik, Sandra; Otero-Espinar, Francisco Javier

    2015-06-20

    This paper proposes an approach to improve drug loading capacity and release properties of poly(2-hydroxyethyl methacrylate) (p(HEMA)) soft contact lenses based on the optimization of the hydrogel composition and microstructural modifications using water during the polymerization process. P(HEMA) based soft contact lenses were prepared by thermal or photopolymerization of 2-hydroxyethyl methacrylate (HEMA) solutions containing ethylene glycol di-methacrylate as crosslinker and different proportions of N-vinyl-2-pyrrolidone (NVP) or methacrylic acid (MA) as co-monomers. Transmittance, water uptake, swelling, microstructure, drug absorption isotherms and in vitro release were characterized using triamcinolone acetonide (TA) as model drug. Best drug loading ratios were obtained with lenses containing the highest amount (200 mM) of MA. Incorporation of 40% V/V of water during the polymerization increases the hydrogel porosity giving a better drug loading capacity. In vitro TA release kinetics shows that MA hydrogels released the drug significantly faster than NVP-hydrogels. Drug release was found to be diffusion controlled and kinetics was shown to be reproducible after consecutive drug loading/release processes. Results of p(HEMA) based soft contact lenses copolymerized with ethylene glycol dimethacrylate (EGDMA) and different co-monomers could be a good alternative to optimize the loading and ocular drug delivery of this corticosteroid drug. Copyright © 2015. Published by Elsevier B.V.

  19. Biocompatibility of antimicrobial melimine lenses: rabbit and human studies.

    PubMed

    Dutta, Debarun; Ozkan, Jerome; Willcox, Mark D P

    2014-05-01

    Covalent immobilization of antimicrobial peptide melimine onto contact lenses can produce broad-spectrum antimicrobial lenses. The purpose of this study was to investigate the performance of melimine-coated contact lenses in an animal model and human clinical trial. Melimine was covalently attached onto the surface of contact lenses via EDC (1-ethyl-3-[3-dimethylaminopropyl] carbodiimide hydrochloride) coupling. A rabbit model of daily contralateral wear of lenses for 22 days was conducted to assess the lens safety. A prospective, randomized, double-masked, one-day human clinical trial was used to evaluate subjective responses and ocular physiology during contralateral wear of melimine-coated (test) and uncoated (control) lenses. Delayed reactions were monitored during follow-up visits after 1 and 4 weeks. Ex vivo retention of antimicrobial activity of worn lenses was assessed by reduction in numbers of viable Pseudomonas aeruginosa and Staphylococcus aureus. Melimine-coated lenses produced no ocular signs or symptoms that would indicate cytotoxicity during the lens wear of rabbits. No histological changes were found in rabbit corneas. During the human trial, no differences were observed in wettability, surface deposition, lens-fitting centration, movement, tightness, and corneal coverage between test and control lenses (p > 0.05). There were no significant differences in bulbar, limbal, or palpebral redness or conjunctival staining (p > 0.05). Mean corneal (extent, depth, and type) staining was higher for test lenses compared with that for control lenses (p < 0.05). There was no significant difference in subjective responses for lens comfort, dryness, and awareness (p > 0.05). No delayed reactions were associated with the test lenses. Worn test lenses retained more than 1.5 log inhibition against both bacterial types. Melimine-coated contact lenses were worn safely by humans. However, they were associated with higher corneal staining. The melimine-coated lenses

  20. Objective Assessment of Ocular Surface Response to Contact Lens Wear in Presbyopic Contact Lens Wearers of Asian Descent.

    PubMed

    Guillon, Michel; Dumbleton, Kathy; Theodoratos, Panagiotis; Patel, Trisha; Karkkainen, Tom; Moody, Kurt

    2018-05-01

    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

  1. Objective Assessment of Ocular Surface Response to Contact Lens Wear in Presbyopic Contact Lens Wearers of Asian Descent

    PubMed Central

    Dumbleton, Kathy; Theodoratos, Panagiotis; Patel, Trisha; Karkkainen, Tom; Moody, Kurt

    2018-01-01

    Introduction: 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. Methods: 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. Results: Lid margin staining was significantly lower with the study contact lenses (2.0±1.0 mm2) than with the participants' own contact lenses (3.2±3.0 mm2) 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. Conclusions: Etafilcon A material, worn under a daily disposable modality, was shown to

  2. A Long Term Study of the Water Content Changes in Three Types of Hydrogel Contact Lenses.

    DTIC Science & Technology

    1987-05-01

    7RD-R1BS 579 A LONG TERM STUDY OF THE HATER CONTENT CHANGES IN THREE 1/2 TYPES OF HYDROGEL ..(U) AIR FORCE INST OF TECH URIGHT-PATTERSON AFI OH L 0...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...SECURITY CLASSIFICATION OF THIS PAGE ("o~tn Date Entered) ABSTRACT A" Sufficient oxygen is required to pass through a hydrogel contact lens for proper

  3. [Refractive Surgery in Children with Myopic Anisometropia and Amblyopia in Comparison with Conventional Treatment by Contact Lenses].

    PubMed

    Autrata, R; Krejčířová, I; Griščíková, L; Doležel, Z

    2016-01-01

    Our study evaluated the visual and refractive results of LASEK and anterior chamber phakic intraocular lens (pIOL) implantation performed for high myopic anisometropia with amblyopia and contact lens intolerance in children compared with conventional treatment by contact lenses.Fourty-three patients (Group A) aged 3 to 7 years (mean, 5,6 years) with high myopic anisometropia and amblyopia had performed multizonal LASEK (27 eyes) or pIOL Verisyse implantation (16 eyes) on the more myopic eye in general anesthesia. Surgery was followed by patching of the dominant eye. Postoperative visual and refractive outcomes were analyzed and all children had minimally two years follow-up after procedure. Refractive surgical data were reported in standard format to describe safety, efficacy, predictability and stability of the procedure. This Group A of 43 children was compared with control Group B of 37 children (mean age 5,4 years), in whom myopic anisometropia and amblyopia were treated conventionally by contact lenses (CL) and patching of the dominant eye. Visual acuity (VA) and binocular vision (BV) outcome were analyzed and compared in both groups.The mean preoperative spherical equivalent (SE) cycloplegic refraction in Group A was - 9,45 ± 2,47 diopters (D) (range -6.0 to -18.25 D) and the mean postoperative SE -1,48 ± 1,13 D (range + 0,75 to - 2,25 D). The mean preop. decimal uncorrected visual acuity (UCVA) 0,023 ± 0,017 increased to 0,46 ± 0,18. The mean preop.decimal best-corrected visual acuity (BCVA) in Group A was 0,28 ± 0.22 and changed to 0,78± 0,19 by 2 years after surgery. The mean BCVA in Group B was 0,23 ± 0,19, at start of CL correction and amblyopia therapy, and improved to 0,42 ± 0,15 after two years. The mean BCVA at final examination was significantly better in Group A (P < 0,05). Binocular vision improvement expressed by the proportions of subjects gained fusion and stereopsis, was overall better in Group A (81 %) than in Group B (33 %), (P < 0

  4. Discrimination against contact lens wearers.

    PubMed

    Blais, B R

    1998-10-01

    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.

  5. Effects of the rigid gas permeable contact lense use on tear and ocular surface among keratoconus patients.

    PubMed

    Yuksel Elgin, Cansu; Iskeleli, Guzin; Aydin, Ovgu

    2018-06-01

    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.

  6. The Changes of Tear Status after Conventional and Wavefront-Guided IntraLASIK

    PubMed Central

    Foo, Say Kiang; Kaur, Sharanjeet; Abd Manan, Faudziah; Low, Aloysius Joseph

    2011-01-01

    Background: IntraLASIK is a LASIK surgery that involved IntraLase femtosecond laser for the corneal flap creating. The objective of this research was to investigate and compare the changes in tear status at 1 and 3 months after undergoing conventional IntraLASIK with Bausch & Lomb PlanoScan (PS) algorithm, Bausch & Lomb Zyoptix Tissue Saving (ZTS) algorithm, and wavefront-guided (WG) IntraLASIK with VISX CustomVue. Methods: Tear status of 36 patients who were divided into 3 groups depending on the type of IntraLASIK they underwent (PS, n = 13; ZTS, n = 9; WG, n = 14) was evaluated. Tear status was determined by classifying the category of the thickness of pre-corneal tear lipid layer, non-invasive tear break-up time, and tear meniscus height. Repeated measures analysis of variance (ANOVA) and one way ANOVA were used for the statistical analyses. Results: The category of the thickness of tear lipid layer, non-invasive tear break up time and tear meniscus height were neither significantly changed after IntraLASIK for all groups nor showed significant difference among groups at 1 and 3 months post-IntraLASIK (P > 0.05). Blinking rate and palpebral aperture also had no significant changed after IntraLASIK. Conclusion: Both conventional (PS and ZTS) and WG IntraLASIK did not affect tear status up to 3 months post-IntraLASIK. WG IntraLASIK did not show superiority in preserving tear status 1 and 3 months post-surgery compared with conventional IntraLASIK. PMID:22135584

  7. Laser-assisted subepithelial keratectomy (LASEK) versus laser-assisted in-situ keratomileusis (LASIK) for correcting myopia.

    PubMed

    Kuryan, Jocelyn; Cheema, Anjum; Chuck, Roy S

    2017-02-15

    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

  8. The efficiency of contact lens care regimens on protein removal from hydrogel and silicone hydrogel lenses

    PubMed Central

    Heynen, Miriam; Liu, Lina; Sheardown, Heather; Jones, Lyndon

    2010-01-01

    Purpose To investigate the efficiency of lysozyme and albumin removal from silicone hydrogel and conventional contact lenses, using a polyhexamethylene biguanide multipurpose solution (MPS) in a soaking or rubbing/soaking application and a hydrogen peroxide system (H2O2). Methods Etafilcon A, lotrafilcon B and balafilcon A materials were incubated in protein solutions for up to 14 days. Lenses were either placed in radiolabeled protein to quantify the amount deposited or in fluorescent-conjugated protein to identify its location, using confocal laser scanning microscopy (CLSM). Lenses were either rinsed with PBS or soaked overnight in H2O2 or MPS with and without lens rubbing. Results After 14 days lysozyme was highest on etafilcon A (2,200 μg) >balafilcon A (50 µg) >lotrafilcon B (9.7 µg) and albumin was highest on balafilcon A (1.9 µg) =lotrafilcon B (1.8 µg) >etafilcon A (0.2 µg). Lysozyme removal was greatest for balafilcon A >etafilcon A >lotrafilcon B, with etafilcon A showing the most change in protein distribution. Albumin removal was highest from etafilcon A >balafilcon A >lotrafilcon B. H2O2 exhibited greater lysozyme removal from etafilcon A compared to both MPS procedures (p<0.001) but performed similarly for lotrafilcon B and balafilcon A lenses (p>0.62). Albumin removal was solely material specific, while all care regimens performed to a similar degree (p>0.69). Conclusions Protein removal efficiency for the regimens evaluated depended on the lens material and protein type. Overall, lens rubbing with MPS before soaking did not reduce the protein content on the lenses compared to nonrubbed lenses (p=0.89). PMID:20098668

  9. Allergic manifestations of contact lens wearing.

    PubMed

    Solomon, Abraham

    2016-10-01

    Contact lens-induced papillary conjunctivitis (CLPC) is a common ocular allergic disease in contact lens wearers. In its more severe form, it can cause giant papillary conjunctivitis, resulting in contact lens intolerance and the need to discontinue the use of contact lenses. This review presents the pathogenesis, clinical manifestations and management guidelines of this common disorder. Different types of contact lenses are associated with differences in the severity of CLPC. Refitting patients with silicone hydrogel contact lenses or with daily disposable contact lenses may improve the signs and symptoms of CLPC. The recent introduction of the topical immunomodulatory agent tacrolimus in other severe allergic eye diseases may apply in suppressing the allergic inflammation in CLPC as well. CLPC is a common ocular disorder in contact lens wearers, with a significant impact on the quality of vision. It should be promptly recognized by healthcare practitioners and managed by modifications of the types and wearing schedules of contact lenses, as well as novel treatment options with topical immunomodulators.

  10. Effects of silicone hydrogel contact lenses on ocular surface after Sub-Bowman's Keratomileusis.

    PubMed

    Gao, Shaohui; Wu, Junshu; Li, Lili; Wang, Yong; Zhong, Xingwu

    2013-11-01

    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.

  11. The effect of procedure room temperature and humidity on LASIK outcomes.

    PubMed

    Seider, Michael I; McLeod, Stephen D; Porco, Travis C; Schallhorn, Steven C

    2013-11-01

    To determine whether procedure room temperature or humidity during LASIK affect refractive outcomes in a large patient sample. Retrospective cohort study. A total of 202 394 eyes of 105 712 patients aged 18 to 75 years 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. Patient age, gender, flap creation technique, pre- and 1-month post-LASIK manifest refraction, and ambient temperature and humidity during LASIK were recorded. Effect size determination and univariate and multivariate analyses were performed to characterize the relationships between LASIK procedure room temperature and humidity and postoperative refractive outcome. One month post-LASIK manifest refraction. 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 1°C during LASIK was associated with a 0.003 diopter (D) more hyperopic refraction 1 month postoperatively, and an increase in 1% 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 preoperative refractive error. Neither procedure room temperature nor humidity during LASIK were found to have a clinically significant relationship with postoperative manifest refraction in our population. Copyright © 2013 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  12. The effect of procedure room temperature and humidity on LASIK outcomes

    PubMed Central

    Seider, Michael I.; McLeod, Stephen D.; Porco, Travis C.; Schallhorn, Steven C.

    2013-01-01

    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

  13. A Prototype Antifungal Contact Lens

    PubMed Central

    Ciolino, Joseph B.; Hudson, Sarah P.; Mobbs, Ashley N.; Hoare, Todd R.; Iwata, Naomi G.; Fink, Gerald R.

    2011-01-01

    Purpose. To design a contact lens to treat and prevent fungal ocular infections. Methods. Curved contact lenses were created by encapsulating econazole-impregnated poly(lactic-co-glycolic) acid (PLGA) films in poly(hydroxyethyl methacrylate) (pHEMA) by ultraviolet photopolymerization. Release studies were conducted in phosphate-buffered saline at 37°C with continuous shaking. The contact lenses and their release media were tested in an antifungal assay against Candida albicans. Cross sections of the pre- and postrelease contact lenses were characterized by scanning electron microscopy and by Raman spectroscopy. Results. Econazole-eluting contact lenses provided extended antifungal activity against Candida albicans fungi. Fungicidal activity varied in duration and effectiveness depending on the mass of the econazole-PLGA film encapsulated in the contact lens. Conclusions. An econazole-eluting contact lens could be used as a treatment for fungal ocular infections. PMID:21527380

  14. Biological oxygen apparent transmissibility of hydrogel contact lenses with and without organosilicon moieties.

    PubMed

    Compañ, V; López-Alemany, A; Riande, E; Refojo, M F

    2004-01-01

    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.

  15. The effect of octylglucoside and sodium cholate in Staphylococcus epidermidis and Pseudomonas aeruginosa adhesion to soft contact lenses.

    PubMed

    Santos, Lívia; Rodrigues, Diana; Lira, Madalena; Oliveira, Rosario; Real Oliveira, M Elisabete C D; Vilar, Eva Yebra-Pimentel; Azeredo, Joana

    2007-05-01

    In this study, the effect of the natural surfactants octylglucoside and sodium cholate in inhibiting Staphylococcus epidermidis and Pseudomonas aeruginosa adhesion to conventional and silicone-hydrogel contact lenses (CL) was assessed. Hydrophobicity was also evaluated to conditioned and nonconditioned CL. The inhibiting effect of the tested surfactants was determined through "in vitro" adhesion studies to conditioned and nonconditioned CL followed by image acquisition and cell enumeration. Hydrophobicity was evaluated through contact angle measurements using the advancing type technique on air. Sodium cholate exhibits a very low capability to inhibit microbial adhesion. Conversely, octylglucoside effectively inhibited microbial adhesion in both types of lenses. This surfactant exhibited an even greater performance than a multipurpose lens care solution used as control. Octylglucoside was the only tested surfactant able to lower the hydrophobicity of all CL, which can explain its high performance. The results obtained in this study point out the potential of octylglucoside as a conditioning agent to prevent microbial colonization.

  16. Fimbrolide-coated antimicrobial lenses: their in vitro and in vivo effects.

    PubMed

    Zhu, Hua; Kumar, Ajay; Ozkan, Jerome; Bandara, Rani; Ding, Aidong; Perera, Indrani; Steinberg, Peter; Kumar, Naresh; Lao, William; Griesser, Stefani S; Britcher, Leanne; Griesser, Hans J; Willcox, Mark D P

    2008-05-01

    To examine the ability of contact lenses coated with fimbrolides, inhibitors of bacterial quorum sensing, to prevent microbial adhesion and their safety during short-term clinical assessment. A fimbrolide was covalently attached to commercially available high Dk contact lenses. Subsequently Pseudomonas aeruginosa, Staphylococcus aureus, Serratia marcescens, or Acanthamoeba sp. were added to the lenses and control uncoated contact lenses. Lenses plus microbes were incubated for 24 h, then washed thoroughly to remove non-adherent microbes. Lenses were macerated and resulting slurry plated onto agar plates. After appropriate incubation, the numbers of colony forming units of bacteria (or numbers of Acanthamoeba trophozoites measured using a hemocytometer) from fimbrolide-coated and uncoated lenses were examined. A Guinea Pig model of lens wear was used to assess the safety of lenses worn on a continuous basis for 1 month. In a separate study, 10 subjects wore fimbrolide-coated lenses for 24 h. The responses of the Guinea Pigs and human volunteers to the lenses were assessed by slit lamp examination. The fimbrolides-coated lenses reduced the adhesion of all bacterial strains tested, with reductions occurring of between 67 and 92%. For Acanthamoeba a reduction of 70% was seen. There were no significant differences in ocular responses to fimbrolide-coated lenses compared with controls in either the 1 month animal model or overnight human trial. Fimbrolide-coated lenses show promise as an antibacterial and anti-acanthamoebal coating on contact lenses and appear to be safe when worn on the eye in an animal model.

  17. [LenSx® femto-LASIK, FEMTO LDV Z4® femto-LASIK, and PRK : Comparison of refractive results and an analysis of complications].

    PubMed

    Pahlitzsch, T; Pahlitzsch, M-L; Sumarni, U; Pahlitzsch, M

    2017-10-30

    The aim of this study is to evaluate three refractive procedures: LenSx® (Alcon, Fort Worth, TX, USA) femto-laser in situ keratomileusis (LASIK), FEMTO LDV Z4® (Ziemer, Port, Switzerland) femto-LASIK, and photorefractive keratectomy (PRK) in terms of refractive outcome, perioperative complications, pain, and patient satisfaction. Data of 168 eyes (myopic n = 84) were included in this retrospective study. Of these, 54 eyes (n = 27, 33.85 ± 7.64 years) were treated with LenSx® femto-LASIK, 60 eyes (n = 30, 35.03 ± 7.46 years) with FEMTO LDV Z4® femto-LASIK, and 54 eyes (n = 27, 33.24 ± 8.52 years) with PRK. Photoablation was induced by a MEL80 Excimerlaser (Zeiss, Oberkochen, Germany). The corrected (V sc ) and uncorrected (V cc ) distance subjective visual acuity, corneal topography (Pentacam® HR; Wetzlar, Germany), and objective astigmatism (ARK-760A Refractometer ; Nidek, Fremont, CA, USA) were measured preoperatively, and 1 day, 1 week, 1 month, and 3 months postoperatively. Subjective pain (verbal rating scale) and patient satisfaction were also recorded. Subjective V sc showed significantly better results in both femto-LASIK cohorts compared to PRK (p < 0.05) 1 day and 1 week postoperatively. There was no significant difference between the groups in terms of spherical equivalent and astigmatism 3 months postoperatively. The LenSx® femto-LASIK caused flap complications. The highest patient satisfaction results were shown in the LDV Z4® group, followed by the LenSx® and PRK cohorts (p = 0.072). LDV Z4® femto-LASIK showed the lowest pain score 1 day postoperatively (p < 0.001). There was no significant correlation between target refraction and preoperative corneal thickness and astigmatism. Femtosecond laser-assisted LASIK is an effective procedure enabling rapid rehabilitation of visual acuity with low postoperative pain compared to PRK. There is no difference between the three techniques regarding refractive outcome after 3

  18. Risk factors for corneal infiltrative events during continuous wear of silicone hydrogel contact lenses.

    PubMed

    Szczotka-Flynn, Loretta; Lass, Jonathan H; Sethi, Ajay; Debanne, Sara; Benetz, Beth Ann; Albright, Matthew; Gillespie, Beth; Kuo, Jana; Jacobs, Michael R; Rimm, Alfred

    2010-11-01

    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).

  19. Risk factors for microbial keratitis with contemporary contact lenses: a case-control study.

    PubMed

    Dart, J K G; Radford, C F; Minassian, D; Verma, S; Stapleton, F

    2008-10-01

    To assess the relative risks (RR) of microbial keratitis (MK) for contemporary contact lens (CL) types and wearing schedules. A 2-year prospective case-control study begun in December 2003. Cases were 367 CL wearers attending Moorfields Eye Hospital with proven or presumed MK. Controls were 1069 hospital controls, who were CL wearers with a disorder unrelated to CL wear, and 639 population-based controls who were CL wearers randomly selected from the Moorfields catchment area. Hospital patients completed a self-administered questionnaire; population-based controls were interviewed by telephone. Multivariate analysis was done both for all cases of MK, and for the moderate and severe MK subgroups alone. The RR for developing MK, and vision loss, for all lens types compared with planned replacement soft lenses (the referent). Compared with planned replacement soft lenses (the referent), the RR of MK was significantly increased with daily disposable (DD) CLs (RR, 1.56x [95% confidence interval (CI), 1.1-2.1]; P = 0.009) and differed between different brands of DD lens, was reduced for rigid lenses (RR, 0.16x [95% CI, 0.06-0.4]; P<0.001), and no different for silicone hydrogel or other types of soft lens. Although the risk of MK was higher overall among DD lens users, the risk of vision loss was less than for planned replacement soft CL users (P = 0.05); no DD lens users lost vision to the level of >or=20/40. The RR for overnight wear, for any lens type, was 5.4 times higher (95% CI, 3.3-10.9; P<0.001). Comparison of the DD soft CL types with planned replacement soft lenses (the referent), showed significant differences between brands for the risk of MK. The risk of MK has not been reduced in users of DD and silicone hydrogel CLs. However, vision loss is less likely to occur in DD than in reusable soft CL users. Different brands of CL may be associated with significantly different risks of keratitis; understanding these differences should lead to the development of

  20. Equivalences between refractive index and equilibrium water content of conventional and silicone hydrogel soft contact lenses from automated and manual refractometry.

    PubMed

    González-Méijome, José M; López-Alemany, Antonio; Lira, Madalena; Almeida, José B; Oliveira, M Elisabete C D Real; Parafita, Manuel A

    2007-01-01

    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.

  1. Peripheral refraction with eye and head rotation with contact lenses.

    PubMed

    Lopes-Ferreira, Daniela P; Neves, Helena I F; Faria-Ribeiro, Miguel; Queirós, António; Fernandes, Paulo R B; González-Méijome, José M

    2015-04-01

    To evaluate the impact of eye and head rotation in the measurement of peripheral refraction with an open-field autorefractometer in myopic eyes wearing two different center-distance designs of multifocal contact lenses (MFCLs). Nineteen right eyes from 19 myopic patients (average central M ± SD = -2.67 ± 1.66 D) aged 20-27 years (mean ± SD = 23.2 ± 3.3 years) were evaluated using a Grand-Seiko autorefractometer. Patients were fitted with one multifocal aspheric center-distance contact lens (Biofinity Multifocal D(®)) and with one multi-concentric MFCL (Acuvue Oasys for Presbyopia). Axial and peripheral refraction were evaluated by eye rotation and by head rotation under naked eye condition and with each MFCL fitted randomly and in independent sessions. For the naked eye, refractive pattern (M, J0 and J45) across the central 60° of the horizontal visual field values did not show significant changes measured by rotating the eye or rotating the head (p > 0.05). Similar results were obtained wearing the Biofinity D, for both testing methods, no obtaining significant differences to M, J0 and J45 values (p > 0.05). For Acuvue Oasys for presbyopia, also no differences were found when comparing measurements obtained by eye and head rotation (p > 0.05). Multivariate analysis did not showed a significant interaction between testing method and lens type neither with measuring locations (MANOVA, p > 0.05). There were significant differences in M and J0 values between naked eyes and each MFCL. Measurements of peripheral refraction by rotating the eye or rotating the head in myopic patients wearing dominant design or multi-concentric multifocal silicone hydrogel contact lens are comparable. Copyright © 2014 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  2. Tear analysis in contact lens wearers.

    PubMed Central

    Farris, R L

    1985-01-01

    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

  3. Seven-year changes in corneal power and aberrations after PRK or LASIK.

    PubMed

    Ivarsen, Anders; Hjortdal, Jesper

    2012-09-06

    To examine long-term changes in corneal power and aberrations in myopic patients randomized to photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK). Forty-five patients with myopia from -6 to -8 diopters (spherical equivalent refraction) were randomized to PRK (n = 20) or LASIK (n = 25). Patients were examined preoperatively and for up to 7 years after surgery. Measurements included refraction, topography (TMS-1), and ultrasound pachymetry. By 3 years, 16 PRK and 15 LASIK patients were examined and by 7 years, 9 PRK and 7 LASIK subjects were available. Only patients who had not been reoperated and attended the two late controls were included in data analyses. Optical analysis of topographic data was used to calculate corneal power and wavefront aberrations. PRK and LASIK caused a similar reduction in corneal power. During the first year after PRK, corneal power increased, but remained stable from 1 to 7 years. In contrast, corneal power continued to increase from 1 to 7 years after LASIK. Both PRK and LASIK caused an increase in coma-like and spherical aberrations that remained constant for 7 years. No significant changes in other higher-order aberrations were observed. The cornea may not be stable even 7 years after LASIK, as indicated by the continuing increase in corneal power. In contrast, PRK appears stable from 1 year post surgery. Coma-like and spherical aberrations are permanently increased after PRK and LASIK. (ClinicalTrials.gov number, NCT00404105.).

  4. Femtosecond laser refractive surgery: small-incision lenticule extraction vs. femtosecond laser-assisted LASIK.

    PubMed

    Lee, Jimmy K; Chuck, Roy S; Park, Choul Yong

    2015-07-01

    Small-incision lenticule extraction (SMILE) is a novel technique devised to correct refractive errors. SMILE circumvents excimer laser photoablation of cornea, as the stromal lenticule cut by femtosecond laser is removed manually. Smaller incisions and preservation of anterior corneal biomechanical strength have been suggested as some of the advantages of SMILE over femtosecond laser-assisted LASIK (FS-LASIK). In this review, we compared previous published results of SMILE and FS-LASIK. The advantage, efficacy and safety of SMILE are compared with FS-LASIK. SMILE achieved similar efficacy, predictability and safety as FS-LASIK. Greater preservations of corneal biomechanical strength and corneal nerves were observed in SMILE when compared with LASIK or PRK. Additionally, the incidence of postoperative dry eye syndrome was found to be less problematic in SMILE than in FS-LASIK. SMILE is a promising new surgery for refractive error correction. Prospective and retrospective studies of SMILE have shown that results of SMILE are similar to FS-LASIK. With advances in femtosecond laser technology, SMILE may gain greater acceptance in the future.

  5. Laser-assisted subepithelial keratectomy (LASEK) versus laser-assisted in-situ keratomileusis (LASIK) for correcting myopia

    PubMed Central

    Kuryan, Jocelyn; Cheema, Anjum; Chuck, Roy S

    2017-01-01

    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

  6. Non-toric extended depth of focus contact lenses for astigmatism and presbyopia correction

    NASA Astrophysics Data System (ADS)

    Ben Yaish, Shai; Zlotnik, Alex; Yehezkel, Oren; Lahav-Yacouel, Karen; Belkin, Michael; Zalevsky, Zeev

    2010-02-01

    Purpose: Testing whether the extended depth of focus technology embedded on non-toric contact lenses is a suitable treatment for both astigmatism and presbyopia. Methods: The extended depth of focus pattern consisting of microndepth concentric grooves was engraved on a surface of a mono-focal soft contact lens. These grooves create an interference pattern extending the focus from a point to a length of about 1mm providing a 3.00D extension in the depth of focus. The extension in the depth of focus provides high quality focused imaging capabilities from near through intermediate and up to far ranges. Due to the angular symmetry of the engraved pattern the extension in the depth of focus can also resolve regular as well as irregular astigmatism aberrations. Results: The contact lens was tested on a group of 8 astigmatic and 13 subjects with presbyopia. Average correction of 0.70D for astigmatism and 1.50D for presbyopia was demonstrated. Conclusions: The extended depth of focus technology in a non-toric contact lens corrects simultaneously astigmatism and presbyopia. The proposed solution is based upon interference rather than diffraction effects and thus it is characterized by high energetic efficiency to the retina plane as well as reduced chromatic aberrations.

  7. Microbial contamination of contact lenses, lens care solutions, and their accessories: a literature review.

    PubMed

    Szczotka-Flynn, Loretta B; Pearlman, Eric; Ghannoum, Mahmoud

    2010-03-01

    A contact lens (CL) can act as a vector for microorganisms to adhere to and transfer to the ocular surface. Commensal microorganisms that uneventfully cohabitate on lid margins and conjunctivae and potential pathogens that are found transiently on the ocular surface can inoculate CLs in vivo. In the presence of reduced tissue resistance, these resident microorganisms or transient pathogens can invade and colonize the cornea or conjunctiva to produce inflammation or infection. The literature was reviewed and used to summarize the findings over the last 30 years on the identification, enumeration, and classification of microorganisms adherent to CLs and their accessories during the course of normal wear and to hypothesize the role that these microorganisms play in CL infection and inflammation. Lens handling greatly increases the incidence of lens contamination, and the ocular surface has a tremendous ability to destroy organisms. However, even when removed aseptically from the eye, more than half of lenses are found to harbor microorganisms, almost exclusively bacteria. Coagulase-negative Staphylococci are most commonly cultured from worn lenses; however, approximately 10% of lenses harbor Gram-negative and highly pathogenic species, even in asymptomatic subjects. In storage cases, the incidence of positive microbial bioburden is also typically greater than 50%. All types of care solutions can become contaminated, including up to 30% of preserved products. The process of CL-related microbial keratitis and inflammation is thought to be preceded by the presence or transfer or both of microorganisms from the lens to the ocular surface. Thus, this detailed understanding of lens-related bioburden is important in the understanding of factors associated with infectious and inflammatory complications. Promising mechanisms to prevent bacterial colonization on lenses and lens cases are forthcoming, which may decrease the incidence of microbially driven CL complications.

  8. Risk Factors for Corneal Infiltrative Events during Continuous Wear of Silicone Hydrogel Contact Lenses

    PubMed Central

    Lass, Jonathan H.; Sethi, Ajay; Debanne, Sara; Benetz, Beth Ann; Albright, Matthew; Gillespie, Beth; Kuo, Jana; Jacobs, Michael R.; Rimm, Alfred

    2010-01-01

    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

  9. Microbial Contamination of Contact Lenses, Lens Care Solutions, and Their Accessories: A Literature Review

    PubMed Central

    Szczotka-Flynn, Loretta B.; Pearlman, Eric; Ghannoum, Mahmoud

    2012-01-01

    Purpose A contact lens (CL) can act as a vector for microorganisms to adhere to and transfer to the ocular surface. Commensal microorganisms that uneventfully cohabitate on lid margins and conjunctivae and potential pathogens that are found transiently on the ocular surface can inoculate CLs in vivo. In the presence of reduced tissue resistance, these resident microorganisms or transient pathogens can invade and colonize the cornea or conjunctiva to produce inflammation or infection. Methods The literature was reviewed and used to summarize the findings over the last 30 years on the identification, enumeration, and classification of microorganisms adherent to CLs and their accessories during the course of normal wear and to hypothesize the role that these microorganisms play in CL infection and inflammation. Results Lens handling greatly increases the incidence of lens contamination, and the ocular surface has a tremendous ability to destroy organisms. However, even when removed aseptically from the eye, more than half of lenses are found to harbor microorganisms, almost exclusively bacteria. Coagulase-negative Staphylococci are most commonly cultured from worn lenses; however, approximately 10% of lenses harbor Gram-negative and highly pathogenic species, even in asymptomatic subjects. In storage cases, the incidence of positive microbial bioburden is also typically greater than 50%. All types of care solutions can become contaminated, including up to 30% of preserved products. Conclusions The process of CL-related microbial keratitis and inflammation is thought to be preceded by the presence or transfer or both of microorganisms from the lens to the ocular surface. Thus, this detailed understanding of lens-related bioburden is important in the understanding of factors associated with infectious and inflammatory complications. Promising mechanisms to prevent bacterial colonization on lenses and lens cases are forthcoming, which may decrease the incidence of

  10. Measurement of the refractive index of soft contact lenses during wear.

    PubMed

    Varikooty, Jalaiah; Keir, Nancy; Woods, Craig A; Fonn, Desmond

    2010-01-01

    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.

  11. Surface mechanical properties of pHEMA contact lenses: viscoelastic and adhesive property changes on exposure to controlled humidity.

    PubMed

    Opdahl, Aric; Kim, Seong H; Koffas, Telly S; Marmo, Chris; Somorjai, Gabor A

    2003-10-01

    The surface mechanical properties of poly(hydroxyethyl)methacrylate (pHEMA)-based contact lenses were monitored as a function of humidity by atomic force microscopy (AFM). Surface viscoelastic and adhesion values were extracted from AFM force versus distance interaction curves and were found to be strongly dependent on the bulk water content of the lens and on the relative humidity. At low relative humidity, 40-50%, the dehydration rate from the surface is faster than the hydration rate from the bulk, leading to a rigid surface region that has mechanical properties similar to those measured on totally dehydrated lenses. At relative humidity values > 60%, the dehydration rate from the lens surface rapidly decreases, leading to higher surface water content and a softer surface region. The results indicate that, in an ocular environment, although the bulk of the pHEMA contact lens is hydrated, the surface region may be in a transition between a dehydrated glassy state and a hydrated rubbery state. Copyright 2003 Wiley Periodicals, Inc. J Biomed Mater Res 67A: 350-356, 2003

  12. Evaluation of safety and efficacy of a new multipurpose disinfecting solution on silicone hydrogel contact lenses.

    PubMed

    Pinto-Fraga, José; Blázquez Arauzo, Francisco; Urbano Rodríguez, Rubén; González-García, María J

    2015-01-01

    To evaluate the safety and efficacy of a new multipurpose disinfecting solution (MPDS) with a formulation that includes aloe vera on its composition. This is a prospective, randomized, double-masked clinical trial with a crossover design that included seven examinations. Two different MPDSs, Avizor Alvera® (study solution) and All Clean Soft® (control solution), each were used for 1 month. Comfilcon A silicone hydrogel contact lenses were used during the trial. The main outcome variables were corneal staining and deposits on the surfaces of the contact lenses. Other parameters including ocular surface response, contact lens wettability, user satisfaction, and adverse events, were analyzed according to the International Organization for Standardization (ISO) 11980:2010 guidance for clinical investigation. Twenty subjects (10 women, 10 men) (mean age, 27.7±5.6 years; range, 20-41) were included. No differences between both MPDSs were found in the percentage of subjects with corneal staining >0 at day 30 (study: 35%, control: 50%; p=0.46); neither in the percentage of subjects with deposits on the surface of the contact lens >0 at day 30 (study: 26.32%, control: 52.63%; p=0.18). The study MPDS received higher rates in comfort (study: 8.14±1.09, control: 7.94±0.92; p=0.56) and satisfaction at day 30 (study: 8.63±0.91, control: 8.29±0.80; p=0.19), however the scores were not significantly different with the control MPDS. The clinical trial showed that the study MPDS is safe, efficient, and has acceptable physiologic tolerance, according to the ISO 11980:2010 guidance for clinical investigation. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  13. Refractive Lenticule Transplantation for Correction of Iatrogenic Hyperopia and High Astigmatism After LASIK.

    PubMed

    Lazaridis, Apostolos; Reinstein, Dan Z; Archer, Timothy J; Schulze, Stephan; Sekundo, Walter

    2016-11-01

    To design a technique for intrastromal transplantation of stromal lenticules with specific refractive power for correction of post-LASIK induced hyperopia and astigmatism. A 28-year-old patient was referred for consultation after complicated LASIK for moderate myopia and astigmatism. The refractive error of the right eye was severely overcorrected due to data entry error. Post-LASIK refraction showed high astigmatism (right eye: +6.50 -9.00 @ 84°) and corrected distance visual acuity (CDVA) of 20/32. The corneal thickness was 282 µm. A refractive lenticule transplantation was performed due to contact lens intolerance, poor visual acuity, and severe anisometropia. A toric and myopic lenticule, obtained from a donor using the femtosecond lenticule extraction technique, was implanted under the flap to reduce the refractive error, bring the refraction of the eye to the level correctable by phakic intraocular lens, and restore corneal volume. Six weeks postoperatively, the donor lenticule was spread smoothly in the interface with a minor temporal decentration in relation to pupil center. The refraction showed a reduction of astigmatism but a stronger myopization compared to preoperative calculations (right eye: -6.50 -4.00 @ 70°). At 3 months, the CDVA returned to the preoperative value of 20/32. One year postoperatively, corneal tomography showed no signs of ectasia and biomicroscopy revealed no signs of rejection. After implanting a toric myopic implantable collamer lens, the patient regained uncorrected distance visual acuity of 20/40 and full stereopsis. The refractive lenticule transplantation technique offers a solution for rare cases of post-LASIK hyperopia and high astigmatism while restoring the volume of thin corneas. Moreover, it is a reversible procedure with low probability of rejection. [J Refract Surg. 2016;32(11):780-786.]. Copyright 2016, SLACK Incorporated.

  14. Lasik eye surgery - discharge

    MedlinePlus

    ... Technique. In: Mannis MJ, Holland EJ, eds. Cornea . 4th ed. Philadelphia, PA: Elsevier; 2017:chap 166. Sierra ... LASIK. In: Yanoff M, Duker JS, eds. Ophthalmology . 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 3. ...

  15. Inner layer-embedded contact lenses for pH-triggered controlled ocular drug delivery.

    PubMed

    Zhu, Qiang; Liu, Chang; Sun, Zheng; Zhang, Xiaofei; Liang, Ning; Mao, Shirui

    2018-07-01

    Contact lenses (CLs) are ideally suited for controlled ocular drug delivery, but are limited by short release duration, poor storage stability and low drug loading. In this study, we present a novel inner layer-embedded contact lens capable of pH-triggered extended ocular drug delivery with good storage stability. Blend film of ethyl cellulose and Eudragit S100 was used as the inner layer, while pHEMA hydrogel was used as outer layer to fabricate inner layer-embedded contact lens. Using diclofenac sodium(DS) as a drug model, influence of polymer ratio in the blend film, EC viscosity, drug/polymer ratio, inner layer thickness and outlayer thickness of pHEMA hydrogel on drug release behavior was studied and optimized for daily use. The pH-triggered drug eluting pattern enables the inner layer-embedded contact lens being stored in phosphate buffer solution pH 6.8 with ignorable drug loss and negligible changes in drug release pattern. In vivo pharmacokinetic study in rabbits showed sustained drug release for over 24 h in tear fluid, indicating significant improvement in drug corneal residence time. A level A IVIVC was established between in vitro drug release and in vivo drug concentration in tear fluid. In conclusion, this inner layer embedded contact lens design could be used as a platform for extended ocular drug delivery with translational potential for both anterior and posterior ocular diseases therapy. Copyright © 2018 Elsevier B.V. All rights reserved.

  16. Bilateral acute angle closure glaucoma after hyperopic LASIK correction

    PubMed Central

    Osman, Essam A.; Alsaleh, Ahmed A.; Al Turki, Turki; AL Obeidan, Saleh A.

    2009-01-01

    Acute angle closure glaucoma is unexpected complication following laser in situ keratomileusis (LASIK). We are reporting a 49-years-old lady that was presented to the emergency department with acute glaucoma in both eyes soon after LASIK correction. Diagnosis was made on detailed clinical history and examination, slit lamp examination, intraocular pressure measurement and gonioscopy. Laser iridotomy in both eyes succeeded in controlling the attack and normalizing the intraocular pressure (IOP) more than 6 months of follow-up. Prophylactic laser iridotomy is essential for narrow angle patients before LASIK surgery if refractive laser surgery is indicated. PMID:23960863

  17. Contact lens complications.

    PubMed

    Suchecki, Jeanine K; Donshik, Peter; Ehlers, William H

    2003-09-01

    Complications associated with contact lenses range from mild to severe and occur with all lens modalities. Contact lens wear can cause a change in corneal physiology, which can lead to epithelial, stromal, and endothelial compromise. Other complications include lens deposition, allergic conjunctivitis, giant papillary conjunctivitis, peripheral infiltrates, microbial keratitis, and neovascularization. Pre-existing conditions can contribute to these complications, or they can occur in association with contact lens wear and care regimens. Patient-related factors, such as alteration of the recommended wearing or replacement schedules and noncompliance with recommended contact lens care regimens for economic reasons, convenience, or in error, contribute to contact lens-related complications and have led to difficulty in accurate determination of complication rates among the various lens wear modalities. Complications may require discontinuation of contact lenses, topical therapy, and changes in contact lens wearing schedules, materials, and care solutions. On initial lens fitting and follow-up evaluations, practitioners should review contact lens replacement and cleaning regimens with patients and discuss complications. To avoid serious complications, patients should be reminded to remove their contact lenses as soon as ocular irritation occurs, and to call their eye care practitioner immediately if symptoms persist.

  18. Special tinted contact lens on colour-defects.

    PubMed

    Mutilab, H A; Sharanjeet-Kaur; Keu, L K; Choo, P F

    2012-01-01

    The objective of this study was to determine the visual function of colour-deficient subjects when wearing special red tint contact lenses. A total of 17 subjects with congenital colour vision deficiency (14 deutans and 3 protans), voluntarily participated in this study. The average age for the subjects was 23.00 ± 4.06 years old. Visual functions tested were visual acuity (LogMAR), contrast sensitivity (FACT Chart) and stereopsis (TNO and Howard Dolman tests). Two types of special red tint lenses were used in this study; Type I (light red) and Type II (dark red). The protans and deutans showed no significant changes in visual acuity and contrast sensitivity when wearing either type of contact lens. Stereopsis testing using the Horward-Dolman test gave no significant changes but significant differences were seen using the TNO test. Stereopsis using the TNO test was significantly poorer with the red tinted contact lenses compared to without for both protons and deutans. Testing binocularly with Ishihara plates showed that 88% (n=15) of patients passed the test with Type I and Type II contact lenses. When D15 test was done, 3 patients (17.6%) were 'normal' when using the Type I contact lenses and 2 patients (11.8%) were 'normal' when using the Type II contact lenses. However, with FM100Hue test, most patients showed deutan responses. Total error scores (TES) were found to be higher with Type I and Type II contact lenses compared to without. The Type I and II special tinted contact lens used in this study did not cause a reduction of visual acuity and contrast sensitivity for the colour defects. Stereopsis was also not reduced with the Type I and Type II contact lenses for the colour defects except when tested with the TNO test. Colour vision defects became difficult to detect using the Ishihara plates but FM100Hue test did not show any improvement with the Type I and Type II contact lenses.

  19. Resultant vertical prism in toric soft contact lenses.

    PubMed

    Sulley, Anna; Hawke, Ryan; Lorenz, Kathrine Osborn; Toubouti, Youssef; Olivares, Giovanna

    2015-08-01

    Rotational stability of toric soft contact lenses (TSCLs) is achieved using a range of designs. Designs utilising prism or peripheral ballast may result in residual prism in the optic zone. This study quantifies the vertical prism in the central 6mm present in TSCLs with various stabilisation methods. Vertical prism was computed using published refractive index and vertical thickness changes in the central optic zone on a full lens thickness map. Thickness maps were measured using scanning transmission microscopy. Designs tested were reusable, silicone hydrogel and hydrogel TSCLs: SofLens(®) Toric, PureVision(®)2 for Astigmatism, PureVision(®) Toric, Biofinity(®) Toric, Avaira(®) Toric, clariti(®) toric, AIR OPTIX(®) for ASTIGMATISM and ACUVUE OASYS(®) for ASTIGMATISM; with eight parameter combinations for each lens (-6.00DS to +3.00DS, -1.25DC, 90° and 180° axes). All TSCL designs evaluated had vertical prism in the optic zone except one which had virtually none (0.01Δ). Mean prism ranged from 0.52Δ to 1.15Δ, with three designs having prism that varied with sphere power. Vertical prism in ACUVUE OASYS(®) for ASTIGMATISM was significantly lower than all other TSCLs tested. TSCL designs utilising prism-ballast and peri-ballast for stabilisation have vertical prism in the central optic zone. In monocular astigmats fitted with a TSCL or those wearing a mix of toric designs, vertical prism imbalance could create or exacerbate disturbances in binocular vision function. Practitioners should be aware of this potential effect when selecting which TSCL designs to prescribe, particularly for monocular astigmats with pre-existing binocular vision anomalies, and when managing complaints of asthenopia in monocular astigmats. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  20. Lasik eye surgery - slideshow

    MedlinePlus

    ... this page: //medlineplus.gov/ency/presentations/100206.htm Lasik eye surgery - series—Normal anatomy To use the ... A.M. Editorial team. Related MedlinePlus Health Topics Laser Eye Surgery A.D.A.M., Inc. is accredited by ...

  1. Practitioner influence on contact lens prescribing in the UK.

    PubMed

    Efron, Nathan; Morgan, Philip B

    2009-08-01

    Contact lenses are mainly fitted by registered optometrists and contact lens opticians in the UK. Data we have gathered from annual contact lens fitting surveys over the past 12 years indicate that, on average, registered optometrists and contact lens opticians undertake 3.2 and 7.1 contact lens fits per week (p<0.0001). More experienced practitioners tend to fit older patients. Practitioners fitting more lenses per year tend to fit a higher proportion of soft lenses. Contact lens opticians tend to fit a higher proportion of patients with planned replacement and daily disposable lenses compared with optometrists.

  2. Evaluation of Protamine as a Disinfectant for Contact Lenses.

    PubMed

    Bandara, Mahesh K; Masoudi, Simin; Zhu, Hua; Bandara, Rani; Willcox, Mark D P

    2016-11-01

    To investigate the ability of protamine, alone or in combination with other antimicrobial agents, to kill bacteria and fungi associated with contact lens-related keratitis. The International Organization for Standardization 14729:2001 procedure was used to test the antimicrobial activity of solutions of protamine (23-228 μM) with and without polyhexamethylene biguanide (PHMB) and ethylenediamine tetra-acetic acid (EDTA). The recommended ISO panel of microbes along with six clinical isolates was tested. The effect of increasing sodium chloride concentration on the antimicrobial activity was also assessed. The cytotoxicity of the final protamine/EDTA/PHMB solution was measured using ISO 10993-5 standard assays. Protamine gave a dose-dependent antimicrobial effect, with the highest effect for most strains being at 228 μM (≥6 log reductions of viable bacteria and ≥1 log reduction of viable fungi). Addition of EDTA and PHMB increased the antimicrobial effect for all strains except Pseudomonas aeruginosa ATCC6538, which had optimum activity (≥6 log inhibition) even in protamine alone. The optimum antimicrobial activity of all microbes was achieved in 0.2% sodium chloride, but even in 0.8% sodium chloride, the activity met or exceeded the ISO standard (>3 log reductions for bacteria and >1 log reduction for fungi). None of the formulations was cytotoxic to mammalian cells. This study highlights the potential for protamine to be used for the development of effective multipurpose disinfection solutions. Further investigations such as stability, compatibility with contact lenses, and in vivo toxicity are warranted.

  3. Implantation of a multifocal toric intraocular lens with a surface-embedded near segment after repeated LASIK treatments.

    PubMed

    Khoramnia, Ramin; Auffarth, Gerd U; Rabsilber, Tanja M; Holzer, Mike P

    2012-11-01

    We report a 66-year-old patient who presented with increasing hyperopia, astigmatism, and presbyopia in both eyes 8 years after bilateral laser in situ keratomileusis (LASIK) and LASIK enhancement in the left eye aiming for spectacle independence. Bilateral multifocal toric Lentis Mplus intraocular lenses (IOLs) with an embedded near segment and individually customized cylinder correction were implanted uneventfully following phacoemulsification. The Haigis-L formula after previous hyperopia correction was chosen for IOL power calculation and provided reliable results. Emmetropia was targeted and achieved. Three months postoperatively, the uncorrected distance visual acuity had increased from 0.40 logMAR to 0.10 logMAR in the right eye and from 0.20 logMAR to 0.00 logMAR in the left eye. The patient gained 6 lines of uncorrected near visual acuity: 0.20 logMAR in the right eye and 0.10 logMAR in the left eye. This case shows that customized premium IOL implantation can provide accurate results even in challenging cases. The International Vision Correction Research Centre, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany, has received research grants, lecture fees, and travel reimbursement from Oculentis GmbH. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Corneal polarimetry after LASIK refractive surgery

    NASA Astrophysics Data System (ADS)

    Bueno, Juan M.; Berrio, Esther; Artal, Pablo

    2006-01-01

    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.

  5. New developments in corneal and external disease--LASIK.

    PubMed

    Dhaliwal, Deepinder K; Mather, Rookaya

    2003-03-01

    Lamellar refractive surgery has evolved into LASIK, which is a widely performed, versatile procedure with a high patient acceptance. In this chapter, the two main components of LASIK were discussed: flap creation and stromal ablation. In each of these areas, the authors explored current technology and new advances, including the femtosecond laser and wavefront-guided ablations. Expanded indications and therapeutic application of LASIK also have come to the forefront. The treatment of anisomyopic amblyopia in the pediatric population is a prime example and was discussed fully in this chapter. The field of refractive surgery has never been stagnant. Surgeons and scientists continue to explore new modalities to increase safety, to improve results, and to broaden applications that benefit the patient population.

  6. Photorefractive keratectomy (PRK) versus laser-assisted in-situ keratomileusis (LASIK) for myopia.

    PubMed

    Shortt, A J; Allan, B D S

    2006-04-19

    Myopia (also known as short-sightedness or near-sightedness) is an ocular condition in which the refractive power of the eye is greater than is required, resulting in light from distant objects being focused in front of the retina instead of directly on it. The two most commonly used surgical techniques to permanently correct myopia are photorefractive keratectomy (PRK) and laser-assisted in-situ keratomileusis (LASIK). The aim of this review was to compare the effectiveness and safety of PRK and LASIK for correction of myopia. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2005, Issue 3), MEDLINE (1966 to September 2005), EMBASE (1980 to September 2005) and LILACs (1982 to 3 November 2005). We also searched the reference lists of the studies and the Science Citation Index. We included randomised controlled trials comparing PRK and LASIK for correction of any degree of myopia. We also included data on adverse events from prospective multicentre consecutive case series in the Food and Drugs Administration (FDA) trials database (http//www.fda.gov/cdrh/LASIK/lasers.htm). Two authors independently assessed trial quality and extracted data. Data were summarised using odds ratio and mean difference. Odds ratios were combined using a random-effects model after testing for heterogeneity. This review included six randomised controlled trials involving a total of 417 eyes, of which 201 were treated with PRK and 216 with LASIK. We found that although LASIK gives a faster visual recovery than PRK, the effectiveness of these two procedures is comparable. We found some evidence that LASIK may be less likely than PRK to result in loss of best spectacle-corrected visual acuity. LASIK gives a faster visual recovery than PRK but the effectiveness of these two procedures is comparable. Further trials using contemporary techniques are required to determine whether LASIK and PRK are equally safe.

  7. Does correcting astigmatism with toric lenses improve driving performance?

    PubMed

    Cox, Daniel J; Banton, Thomas; Record, Steven; Grabman, Jesse H; Hawkins, Ronald J

    2015-04-01

    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

  8. [Rules and regulations concerning contact lens-related infection].

    PubMed

    Feys, J

    2004-04-01

    Contact lens-related infectious keratitis is a potentially sight-threatening complication. Bacterial keratitis, mostly due to Gram-negative bacteria, is associated with poor lens hygiene, overnight wear, and contaminated lens care solutions. Contamination of the lens storage case may cause fungal keratitis. Acanthamoeba infection is related to the use of tap water or swimming while wearing soft lenses. Viruses are of less concern among contact lens wearers. Possible transmission of Creutzfeldt-Jakob disease by multi-patient trial lenses must be taken in account. To minimize these risk factors, regulations are applied at various levels: CE marking of contact lenses and care products as they are medical devices; contact lens fitting only by health care professionals; distribution of contact lenses by opticians and lens care solutions by opticians and pharmacists; hygienic management of trial lenses following official recommendations. Contact lens-related keratitis must be reported to health care Authorities.

  9. Intraoperative cyclorotation and pupil centroid shift during LASIK and PRK.

    PubMed

    Narváez, Julio; Brucks, Matthew; Zimmerman, Grenith; Bekendam, Peter; Bacon, Gregory; Schmid, Kristin

    2012-05-01

    To determine the degree of cyclorotation and centroid shift in the x and y axis that occurs intraoperatively during LASIK and photorefractive keratectomy (PRK). Intraoperative cyclorotation and centroid shift were measured in 63 eyes from 34 patients with a mean age of 34 years (range: 20 to 56 years) undergoing either LASIK or PRK. Preoperatively, an iris image of each eye was obtained with the VISX WaveScan Wavefront System (Abbott Medical Optics Inc) with iris registration. A VISX Star S4 (Abbott Medical Optics Inc) laser was later used to measure cyclotorsion and pupil centroid shift at the beginning of the refractive procedure and after flap creation or epithelial removal. The mean change in intraoperative cyclorotation was 1.48±1.11° in LASIK eyes and 2.02±2.63° in PRK eyes. Cyclorotation direction changed by >2° in 21% of eyes after flap creation in LASIK and in 32% of eyes after epithelial removal in PRK. The respective mean intraoperative shift in the x axis and y axis was 0.13±0.15 mm and 0.17±0.14 mm, respectively, in LASIK eyes, and 0.09±0.07 mm and 0.10±0.13 mm, respectively, in PRK eyes. Intraoperative centroid shifts >100 μm in either the x axis or y axis occurred in 71% of LASIK eyes and 55% of PRK eyes. Significant changes in cyclotorsion and centroid shifts were noted prior to surgery as well as intraoperatively with both LASIK and PRK. It may be advantageous to engage iris registration immediately prior to ablation to provide a reference point representative of eye position at the initiation of laser delivery. Copyright 2012, SLACK Incorporated.

  10. Fluorescent solute-partitioning characterization of layered soft contact lenses.

    PubMed

    Dursch, T J; Liu, D E; Oh, Y; Radke, C J

    2015-03-01

    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

  11. Is LASIK for Me? A Patient's Guide to Refractive Surgery

    MedlinePlus

    ... whether LASIK would be appropriate for you are: • dry eye syndrome . If dry eye is left untreated prior to surgery, patients may be disappointed with their LASIK results. If dry eye is diagnosed and adequately treated before surgery, you ...

  12. Solutions for care of silicone hydrogel lenses.

    PubMed

    Willcox, Mark D P

    2013-01-01

    During wear of contact lenses on a daily wear basis, it is necessary to disinfect the lens overnight before reinserting the lens the next day. The ability of the solutions used for this to disinfect lenses and lens cases is important for safe lens wear. The literature on the disinfecting ability of multipurpose disinfecting solutions (MPDS) commonly used with silicone hydrogel lenses reported during the period 2000 to 2012 is reviewed, as this is the period of time during which these lenses have been commercially available. Particular emphasis is placed on the ability of disinfecting solutions to control colonization of lens cases by microbes and changes in composition and use of the solutions. In addition, the literature is reviewed on ways of minimizing lens case microbial contamination. Maintaining the hygiene of contact lenses and lens cases is important in minimizing various forms of corneal infiltrative events that occur during lens wear. Although lens case contamination is not associated with different lenses, it is determined by use of different MPDS. MPDS that allow more frequent or heavy contamination of cases by Gram-negative bacteria are associated with a higher incidence of corneal infiltrative events. MPDS are now available that contain dual disinfectants. Wiping lens cases with tissues or using lens cases that incorporate silver are associated with reductions in contamination in clinical trials. Similarly, using MPDS to rub and rinse lenses before disinfection may reduce levels of microbes on lenses. The MPDS also contain surfactants that help reduce deposition and denaturation of proteins on lenses. Improvements in MPDS formulations and hygiene practices may help to reduce the incidence of adverse events that are seen during use with silicone hydrogel lenses.

  13. Contact Lens Solutions and Contact Lens Discomfort: Examining the Correlations Between Solution Components, Keratitis, and Contact Lens Discomfort.

    PubMed

    Kuc, Christopher J; Lebow, Kenneth A

    2018-06-13

    This article will examine the current literature, as it relates to contact lens discomfort (CLD) secondary to contact lens solutions. The reader will better understand the characteristics of contact lenses, as they uniquely interact with each type of contact lens solution and also gain a better comprehension of the components of contact lens solution such as preservatives, surfactants, and chelating agents, which may contribute to discomfort. By investigating corneal staining theory and the mechanisms that contribute to its presence, the reader will gain insight into this clinical finding, which relates to selection of contact lens solutions. The FDA standards for testing solutions and how this relates to contact lens keratitis will also be appraised in regards to current ISO recommendations. Finally, better selection of multipurpose contact lens solution (MPS) and hydrogen peroxide-based solutions for patients should be accessible to the clinician based on this review and preexisting clinical findings or diagnoses. A review of current published literature from peer reviewed journals and online journals was conducted to gain an understanding of contact lens solution's impact on contact lens discomfort. Many studies have been conducted comparing comfort between various types of contact lens solutions. It is challenging to decipher this information and apply it clinically when selecting solutions for patients. By comparing solution components, how contact lens solutions interact with different types of lenses, keratitis related to contact lenses, and preexisting ocular conditions, this review will improve a clinician's ability to eliminate CLD.

  14. Using InterWave Aberrometry to Measure and Improve the Quality of Vision in LASIK Surgery

    PubMed Central

    Thompson, Keith P.; Staver, P. Randall; Garcia, Jose R.; Burns, Stephen A.; Webb, Robert H.; Stulting, R. Doyle

    2005-01-01

    Objective To compare visual outcomes in eyes undergoing aberrometry-guided (InterWave) LASIK with those in eyes undergoing standard LASIK treatment based upon refractive measures. Design Single-center, comparative, interventional, consecutive case series. Participants Four hundred two consecutive eyes undergoing LASIK were analyzed retrospectively. One group, 106 eyes undergoing primary LASIK and 224 eyes undergoing LASIK enhancement, was treated with standard LASIK treatment using a 5.5-mm optical zone, 1.5-mm transition zone laser with the settings determined by manifest refraction. The second group, 44 untreated (primary) eyes and 28 previously treated (enhancement) eyes, received a multipass, multistage treatment in which the laser settings for each stage were determined by aberrometry measurements. Eyes with desired monovision (undercorrected) outcome and preoperative hyperopia were excluded from the study. Intervention An aberrometry-guided laser treatment (InterWave LASIK) was compared with the standard LASIK treatment based upon the manifest refraction. Main Outcome Measures Uncorrected visual acuity (VA), manifest refraction, best spectacle-corrected VA (BSCVA), severity of halos, and root mean square (RMS) retinal blur area measured at 3 months postoperatively. Results Three months postoperatively there was no difference in uncorrected VA, BSCVA, refraction, or RMS retinal blur areas for pupil sizes of 3.5 mm between eyes treated by InterWave and those treated by standard LASIK. However, InterWave LASIK reduced the retinal blur area by 48% (P<0.0103) and 58% (P<0.0004) in primary cases and 43% (P<0.0430) and 74% (P<0.0271) in enhancement cases, respectively, for pupil sizes of 4.5 and 6.5 mm relative to standard LASIK treatments. Patients undergoing InterWave-guided treatment reported less severity of halo (0.37 vs. 0.98 [P<0.016] for primary cases and 0.35 vs. 0.73 [P<0.04] for enhancement cases). Conclusion InterWave LASIK achieved acuity and refractive

  15. Evaluation of corneal biomechanics in patients with keratectasia following LASIK using dynamic Scheimpflug analyzer.

    PubMed

    Ueki, Ryotaro; Maeda, Naoyuki; Fuchihata, Mutsumi; Asai, Tomoko; Koh, Shizuka; Fujimoto, Hisataka; Uematsu, Masafumi; Nishida, Kohji

    2018-04-26

    To investigate the corneal biomechanics in eyes with keratectasia following LASIK using a dynamic Scheimpflug analyzer. Case-Control study. The subjects in the study included 12 eyes with keratectasia after LASIK (KE), 24 eyes with keratoconus (KC), 17 eyes without keratectasia after LASIK (LASIK), and 34 eyes with normal corneas (Normal). Corneal biomechanics of the four groups were evaluated using a dynamic Scheimpflug analyzer. Compared with Normal (7.06 ± 0.54), the radius at the highest concavity (radius, mm) of LASIK (5.96 ± 0.76), KE (4.93 ± 0.61) and KC (5.39 ± 1.02) were significantly small. The Deflection Amplitude (HCDLA, mm) of Normal (0.94 ± 0.07) was significantly lower than those of KE (1.11 ± 0.10) and KC (1.06 ± 0.16), and was not significantly different from that of LASIK (0.98 ± 0.07). There were significant differences between LASIK and KE in radius and HCDLA (P < 0.05), whereas KE and KC had no differences in these parameters. Corneal biomechanical features evaluated using the dynamic Scheimpflug analyzer suggest that biomechanical properties in eyes with keratectasia, keratoconus, and LASIK are different from those of normal eyes. Although the biomechanics in eyes with keratectasia differs from that in eyes with LASIK, it is similar to that in eyes with keratoconus.

  16. LASIK and PRK in hyperopic astigmatic eyes: is early retreatment advisable?

    PubMed

    Frings, Andreas; Richard, Gisbert; Steinberg, Johannes; Druchkiv, Vasyl; Linke, Stephan Johannes; Katz, Toam

    2016-01-01

    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. 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. 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. 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.

  17. Bacterial transmission from lens storage cases to contact lenses-Effects of lens care solutions and silver impregnation of cases.

    PubMed

    Vermeltfoort, Pit B J; Hooymans, Johanna M M; Busscher, Henk J; van der Mei, Henny C

    2008-10-01

    The killing efficacies of multipurpose lens care solutions on planktonic and biofilm bacteria grown in polypropylene contact lens storage cases with and without silver impregnation and effects on bacterial transmission from storage cases to silicone hydrogel contact lenses were investigated. For transmission studies, biofilms of Staphylococcus aureus 835 or Pseudomonas aeruginosa no. 3 were grown on lens storage cases and incubated with a contact lens in different multipurpose lens care solutions (Opti-Free(R)Express(R), ReNu(R) MultiPlus(R), and SoloCare Aquatrade mark) or 0.9% NaCl. In addition, planktonic bacteria were directly suspended in multipurpose solutions and their killing efficacies were determined. The numbers of transmitted live and dead bacteria on the lenses were measured using a combination of plate counting and fluorescence microscopy. The highest killing efficacies were shown by Opti-Free(R) Express(R) for planktonic as well as for biofilm bacteria. Silver impregnation of lens cases in combination with the prescribed solution increased the killing efficacy for P. aeruginosa in biofilms, whereas effects for S. aureus were minor. Lowest numbers of live and dead bacteria were transmitted to a lens in Opti-Free(R) Express(R) multipurpose solution, with no significant differences between lens types and no effects of silver impregnation. (c) 2008 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 2008. (c) 2008 Wiley Periodicals, Inc.

  18. Diffusion of Antimicrobials Across Silicone Hydrogel Contact Lenses.

    PubMed

    Zambelli, Alison M; Brothers, Kimberly M; Hunt, Kristin M; Romanowski, Eric G; Nau, Amy C; Dhaliwal, Deepinder K; Shanks, Robert M Q

    2015-09-01

    To measure the diffusion of topical preparations of moxifloxacin, amphotericin B (AmB), and polyhexamethylene biguanide (PHMB) through silicone hydrogel (SH) contact lenses (CLs) in vitro. Using an in vitro model, the diffusion of three antimicrobials through SH CLs was measured. Diffused compounds were measured using a spectrophotometer at set time points over a period of 4 hr. The amount of each diffused antimicrobial was determined by comparing the experimental value with a standard curve. A biological assay was performed to validate the CL 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 four independent replicates. Our data show detectable moxifloxacin and PHMB diffusion through SH CLs at 30 min, whereas AmB diffusion remained below the limit of detection within the 4-hr experimental period. In the biological assay, diffused moxifloxacin demonstrated microbial killing starting at 20 min on bacterial lawns, whereas PHMB and AmB failed to demonstrate killing on microbial lawns over the course of the 60-min experiment. In vitro diffusion assays demonstrate limited penetration of certain anti-infective agents through SH CLs. Further studies regarding the clinical benefit of using these agents along with bandage CL for corneal pathologic condition are warranted.

  19. Scanning laser polarimetry retinal nerve fiber layer thickness measurements after LASIK.

    PubMed

    Zangwill, Linda M; Abunto, Teresa; Bowd, Christopher; Angeles, Raymund; Schanzlin, David J; Weinreb, Robert N

    2005-02-01

    To compare retinal nerve fiber layer (RNFL) thickness measurements before and after LASIK. Cohort study. Twenty participants undergoing LASIK and 14 normal controls. Retinal nerve fiber layer thickness was measured before LASIK and approximately 3 months after surgery in one eye each of 20 patients using a scanning laser polarimeter (GDx Nerve Fiber Analyzer) with fixed corneal compensation (FCC), one with variable corneal compensation (GDx VCC), and optical coherence tomography (OCT). Fourteen normal controls also were tested at baseline and approximately 3 months later. Retinal nerve fiber layer thicknesses measured with the GDx FCC, GDx VCC, and OCT. At baseline, mean (95% confidence interval [CI]) RNFL thicknesses for the GDx FCC, GDx VCC, and OCT were 78.1 microm (72.2-83.9), 54.3 microm (52.7-56.0), and 96.8 microm (93.2-100.5), respectively. In both LASIK and control groups, there were no significant changes between baseline and follow-up examinations in GDx VCC and OCT RNFL thickness measurements globally or in the superior and inferior quadrants (mean change, <5 microm for each instrument). In the control group, there also was no significant change in GDx FCC measurements between baseline and follow-up. In LASIK patients, significant reductions were observed in GDx FCC RNFL measurements. Average absolute values of the mean (95% CI) change in thickness were 12.4 microm (7.7-17.2), 15.3 microm (9.6-20.9), and 12.9 microm (7.6-18.1) for GDx FCC RNFL measurements superiorly, inferiorly, and globally, respectively (all Ps < or = 0.001). LASIK does not seem to change RNFL thickness. Reduction in GDx FCC RNFL thickness measurements after LASIK is a measurement artifact and is most likely due to erroneous compensation for corneal birefringence. With scanning laser polarimetry, it is mandatory to compensate individually for change in corneal birefringence after LASIK to ensure accurate RNFL assessment.

  20. Chronic dry eye in PRK and LASIK: manifestations, incidence and predictive factors

    PubMed Central

    Bower, Kraig S.; Sia, Rose K.; Ryan, Denise S.; Mines, Michael J.; Dartt, Darlene A.

    2017-01-01

    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

  1. Segmentation of 830- and 1310-nm LASIK corneal optical coherence tomography images

    NASA Astrophysics Data System (ADS)

    Li, Yan; Shekhar, Raj; Huang, David

    2002-05-01

    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.

  2. Producing optical (contact) lenses by a novel low cost process

    NASA Astrophysics Data System (ADS)

    Skipper, Richard S.; Spencer, Ian D.

    2005-09-01

    The rapid and impressive growth of China has been achieved on the back of highly labour intensive industries, often in manufacturing, and at the cost of companies and jobs in Europe and America. Approaches that worked well in the 1990's to reduce production costs in the developed countries are no longer effective when confronted with the low labour costs of China and India. We have looked at contact lenses as a product that has become highly available to consumers here but as an industry that has reduced costs by moving to low labour cost countries. The question to be answered was, "Do we have the skill to still make the product in the UK, and can we make it cheap enough to export to China?" if we do not, then contact lens manufacture will move to China sooner or later. The challenge to enter the markets of the BRIC (Brazil, Russia, India and China) countries is extremely exciting as here is the new money, high growth and here is a product that sells to those with disposable incomes. To succeed we knew we had to be radical in our approach; the radical step was very simple: to devise a process in which each step added value to the customer and not cost to the product. The presentation examines the processes used by the major producers and how, by applying good manufacturing practice sound scientific principles to them, the opportunity to design a new low cost patented process was identified.

  3. Contact Lens Care

    MedlinePlus

    ... your prescription expires Lens measurements The contact lens brand name and material Your doctor’s name and contact ... mail-order sellers may send you a different brand. Contact lenses may look the same, but materials ...

  4. Exploration and comparison of in vitro eye irritation tests with the ISO standard in vivo rabbit test for the evaluation of the ocular irritancy of contact lenses.

    PubMed

    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

    2016-12-01

    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.

  5. SMILE and Wavefront-Guided LASIK Out-Compete Other Refractive Surgeries in Ameliorating the Induction of High-Order Aberrations in Anterior Corneal Surface

    PubMed Central

    2016-01-01

    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

  6. Accommodative Behavior of Young Eyes Wearing Multifocal Contact Lenses.

    PubMed

    Altoaimi, Basal H; Almutairi, Meznah S; Kollbaum, Pete S; Bradley, Arthur

    2018-05-01

    The effectiveness of multifocal contact lenses (MFCLs) at slowing myopia progression may hinge on the accommodative behavior of young eyes fit with these presbyopic style lenses. Can they remove hyperopic defocus? Convergence accommodation as well as pupil size and the zonal geometry are likely to contribute to the final accommodative responses. The aim of this study was to examine the accommodation behavior of young adult eyes wearing MFCLs and the effectiveness of these MFCLs at removing foveal hyperopic defocus when viewing near targets binocularly. Using a high-resolution Shack-Hartmann aberrometer, accommodation and pupil behavior of eight young adults (27.25 ± 2.05 years) were measured while subjects fixated a 20/40 character positioned between 2 m and 20 cm (0.50 to 5.00 diopters [D]) in 0.25-D steps. Refractive states were measured while viewing binocularly and monocularly with single-vision and both center-distance and center-near +2.00 D add MFCLs. Refractive state was defined using three criteria: the dioptric power that would (1) minimize the root mean square wavefront error, (2) focus the pupil center, and (3) provide the peak image quality. Refractive state pupil maps reveal the complex optics that exist in eyes wearing MFCLs. Reduced accommodative gain beyond the far point of the near add revealed that young subjects used the added plus power to help focus near targets. During accommodation to stimuli closer than the far point generated by the add power, a midperipheral region of the pupil was approximately focused, resulting in the smallest accommodative errors for the minimum root mean square-defined measures of refractive state. Paraxial images were always hyperopically or myopically defocused in eyes viewing binocularly with center-distance or center-near MFCLs, respectively. Because of zone geometry in the concentric MFCLs tested, the highly aberrated transition zone between the distance and near optics contributed a significant proportion and

  7. Prevalence of ocular surface symptoms, signs, and uncomfortable hours of wear in contact lens wearers: the effect of refitting with daily-wear silicone hydrogel lenses (senofilcon a).

    PubMed

    Riley, Colleen; Young, Graeme; Chalmers, Robin

    2006-12-01

    Many soft contact lens wearers have symptoms or signs that compromise successful lens wear. This study estimated the prevalence of problems in current wearers of soft contact lenses and tested the effect of refitting patients with senofilcon A silicone hydrogel lenses (ACUVUE Oasys). Prevalence was estimated from 1,092 current lens wearers for frequent or constant discomfort or dryness, at least 2 hours of uncomfortable wear, at least grade 2 limbal or bulbar hyperemia (0-4), or at least grade 3 corneal staining (0-15). In the second part of the study, 112 of the 564 wearers classified as problem patients were refitted with senofilcon A lenses and reassessed 2 weeks later. Fifty-two percent (564 of 1,092) had some qualifying criteria, with dryness reported by 23%, discomfort by 13%, and at least 2 hours of uncomfortable wear by 27%. Six percent of subjects had qualifying limbal hyperemia; 10% had bulbar hyperemia; and 12% had corneal staining. After refitting 112 problem patients, 75% had less dryness; 88% had better comfort (P<0.0001 each); and 76% had fewer uncomfortable hours of wear (P=0.004). Although the average wearing time was unchanged, comfortable wearing time increased significantly (10.4 to 11.6 hours) (P=0.004). All (35 of 35) eyes with qualifying limbal hyperemia before the refit also improved (P<0.0001), as did 80% (40 of 50) of those with bulbar hyperemia (P<0.0001) and 76% (26 of 34) of those with corneal staining (P=0.005). Most soft lens wearers encounter clinically significant signs or symptoms with their current contact lenses. Refitting with new-generation silicone hydrogel lenses (senofilcon A) can alleviate some of these common problems.

  8. Approach to knowledge of the interaction between the constituents of contact lenses and ocular tears: mixed monolayers of poly(methyl methacrylate) and dipalmitoyl phosphatidyl choline.

    PubMed

    Miñones Conde, M; Conde, O; Trillo, J M; Miñones, J

    2011-04-05

    Mixed monolayers of poly(methyl methacrylate) (PMMA), the main component of hard contact lenses, and dipalmitoyl phosphatidyl choline (DPPC), a characteristic phospholipidic constituent of ocular tear films, were selected as an in vitro model in order to observe the behavior of contact lenses on the eye. Using Langmuir monolayer and Brewster angle microscopy (BAM) techniques, the interaction between both components was analyzed from the data of surface pressure-area isotherms, compressional modulus-surface pressure, and relative film thickness versus time elapsed from the beginning of compression, together with BAM images. Regardless of the surface pressure at which the molecular/monomer areas (A(m)) were recorded, the A(m) mole fractions of PMMA (X(PMMA)) plots show that the experimental results match the theoretical values calculated from additivity rule A(m) = X(PMMA)A(PMMA) + X(DPPC)A(DPPC). The application of the Crisp phase rule to the phase diagram of the PMMA-DPPC system can explain the existence of a mixed monolayer made up of miscible components with ideal behavior at surface pressures below 25 mN/m. However, at very high surface pressures, when collapse is reached (at 60 mN/m), the single collapsed components are segregated into two independent phases. These results allows us to argue that PMMA hard contact lenses in the eye do not alter the structural characteristics of the phospholipid (DPPC) in tears.

  9. Effect of sport-tinted contact lenses for contrast enhancement on retinal straylight measurements.

    PubMed

    Cerviño, Alejandro; Gonzalez-Meijome, Jose M; Linhares, João M M; Hosking, Sarah L; Montes-Mico, Robert

    2008-03-01

    To investigate the effect of two tinted contact lenses (CL) designed for outdoor sports activity on the psychometric determination of retinal straylight using the compensation comparison method. Thirteen emmetropic subjects were randomly fitted with two different tinted Nike Maxsight (Bausch & Lomb, Rochester, NY, USA) CL in one eye, while the contralateral eye was fitted with a clear lens made of the same material (Optima 38, Bausch & Lomb). Three valid straylight measurements were taken on each eye before and a few minutes after lens insertion, when lens stabilization had occurred. The subjects' mean straylight values were 0.90 +/- 0.09 at baseline and 0.95 +/- 0.10 with the clear Optima 38 CL. Straylight values were 0.97 +/- 0.10 and 1.0 +/- 0.10 log units with the amber and grey-green tinted CL, respectively. Differences in straylight between baseline (without CL) and with the clear CL in place were neither statistically significant (p = 0.066) nor was there a significant difference between baseline and the amber CL (p = 0.052). However, the grey-green CL showed a statistically significant difference from baseline (p = 0.006). Differences in straylight with the clear CL compared with the grey-green CL were also statistically different from zero (p = 0.002) showing an increased straylight value for the tinted CL. These differences were variable, but consistent for each subject, thus those showing higher or lower changes with one tinted lens tended to show the same trend with the second lens (r(2) = 0.736). Despite increases having been found in straylight values with tinted contact lenses, those changes are not likely to induce clinically significant changes in visual function under photopic conditions, even for the grey-green CL, which seems to increase straylight values more significantly than the amber CL. This difference between the tinted CL could suggest a wavelength dependence of straylight values, although this should be investigated further by

  10. Visual outcomes after Epi-LASIK and PRK for low and moderate myopia.

    PubMed

    Sia, Rose K; Coe, Charles D; Edwards, Jayson D; Ryan, Denise S; Bower, Kraig S

    2012-01-01

    To evaluate visual outcomes following epi-LASIK compared to photorefractive keratectomy (PRK). Of a total 294 patients aged ≥21 years, 145 (290 eyes) underwent epi-LASIK and 149 (298 eyes) underwent PRK for low to moderate myopia or myopic astigmatism. Epi-LASIK was performed with the Amadeus II epikeratome (Abbott Medical Optics) and PRK with the Amoils rotary epithelial brush (Innovative Excimer Solutions). All ablations were performed using the same excimer laser system. Outcome measures included intraoperative complications, corneal reepithelialization, postoperative pain, uncorrected distance visual acuity (UDVA), manifest refraction spherical equivalent (MRSE), corrected distance visual acuity (CDVA), corneal haze, and quality of vision. Mean preoperative MRSE was -2.97±1.19 diopters (D) for epi-LASIK versus -2.95±1.06 D for PRK. Complete reepithelialization was achieved by postoperative day 4 in 46.9% of epi-LASIK eyes versus 92.4% of PRK eyes, with superior UDVA at postoperative day 1 in the PRK group (P=.002). Using Fisher exact test, a significantly higher percentage of epi-LASIK eyes compared to PRK eyes achieved 20/15 or better at 1 month (25.8% vs 17.8%, P=.031), 3 months (62.3% vs 49.3%, P=.004), 6 months (77.1% vs 57.9%, P<.001), and 12 months (75.9% vs 61.9%, P=.002). A change in MRSE >0.50 D occurred in 8.4% of epi-LASIK eyes within the 3- and 12-month interval versus 17.7% of PRK eyes (P=.04). No differences were noted between the two procedures in CDVA or clinically significant haze. Epi-LASIK showed superior refractive efficacy and stability but required more time for wound healing, resulting in inferior early visual outcomes and a tendency to overcorrect higher refractive errors compared to PRK. Both treatments were safe and comparable in terms of pain and haze formation. Copyright 2012, SLACK Incorporated.

  11. Comparative evaluation of Comfilcon A and Senofilcon A bandage contact lenses after transepithelial photorefractive keratectomy

    PubMed Central

    Mukherjee, Achyut; Ioannides, Antonis; Aslanides, Ioannis

    2014-01-01

    Purpose 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). Methods 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. Results 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). Conclusion 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. PMID:25649638

  12. Comparative evaluation of Comfilcon A and Senofilcon A bandage contact lenses after transepithelial photorefractive keratectomy.

    PubMed

    Mukherjee, Achyut; Ioannides, Antonis; Aslanides, Ioannis

    2015-01-01

    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.

  13. A relatively small change in sodium chloride concentration has a strong effect on adhesion of ocular bacteria to contact lenses.

    PubMed

    Cowell, B A; Willcox, M D; Schneider, R P

    1998-06-01

    Adhesion of bacteria to hydrogel lenses is thought to be an initial step of ocular colonization allowing evasion of normal host defences. The salt concentration of media is an important parameter controlling microbial adhesion. Salinity varies from 0.97% NaCl equivalents in the open eye to 0.89% in the closed eye state. In this study, the effect of sodium chloride in the concentration range of 0.8-1.0% (w/v) NaCl on adhesion of ocular bacteria to soft contact lenses was investigated using a static adhesion assay. Pseudomonas aeruginosa was found to adhere to lenses in significantly greater amounts than Serratia marcescens, Flavobacterium meningosepticum, Stenotrophomonas maltophilia and Staphylococcus intermedius. Increasing NaCl from 0.8% to 1.0% (w/v) increased adhesion of all bacteria tested. This adhesion was strong since the organisms could not be removed by washing in low ionic buffer. Adhesion of these organisms did not correlate with their cell surface properties as determined by bacterial adhesion to hydrocarbons (BATH) and retention on sepharose columns.

  14. Impact of Cosmetics on the Surface Properties of Silicone Hydrogel Contact Lenses.

    PubMed

    Srinivasan, Sruthi; Otchere, Heinz; Yu, Mili; Yang, Jeffery; Luensmann, Doerte; Jones, Lyndon

    2015-07-01

    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.

  15. Bacterial adhesion to conventional hydrogel and new silicone-hydrogel contact lens materials.

    PubMed

    Kodjikian, Laurent; Casoli-Bergeron, Emmanuelle; Malet, Florence; Janin-Manificat, Hélène; Freney, Jean; Burillon, Carole; Colin, Joseph; Steghens, Jean-Paul

    2008-02-01

    As bacterial adhesion to contact lenses may contribute to the pathogenesis of keratitis, the aim of our study was to investigate in vitro adhesion of clinically relevant bacteria to conventional hydrogel (standard HEMA) and silicone-hydrogel contact lenses using a bioluminescent ATP assay. Four types of unworn contact lenses (Etafilcon A, Galyfilcon A, Balafilcon A, Lotrafilcon B) were incubated with Staphylococcus epidermidis (two different strains) and Pseudomonas aeruginosa suspended in phosphate buffered saline (PBS). Lenses were placed with the posterior surface facing up and were incubated in the bacterial suspension for 4 hours at 37 degrees C. Bacterial binding was then measured and studied by bioluminescent ATP assay. Six replicate experiments were performed for each lens and strain. Adhesion of all species of bacteria to standard HEMA contact lenses (Etafilcon A) was found to be significantly lower than that of three types of silicone-hydrogel contact lenses, whereas Lotrafilcon B material showed the highest level of bacterial binding. Differences between species in the overall level of adhesion to the different types of contact lenses were observed. Adhesion of P. aeruginosa was typically at least 20 times greater than that observed with both S. epidermidis strains. Conventional hydrogel contact lenses exhibit significantly lower bacterial adhesion in vitro than silicone-hydrogel ones. This could be due to the greater hydrophobicity but also to the higher oxygen transmissibility of silicone-hydrogel lenses.

  16. Immunoglobulin Concentration in Tears of Contact Lens Wearers

    PubMed Central

    Maurya, Rajendra P.; Bhushan, Prashant; Singh, Virendra P.; Singh, Mahendra K.; Kumar, Prakash; Bhatia, Ravindra P.S.; Singh, Usha

    2014-01-01

    Purpose: To evaluate changes in the concentration of tear immunoglobulins in contact lens wearers. Methods: A total of 45 cases including 23 contact lens wearers (43 eyes) and 22 age and sex matched healthy controls having no ocular pathology were studied for immunoglobulins (IgA, IgG, IgM) in their tears by single radial immunodiffusion method. Results: Most of the cases used soft (56.6%) and semi-soft gas permeable (30.4%) contact lenses. Tear IgM was detected in only 17.4% and tear IgG in 43.6% of contact lens wearers, while in controls IgG was detected in 9.1% but none of the controls had IgM. There was a significant rise in total tear IgA (13.17 ± 4.44 mg/dl) in contact lens wearer as compared to controls (8.93 ± 3.79 mg/dl). Rise of tear IgA was more in symptomatic patients (15.38 ± 5.28 mg/dl) and in those wearing hard (19.73 ± 5.43 mg/dl) and semi-soft contact lenses (13.31 ± 5.43 mg/dl). A significant increase in tear IgA was noticed in subjects wearing lenses for >3 years (15.69 ± 5.39 mg/dl). About 43.4% of lens wearers were symptomatic and 80% of their lenses showed deposits and/or haziness. All cases with IgM in tear were symptomatic. Conclusion: The relation of immunoglobulin concentration with increasing duration of wear and material of contact lens shows that tear immunoglobulin rise accrues due to mechanical stimulation, hence contact lenses should not be used for a long period and lenses of hard nature should be discouraged. The maintenance, cleaning and deproteinization of the lenses are of high importance to avoid immunostimulation. PMID:25667732

  17. Drug resistance profile and biofilm forming potential of Pseudomonas aeruginosa isolated from contact lenses in Karachi-Pakistan

    PubMed Central

    2013-01-01

    Background The contaminated contact lens provides Pseudomonas aeruginosa an ideal site for attachment and biofilm production. Continuous contact of the eye to the biofilm-infested lens can lead to serious ocular diseases, such as keratitis (corneal ulcers). The biofilms also prevent effective penetration of the antibiotics, which increase the chances of antibiotic resistance. Methods For this study, 22 Pseudomonas aeruginosa isolates were obtained from 36 contact lenses and 14 contact lens protective fluid samples. These isolates were tested against eight commonly used antibiotics using Kirby-Bauer disk diffusion method. The biofilm forming potential of these isolates was also evaluated using various qualitative and quantitative techniques. Finally, a relationship between biofilm formation and antibiotic resistance was also examined. Results The isolates of Pseudomonas aeruginosa tested were found resistant to most of the antibiotics tested. Qualitative and quantitative biofilm analysis revealed that most of the isolates exhibited strong biofilm production. The biofilm production was significantly higher in isolates that were multi-drug resistant (p < 0.0001). Conclusion Our study indicates that multi-drug resistant, biofilm forming Pseudomonas aeruginosa isolates are mainly involved in contact lens associated infections. This appears to be the first report from Pakistan, which analyzes both antibiotic resistance profile and biofilm forming potential of Pseudomonas aeruginosa isolates from contact lens of the patients with contact lens associated infections. PMID:24134792

  18. Confocal microscopy of corneal stroma and endothelium after LASIK and PRK.

    PubMed

    Amoozadeh, Javad; Aliakbari, Soheil; Behesht-Nejad, Amir-Houshang; Seyedian, Mohammad-Amin; Rezvan, Bijan; Hashemi, Hassan

    2009-10-01

    To compare with confocal microscopy the changes in stromal keratocyte density and endothelial cell count due to photorefractive keratectomy (PRK) and LASIK. In this prospective study, 32 eyes (16 myopic patients) were examined with the NIDEK Confoscan 3 confocal microscope before and 6 months after PRK and LASIK. The preoperative mean myopia was -2.85+/-0.99 diopters (D) (range: -1.00 to -4.00 D) in 24 eyes that underwent PRK and -2.94+/-0.96 D (range: -2.00 to -4.25 D) in 8 eyes that underwent LASIK. Keratocyte density in the anterior and posterior stroma and the endothelial cell count were measured. Statistically significant changes were assessed using the t test. P<.05 was considered statistically significant. Preoperative hexagonal cell percentage in the LASIK group was 52.17+/-11.43 and 51.33+/-10.98 in the PRK group. Postoperatively, the percentages were 52.96+/-7.55 and 53.34+/-10.2, respectively. Six months postoperatively, keratocyte density changed by 367.12+/-103.35 cells/mm(2) (34.7% reduction) in the anterior stroma (P<.05) and 9.25+/-28.28 cells/mm(2) (1.31% reduction) in the posterior stroma (P>.05) for the LASIK group. In the PRK group, these values were 319.71+/-83.45 cells/mm(2) (31.13% reduction) in the anterior stroma (P<.05) and 0.17+/-38.97 cells/mm(2) (0.02% reduction) in the posterior stroma (P>.05). The changes in keratocyte densities were not statistically significant between groups (P>.05). The mean number of keratocytes decreased by 37.2% in the retroablation zone of the LASIK group (P<.05). No changes were noted in endothelial cell counts. A significant decrease occurred in the number of stromal keratocytes in the anterior stroma. Despite differences in surgery, the change in keratocyte density and endothelial cell counts were similar between LASIK and PRK groups (P>.05). Copyright 2009, SLACK Incorporated.

  19. Satisfactory clinical outcome following delayed repositioning of a traumatic post-LASIK flap with dislocation and shrinkage managed by irrigation, stretching, and debridement.

    PubMed

    Xu, Ye-Sheng; Xie, Wen-Jia; Yao, Yu-Feng

    2017-06-01

    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.

  20. Contact lenses and corrective flying spectacles in military aircrew--implications for flight safety.

    PubMed

    Partner, Andrew M; Scott, Robert A H; Shaw, Penny; Coker, William J

    2005-07-01

    Refractive devices used by aviators need to suit the aerospace environment or their failure can have serious implications. A relatively minor visual disability can result in loss of life and aircraft. We surveyed commonly occurring problems with the different types of refractive correction worn by Royal Air Force (RAF) aircrew over the previous 12 mo. We also asked if they had experienced any flight safety incidents (FSI) relating to their refractive correction. A retrospective anonymous questionnaire survey was given to 700 active aircrew occupationally graded as requiring corrective flying spectacles (CFS) or contact lenses (CL) for flying. 63% (443) of the questionnaires were completed. CL were worn by 53% of aircrew; 71% of them used daily disposable CL. CFS were worn by the remaining 47% of aircrew, 14% of whom used multifocal lenses. Of CFS wearers, 83% reported problems including misting, moving, discomfort, and conflict with helmet-mounted devices (HMD). CL-related ocular symptoms were reported in 67% of wearers including cloudy vision, dry eye, photophobia, red eyes, excessive mucus formation, CL movement, itching, and grittiness. No CL-related FSI were reported over the previous 12 mo compared with 5% CFS-related FSI (p < 0.001). The graded performance of CL for vision, comfort, handling, convenience, and overall satisfaction was significantly higher than for CFS. CFS are associated with problems in terms of comfort and safety. CL are well tolerated by aircrew, and deliver improved visual performance.

  1. LASIK flap buttonhole treated immediately by PRK with mitomycin C.

    PubMed

    Kymionis, George D; Portaliou, Dimitra M; Karavitaki, Alexandra E; Krasia, Maria S; Kontadakis, Georgios A; Stratos, Aimilianos; Yoo, Sonia H

    2010-03-01

    To describe the visual outcomes of three patients who had LASIK flap buttonhole and were treated immediately with photorefractive keratectomy (PRK) and topical mitomycin C (MMC) 0.02%. Three patients underwent bilateral LASIK with the SCHWIND Carriazo-Pendula 90 microm head microkeratome. In all three cases, a buttonhole flap occurred in the left eye. The flap was repositioned and phototherapeutic keratectomy for 50 microm was used for epithelial removal while immediate PRK with MMC was performed to treat the buttonhole flap. Three months after the procedure, uncorrected distance visual acuity and corrected distance visual acuity were 20/20 with regular topographic findings. Using PRK with MCC immediately after the occurrence of the LASIK flap buttonhole may be an effective treatment.

  2. Ocular discomfort responses after short periods of contact lens wear.

    PubMed

    Papas, Eric; Tilia, Daniel; McNally, John; de la Jara, Percy Lazon

    2015-06-01

    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.

  3. Comparison of the visual results after SMILE and femtosecond laser-assisted LASIK for myopia.

    PubMed

    Lin, Fangyu; Xu, Yesheng; Yang, Yabo

    2014-04-01

    To perform a comparative clinical analysis of the safety, efficacy, and predictability of two surgical procedures (ie, small incision lenticule extraction [SMILE] and femtosecond laser-assisted LASIK [FS-LASIK]) to correct myopia. Sixty eyes of 31 patients with a mean spherical equivalent of -5.13 ± 1.75 diopters underwent myopia correction with the SMILE procedure. Fifty-one eyes of 27 patients with a mean spherical equivalent of -5.58 ± 2.41 diopters were treated with the FS-LASIK procedure. Postoperative uncorrected and corrected distance visual acuity, manifest refraction, and higher-order aberrations were analyzed statistically at 1 and 3 months postoperatively. No statistically significant differences were found at 1 and 3 months in parameters that included the percentage of eyes with an uncorrected distance visual acuity of 20/20 or better (P = .556, .920) and mean spherical equivalent refraction (P = .055, .335). At 1 month, 4 SMILE-treated eyes and 1 FS-LASIK-treated eye lost one or more line of visual acuity (P = .214, chi-square test). At 3 months, 2 SMILE-treated eyes lost one or more line of visual acuity, whereas all FS-LASIK-treated eyes had an unchanged or corrected distance visual acuity. Higher-order aberrations and spherical aberration were significantly lower in the SMILE group than the FS-LASIK group at 1 (P = .007, .000) and 3 (P = .006, .000) months of follow-up. SMILE and FS-LASIK are safe, effective, and predictable surgical procedures to treat myopia. SMILE has a lower induction rate of higher-order aberrations and spherical aberration than the FS-LASIK procedure. Copyright 2014, SLACK Incorporated.

  4. Coagulase-negative staphylococci isolated from ocular wound infections after laser refractive surgery: attachment to and accumulation on soft contact lenses.

    PubMed

    Faghri, Jamshid; Razavi, Mohamad Reza

    2009-03-01

    Disposable soft contact lenses that are commonly used after laser refractive surgery are known to be colonized by bacteria and play a key role in Bacterial Keraitis (BK) pathogenesis. Coagulase-negative staphylococci (CoNS) have been found to be the most common pathogen involved in this postoperative infection. In this study a rapid and a simple assay was developed for studying attachment and accumulation of CoNS on soft contact lenses in vitro using [3H] thymidine. Thirty-five isolates of CoNS were obtained from 27 laser refractive surgery patients. Twenty-five of these thirty-five CoNS were isolated in multiple cultures. Ten CoNS were isolated in cultures from patients who underwent reoperation. The assay was optimized using a biofilm-producing strain, S. epidermidis RP62A, which was subcultured overnight at 37 degrees C on blood agar medium. Quantitative determination of biofilm production was tested. Presence of the genes icaADB and icaD was determined in all isolates. All isolates were biochemically analyzed using the Phene Plate (PhP) system modified for typing of CoNS. The CoNS isolates were further characterized to species level using ID32Staph.Mann-Whitney rank sum test and chi-square test were used to identify statistical differences in adherence, index, antibiotic susceptibility patterns, and biofilm production or presence of the ica operon between clinically significant isolates and non-postoperative BK isolates. No differences in attachment and accumulation were found between isolates causing BK after laser refractive surgery and contaminant isolates. In addition, there were no differences in the distribution of the ica operon between the two groups, as determined by polymerase chain reaction. Nevertheless, the ability to produce biofilm was found to be present significantly more frequently among BK isolates than among non-postoperative BK isolates. This study shows that the method using radioactive thymidine to analyze adherence of CoNS to soft

  5. Higher order aberrations and relative risk of symptoms after LASIK.

    PubMed

    Sharma, Munish; Wachler, Brian S Boxer; Chan, Colin C K

    2007-03-01

    To understand what level of higher order aberrations increases the relative risk of visual symptoms in patients after myopic LASIK. This study was a retrospective comparative analysis of 103 eyes of 62 patients divided in two groups, matched for age, gender, pupil size, and spherical equivalent refraction. The symptomatic group comprised 36 eyes of 24 patients after conventional LASIK with different laser systems evaluated in our referral clinic and the asymptomatic control group consisted of 67 eyes of 38 patients following LADARVision CustomCornea wavefront LASIK. Comparative analysis was performed for uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contrast sensitivity, refractive cylinder, and higher order aberrations. Wavefront analysis was performed with the LADARWave aberrometer at 6.5-mm analysis for all eyes. Blurring of vision was the most common symptom (41.6%) followed by double image (19.4%), halo (16.7%), and fluctuation in vision (13.9%) in symptomatic patients. A statistically significant difference was noted in UCVA (P = .001), BSCVA (P = .001), contrast sensitivity (P < .001), and manifest cylinder (P = .001) in the two groups. The percentage difference between the symptomatic and control group mean root-mean-square (RMS) values ranged from 157% to 206% or 1.57 to 2.06 times greater. Patients with visual symptoms after LASIK have significantly lower visual acuity and contrast sensitivity and higher mean RMS values for higher order aberrations than patients without symptoms. Root-mean-square values of greater than two times the normal after-LASIK population for any given laser platform may increase the relative risk of symptoms.

  6. Chromatic confocal microscope using hybrid aspheric diffractive lenses

    NASA Astrophysics Data System (ADS)

    Rayer, Mathieu; Mansfield, Daniel

    2014-05-01

    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.

  7. Peripheral corneal infiltrates associated with contact lens wear.

    PubMed Central

    Donshik, P C; Suchecki, J K; Ehlers, W H

    1995-01-01

    PURPOSE: A retrospective study was performed to review the clinical characteristics of peripheral corneal infiltrates in contact lens wearers. METHODS: The charts of all contact lens patients with peripheral corneal infiltrates 1.5 mm or less in size who presented to the office from 1987 to 1994 were reviewed. RESULTS: The epidemiological and clinical characteristics of peripheral corneal infiltrates associated with contact lens wear were reviewed in 52 patients (64 infiltrates). Forty-four patients presented with a single infiltrate, while the remaining 8 patients had multiple infiltrates. While there was no predilection for a specific quadrant of the cornea, when a subgroup of patients who wore extended wear lenses was analyzed, 19 of the 40 infiltrates were located in the superior quadrant. Forty percent of the patients were wearing disposable extended wear contact lenses, 21% were wearing conventional extended wear lenses, 33% were wearing conventional or frequent replacement/disposable daily wear contact lenses and 6% were wearing rigid gas permeable lenses. The majority of patients had minimal conjunctival inflammation, an anterior stromal cellular reaction and minimal anterior chamber activity. A subgroup of 16 patients had corneal cultures of their infiltrates. In this group, 8 of the 16 had positive cultures. All patients had a resolution of the infiltrates without complications and the majority were refitted to daily wear soft or rigid contact lenses. CONCLUSION: Peripheral corneal infiltrates in contact lens wearers appears to be more common in patients wearing extended wear soft contact lenses. While often considered "sterile" in the literature, a significant number have been shown to be culture-positive. The organisms that have been associated with peripheral infiltrates appear to be less "pathogenic" than those that have been reported to be associated with central corneal ulcer. However, it is probably advisable that patients with peripheral corneal

  8. Clinical results of the laser-assisted in situ keratomileusis (LASIK) for myopia

    NASA Astrophysics Data System (ADS)

    Guo, Hai-ke; Yao, Da-qing; Gui, Lu-ping

    1998-11-01

    To observe and analyze the refractive and complications of the LASIK for corrections of myopia. With the microlamellar keratoplasty and the excimer laser, LASIK was performed on 194 cases. According to the preoperative spherical equivalent refraction, divide the patients into three groups.

  9. Efficacy of detergent and water versus bleach for disinfection of direct contact ophthalmic lenses.

    PubMed

    Abbey, Ashkan M; Gregori, Ninel Z; Surapaneni, Krishna; Miller, Darlene

    2014-06-01

    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.

  10. Effects of Soft Contact Lenses on Contrast Sensitivity

    DTIC Science & Technology

    1983-04-01

    Problem ............... .......... 7 Subjects .. ............... ............... 9 *Material and Methods .. ............... ......... 14 Treatment of...abil- ity to achieve visual acuity comparable to that with their spectacle lenses, these patients frequently complain that their new vision is "not...available through Cadwell Laboratories) and the Arden Photographic Plates (available from American Optical Co.). In light of these new capabilities and

  11. Contact lens rehabilitation following repaired corneal perforations

    PubMed Central

    Titiyal, Jeewan S; Sinha, Rajesh; Sharma, Namrata; Sreenivas, V; Vajpayee, Rasik B

    2006-01-01

    Background Visual outcome following repair of post-traumatic corneal perforation may not be optimal due to presence of irregular keratometric astigmatism. We performed a study to evaluate and compare rigid gas permeable contact lens and spectacles in visual rehabilitation following perforating corneal injuries. Method Eyes that had undergone repair for corneal perforating injuries with or without lens aspiration were fitted rigid gas permeable contact lenses. The fitting pattern and the improvement in visual acuity by contact lens over spectacle correction were noted. Results Forty eyes of 40 patients that had undergone surgical repair of posttraumatic corneal perforations were fitted rigid gas permeable contact lenses for visual rehabilitation. Twenty-four eyes (60%) required aphakic contact lenses. The best corrected visual acuity (BCVA) of ≥ 6/18 in the snellen's acuity chart was seen in 10 (25%) eyes with spectacle correction and 37 (92.5%) eyes with the use of contact lens (p < 0.001). The best-corrected visual acuity with spectacles was 0.20 ± 0.13 while the same with contact lens was 0.58 ± 0.26. All the patients showed an improvement of ≥ 2 lines over spectacles in the snellen's acuity chart with contact lens. Conclusion Rigid gas permeable contact lenses are better means of rehabilitation in eyes that have an irregular cornea due to scars caused by perforating corneal injuries. PMID:16536877

  12. Initial resident refractive surgical experience: outcomes of PRK and LASIK for myopia.

    PubMed

    Wagoner, Michael D; Wickard, Joseph C; Wandling, George R; Milder, Lisa C; Rauen, Matthew P; Kitzmann, Anna S; Sutphin, John E; Goins, Kenneth M

    2011-03-01

    To evaluate and compare the outcome of initial resident surgical experience with photorefractive keratectomy (PRK) and LASIK. Retrospective review of all cases performed with the VISX Star S4 platform (Abbott Medical Optics) between July 1, 2003 and June 30, 2007. Inclusion criteria were spherical equivalent of -0.50 to -10.00 diopters (D), refractive astigmatic error of ≤3.00 D, intention to provide full distance correction, and minimum 3-month postoperative follow-up after initial ablation or retreatment (if performed). A total of 153 cases performed by 20 different residents met the inclusion criteria; 38 eyes underwent PRK and 115 eyes had LASIK. After initial treatment, mean Snellen uncorrected distance visual acuity (UDVA) after PRK was 20/17.3 and after LASIK was 20/19.5. Photorefractive keratectomy was associated with a significantly better approximation between preoperative corrected distance visual acuity (CDVA) and postoperative UDVA (ΔlogMAR 0.009 vs 0.091; P=.004) and a greater percentage of eyes that achieved UDVA of 20/20 or better (94.7% vs 78.3%; P=.02) or 20/30 or better (100% vs 87.8%; P=.02). There was a higher prevalence of retreatment in eyes that underwent LASIK (7.0% vs 0%; P=.20). One (0.9%) eye lost 2 lines of CDVA after LASIK. Supervised refractive surgery residents can achieve excellent visual outcomes in patients operated during their initial refractive experience. Photorefractive keratectomy was associated with better visual outcome than LASIK. Copyright 2011, SLACK Incorporated.

  13. Intacs for keratoconus and post-LASIK ectasia: mechanical versus femtosecond laser-assisted channel creation.

    PubMed

    Carrasquillo, Karen G; Rand, Janet; Talamo, Jonathan H

    2007-09-01

    To evaluate the efficacy of intracorneal ring segments to treat keratoconus and post-laser in situ keratomileusis (LASIK) keratectasia implanted by using either mechanical dissection or a femtosecond laser. Thirty-three eyes of 29 patients had intracorneal ring segments implanted by using mechanical dissection (17 eyes) or a femtosecond laser (16 eyes). Mean follow-up was 10.3 months. Parameters assessed before and after surgery included uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refractive spherical equivalent (MRSE), refractive cylinder (RC), best contact lens-corrected visual acuity (BCLVA), and contact lens tolerance. Statistically significant changes occurred for all parameters when we analyzed all 33 eyes as 1 group. Mean UCVA LogMar values improved from 1.0 +/- 0.3 (20/200) to 0.6 +/- 0.4 (20/80) (P < 0.0005). Mean BSCVA changed from 0.3 +/- 0.2 (20/40) to 0.2 +/- 0.2 (20/30) (10%; P < 0.05), and MRSE from -9 +/- 4 to -7 +/- 4 D (P < 0.05; 20%). There was a decrease of 0.5 D or more of RC in 62% of eyes. BCLVA improved from 0.2 +/- 0.2 (20/30) to 0.1 +/- 0.1 (20/25) after surgery (P < 0.02). Contact lens tolerance improved in 81% of eyes. There was no statistically significant difference in outcomes between mechanical dissection and femtosecond laser-assisted techniques. However, although statistical power was adequate to detect changes in clinical parameters as a result of surgery, it was not sufficient to conclusively show such differences between surgical techniques. For mild to moderate cases of keratoconus and post-LASIK keratectasia, the use of a femtosecond laser for Intacs channel creation seems as effective as mechanical dissection. Future studies are warranted to further evaluate channel creation by a femtosecond laser.

  14. Comparison of astigmatic correction after femtosecond lenticule extraction and wavefront-guided LASIK for myopic astigmatism.

    PubMed

    Ali, Mohamed A; Kobashi, Hidenaga; Kamiya, Kazutaka; Igarashi, Akihito; Miyake, Toshiyuki; Elewa, Mohamed Ehab M; Komatsu, Mari; Shimizu, Kimiya

    2014-12-01

    To compare postoperative astigmatic correction between femtosecond lenticule extraction (FLEx) and wavefront-guided LASIK in eyes with myopic astigmatism. Fifty-eight eyes of 41 patients undergoing FLEx and 49 eyes of 29 patients undergoing wavefront-guided LASIK to correct myopic astigmatism were examined. Visual acuity, cylindrical refraction, predictability of the astigmatic correction, and astigmatic vector components were compared between groups 6 months after surgery. There was no statistically significant difference in manifest cylindrical refraction (P = .08) or percentage of eyes within ± 0.50 diopter (D) of its refraction (P = .11) between the surgical procedures. The index of success in FLEx was statistically significantly better than that of wavefront-guided LASIK (P = .02), although there was no significant difference between the groups in other indices (eg, surgically induced astigmatism, target-induced astigmatism, astigmatic correction index, angle of error, difference vector, and flattening index). Subgroup analysis showed that FLEx had a better index of success (P = .02) and difference vector (P = .04) than wavefront-guided LASIK in the low cylinder subgroup; the angle of error in FLEx was significantly smaller than that of wavefront-guided LASIK in the moderate cylinder subgroup (P = .03). Both FLEx and wavefront-guided LASIK worked well for the correction of myopic astigmatism by the 6-month follow-up visit. Although FLEx had a better index of success than wavefront-guided LASIK when using vector analysis, it appears equivalent to wavefront-guided LASIK in terms of visual acuity and the correction of astigmatism. Copyright 2014, SLACK Incorporated.

  15. [Keratitis after laser in situ keratomileusis (LASIK). A different entity and treatment management].

    PubMed

    Ahmed, Shakil; Ahmed, Hassan Javed; Holm, Lars Morten

    2014-12-15

    Keratitis after laser in situ keratomileusis (LASIK) is rare and challenging as patients may present with mild symptoms and initial management differs significantly. Post-LASIK keratitis is usually due to gram-positive bacteria or opportunistic/atypical microorganisms located beneath the corneal flap. Due to relative protective interface location it is necessary to lift the corneal flap for cultures and antibiotic irrigation. The case report demonstrates that post-LASIK keratitis requires prompt referral to ophthalmology department as correct initial management is pivotal for good visual outcome.

  16. Daily disposable contact lens prescribing around the world.

    PubMed

    Efron, Nathan; Morgan, Philip B; Helland, Magne; Itoi, Motozumi; Jones, Deborah; Nichols, Jason J; van der Worp, Eef; Woods, Craig A

    2010-10-01

    Daily disposable contact lenses were introduced into the market 16 years ago. Data that we have gathered from annual contact lens fitting surveys conducted in Australia, Canada, Japan, The Netherlands, Norway, the UK and the USA between 2000 and 2008 indicates an overall increase in daily disposable lens fitting during this period. Daily disposable lenses are especially popular in Japan, Norway and the UK. There is a trend for these lenses to be fitted on a part-time basis. Males are over-represented in daily disposable lens fitting-a trend that is especially evident in Canada. Daily disposable lens wearers are about two years younger than wearers of reusable lenses in Japan and The Netherlands. The convenience and health benefits of daily disposable lenses are expected to fuel continued growth in this sector. Copyright (c) 2010 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  17. Satisfactory clinical outcome following delayed repositioning of a traumatic post-LASIK flap with dislocation and shrinkage managed by irrigation, stretching, and debridement*

    PubMed Central

    Xu, Ye-sheng; Xie, Wen-jia; Yao, Yu-feng

    2017-01-01

    Objective: 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. Methods: 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. Results: 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. Conclusions: 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. PMID:28585430

  18. Biocompatibility in the development of silicone-hydrogel lenses.

    PubMed

    Jacob, Jean T

    2013-01-01

    In response to patient demands for extended contact lens wearing times, the contact lens industry has developed novel silicone-hydrogel (SiHy) lens materials that combine the enhanced oxygen permeability of silicone polymers with the water-based comfort of conventional hydrogels. In the past 12 years since the successful launch of these SiHy lenses, much has been learned about their ability to provide the biocompatibility necessary to sustain ocular health and comfort. A review of the unique physiologic requirements for a successful extended wear lens and how the first and current SiHy lenses address them is provided.

  19. Evaluation of transcutaneous electrical simulation to improve recovery from corneal hypoesthesia after LASIK.

    PubMed

    Ghaffariyeh, Alireza; Peyman, Alireza; Puyan, Sadollah; Honarpisheh, Nazafarin; Bagheri, Babak; Peyman, Mohammadreza

    2009-08-01

    To evaluate the efficacy, and safety of transcutaneous electrical stimulation (TES) to accelerate corneal nerve regeneration and improved recovery from corneal hypesthasia after laser-assisted in situ keratomileusis (LASIK). Khodadoust Eye Hospital, Shiraz, Fars, Iran This prospective, randomized, clinical study comprised 40 eyes of 20 patients scheduled to undergo bilateral LASIK. In each patient, one eye was randomly assigned to receive transcutaneous electrical stimulation (20 HZ) for 60 minutes, and the other eye allocated as control. Corneal sensitivity was measured using the Cochet-Bonnet esthesiometer in four areas outside and five areas inside the LASIK flap preoperatively, and at 1 day, 1 week, 1 month, and 3 months postoperatively. Best-corrected visual acuity and the incidence of adverse events were noted at each visit. For all four points outside the LASIK flap, normal corneal sensitivity was maintained throughout the study; no significant difference was found between the study eyes and the control eyes at these points (P > 0.05). All points within the LASIK flap except the point closest to the hinge demonstrated profound corneal hypoesthesia at 1 day, 1 week, and 1 month postoperatively, with no differences noted between the control and study eyes (P > 0.05). After 3 months, points within the flap had statistically significantly better corneal sensitivity in the study group than in the control group (P < 0.05). Transcutaneous electrical stimulation significantly improves corneal sensitivity at 3 months after LASIK. This may be due to accelerated corneal nerve regeneration by electrical stimulation.

  20. Role of percent peripheral tissue ablated on refractive outcomes following hyperopic LASIK

    PubMed Central

    Stapleton, Fiona; Versace, Patrick

    2017-01-01

    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

  1. Sequential lift and suture technique for post-LASIK corneal striae.

    PubMed

    Mackool, Richard J; Monsanto, Vivian R

    2003-04-01

    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.

  2. Focusing on Contact Lens Safety

    MedlinePlus

    ... lenses to FDA’s MedWatch reporting program . How to Report Problems Here’s how you can help: If you ... selling contact lenses over the Web, you should report it to the FDA . If you don’t ...

  3. Optical performance of multifocal soft contact lenses via a single-pass method.

    PubMed

    Bakaraju, Ravi C; Ehrmann, Klaus; Falk, Darrin; Ho, Arthur; Papas, Eric

    2012-08-01

    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.

  4. Soft Contact Lens Wear at Altitude: Effects of Hypoxia

    DTIC Science & Technology

    1988-01-01

    conjunctiva (2). If the edema is severe, breakdown of some and aircraft with cabin pressures equivalent to lower altitudes, of the epithelial cells from...debris, conjunctival injection, and corneal epithelial of hydrogel lenses. International Contact Lens Clinic. 1983. staining, showed heightened...cornea may be severe enough to affect vision stnae accompanying the wearing of hydrogel lenses. Am. J. and preclude wearing soft contact lenses during

  5. Controlled delivery of pirfenidone through vitamin E-loaded contact lens ameliorates corneal inflammation.

    PubMed

    Dixon, Phillip; Ghosh, Tanushri; Mondal, Kalyani; Konar, Aditya; Chauhan, Anuj; Hazra, Sarbani

    2018-06-01

    Chemical injury by alkali burn is a major cause of corneal blindness in the clinical setting. Current management advocates multiple therapies aimed to prevent inflammation, initiate quick re-epithelialization, arrest the fibrosis, and avoid dry eye and pain by using bandage contact lenses. We hypothesized sustained delivery of the anti-inflammatory, antifibrotic drug pirfenidone through vitamin E-loaded contact lenses as a logical single approach to counter the pathology involved. Vitamin E particles were created in situ in commercial silicon hydrogel contact lenses by soaking the lenses in a vitamin E-ethanol solution. The vitamin E-laden lenses were then placed into pirfenidone-saline solution to load the drug into the lens. The contact lenses were evaluated by both in vitro and in vivo means. For in vitro, lenses were placed into 3 mL of saline solution. The concentration of pirfenidone released was measured by UV-vis spectrophotometry. The contact lenses were implanted in rabbit eyes following the alkali burn; the drug availability in the aqueous humor was evaluated by HPLC at various time points 10 min, 30 min, 2 h, and 3 h; and gene expression of inflammatory cytokines IL-1β, TNF-α, and TGF-β1 was evaluated in the cornea at the end of the study period. In another group of rabbits inflicted with alkali injury, the corneas were graded after 7 days of contact lens implantation with and without pirfenidone. A mathematical model was developed for delivery of the drug to the cornea and aqueous humor after a contact lens is inserted in the eye. The model was validated with experimental data and used to determine the bioavailability both for contact lenses and eye drops. In vitro release of unmodified commercial contact lenses saw a release time of approximately 20 min, with a partition coefficient of 2.68 ± 0.06. The release of pirfenidone from 20% vitamin E-loaded lenses saw a release time of approximately 80 min, with a partition coefficient of 4

  6. Intraocular straylight and contrast sensitivity after contralateral wavefront-guided LASIK and wavefront-guided PRK for myopia.

    PubMed

    Barreto, Jackson; Barboni, Mirella T S; Feitosa-Santana, Claudia; Sato, João R; Bechara, Samir J; Ventura, Dora F; Alves, Milton Ruiz

    2010-08-01

    To compare intraocular straylight measurements and contrast sensitivity after wavefront-guided LASIK (WFG LASIK) in one eye and wavefront-guided photorefractive keratectomy (WFG PRK) in the fellow eye for myopia and myopic astigmatism correction. A prospective, randomized study of 22 eyes of 11 patients who underwent simultaneous WFG LASIK and WFG PRK (contralateral eye). Both groups were treated with the NIDEK Advanced Vision Excimer Laser System, and a microkeratome was used for flap creation in the WFG LASIK group. High and low contrast visual acuity, wavefront analysis, contrast sensitivity, and retinal straylight measurements were performed preoperatively and at 3, 6, and 12 months postoperatively. A third-generation straylight meter, C-Quant (Oculus Optikgeräte GmbH), was used for measuring intraocular straylight. Twelve months postoperatively, mean uncorrected distance visual acuity was -0.06 +/- 0.07 logMAR in the WFG LASIK group and -0.10 +/- 0.10 logMAR in the WFG PRK group. Mean preoperative intraocular straylight was 0.94 +/- 0.12 logs for the WFG LASIK group and 0.96 +/- 0.11 logs for the WFG PRK group. After 12 months, the mean straylight value was 1.01 +/- 0.1 log s for the WFG LASIK group and 0.97 +/- 0.12 log s for the WFG PRK group. No difference was found between techniques after 12 months (P = .306). No significant difference in photopic and mesopic contrast sensitivity between groups was noted. Intraocular straylight showed no statistically significant increase 1 year after WFG LASIK and WFG PRK. Higher order aberrations increased significantly after surgery for both groups. Nevertheless, WFG LASIK and WFG PRK yielded excellent visual acuity and contrast sensitivity performance without significant differences between techniques.

  7. Efficacy of Detergent and Water Versus Bleach for the Disinfection of Direct Contact Ophthalmic Lenses

    PubMed Central

    Abbey, Ashkan M.; Gregori, Ninel Z.; Surapaneni, Krishna; Miller, Darlene

    2014-01-01

    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

  8. Relative peripheral refraction across 4 meridians after orthokeratology and LASIK surgery.

    PubMed

    Queirós, António; Amorim-de-Sousa, Ana; Lopes-Ferreira, Daniela; Villa-Collar, César; Gutiérrez, Ángel Ramón; González-Méijome, José Manuel

    2018-01-01

    To characterize the axial and off-axis refraction across four meridians of the retina in myopic eyes before and after Orthokeratology (OK) and LASIK surgery. Sixty right eyes with a spherical equivalent (M) between - 0.75 to - 5.25 D (cylinder <- 1.00 D) underwent LASIK (n = 26) or OK (n = 34) to treat myopia. Axial and off-axis refraction were measured with an open-field autorefractometer before and after stabilized treatments. Off-axis measurements were obtained for the horizontal (35° nasal and temporal retina) and vertical (15° superior and inferior retina) meridians, and for two oblique directions (45-225° and 135-315°) up to 20° of eccentricity. The refractive profile was addressed as relative peripheral refractive error (RPRE). OK and LASIK post-treatment results showed an increase of myopic relative refraction at several eccentric locations. At the four meridians evaluated, the M component of the pre-treatment RPRE values was not statistically different ( p > 0.05) from the post-treatment RPRE within 30° and 20° of the central visual field after LASIK and OK, respectively. These results demonstrated that the treatment zone warrants an optimal central field of vision. The present study gives an overview of RPRE after refractive corneal reshaping treatments (OK and LASIK) across vertical, horizontal and two oblique meridians together. This allows a 3D representation of RPRE at the retina and shows that the myopic shift induced by both treatments is more relevant in horizontal directions.

  9. Ocular residual astigmatism's effect on high myopic astigmatism LASIK surgery

    PubMed Central

    Teus, M A; Arruabarrena, C; Hernández-Verdejo, J L; Cañones, R; Mikropoulos, D G

    2014-01-01

    Purpose To analyze the effect of ocular residual astigmatism (ORA) on the effectiveness of LASIK for treating high myopic astigmatism. Methods This is an observational, cross-sectional study. We studied 116 consecutive myopic eyes with −3 diopters (D) or more of astigmatism that underwent LASIK surgery. The magnitude of uncorrected residual refractive astigmatism 3 months postoperatively was measured. Results The mean preoperative cylinder was −4.0±0.83 D (range, −7.5 to −3 D) and the mean preoperative ORA was 0.82±0.5 D. The mean residual refractive cylinder 3 months postoperatively was −0.78±0.83 D (range, −3 to 0 D). No correlation was found between ORA and the refractive cylinder 3 months postoperatively (P=0.6). Conclusion In eyes with high myopic astigmatism undergoing LASIK, ORA was not correlated with the residual postoperative cylinder. PMID:24971989

  10. Three-year changes in epithelial and stromal thickness after PRK or LASIK for high myopia.

    PubMed

    Ivarsen, Anders; Fledelius, Walther; Hjortdal, Jesper Ø

    2009-05-01

    To compare 3-year changes in corneal sublayer thickness after photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK). Forty-six patients with spheroequivalent refraction of -6.0 to -8.0 diopters (D) were randomly assigned to PRK or LASIK. One eye from each patient was included in the study. Examinations included manifest refraction and confocal microscopy through focusing (CMTF) and were performed preoperatively and postoperatively at 1 week and at 1, 3, 6, 12, and 36 months. From CMTF scans, the thicknesses of the central cornea (CT), epithelium (ET), stroma (ST), LASIK flap (FT), and residual stromal bed (BT) were calculated. After LASIK, spheroequivalent refraction averaged -0.76 D by 1 week and -1.19 D by 1 month, with no subsequent significant change. ET increased 9.0 +/- 7.0 microm within 1 week and remained constant thereafter. ST increased 12.9 +/- 9.4 microm within 1 year because of increased BT. One week after PRK, refraction averaged -0.23 D and stabilized at -1.42 D by 6 months. By 1 week, ET was reduced by 7.5 +/- 5.7 microm, reached preoperative thickness by 6 months, and increased further 7.3 +/- 6.0 microm by 3 years. ST increased 25.3 +/- 17.2 microm during 1 year, correlating with the postoperative refractive regression. After both procedures, changes in CT also correlated with refractive changes. No other correlations were identified. PRK and LASIK induce a persistent increase in ET that stabilizes 1 week after LASIK and 1 year after PRK. Stromal regrowth is most pronounced after PRK. After LASIK, regrowth is restricted to the residual stromal bed. Postoperative refractive changes correlate with changes in ST (PRK) and CT (PRK and LASIK) but not with changes in ET.

  11. Contact Lenses on Submarines

    DTIC Science & Technology

    1985-04-29

    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

  12. Scleral Contact Lenses in an Academic Oculoplastics Clinic: Epidemiology and Emerging Considerations.

    PubMed

    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

  13. In vitro and in vivo delivery of the secretagogue diadenosine tetraphosphate from conventional and silicone hydrogel soft contact lenses

    PubMed Central

    Dominguez-Godinez, Carmen Olalla; Martin-Gil, Alba; Carracedo, Gonzalo; Guzman-Aranguez, Ana; González-Méijome, José Manuel; Pintor, Jesús

    2013-01-01

    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.

  14. Adhesion of Pseudomonas aeruginosa to orthokeratology and alignment lenses.

    PubMed

    Choo, Jennifer D; Holden, Brien A; Papas, Eric B; Willcox, Mark D P

    2009-02-01

    To determine whether contact lenses designed for orthokeratology (OK) are colonized by greater numbers of bacteria compared with standard (alignment fitted) design rigid gas permeable lenses before and after lens wear. Eighteen 1-year-old cats were randomly fitted with an OK lens in one eye and an alignment fitted (AF) lens in the other eye. Both lenses were made in the same diameter and central thickness and of the same material. Two separate wearing periods of 2 weeks and 6 weeks were used. After each wearing period, lenses were soaked in Pseudomonas aeruginosa (6294 or 6206) for 10 min. The lenses were then reinserted onto their respective corneas for a wearing period of 16 hours after which lenses were collected and remaining adhered bacteria quantified. Unworn control lenses were also soaked and bacteria enumerated for comparison. There were no significant differences in the number of bacteria adherent to unworn AF and OK lenses. Analysis of lenses after wear showed OK lenses retained significantly higher numbers of viable bacteria than AF lenses in all studies. OK lenses retain more bacteria than AF rigid gas permeable lenses after bacteria-loaded overnight lens wear. This may increase the risk for an infection in OK patients should suitable conditions be present. Specific education on the cleaning of OK lenses is essential.

  15. A Drug-Eluting Contact Lens

    PubMed Central

    Ciolino, Joseph B.; Hoare, Todd R.; Iwata, Naomi G.; Behlau, Irmgard; Dohlman, Claes H.; Langer, Robert; Kohane, Daniel S.

    2014-01-01

    Purpose To formulate and characterize a drug-eluting contact lens designed to provide extended, controlled release of a drug. Methods Prototype contact lenses were created by coating PLGA (poly[lactic-co-glycolic acid]) films containing test compounds with pHEMA (poly[hydroxyethyl methacrylate]) by ultraviolet light polymerization. The films, containing encapsulated fluorescein or ciprofloxacin, were characterized by scanning electron microscopy. Release studies were conducted in phosphate-buffered saline at 37°C with continuous shaking. Ciprofloxacin eluted from the contact lens was studied in an antimicrobial assay to verify antimicrobial effectiveness. Results After a brief and minimal initial burst, the prototype contact lenses demonstrated controlled release of the molecules studied, with zero-order release kinetics under infinite sink conditions for over 4 weeks. The rate of drug release was controlled by changing either the ratio of drug to PLGA or the molecular mass of the PLGA used. Both the PLGA and the pHEMA affected release kinetics. Ciprofloxacin released from the contact lenses inhibited ciprofloxacin-sensitive Staphylococcus aureus at all time-points tested. Conclusions A prototype contact lens for sustained drug release consisting of a thin drug-PLGA film coated with pHEMA could be used as a platform for ocular drug delivery with widespread therapeutic applications. PMID:19136709

  16. Photorefractive keratectomy (PRK) versus laser assisted in situ keratomileusis (LASIK) for hyperopia correction.

    PubMed

    Settas, George; Settas, C; Minos, E; Yeung, Ian Y L

    2009-04-15

    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

  17. Functionalized patchy particles using colloidal lenses

    NASA Astrophysics Data System (ADS)

    Middleton, Christine

    2014-03-01

    Colloidal assembly had been limited by the isotropic, nonspecific nature of interactions between spherical colloidal particles. By giving particles patches functionalized with single stranded DNA, these interactions can be made both directional and specific. We create patchy particles by adding patches to spherical emulsion droplets using the depletion interaction. First we make polystyrene particles in the shape of contact lenses to be the patches. The lenses are functionalized with single stranded DNA on their convex side. Then we put the lenses on the surface of oil emulsion droplets using the depletion interaction, creating a patch (or multiple patches) on the surface of each emulsion droplet. The emulsion droplets can now interact with each other in a specific, directional way through DNA functionalized patches.

  18. Visual and flight performance recovery after PRK or LASIK in helicopter pilots.

    PubMed

    Van de Pol, Corina; Greig, Joanna L; Estrada, Art; Bissette, Gina M; Bower, Kraig S

    2007-06-01

    Refractive surgery, specifically photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK), is becoming more accepted in the military environment. Determination of the impact on visual performance in the more demanding aviation environment was the impetus for this study. A prospective evaluation of 20 Black Hawk pilots pre-surgically and at 1 wk, 1 mo, and 6 mo postsurgery was conducted to assess both PRK and LASIK visual and flight performance outcomes on the return of aviators to duty. Of 20 pilots, 19 returned to flight status at 1 mo after surgery; 1 PRK subject was delayed due to corneal haze and subjective visual symptoms. Improvements were seen under simulator night and night vision goggle flight after LASIK; no significant changes in flight performance were measured in the aircraft. Results indicated a significantly faster recovery of all visual performance outcomes 1 wk after LASIK vs. PRK, with no difference between procedures at 1 and 6 mo. Low contrast acuity and contrast sensitivity only weakly correlated to flight performance in the early post-operative period. Overall flight performance assessed in this study after PRK and LASIK was stable or improved from baseline, indicating a resilience of performance despite measured decrements in visual performance, especially in PRK. More visually demanding flight tasks may be impacted by subtle changes in visual performance. Contrast tests are more sensitive to the effects of refractive surgical intervention and may prove to be a better indicator of visual recovery for return to flight status.

  19. Increased resistance of contact lens related bacterial biofilms to antimicrobial activity of soft contact lens care solutions

    PubMed Central

    Szczotka-Flynn, Loretta B.; Imamura, Yoshifumi; Chandra, Jyotsna; Yu, Changping; Mukherjee, Pranab K.; Pearlman, Eric; Ghannoum, Mahmoud A.

    2014-01-01

    PURPOSE To determine if clinical and reference strains of Pseudomonas aeruginosa, Serratia marcescens, and Staphylococcus aureus form biofilms on silicone hydrogel contact lenses, and ascertain antimicrobial activities of contact lens care solutions. METHODS Clinical and American Type Culture Collection (ATCC) reference strains of Pseudomonas aeruginosa, Serratia marcescens, and Staphylococcus aureus were incubated with lotrafilcon A lenses under conditions that facilitate biofilm formation. Biofilms were quantified by quantitative culturing (colony forming units, CFUs), and gross morphology and architecture were evaluated using scanning electron microscopy (SEM) and confocal microscopy. Susceptibilities of the planktonic and biofilm growth phases of the bacteria to five common multipurpose contact lens care solutions and one hydrogen peroxide care solution were assessed. RESULTS P. aeruginosa, S. marcescens, and S. aureus reference and clinical strains formed biofilms on lotrafilcon A silicone hydrogel contact lenses, as dense networks of cells arranged in multiple layers with visible extracellular matrix. The biofilms were resistant to commonly used biguanide preserved multipurpose care solutions. P. aeruginosa and S. aureus biofilms were susceptible to a hydrogen peroxide and a polyquaternium preserved care solution, whereas S. marcescens biofilm was resistant to a polyquaternium preserved care solution but susceptible to hydrogen peroxide disinfection. In contrast, the planktonic forms were always susceptible. CONCLUSIONS P. aeruginosa, S. marcescens, and S. aureus form biofilms on lotrafilcon A contact lenses, which in contrast to planktonic cells, are resistant to the antimicrobial activity of several soft contact lens care products. PMID:19654521

  20. Use of a novel extended blink test to evaluate the performance of two polyvinylpyrrolidone-containing, silicone hydrogel contact lenses

    PubMed Central

    Schafer, Jeffery; Reindel, William; Steffen, Robert; Mosehauer, Gary; Chinn, Joseph

    2018-01-01

    Background Sustained digital display viewing reduces eye blink frequency and tear film stability. To retain water and preserve a smooth optical surface, contact lens manufacturers have integrated the humectant polyvinylpyrrolidone (PVP) into silicone hydrogel contact lenses. In this study, extended blink time (EBT) was used to assess visual stability over a prolonged blink interval of two PVP-containing silicone hydrogel lenses, samfilcon A (SAM) and senofilcon A (SEN). Materials and methods This randomized, bilateral, masked, crossover study assessed lens performance in ten subjects after 16 hours of wear. EBT, ie, the time elapsed between cessation of blinking and blur-out of a threshold letter on the acuity chart, was measured. At the end of the wear period, subjects reported duration of computer use and rated visual quality (VQ) and comfort while wearing the assigned lens, and the investigator evaluated lens surface wetting characteristics. Each lens was removed and immediately weighed to determine total water content. Results EBTs were 10.42 seconds for SAM and 8.04 seconds for SEN (p = 0.015). Subjective ratings of VQ after 16 hours of wear were 84.6 for SAM and 74.4 for SEN (p = 0.049). Comfort ratings were 85.9 for SAM and 80.2 for SEN (p > 0.05). Median times of computer use were 6–8 hours for both lens types. Post blink, 70.0% of SAM and 30.0% of SEN lenses were completely wet (p = 0.021). Total water content after wear was 43.7% for SAM and 35.5% for SEN (p < 0.001). Conclusion EBT measurement indicated more stable vision with the PVP-containing SAM polymer compared with the PVP-containing SEN polymer. The SAM polymer also demonstrated better surface wetting and maintained higher water content after a prolonged period of wear. EBT can be valuable in assessing vision stability of patients after hours of computer use. PMID:29765195

  1. Care System Versus Transmitted Light Wavefront Pattern of Contact Lenses.

    PubMed

    Chiericati, Stefano; Borghesi, Alessandro; Cozza, Federica; Ferraro, Lorenzo; Acciarri, Maurizio; Farris, Stefano; Tavazzi, Silvia

    2017-05-01

    This article compares the optical performance of soft contact lenses (CLs) treated with multipurpose or hydrogen peroxide care systems. The investigated care systems were (1) 3% hydrogen peroxide solution Oxysept (Abbot Medical Optics, Abbott Park, IL) and (2) multipurpose solution Regard (Vita Research, Ariccia, Italy). Three types of silicone hydrogel CLs were studied (comfilcon A, lotrafilcon B, and balafilcon A), unworn and exposed for 30 times to the solutions, which were replaced every 8 hr. The optical performance of the CLs was evaluated through the on-eye transmitted light wavefront patterns by considering new CLs as references. The surface morphology of the CLs was investigated by scanning electron microscopy. Statistically significant modifications in the range 0.1 to 0.3 μm of Zernicke coefficients and modifications of the root mean square of the wavefront aberration function were found for CLs treated with multipurpose solution, in agreement with the observed modifications of the surface morphology. Statistically significant changes were also found after exposure to the hydrogen peroxide solution, but the variation of the Zernicke coefficients was found lower than 0.1 μm, thus being negligible in CL optical performances. In addition to disinfection ability and ocular surface reactions, CL care systems are different in solution-related CL optical performance. Multipurpose solutions may affect the CL surface morphology with significant modifications of the transmitted light wavefront pattern.

  2. Corneal Biomechanical Changes Following Toric Soft Contact Lens Wear.

    PubMed

    Radaie-Moghadam, Somayeh; Hashemi, Hassan; Jafarzadehpur, Ebrahim; Yekta, Abbas Ali; Khabazkhoob, Mehdi

    2016-01-01

    To determine the effect of using toric soft contact lenses on corneal biomechanical properties. We enrolled 33 healthy patients with mean age of 23.18 ± 4.06 and minimal cylinder power of 1 D (-1.98 ± 0.808 SD) and negative history of contact lens use; keratoconic patients were excluded from the study. Toric soft contact lenses (BIOFINITY, Comfilcon A, Coopervision, Southampton, UK) were fitted in all participants. The Ocular Response Analyzer (Reichert Ophthalmic Instruments, Depew, New York, USA) was used to measure corneal hysteresis (CH), corneal resistance factor (CRF), and the Pentacam HR (Oculus, Inc., Lynnwood, WA, USA) was used to measure central corneal thickness (CCT) and mean keratometry (K mean) before and one week, one month, and three months after using the toric soft contact lenses. CH and CRF were decreased significantly one month after using the contact lens; mean CH decreased from 9.99 ± 1.44 to 9.59 ± 1.54 mmHg, and mean CRF decreased from 9.96 ± 1.71 to 9.63 ± 1.73 mmHg (P = 0.013 and P = 0.017, respectively). Mean CCT and K mean did not show a significant change during the period of toric soft contact lens use. CH and CRF decreased significantly one month after fitting toric soft contact lenses while CCT and Kmean did not change significantly. Corneal biomechanical parameters may alter with toric soft contact lens use and such changes may have implications with long-term use such lenses.

  3. Z-LASIK and Trans-PRK for correction of high-grade myopia: safety, efficacy, predictability and clinical outcomes.

    PubMed

    Gershoni, Assaf; Mimouni, Michael; Livny, Eitan; Bahar, Irit

    2018-03-12

    The aim of the study was to examine the outcomes of transepithelial photorefractive keratectomy (Trans-PRK) and Femtosecond Laser-assisted in situ keratomileusis (Z-LASIK) for the correction of high myopia. A retrospective cohort study design was used. The study group included 792 eyes with high-grade myopia (- 6.0 diopters or higher) or high-grade myopia with astigmatism that were treated with Z-LASIK or Trans-PRK in 2013 through 2014 in an optical outpatient clinic of a large private medical service. The Trans-PRK group comprised of 674 eyes with a spherical equivalent (SE) of - 7.87 ± 1.46 and the Z-LASIK group comprised of 118 eyes with a SE of - 7.19 ± 0.81 (P < 0.001). The mean postoperative SE in the Trans-PRK group was - 0.06 and - 0.02 in the Z-LASIK group (P = 0.545). Efficacy index values were 0.92 in the Trans-PRK group and 0.95 in the Z-LASIK group (P = 0.083), and corresponding safety index values were 0.95 and 0.97 (P = 0.056). An UCVA of 20/40 or better was achieved in 94.20% of eyes in the Trans-PRK group, and 98.31% in the Z-LASIK group (P = 0.063). The majority of eyes in both the Trans-PRK and Z-LASIK groups were within ± 0.5D of attempted correction: 59.35 and 64.71%, respectively (P = 0.271). Both Trans-PRK and Z-LASIK demonstrated excellent efficacy, safety and predictability profiles, with results comparable and in some cases superior to the current literature. Results of Z-LASIK were slightly better than those of Trans-PRK, though the preoperative SE of the latter was higher.

  4. Controlled drug release from hydrogels for contact lenses: Drug partitioning and diffusion.

    PubMed

    Pimenta, A F R; Ascenso, J; Fernandes, J C S; Colaço, R; Serro, A P; Saramago, B

    2016-12-30

    Optimization of drug delivery from drug loaded contact lenses assumes understanding the drug transport mechanisms through hydrogels which relies on the knowledge of drug partition and diffusion coefficients. We chose, as model systems, two materials used in contact lens, a poly-hydroxyethylmethacrylate (pHEMA) based hydrogel and a silicone based hydrogel, and three drugs with different sizes and charges: chlorhexidine, levofloxacin and diclofenac. Equilibrium partition coefficients were determined at different ionic strength and pH, using water (pH 5.6) and PBS (pH 7.4). The measured partition coefficients were related with the polymer volume fraction in the hydrogel, through the introduction of an enhancement factor following the approach developed by the group of C. J. Radke (Kotsmar et al., 2012; Liu et al., 2013). This factor may be decomposed in the product of three other factors E HS , E el and E ad which account for, respectively, hard-sphere size exclusion, electrostatic interactions, and specific solute adsorption. While E HS and E el are close to 1, E ad >1 in all cases suggesting strong specific interactions between the drugs and the hydrogels. Adsorption was maximal for chlorhexidine on the silicone based hydrogel, in water, due to strong hydrogen bonding. The effective diffusion coefficients, D e , were determined from the drug release profiles. Estimations of diffusion coefficients of the non-adsorbed solutes D=D e ×E ad allowed comparison with theories for solute diffusion in the absence of specific interaction with the polymeric membrane. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Daily Wear Contact Lenses Manufactured in Etafilcon A Are Noninferior to Two Silicone Hydrogel Lens Types With Respect to Hypoxic Stress.

    PubMed

    Szczotka-Flynn, Loretta B; Debanne, Sara; Benetz, Beth Ann; Wilson, Tawnya; Brennan, Noel

    2018-05-01

    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

  6. Conjunctival epithelial flap in continuous contact lens wear.

    PubMed

    Graham, Andrew D; Truong, Tan N; Lin, Meng C

    2009-04-01

    Composed of sheets of cells detached from the underlying conjunctiva, conjunctival epithelial flap (CEF) is a recently reported phenomenon associated with contact lens wear with potential consequences for ocular health. Although CEF is generally asymptomatic, it is not known to what extent it might increase the longer-term risk of discomfort, inflammatory response, or infection. In this study, we use survival analysis methods to obtain unbiased estimates of the probability of developing CEF, the mean survival time free of CEF, and the effects of age, gender, ethnicity, and contact lens type. Two hundred four subjects were recruited for a continuous wear (CW) study of silicone hydrogel (SiH) and gas permeable (GP) contact lenses. Subjects were examined by optometrists throughout contact lens adaptation and CW periods. Statistical methods included the Kaplan-Meier nonparametric estimator of the survival function and the Cox proportional hazards model for estimating the relative effects of covariates. Of the 204 subjects, 72 (35%) developed CEF. In 64% of cases, CEFs were observed bilaterally. The majority of cases (90.3%) presented with CEF in the superior conjunctiva. Mean survival time free of CEF was longer for GP lenses (94.3 days) than for SiH lenses (76.5 days), and the probability of developing CEF was significantly greater for SiH lenses (p = 0.002). Although there was some evidence that women and non-Asians remain free of CEF longer, the effects of age, gender, and ethnicity were not statistically significant. There was a significantly increased risk of CEF in subjects wearing SiH lenses, compared with GP lenses. Subjects wearing SiH lenses remained free of CEF for a shorter time on average. Further study is needed to determine whether the increased incidence of CEF in CW with SiH lenses poses an increased risk of adverse ocular response or infection.

  7. Virulent T4 Acanthamoeba causing keratitis in a patient after swimming while wearing contact lenses in Southern Brazil.

    PubMed

    Fabres, Laura Fuhrich; Maschio, Vinicius José; Santos, Denise Leal Dos; Kwitko, Sergio; Marinho, Diane Ruschel; Araújo, Bruno Schneider de; Locatelli, Claudete Inês; Rott, Marilise Brittes

    2018-06-26

    Several strains of free-living amoebae belonging to the genus Acanthamoeba can cause a painful sight-threatening disease of the cornea known as Acanthamoeba keratitis (AK). The numbers of AK cases keep rising worldwide mainly due to an increase in contact lens wearers and lack of hygiene in the maintenance of contact lenses and their cases. We report a case of AK in a healthy young woman admitted to the Hospital de Clinicas in Porto Alegre, southern Brazil. Corneal scrapings were examined for the presence of Acanthamoeba strains. The initial isolate was characterized by morphological and genotypic properties. The isolate belonged to group III according to Pussard and Pons' cyst morphology. Analysis of its 18S rDNA sequence identified the isolate as genotype T4. The T4 genotype is the most commonly reported among keratitis isolates and the most common in environmental samples.

  8. Corneal collagen crosslinking for corneal ectasia of post-LASIK: one-year results

    PubMed Central

    Li, Gang; Fan, Zheng-Jun; Peng, Xiu-Jun

    2012-01-01

    AIM To evaluate the efficacy and safety of corneal collagen crosslinking (CXL) to prevent the progression of post-laser in situ keratomileusis (LASIK) corneal ectasia. METHODS In a prospective, nonrandomized, single-centre study, CXL was performed in 20 eyes of 11 patients who had LASIK for myopic astigmatism and subsequently developed keratectasia.The procedure included instillation of 0.1% riboflavin-20% dextrane solution 30 minutes before UVA irradiation and every 5 minutes for an additional 30 minutes during irradiation. The eyes were evaluated preoperatively and at 1-, 3-, 6-, and 12-month intervals. The complete ophthalmologic examination comprised uncorrected visual acuity, best spectacle-corrected visual acuity, endothelial cell count, ultrasound pachymetry, corneal topography, and in vivo confocal microscopy. RESULTS CXL appeared to stabilise or partially reverse the progression of post-LASIK corneal ectasia without apparent complication in our cohort. UCVA and BCVA improvements were statistically significant(P<0.05) beyond 12 months after surgery (improvement of 0.07 and 0.13 logMAR at 1 year, respectively). Mean baseline flattest meridian keratometry and mean steepest meridian keratometry reduction (improvement of 2.00 and 1.50 diopters(D), respectively) were statistically significant (P<0.05) at 12 months postoperatively. At 1 year after CXL, mean endothelial cell count did not deteriorate. Mean thinnest cornea pachymetry increased significantly. CONCLUSION The results of the study showed a long-term stability of post-LASIK corneal ectasia after crosslinking without relevant side effects. It seems to be a safe and promising procedure to stop the progression of post-LASIK keratectasia, thereby avoiding or delaying keratoplasty. PMID:22762048

  9. Early corneal nerve damage and recovery following small incision lenticule extraction (SMILE) and laser in situ keratomileusis (LASIK).

    PubMed

    Mohamed-Noriega, Karim; Riau, Andri K; Lwin, Nyein C; Chaurasia, Shyam S; Tan, Donald T; Mehta, Jodhbir S

    2014-03-25

    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.

  10. Two-year results of femtosecond assisted LASIK versus PRK for different severity of astigmatism.

    PubMed

    Miraftab, Mohammad; Hashemi, Hassan; Asgari, Soheila

    2018-03-01

    To compare two-year results of femtosecond laser assisted LASIK (femto-LASIK) and photorefractive keratectomy (PRK) in terms of astigmatism correction in patients with less than 2.0 diopters (D) of spherical error and more than 2.0 D of cylinder error. In this retrospective study, data were extracted from 100 patient charts. The two study groups were matched by age, gender, and baseline uncorrected distance visual acuity (UDVA) and refractive astigmatism (RA). Preoperative astigmatism was categorized as mild: 2.00 to <3.00 D, moderate: 3.00 to <4.00 D, and severe: ≥4.00 D. Mean RA in the femto-LASIK and PRK groups was respectively -3.15 ± 0.94 D (-7.00 to -2.00 D) and -3.29 ± 0.95 D (-6.25 to -2.00 D) at baseline ( P  = 0.284), and -0.61 ± 0.40 D and -0.62 ± 0.60 D one year after surgery ( P  = 0.674), but significantly lower in the femto-LASIK group (-0.61 ± 0.39 vs. -0.83 ± 0.56 D, P  = 0.021) at 2 years when the rate of residual astigmatism more than 1.0 D was 6.3% in the femto-LASIK and 19.6% in the PRK group ( P  = 0.046). Mean UDVA in the femto-LASIK group (0.02 ± 0.05 logMAR) was better than the PRK group (0.06 ± 0.10 logMAR) ( P  = 0.025). Mean corrected distance visual acuity (CDVA) was not significantly different between groups (0.01 ± 0.03 vs. 0.01 ± 0.04 logMAR, P  = 0.714). Both groups had 1-4 Snellen lines CDVA improvement. The three subgroups of baseline astigmatism did not differ significantly in terms of residual astigmatism (all P  > 0.05). However, in subgroups with ≥4.00 D cylinder, there was less astigmatic regression at 1 year in the femto-LASIK group (0.28 ± 0.43 D) than the PRK group (0.54 ± 0.68 D) ( P  = 0.007). Our results pointed to better two-year results with femto-LASIK in the treatment of different degrees of astigmatism. UDVA improvement was superior with femto-LASIK, but the two methods did not significantly differ in terms of CDVA improvement.

  11. Fitting an MSD (mini scleral design) rigid contact lens in advanced keratoconus with INTACS.

    PubMed

    Dalton, Kristine; Sorbara, Luigina

    2011-12-01

    Keratoconus is a bilateral degenerative disease characterized by a non-inflammatory, progressive central corneal ectasia (typically asymmetric) and decreased vision. In its early stages it may be managed with spectacles and soft contact lenses but more commonly it is managed with rigid contact lenses. In advanced stages, when contact lenses can no longer be fit, have become intolerable, or corneal damage is severe, a penetrating keratoplasty is commonly performed. Alternative surgical techniques, such as the use of intra-stromal corneal ring segments (INTACS) have been developed to try and improve the fit of rigid contact lenses in keratoconic patients and avoid penetrating keratoplasties. This case report follows through the fitting of rigid contact lenses in an advanced keratoconic cornea after an INTACS procedure and discusses clinical findings, treatment options, and the use of mini-scleral and scleral lens designs as they relate to the challenges encountered in managing such a patient. Mini-scleral and scleral lenses are relatively easy to fit, and can be of benefit to many patients, including advanced keratoconic patients, post-INTAC patients and post-penetrating keratoplasty patients. 2011 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  12. Overview of refractive surgery.

    PubMed

    Bower, K S; Weichel, E D; Kim, T J

    2001-10-01

    Patients with myopia, hyperopia and astigmatism can now reduce or eliminate their dependence on contact lenses and eyeglasses through refractive surgery that includes radial keratotomy (RK), photorefractive keratectomy (PRK), laser-assisted in situ keratomileusis (LASIK), laser thermal keratoplasty (LTK) and intrastromal corneal rings (ICR). Since the approval of the excimer laser in 1995, the popularity of RK has declined because of the superior outcomes from PRK and LASIK. In patients with low-to-moderate myopia, PRK produces stable and predictable results with an excellent safety profile. LASIK is also efficacious, predictable and safe, with the additional advantages of rapid vision recovery and minimal pain. LASIK has rapidly become the most widely performed refractive surgery, with high patient and surgeon satisfaction. Noncontact Holium: YAG LTK provides satisfactory correction in patients with low hyperopia. ICR offers patients with low myopia the potential advantage of removal if the vision outcome is unsatisfactory. Despite the current widespread advertising and media attention about laser refractive surgery, not all patients are good candidates for this surgery. Family physicians should be familiar with the different refractive surgeries and their potential complications.

  13. Dry Eye Disease following Refractive Surgery: A 12-Month Follow-Up of SMILE versus FS-LASIK in High Myopia

    PubMed Central

    Wang, Bingjie; Chu, Renyuan; Dai, Jinhui; Qu, Xiaomei; Zhou, Hao

    2015-01-01

    Purpose. To compare dry eye disease following SMILE versus FS-LASIK. Design. Prospective, nonrandomised, observational study. Patients. 90 patients undergoing refractive surgery for myopia were included. 47 eyes underwent SMILE and 43 eyes underwent FS-LASIK. Methods. Evaluation of dry eye disease was conducted preoperatively and at 1, 3, 6, and 12 months postoperatively, using the Salisbury Eye Evaluation Questionnaire (SEEQ) and TBUT. Results. TBUT reduced following SMILE at 1 and 3 months (p < 0.001) and at 1, 3, and 6 months following FS-LASIK (p < 0.001). TBUT was greater following SMILE than FS-LASIK at 3, 6, and 12 months (p < 0.001, p < 0.001, and p = 0.009, resp.). SEEQ scores increased (greater symptoms) following SMILE at 1 month (p < 0.001) and 3 months (p = 0.003) and at 1, 3, and 6 months following FS-LASIK (p < 0.001). SMILE produced lower SEEQ scores (fewer symptoms) than FS-LASIK at 1, 3, and 6 months (p < 0.001). Conclusion. SMILE produces less dry eye disease than FS-LASIK at 6 months postoperatively but demonstrates similar degrees of dry eye disease at 12 months. PMID:26649190

  14. Fundus oculi pigmentation studies simulating the fs-LASIK process Fundus oculi pigmentation studies simulating the fs-LASIK process

    NASA Astrophysics Data System (ADS)

    Sander, M.; Minet, O.; Zabarylo, U.; Müller, M.; Tetz, M. R.

    2012-06-01

    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.

  15. One-year outcomes of a bilateral randomised prospective clinical trial comparing PRK with mitomycin C and LASIK.

    PubMed

    Wallau, A D; Campos, M

    2009-12-01

    To compare 1-year follow-up results of photorefractive keratectomy (PRK) with mitomycin C (MMC) and laser in situ keratomileusis (LASIK) for custom correction of myopia. Eighty-eight eyes of 44 patients with moderate myopia were randomised to PRK with 0.002% MMC for 1 min in one eye and LASIK in the fellow eye. The 1-year follow-up was evaluated. There were no differences between LASIK and MMC-PRK eyes preoperatively. Forty-two patients completed the 1-year follow-up. MMC-PRK eyes achieved better uncorrected visual acuity (p = 0.03) and better best-spectacle-corrected visual acuity (p<0.001) 1 year after surgery. SE did not differ in the two groups during follow-up (p = 0.12). Clinically significant haze was not found in surface ablation eyes. LASIK eyes showed a greater higher-order aberration (p = 0.01) and lower contrast sensitivity (p<0.05) than MMC-PRK eyes postoperatively. Excellent vision was reported in 64% of LASIK and 74% of MMC-PRK eyes 1 year after surgery. The corneal resistance factor and corneal hysteresis (ORA, Reichert) were higher in LASIK than in MMC-PRK eyes (p<0.01) at the last follow-up. Wavefront-guided PRK with 0.002% MMC was more effective than wavefront-guided LASIK for correction of moderate myopia. Further research is necessary to determine the optimal concentration, exposure time and long-term corneal side effect of MMC.

  16. One-year outcomes of a bilateral randomised prospective clinical trial comparing PRK with mitomycin C and LASIK

    PubMed Central

    Wallau, A D; Campos, M

    2009-01-01

    Aim: To compare 1-year follow-up results of photorefractive keratectomy (PRK) with mitomycin C (MMC) and laser in situ keratomileusis (LASIK) for custom correction of myopia. Methods: Eighty-eight eyes of 44 patients with moderate myopia were randomised to PRK with 0.002% MMC for 1 min in one eye and LASIK in the fellow eye. The 1-year follow-up was evaluated. Results: There were no differences between LASIK and MMC-PRK eyes preoperatively. Forty-two patients completed the 1-year follow-up. MMC-PRK eyes achieved better uncorrected visual acuity (p = 0.03) and better best-spectacle-corrected visual acuity (p<0.001) 1 year after surgery. SE did not differ in the two groups during follow-up (p = 0.12). Clinically significant haze was not found in surface ablation eyes. LASIK eyes showed a greater higher-order aberration (p = 0.01) and lower contrast sensitivity (p<0.05) than MMC-PRK eyes postoperatively. Excellent vision was reported in 64% of LASIK and 74% of MMC-PRK eyes 1 year after surgery. The corneal resistance factor and corneal hysteresis (ORA, Reichert) were higher in LASIK than in MMC-PRK eyes (p<0.01) at the last follow-up. Conclusions: Wavefront-guided PRK with 0.002% MMC was more effective than wavefront-guided LASIK for correction of moderate myopia. Further research is necessary to determine the optimal concentration, exposure time and long-term corneal side effect of MMC. PMID:19889831

  17. Effects of acetazolamide on infantile nystagmus syndrome waveforms: comparisons to contact lenses and convergence in a well-studied subject.

    PubMed

    Thurtell, M J; Dell'osso, L F; Leigh, R J; Matta, M; Jacobs, J B; Tomsak, R L

    2010-07-29

    To determine if acetazolamide, an effective treatment for certain inherited channelopathies, has therapeutic effects on infantile nystagmus syndrome (INS) in a well-studied subject, compare them to other therapies in the same subject and to tenotomy and reattachment (T&R) in other subjects. Eye-movement data were taken using a high-speed digital video recording system. Nystagmus waveforms were analyzed by applying an eXpanded Nystagmus Acuity Function (NAFX) at different gaze angles and determining the Longest Foveation Domain (LFD). Acetazolamide improved foveation by both a 59.7% increase in the peak value of the NAFX function (from 0.395 to 0.580) and a 70% broadening of the NAFX vs Gaze Angle curve (the LFD increased from 20° to 34°). The resulting U-shaped improvement in the percent NAFX vs Gaze Angle curve, varied from ~60% near the NAFX peak to over 1000% laterally. The therapeutic improvements in NAFX from acetazolamide (similar to T&R) were intermediate between those of soft contact lenses and convergence, the latter was best; for LFD improvements, acetazolamide and contact lenses were equivalent and less effective than convergence. Computer simulations suggested that damping the central oscillation driving INS was insufficient to produce the foveation improvements and increased NAFX values. Acetazolamide resulted in improved-foveation INS waveforms over a broadened range of gaze angles, probably acting at more than one site. This raises the question of whether hereditary INS involves an inherited channelopathy, and whether other agents with known effects on ion channels should be investigated as therapy for this condition.

  18. Retinal nerve fiber layer changes after LASIK evaluated with optical coherence tomography.

    PubMed

    Dementyev, Dmitriy D; Kourenkov, Vyacheslav V; Rodin, Alexander S; Fadeykina, Tatyana L; Diaz Martines, Tatyana E

    2005-01-01

    To determine whether the increase in intraocular pressure (IOP) during LASIK suction can induce a decrease in retinal nerve fiber layer thickness assessed by optical coherence tomography (OCT). Nineteen patients (38 eyes) were enrolled in the study. Intraocular pressure was normal at all pre- and postoperative examinations. Retinal nerve fiber layer thickness was measured using OCT-3 Stratus prior to and 1 week and 3 months after LASIK. Laser in situ keratomileusis was performed using the Bausch & Lomb Hansatome microkeratome and the NIDEK EC-5000 excimer laser. Optical coherence tomography mean retinal nerve fiber layer thickness values before and after LASIK were compared using the Student paired t test. Mean patient age was 27.8 years (range: 18 to 33 years). Mean preoperative spherical equivalent refractive error was -4.9 diopters (D) (range: -2.0 to -8.5 D). Mean time of microkeratome suction was 30 seconds (range: 20 to 50 seconds). Preoperatively, the mean retinal nerve fiber layer thickness obtained by OCT was 104.2+/-9.0 microm; at 1 week postoperatively the mean thickness was 101.9+/-6.9 microm, and 106.7+/-6.1 microm at 3 months postoperatively. Mean retinal nerve fiber layer thicknesses obtained by OCT were not significantly different between preoperative and 1 week and 3 months after LASIK (P > or = .05). Laser in situ keratomileusis performed on young myopic patients does not have a significant effect on retinal nerve fiber layer thickness determined by OCT. Further studies are required to reveal the risk of possible optic nerve or retinal nerve fiber layer damage by elevated IOP during LASIK.

  19. Corneal power, thickness, and stiffness: results of a prospective randomized controlled trial of PRK and LASIK for myopia.

    PubMed

    Hjortdal, Jesper Ø; Møller-Pedersen, Torben; Ivarsen, Anders; Ehlers, Niels

    2005-01-01

    To compare the short-, medium-, and long-term changes in corneal optical power and corneal aberrations, central corneal thickness, and corneal "stiffness" assessed by pneumotonometry readings in patients having laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) for myopia. Department of Ophthalmology, Arhus University Hospital, Arhus, Denmark. One eye of each of 45 patients with myopia ranging from -6.00 to -8.00 diopters (D) (spherical equivalent spectacle refraction [SER]) was randomized to LASIK (n=25; mean SER -7.12 D +/- 0.57 [SD]) or PRK (n=20; mean SER -6.91 +/- 0.57 D). Data were collected prospectively before and 1, 3, 6, 12, and 36 months after surgery. Measurements included corneal topography (TMS-1, Tomey), corneal thickness (ultrasound pachymetry), and apparent intraocular pressure (IOP) (pneumotonometry). Retreatments were not performed during the first year, and retreated eyes were excluded from the 3-year follow-up. Changes in corneal power and aberrations, thickness, and apparent IOP were calculated in a pair-wise manner for 3 time periods: short term (preoperative to 1 month after surgery), medium term (1 to 12 months after surgery), and long term (1 to 3 years after surgery). In the short term, corneal power decreased equally in LASIK and PRK eyes. Spherical aberrations and coma-like aberrations increased equally, while corneal thickness decreased significantly less in LASIK eyes than in PRK eyes. The apparent IOP decreased more in LASIK eyes than in PRK eyes. In the medium term, corneal power increased significantly in both groups. Spherical aberrations decreased significantly in PRK eyes but not in LASIK eyes. From 1 to 12 months, corneal thickness increased more in PRK eyes than in LASIK eyes. During this period, the apparent IOP increased significantly in LASIK eyes. In the long term, corneal power and corneal aberrations did not change significantly in either group. Corneal thickness increased slightly but

  20. Femtosecond-Assisted LASIK Versus PRK: Comparison of 6-Month Visual Acuity and Quality Outcome for High Myopia.

    PubMed

    Hashemi, Hassan; Miraftab, Mohammad; Ghaffari, Reza; Asgari, Soheila

    2016-11-01

    To compare the results of femtosecond-assisted laser in situ keratomileusis (femto-LASIK) and photorefractive keratectomy with mitomycin C (PRK-MMC) for the correction of myopia more than 7.0 diopters (D). In this comparative nonrandomized trial, 60 eyes (30 eyes in each group) were enrolled. Patients were tested for uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent, ocular and corneal aberrations, and contrast sensitivity (CS) before surgery and at 3 and 6 months postoperatively. Mean preoperative myopia was -8.65±1.51 and -8.04±1.70 D in the femto-LASIK and PRK-MMC groups, respectively (P=0.149). Intergroup differences in baseline indices were not statistically significant. At 6 months after surgery, UDVA showed an improving trend, but it was better in the femto-LASIK group (P=0.026). CDVA in the two groups remained similarly unchanged (P=0.170). For the femto-LASIK and PRK-MMC groups, the safety indices were 1.01±0.05 and 1.01±0.14 (P=0.949), respectively, and the efficacy indices were 0.99±0.07 and 0.93±0.22 (P=0.192), respectively. Comparing CS, only CS18 showed a significantly greater decrease in the femto-LASIK group compared with the PRK-MMC group (P=0.016). Intergroup differences were not statistically significant in other spatial frequencies. Changes in the ocular and corneal higher order aberrations were not statistically different between the two groups except ocular coma, which increased in the femto-LASIK group (P=0.041). Femto-LASIK improves UDVA better than PRK-MMC in high myopia. However, because of increased coma, the quality of vision is reduced. In other words, visual acuity outcome is better with femto-LASIK and visual quality outcome is better with PRK-MMC.

  1. A prospective, contralateral comparison of photorefractive keratectomy (PRK) versus thin-flap LASIK: assessment of visual function.

    PubMed

    Hatch, Bryndon B; Moshirfar, Majid; Ollerton, Andrew J; Sikder, Shameema; Mifflin, Mark D

    2011-01-01

    To compare differences in visual acuity, contrast sensitivity, complications, and higher-order ocular aberrations (HOAs) in eyes with stable myopia undergoing either photo-refractive keratectomy (PRK) or thin-flap laser in situ keratomileusis (LASIK) (intended flap thickness of 90 μm) using the VISX Star S4 CustomVue excimer laser and the IntraLase FS60 femtosecond laser at 1, 3, and 6 months postoperatively. In this prospective, masked, and randomized pilot study, refractive surgery was performed contralaterally on 52 eyes: 26 with PRK and 26 with thin-flap LASIK. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, and complications. At 6 months, mean values for UDVA (logMAR) were -0.043 ± 0.668 and -0.061 ± 0.099 in the PRK and thin-flap LASIK groups, respectively (n = 25, P = 0.466). UDVA of 20/20 or better was achieved in 96% of eyes undergoing PRK and 92% of eyes undergoing thin-flap LASIK, whereas 20/15 vision or better was achieved in 73% of eyes undergoing PRK and 72% of eyes undergoing thin-flap LASIK (P > 0.600). Significant differences were not found between treatment groups in contrast sensitivity (P ≥ 0.156) or CDVA (P = 0.800) at postoperative 6 months. Types of complications differed between groups, notably 35% of eyes in the thin-flap LASIK group experiencing complications, including microstriae and 2 flap tears. Under well-controlled surgical conditions, PRK and thin-flap LASIK refractive surgeries achieve similar results in visual acuity, contrast sensitivity, and induction of HOAs, with differences in experienced complications.

  2. A prospective, contralateral comparison of photorefractive keratectomy (PRK) versus thin-flap LASIK: assessment of visual function

    PubMed Central

    Hatch, Bryndon B; Moshirfar, Majid; Ollerton, Andrew J; Sikder, Shameema; Mifflin, Mark D

    2011-01-01

    Purpose: To compare differences in visual acuity, contrast sensitivity, complications, and higher-order ocular aberrations (HOAs) in eyes with stable myopia undergoing either photo-refractive keratectomy (PRK) or thin-flap laser in situ keratomileusis (LASIK) (intended flap thickness of 90 μm) using the VISX Star S4 CustomVue excimer laser and the IntraLase FS60 femtosecond laser at 1, 3, and 6 months postoperatively. Methods: In this prospective, masked, and randomized pilot study, refractive surgery was performed contralaterally on 52 eyes: 26 with PRK and 26 with thin-flap LASIK. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, and complications. Results: At 6 months, mean values for UDVA (logMAR) were −0.043 ± 0.668 and −0.061 ± 0.099 in the PRK and thin-flap LASIK groups, respectively (n = 25, P = 0.466). UDVA of 20/20 or better was achieved in 96% of eyes undergoing PRK and 92% of eyes undergoing thin-flap LASIK, whereas 20/15 vision or better was achieved in 73% of eyes undergoing PRK and 72% of eyes undergoing thin-flap LASIK (P > 0.600). Significant differences were not found between treatment groups in contrast sensitivity (P ≥ 0.156) or CDVA (P = 0.800) at postoperative 6 months. Types of complications differed between groups, notably 35% of eyes in the thin-flap LASIK group experiencing complications, including microstriae and 2 flap tears. Conclusion: Under well-controlled surgical conditions, PRK and thin-flap LASIK refractive surgeries achieve similar results in visual acuity, contrast sensitivity, and induction of HOAs, with differences in experienced complications. PMID:21573091

  3. Relative performance of soft contact lenses having lathe-cut posterior surfaces with and without additional polishing.

    PubMed

    O'Brien, C; Charman, W N

    2006-05-01

    After a preliminary investigation of the effects of tool feed rate and spindle speed on the surface roughness of unhydrated, lathe-cut polymacon surfaces, a laboratory and clinical comparison was made between lenses with identical parameters except that the lathe-cut posterior surface was left unpolished in the "test" lenses and was polished in the "control" lenses. The lenses had moulded anterior surfaces. Laboratory comparisons included surface roughness, lens power and its uniformity across the surface. Double-blind clinical trials over 4-hour (27 subjects) and 1-month (10 subjects) periods, involved one eye of each subject wearing a "test" lens and the other, a "control" lens. No clinically significant differences were found between the results for the test and control lenses. It is concluded that today's lathing technology makes a final polishing stage unnecessary.

  4. Dry Eye after Small Incision Lenticule Extraction (SMILE) versus Femtosecond Laser-Assisted in Situ Keratomileusis (FS-LASIK) for Myopia: A Meta-Analysis.

    PubMed

    Shen, Zeren; Zhu, Yanan; Song, Xiaohui; Yan, Jie; Yao, Ke

    2016-01-01

    To compare dry eye after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (FS-LASIK) for correcting myopia. CENTRAL, Embase and PubMed were searched in November 2016. All randomized controlled trials (RCTs) and prospective cohorts that compared dry eye after SMILE with FS-LASIK were selected. Five cohorts and one RCT were identified for comparing dry eye after SMILE (291 eyes) and FS-LASIK (277 eyes). The pooled results revealed that the SMILE and FS-LASIK groups did not differ significantly in terms of Schirmer's I test (SIT) and tear film osmolarity (TFO) at any postoperative visits. By contrast, tear break up time (TBUT; p = 0.04 for one month, p < 0.001 for three months, and p = 0.02 for six months) and ocular surface disease index (OSDI; p < 0.001 for one month and three months, and p = 0.006 for six months) were significantly worse in the FS-LASIK group than in the SMILE group at follow-up. At six months postoperatively, TBUT and TFO values in both the SMILE and FS-LASIK groups and OSDI scores in the SMILE group returned to preoperative levels, but SIT values in both groups (p = 0.02 for the SMILE group and p < 0.001 for the FS-LASIK group) and OSDI in the FS-LASIK group (p < 0.001) were still statistically impaired. Dry eye after both SMILE and FS-LASIK usually occurs transiently. SMILE does not show obvious superiority over FS-LASIK by exhibiting similar and acceptable objective parameters, and SMILE may have milder subjective symptoms.

  5. Retinal measurements using time domain optical coherence tomography imaging before and after myopic Lasik

    PubMed Central

    Lei, Feng; Burns, Stephen A.; shao, Liqin; Yang, Yabo

    2014-01-01

    Purpose To compare retinal measurements obtained by time domain optical coherence tomography (OCT) devices before and after myopic laser in situ keratomileusis (Lasik) and to assess the interaction of Lasik and retinal structures as measured by time domain OCT. Methods 53 patients randomly selected participated in the study. Only the right eye of each subject was included in the study. Comprehensive ophthalmic examinations including refraction examination, slitlamp examination, dilated fundus examination, corneal topography, corneal thickness, intraocular pressure, and retinal Stratus OCT scans were acquired for each patient before myopic Lasik and 3 months after surgery. Results Total macular volume (TMV) changed significantly between preoperative and postoperative measurements (p=0.003). No statistical differences were found between preoperative and postoperative disc area, rim area, cup/disk vert. ratio, or average foveal thickness (p>0.05). The variation in TMV correlated significantly with the change in spherical refraction equivalent, maximal corneal curvature, minimal corneal curvature, and corneal ablation depth. Conclusion Most retinal OCT measurements undergo no obvious changes after myopic Lasik. The increased TMV measurements we measured after Lasik seem to be correlated with the alteration in corneal shape. The exact mechanism for this change is not clear, while we examined several possibilities including subclinical macular edema, magnification changes, errors in OCT analysis and IOP, none of these seem to be a likely cause. PMID:22512373

  6. Quantification of individual proteins in silicone hydrogel contact lens deposits

    PubMed Central

    Zhao, Zhenjun; Zhu, Hua; Tilia, Daniel; Willcox, Mark D.P.

    2013-01-01

    Purpose The aim of this study was to quantify specific proteins deposited on daily wear silicone hydrogel lenses used in combination with multipurpose disinfecting solutions (MPDSs) by applying multiple-reaction-monitoring mass spectrometry (MRM-MS). Methods Balafilcon A or senofilcon A contact lenses used with different MPDSs on a daily wear schedule were collected. Each worn lens was extracted and then digested with trypsin. MRM-MS was applied to quantify the amounts of lysozyme, lactoferrin, lipocalin-1, proline-rich protein-4, and keratin-1 in the extracts. Results The amount of protein extracted from the contact lenses was affected by the individual wearers, lens material, and type of care system used. Higher amounts of proteins were extracted from lenses after wear when they were used with an MPDS containing polyhexamethylene biguanide (PHMB) and poloxamer 407 compared with MPDSs containing polyquaternium-1 (PQ-1)/alexidine dihydrochloride with Tetronic 904 or PQ-1/ PHMB with poloxamine and sulfobetaine (p<0.05). There was a correlation between the amount of lipocalin-1 or keratin-1 extracted from lenses and symptoms of ocular dryness. Conclusions The MRM-MS technique is a promising approach that could be used to reveal associations of individual proteins deposited on lenses with performance of contact lenses during wear. PMID:23441110

  7. Pseudomonas aeruginosa Survival at Posterior Contact Lens Surfaces after Daily Wear

    PubMed Central

    Wu, Yvonne T.; Zhu, Lucia S.; Tam, K. P. Connie; Evans, David J.; Fleiszig, Suzanne M. J.

    2015-01-01

    Purpose Pseudomonas aeruginosa keratitis is a sight-threatening complication of contact lens wear, yet mechanisms by which lenses predispose to infection remain unclear. Here, we tested the hypothesis that tear fluid at the posterior contact lens surface can lose antimicrobial activity over time during lens wear. Methods Daily disposable lenses were worn for 1, 2, 4, 6 or 8 h immediately after removal from their packaging, or after presoaking in sterile saline for 2 days to remove packaging solution. Unworn lenses were also tested, some coated in tears “aged” in vitro for 1 or 8 h. Lenses were placed anterior surface down into tryptic soy agar cradles containing gentamicin (100µg/ml) to kill bacteria already on the lens, and posterior surfaces inoculated with gentamicin-resistant P. aeruginosa for 3 h. Surviving bacteria were enumerated by viable counts of lens homogenates. Results Posterior surfaces of lenses worn by patients for 8 h supported more P. aeruginosa growth than lenses worn for only 1 h, if lenses were presoaked prior to wear (~ 2.4-fold, p = 0.01). This increase was offset if lenses were not presoaked to remove packaging solution (p = 0.04 at 2 h and 4 h). Irrespective of presoaking, lenses worn for 8 h showed more growth on their posterior surface than unworn lenses coated with tear fluid that was “aged” for 8 h vitro (~8.6-fold, presoaked, p = 0.003: ~ 5.4-fold from packaging solution, p = 0.004). Indeed, in vitro incubation did not impact tear antimicrobial activity. Conclusions This study shows that post lens tear fluid can lose antimicrobial activity over time during contact lens wear, supporting the idea that efficient tear exchange under a lens is critical for homeostasis. Additional studies are needed to determine applicability to other lens types, wearing modalities, and relevance to contact lens-related infections. PMID:25955639

  8. Laser-assisted in-situ keratomileusis (LASIK) versus photorefractive keratectomy (PRK) for myopia.

    PubMed

    Shortt, Alex J; Allan, Bruce D S; Evans, Jennifer R

    2013-01-31

    Myopia (also known as short-sightedness or near-sightedness) is an ocular condition in which the refractive power of the eye is greater than is required, resulting in light from distant objects being focused in front of the retina instead of directly on it. The two most commonly used surgical techniques to permanently correct myopia are photorefractive keratectomy (PRK) and laser-assisted in-situ keratomileusis (LASIK). To compare the effectiveness and safety of LASIK and PRK for correction of myopia by examining post-treatment uncorrected visual acuity, refractive outcome, loss of best spectacle-corrected visual acuity, pain scores, flap complications in LASIK, subepithelial haze, adverse events, quality of life indices and higher order aberrations. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2012, Issue 11), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to November 2012), EMBASE (January 1980 to November 2012), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to November 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). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 15 November 2012. We also searched the reference lists of the studies and the Science Citation Index. We included randomised controlled trials comparing LASIK and PRK for the correction of any degree of myopia. Two authors independently assessed trial quality and extracted data. We summarised data using the odds ratio and mean difference. We combined odds ratios using a random-effects model after testing for heterogeneity. We included 13 trials (1135 participants, 1923 eyes

  9. [Post-lasik corneal ectasia in patients with significant differences in keratometry readings between both eyes].

    PubMed

    Ortega-Usobiaga, J; Llovet-Osuna, F; Djodeyre, M R; Llovet-Rausell, A; Beltran-Sanz, J; Baviera-Sabater, J

    2014-03-01

    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.

  10. The use of contact lens telescopic systems in low vision rehabilitation.

    PubMed

    Vincent, Stephen J

    2017-06-01

    Refracting telescopes are afocal compound optical systems consisting of two lenses that produce an apparent magnification of the retinal image. They are routinely used in visual rehabilitation in the form of monocular or binocular hand held low vision aids, and head or spectacle-mounted devices to improve distance visual acuity, and with slight modifications, to enhance acuity for near and intermediate tasks. Since the advent of ground glass haptic lenses in the 1930's, contact lenses have been employed as a useful refracting element of telescopic systems; primarily as a mobile ocular lens (the eyepiece), that moves with the eye. Telescopes which incorporate a contact lens eyepiece significantly improve the weight, comesis, and field of view compared to traditional spectacle-mounted telescopes, in addition to potential related psycho-social benefits. This review summarises the underlying optics and use of contact lenses to provide telescopic magnification from the era of Descartes, to Dallos, and the present day. The limitations and clinical challenges associated with such devices are discussed, along with the potential future use of reflecting telescopes incorporated within scleral lenses and tactile contact lens systems in low vision rehabilitation. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  11. Dry Eye after Small Incision Lenticule Extraction (SMILE) versus Femtosecond Laser-Assisted in Situ Keratomileusis (FS-LASIK) for Myopia: A Meta-Analysis

    PubMed Central

    Shen, Zeren; Zhu, Yanan; Song, Xiaohui; Yan, Jie; Yao, Ke

    2016-01-01

    Purpose To compare dry eye after small incision lenticule extraction (SMILE) and femtosecond laser-assisted LASIK (FS-LASIK) for correcting myopia. Methods CENTRAL, Embase and PubMed were searched in November 2016. All randomized controlled trials (RCTs) and prospective cohorts that compared dry eye after SMILE with FS-LASIK were selected. Results Five cohorts and one RCT were identified for comparing dry eye after SMILE (291 eyes) and FS-LASIK (277 eyes). The pooled results revealed that the SMILE and FS-LASIK groups did not differ significantly in terms of Schirmer’s I test (SIT) and tear film osmolarity (TFO) at any postoperative visits. By contrast, tear break up time (TBUT; p = 0.04 for one month, p < 0.001 for three months, and p = 0.02 for six months) and ocular surface disease index (OSDI; p < 0.001 for one month and three months, and p = 0.006 for six months) were significantly worse in the FS-LASIK group than in the SMILE group at follow-up. At six months postoperatively, TBUT and TFO values in both the SMILE and FS-LASIK groups and OSDI scores in the SMILE group returned to preoperative levels, but SIT values in both groups (p = 0.02 for the SMILE group and p < 0.001 for the FS-LASIK group) and OSDI in the FS-LASIK group (p < 0.001) were still statistically impaired. Conclusion Dry eye after both SMILE and FS-LASIK usually occurs transiently. SMILE does not show obvious superiority over FS-LASIK by exhibiting similar and acceptable objective parameters, and SMILE may have milder subjective symptoms. PMID:27992482

  12. Laser in situ keratomileusis enhancements with the Ziemer FEMTO LDV femtosecond laser following previous LASIK treatments.

    PubMed

    Pietilä, Juhani; Huhtala, Anne; Mäkinen, Petri; Uusitalo, Hannu

    2013-02-01

    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.

  13. Photorefractive keratectomy (PRK) versus laser assisted in situ keratomileusis (LASIK) for hyperopia correction.

    PubMed

    Settas, George; Settas, Clare; Minos, Evangelos; Yeung, Ian Yl

    2012-06-13

    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

  14. Accuracy of Visual Estimation of LASIK Flap Thickness.

    PubMed

    Brenner, Jason E; Fadlallah, Ali; Hatch, Kathryn M; Choi, Catherine; Sayegh, Rony R; Kouyoumjian, Paul; Wu, Simon; Frangieh, George T; Melki, Samir A

    2017-11-01

    To assess the accuracy of surgeons' visual estimation of LASIK flap thickness when created by a femtosecond laser by comparing it to ultrasound measurements. Surgeons were asked to visually estimate the thickness of a femtosecond flap during the procedure. Total corneal thickness was measured by ultrasound pachymetry prior to the procedure and the stromal bed was similarly measured after flap lifting. The estimates from three experienced surgeons (cornea fellowship trained and more than 5 years in practice) were compared to those of three cornea fellows, with each surgeon evaluating 20 eyes (120 total). Surgeons were not told the thickness of the flaps unless required for safety reasons. The average difference between visual and ultrasonic estimation of LASIK flap thickness was 15.20 μm. The flap was 10 μm thicker than estimated in 37% of eyes, 20 μm thicker in 17% of eyes, and 30 μm thicker in 10% of eyes. The largest deviation was 53 μm. There was no statistically significant difference between the accuracy of experienced surgeons and fellows (P = .51). There are significant differences between surgeons' visual estimates and ultrasonic measurements of LASIK flap thickness. Relying on these visual estimates may lead to deeper excimer laser ablation than intended. This could lead to thinner residual stromal beds and higher percent tissue altered than planned. The authors recommend that surgeons measure flaps intraoperatively to maximize accuracy and safety. [J Refract Surg. 2017;33(11):765-767.]. Copyright 2017, SLACK Incorporated.

  15. Application of a hydrogel ocular sealant to avoid recurrence of epithelial ingrowth after LASIK enhancement.

    PubMed

    Yesilirmak, Nilufer; Diakonis, Vasilios F; Battle, Juan F; Yoo, Sonia H

    2015-04-01

    To report a case of clinically significant epithelial ingrowth after LASIK that was successfully treated with a hydrogel ocular sealant in combination with flap lifting and scraping technique. Case report. A 56-year-old woman underwent LASIK and a LASIK enhancement procedure in 2002 and 2012, respectively. Six months after the enhancement, visually significant epithelial ingrowth developed in both of her eyes. The left eye was treated with flap lifting, scraping, and suturing, and the right eye was treated with a hydrogel ocular sealant in combination with flap lifting and scraping. No recurrence was evident during a 6-month follow-up period and visual acuity improved in both eyes. No adverse effects were noticed. Recurrent epithelial ingrowth may be successfully avoided with the intraoperative use of a hydrogel ocular sealant combined with flap lifting and scraping. This approach could be used as an alternative to LASIK flap suturing. Copyright 2015, SLACK Incorporated.

  16. Effect of multizone refractive multifocal contact lenses on standard automated perimetry.

    PubMed

    Madrid-Costa, David; Ruiz-Alcocer, Javier; García-Lázaro, Santiago; Albarrán-Diego, César; Ferrer-Blasco, Teresa

    2012-09-01

    The aim of this study was to evaluate whether the creation of 2 foci (distance and near) provided by multizone refractive multifocal contact lenses (CLs) for presbyopia correction affects the measurements on Humphreys 24-2 Swedish interactive threshold algorithm (SITA) standard automated perimetry (SAP). In this crossover study, 30 subjects were fitted in random order with either a multifocal CL or a monofocal CL. After 1 month, a Humphrey 24-2 SITA standard strategy was performed. The visual field global indices (the mean deviation [MD] and pattern standard deviation [PSD]), reliability indices, test duration, and number of depressed points deviating at P<5%, P<2%, P<1%, and P<0.5% on pattern deviation probability plots were determined and compared between multifocal and monofocal CLs. Thirty eyes of 30 subjects were included in this study. There were no statistically significant differences in reliability indices or test duration. There was a statistically significant reduction in the MD with the multifocal CL compared with monfocal CL (P=0.001). Differences were not found in PSD nor in the number of depressed points deviating at P<5%, P<2%, P<1%, and P<0.5% in the pattern deviation probability maps studied. The results of this study suggest that the multizone refractive lens produces a generalized depression in threshold sensitivity as measured by the Humphreys 24-2 SITA SAP.

  17. Nonarteritic ischemic optic neuropathy secondary to severe ocular hypertension masked by interface fluid in a post-LASIK eye.

    PubMed

    Pham, Mai T; Peck, Rachel E; Dobbins, Kendall R B

    2013-06-01

    We report a case of ischemic optic neuropathy arising from elevated intraocular pressure (IOP) masked by interface fluid in a post-laser in situ keratomileusis (LASIK) eye. A 51-year-old man, who had had LASIK 6 years prior to presentation, sustained blunt trauma to the left eye that resulted in a hyphema and ocular hypertension. Elevated IOP resulted in accumulation of fluid in the stromal bed-LASIK flap interface, leading to underestimation of IOP when measured centrally over the flap. After days of unrecognized ocular hypertension, ischemic optic neuropathy developed. To our knowledge, this is the first reported case of ischemic optic neuropathy resulting from underestimated IOP measurements in a post-LASIK patient. It highlights the inaccuracy of IOP measurements in post-LASIK eyes and a vision-threatening potential complication. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  18. Excimer laser photorefractive surgery of the cornea

    NASA Astrophysics Data System (ADS)

    Gaster, Ronald N.

    1998-09-01

    The 193 nm argon fluoride (ArF) excimer laser can effectively be used to change the radius of curvature of the cornea and thus alter the refractive state of the eye. This change allows myopic (nearsighted) patients to see well with less dependence on glasses or contact lenses. The two major techniques of laser refractive surgery currently in effect in the United States are photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). This paper will discuss these refractive cornea surgical techniques.

  19. Phakic intraocular lenses for the treatment of refractive errors: an evidence-based analysis.

    PubMed

    2009-01-01

    The objective of this analysis is to review the effectiveness, safety, and cost-effectiveness of phakic intraocular lenses (pIOLs) for the treatment of myopia, hyperopia, and astigmatism. CONDITION AND TARGET POPULATION REFRACTIVE ERRORS: Refractive errors occur when the eye cannot focus light properly. In myopia (near- or short-sightedness), distant objects appear blurry because the axis of the eye is too long or the cornea is too steep, so light becomes focused in front of the retina. Hyperopia (far sightedness) occurs when light is focused behind the retina causing nearby objects to appear blurry. In astigmatism, blurred or distorted vision occurs when light is focused at two points rather than one due to an irregularly shaped cornea or lens. Refractive errors are common worldwide, but high refractive errors are less common. In the United States, the prevalence of high myopia (≤ -5 D) in people aged 20 to 39, 40 to 59, and 60 years and older is 7.4% (95% confidence interval [CI], 6.5% - 8.3%), 7.8% (95% CI, 6.4% - 8.6%), and 3.1% (95% CI, 2.2% - 3.9%), respectively. The prevalence of high hyperopia (≥ 3 D) is 1.0% (95% CI, .6% - 1.4%), 2.4% (95% CI, 1.7% - 3.0%), and 10.0% (95% CI, 9.1% - 10.9%) for the same age groupings. Finally, the prevalence of astigmatism (≥ 1 D cylinder) is 23.1% (95% CI, 21.6% - 24.5%), 27.6% (95% CI, 25.8% - 29.3%) and 50.1% (48.2% - 52.0%). LOW VISION: According to the Ontario Schedule of Benefits, low visual acuity is defined by a best spectacle corrected visual acuity (BSCVA) of 20/50 (6/15) or less in the better eye and not amenable to further medical and/or surgical treatment. Similarly, the Ontario Assistive Devices Program defines low vision as BSCVA in the better eye in the range of 20/70 or less that cannot be corrected medically, surgically, or with ordinary eyeglasses or contact lenses. Estimates of the prevalence of low vision vary. Using the criteria of BSCVA ranging from 20/70 to 20/160, one study estimated that 35

  20. Clinical outcomes of small incision lenticule extraction versus femtosecond laser-assisted LASIK for myopia: a Meta-analysis

    PubMed Central

    Yan, Huan; Gong, Li-Yan; Huang, Wei; Peng, Yan-Li

    2017-01-01

    AIM To evaluate the possible differences in visual quality between small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) for myopia. METHODS A Meta-analysis was performed. Patients were from previously reported comparative studies treated with SMILE versus FS-LASIK. The PubMed, EMBASE, Cochrane, Web of Science and Chinese databases (i.e. WANFANG and CNKI) were searched in Nov. of 2016 using RevMan 5.1 version software. The differences in visual acuity, aberration and biomechanical effects within six months postoperatively were showed. Twenty-seven studies including 4223 eyes were included. RESULTS No significant differences were observed between SMILE and FS-LASIK in terms of the proportion of eyes that lost one or more lines of corrected distance visual acuity after surgery (P=0.14), the proportion of eyes achieving an uncorrected distance visual acuity of 20/20 or better (P=0.43), the final refractive spherical equivalent (P=0.89), the refractive spherical equivalent within ±1.00 diopter of the target values (P=0.80), vertical coma (P=0.45) and horizontal coma (P=0.06). Compared with the FS-LASIK group, total higher-order aberration (P<0.001) and spherical aberration (P<0.001) were higher and the decrease in corneal hysteresis (P=0.0005) and corneal resistance factor (P=0.02) were lower in the SMILE group. CONCLUSION SMILE and FS-LASIK are comparable in efficacy, safety and predictability for correcting myopia. However, the aberration in the SMILE group is superior to that in the FS-LASIK group, and the loss of biomechanical effects may occur less frequently after SMILE than after FS-LASIK. PMID:28944205

  1. Astigmatism induced by conventional spherical ablation after PRK and LASIK in myopia with astigmatism < 1.00 D.

    PubMed

    Christiansen, Steven M; Mifflin, Mark D; Edmonds, Jason N; Simpson, Rachel G; Moshirfar, Majid

    2012-01-01

    The purpose of this study was to evaluate surgically-induced astigmatism after spherical ablation in photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) for myopia with astigmatism < 1.00 D. The charts of patients undergoing spherical PRK or LASIK for the correction of myopia with minimal astigmatism of <1.00 D from 2002 to 2012 at the John A Moran Eye Center in Salt Lake City, UT, were retrospectively reviewed. Astigmatism was measured by manifest refraction. The final astigmatic refractive outcome at 6 months postoperatively was compared with the initial refraction by Alpins vector analysis. For PRK, average cylinder increased from 0.39 ± 0.25 (0.00-0.75) preoperatively to 0.55 ± 0.48 (0.00-1.75) postoperatively (P = 0.014), compared with an increase in LASIK eyes from 0.40 ± 0.27 (0.00-0.75) preoperatively to 0.52 ± 0.45 (0.00-2.00) postoperatively (P = 0.041). PRK eyes experienced an absolute value change in cylinder of 0.41 ± 0.32 (0.00-1.50) and LASIK eyes experienced a change of 0.41 ± 0.31 (0.00-1.50, P = 0.955). Mean surgically-induced astigmatism was 0.59 ± 0.35 (0.00-1.70) in PRK eyes, with an increase in surgically-induced astigmatism of 0.44 D for each additional 1.00 D of preoperative cylinder; in LASIK eyes, mean surgically-induced astigmatism was 0.55 ± 0.32 (0.00-1.80, P = 0.482), with an increase in surgically-induced astigmatism of 0.29 D for each 1.00 D of preoperative cylinder. Spherical ablation can induce substantial astigmatism even in eyes with less than one diopter of preoperative astigmatism in both PRK and LASIK. No significant difference in the magnitude of surgically-induced astigmatism was found between eyes treated with PRK and LASIK, although surgically-induced astigmatism was found to increase with greater levels of preoperative astigmatism in both PRK and LASIK.

  2. Femtosecond laser-assisted LASIK versus PRK for high myopia: comparison of 18-month visual acuity and quality.

    PubMed

    Hashemi, Hassan; Ghaffari, Reza; Miraftab, Mohammad; Asgari, Soheila

    2017-08-01

    To compare 18-month outcomes between femtosecond laser-assisted LASIK (femto-LASIK) and photorefractive keratectomy with mitomycin-C (PRK-MMC) for myopia of more than 7.0 D in terms of visual acuity and quality. In this comparative nonrandomized clinical trial, 60 eyes from 30 patients (30 eyes in each group) were enrolled. The two procedures were compared in terms of 18-month changes in uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent, ocular and corneal higher order aberrations (HOAs), and contrast sensitivity (CS). Mean myopia was -8.65 ± 1.51 and -8.04 ± 1.70 D (P = 0.149) and mean ablation depth was 109.37 ± 9.07 and 105.09 ± 12.59 µm (P = 0.138), in the femto-LASIK and PRK-MMC groups, respectively. Baseline parameters were not significantly different between the two groups (all P > 0.05). At 18 months postoperatively, 75 % in the femto-LASIK, versus 57.1 % in the PRK-MMC group, had 20/20 UDVA (P = 0.017). CDVA remained similarly unchanged in both groups (P = 0.616). No case had residual refractive error more than 1.0 D in the femto-LASIK group, while 33.5 % in the other group had more than 1.0 D residual error (P = 0.390). Changes in corneal HOA were not significantly different between the two groups (P = 0.260). Cases in the femto-LASIK group showed more increase in ocular HOA (P = 0.032) and coma (P = 0.083, power = 72 %). CS remained similarly unchanged in all spatial frequencies in both groups (all P > 0.05). Although femto-LASIK induces more HOA compared to PRK-MMC, considering outcomes in terms of 20/20 UDVA, residual refractive error, and CS stability, femto-LASIK provides more favorable results than PRK-MMC in high myopia.

  3. Treating amblyopia in adults with prosthetic occluding contact lenses.

    PubMed

    Garcia-Romo, Esperanza; Perez-Rico, Consuelo; Roldán-Díaz, Isabel; Arévalo-Serrano, Juan; Blanco, Román

    2018-05-01

    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.

  4. Bandage soft contact lenses for ocular graft-versus-host disease

    PubMed Central

    Inamoto, Yoshihiro; Sun, Yi-Chen; Flowers, Mary E. D.; Carpenter, Paul A.; Martin, Paul J.; Li, Peng; Wang, Ruikang; Chai, Xiaoyu; Storer, Barry E.; Shen, Tueng T.; Lee, Stephanie J.

    2015-01-01

    To examine safety and efficacy of bandage soft contact lenses (BSCLs) for ocular chronic graft-versus host disease (GVHD), we conducted a phase II clinical trial. Extended-wear BSCLs were applied under daily topical antibiotics prophylaxis. Patients completed standardized symptom questionnaires at enrollment and at 2 weeks, 4 weeks and 3 months afterwards. Ophthalmologic assessment was performed at enrollment, at 2 weeks and afterwards as medically needed. Assessments at follow-up were compared with baseline by paired t-test. Nineteen patients with ocular GVHD who remained symptomatic despite conventional treatments were studied. The mean Lee eye subscale score was 75.4 at enrollment, and improved significantly to 63.2 at 2 weeks (p=0.01), to 61.8 at 4 weeks (p=0.005) and to 56.3 at 3 months (p=0.02). The ocular surface disease index score and 11-point eye symptom ratings also improved significantly. According to the Lee eye subscale, clinically meaningful improvement was observed in 9 patients (47%) at 2 weeks, in 11 (58%) at 4 weeks and in 9 (47%) at 3 months. Visual acuity improved significantly at 2 weeks compared with enrollment values. Based on slit lamp exam at 2 weeks, punctate epithelial erosions improved in 58% of the patients, showed stability in 16% and worsened in 5%. No corneal ulceration or ocular infection occurred. BSCLs are a widely available, safe and effective treatment option that improves manifestations of ocular graft-versus host disease in approximately 50% of patients. This study was registered at www.clinicaltrials.gov as NCT01616056. PMID:26189353

  5. Optical Assessment of Soft Contact Lens Edge-Thickness.

    PubMed

    Tankam, Patrice; Won, Jungeun; Canavesi, Cristina; Cox, Ian; Rolland, Jannick P

    2016-08-01

    To assess the edge shape of soft contact lenses using Gabor-Domain Optical Coherence Microscopy (GD-OCM) with a 2-μm imaging resolution in three dimensions and to generate edge-thickness profiles at different distances from the edge tip of soft contact lenses. A high-speed custom-designed GD-OCM system was used to produce 3D images of the edge of an experimental soft contact lens (Bausch + Lomb, Rochester, NY) in four different configurations: in air, submerged into water, submerged into saline with contrast agent, and placed onto the cornea of a porcine eyeball. An algorithm to compute the edge-thickness was developed and applied to cross-sectional images. The proposed algorithm includes the accurate detection of the interfaces between the lens and the environment, and the correction of the refraction error. The sharply defined edge tip of a soft contact lens was visualized in 3D. Results showed precise thickness measurement of the contact lens edge profile. Fifty cross-sectional image frames for each configuration were used to test the robustness of the algorithm in evaluating the edge-thickness at any distance from the edge tip. The precision of the measurements was less than 0.2 μm. The results confirmed the ability of GD-OCM to provide high-definition images of soft contact lens edges. As a nondestructive, precise, and fast metrology tool for soft contact lens measurement, the integration of GD-OCM in the design and manufacturing of contact lenses will be beneficial for further improvement in edge design and quality control. In the clinical perspective, the in vivo evaluation of the lens fitted onto the cornea will advance our understanding of how the edge interacts with the ocular surface. The latter will provide insights into the impact of long-term use of contact lenses on the visual performance.

  6. Optical Assessment of Soft Contact Lens Edge-Thickness

    PubMed Central

    Tankam, Patrice; Won, Jungeun; Canavesi, Cristina; Cox, Ian; Rolland, Jannick P.

    2016-01-01

    Purpose To assess the edge shape of soft contact lenses using Gabor-Domain Optical Coherence Microscopy (GD-OCM) with a 2 μm imaging resolution in three dimensions, and to generate edge-thickness profiles at different distances from the edge tip of soft contact lenses. Methods A high-speed custom-designed GD-OCM system was used to produce 3D images of the edge of an experimental soft contact lens (Bausch + Lomb, Rochester NY) in four different configurations: in air, submerged into water, submerged into saline with contrast agent, and placed onto the cornea of a porcine eyeball. An algorithm to compute the edge-thickness was developed and applied to cross-sectional images. The proposed algorithm includes the accurate detection of the interfaces between the lens and the environment, and the correction of the refraction error. Results The sharply defined edge tip of a soft contact lens was visualized in 3D. Results showed precise thickness measurement of the contact lens edge profile. 50 cross-sectional image frames for each configuration were used to test the robustness of the algorithm in evaluating the edge-thickness at any distance from the edge tip. The precision of the measurements was less than 0.2 μm. Conclusions The results confirmed the ability of GD-OCM to provide high definition images of soft contact lens edges. As a non-destructive, precise, and fast metrology tool for soft contact lens measurement, the integration of GD-OCM in the design and manufacturing of contact lenses will be beneficial for further improvement in edge design and quality control. In the clinical perspective, the in-vivo evaluation of the lens fitted onto the cornea will advance our understanding of how the edge interacts with the ocular surface. The latter will provide insights into the impact of long-term use of contact lenses on the visual performance. PMID:27232902

  7. Active eye-tracking improves LASIK results.

    PubMed

    Lee, Yuan-Chieh

    2007-06-01

    To study the advantage of active eye-tracking for photorefractive surgery. In a prospective, double-masked study, LASIK for myopia and myopic astigmatism was performed in 50 patients using the ALLEGRETTO WAVE version 1007. All patients received LASIK with full comprehension of the importance of fixation during the procedure. All surgical procedures were performed by a single surgeon. The eye-tracker was turned off in one group (n = 25) and kept on in another group (n = 25). Preoperatively and 3 months postoperatively, patients underwent a standard ophthalmic examination, which included comeal topography. In the patients treated with the eye-tracker off, all had uncorrected visual acuity (UCVA) of > or = 20/40 and 64% had > or = 20/20. Compared with the patients treated with the eye-tracker on, they had higher residual cylindrical astigmatism (P < .05). Those treated with the eye-tracker on achieved better UCVA and best spectacle-corrected visual acuity (P < .05). Spherical error and potential visual acuity (TMS-II) were not significantly different between the groups. The flying-spot system can achieve a fair result without active eye-tracking, but active eye-tracking helps improve the visual outcome and reduces postoperative cylindrical astigmatism.

  8. [Laser in situ keratomyleusis (LASIK) for correction of myopia and hypermetropia--our one year experience].

    PubMed

    Vukosavljević, Miroslav; Milivojević, Milorad; Resan, Mirko; Cerović, Vesna

    2009-12-01

    Laser in situ keratamileusis (LASIK) is the most commonly used refractive surgical method worldwide. The aim of this study was to examine the effectiveness and safety of LASIK in the correction of myopia and hyperopia. The study included myopic and hyperopic eyes with preoperative best corrected visual acuity (BCVA) = 1 (20/20), of the total number of 322 divided into 2 groups--1) myopic eyes (n = 241) which were divided into 4 subgroups according to the myopia strength: a) < or = -1.75 D (n = 23), b) from -2 to -3.75 D (n = 81), c) from -4 to -6.75 D (n = 113), d) > or = -7 D (n = 24); 2) hyperopic eyes (n = 81) which were divided into 3 subgroups according to the hyperopia strength: a) < or = +1.75D (n = 10), b) from +2 to +3.75 D (n = 46), c) > or = +4 D (n = 25). Myopic and hyperopic eyes with preoperative BCVA < or = 0.9 (eyes with ambliopia) were excluded from the study, as well as eyes with astigmatism > 1.5 D. To assess the effectiveness of LASIK we examined the percentage of eyes in the mentioned subgroups, which derived uncorrected visual acuity (UCVA) 6 month after the intervention to the following: a) UCVA = 1 (20/20) and b) UCVA > or = 0.5 (20/40). To assess the safety of LASIK we examined the frequency of intraoperative and postoperative complications. A prospective study was performed in a 6-months follow-up period. RESULTS. Refractive spherical equivalent (RSE) of myopic eyes was in the range from -0.75 D to -12 D. In the first subgroup preoperative mean value of RSE with standard deviation (mean RSE +/- SD) was -1.39 +/- 0.36 D, and 6 months after the LASIK 100% of the eyes had UCVA = 20/20. In the second subgroup preoperative mean RSE +/- SD was -2.85 +/- 0.50 D, and 6 months after LASIK 93% of the eyes had UCVA = 20/20, but 100% of the eyes had UCVA > or = 20/40. In the third subgroup preoperative mean RSE +/- SD was -5.03 +/- 0.75 D, and 6 months after the LASIK 90% of the eyes had UCVA = 20/20, but 100% of the eyes had UCVA > or = 20/40. In the

  9. Disruption of Contact Lens–Associated Pseudomonas aeruginosa Biofilms Formed in the Presence of Neutrophils

    PubMed Central

    Parks, Quinn M.; Young, Robert L.; Kret, Jennifer; Poch, Katie R.; Malcolm, Kenneth C.; Nichols, David P.; Nichols, Michelle; Zhu, Meifang; Cavanagh, H. Dwight; Nick, Jerry A.

    2011-01-01

    Purpose. To evaluate the capacity of neutrophils to enhance biofilm formation on contact lenses by an infectious Pseudomonas aeruginosa (PA) corneal isolate. Agents that target F-actin and DNA were tested as a therapeutic strategy for disrupting biofilms formed in the setting of neutrophils in vitro and for limiting the infectious bioburden in vivo. Methods. Biofilm formation by infectious PA strain 6294 was assessed in the presence of neutrophils on a static biofilm plate and on unworn etafilcon A soft contact lenses. A d-isomer of poly(aspartic acid) was used alone and with DNase to reduce biofilm formation on test contact lenses. The gentamicin survival assay was used to determine the effectiveness of the test compound in reducing subsequent intracellular bacterial load in the corneal epithelium in a contact lens infection model in the rabbit. Results. In a static reactor and on hydrogel lenses, PA biofilm density was enhanced 30-fold at 24 hours in the presence of neutrophils (P < 0.0001). The combination of DNase and anionic poly(aspartic acid) reduced the PA biofilms formed in the presence of activated neutrophils by 79.2% on hydrogel contact lenses (P < 0.001). An identical treatment resulted in a 41% reduction in internalized PA in the rabbit corneal epithelium after 24 hours (P = 0.03). Conclusions. These results demonstrate that PA can exploit the presence of neutrophils to form biofilm on contact lenses within a short time. Incorporation of F-actin and DNA represent a mechanism for neutrophil-induced biofilm enhancement and are targets for available agents to disrupt pathogenic biofilms formed on contact lenses and as a treatment for established corneal infections. PMID:21245396

  10. Retrospective Comparison of Visual Outcomes After KAMRA Corneal Inlay Implantation With Simultaneous PRK or LASIK.

    PubMed

    Moshirfar, Majid; Bean, Andrew E; Albarracin, Julio C; Rebenitsch, Ronald L; Wallace, Ryan T; Birdsong, Orry C

    2018-05-01

    To report a retrospective study of simultaneous LASIK versus photorefractive keratectomy (PRK) with accompanying small-aperture cornea inlay implantation (KAMRA; AcuFocus, Inc., Irvine, CA) in treating presbyopia. Simultaneous LASIK/inlay and simultaneous PRK/inlay was performed on 79 and 47 patients, respectively. Follow-up examinations were conducted at 1, 3, and 6 months postoperatively. The main outcome measures were safety, efficacy, predictability, and stability with primary emphasis on monocular uncorrected near visual acuity (UNVA). Both groups met U.S. Food and Drug Administration criteria for efficacy with 95% and 55% of the LASIK/inlay group and 83% and 52% of the PRK/inlay group having a monocular UNVA of 20/40 (J5) and 20/25 (J2), respectively, at 6-month follow-up. Ninety-two percent of the LASIK/inlay group and 95% of the PRK/inlay group had a UDVA of 20/40 or better at 6 months. Two eyes lost one line of corrected distance visual acuity (CDVA). Mild hyperopic shift was noted in both groups at 6 months. Simultaneous PRK/inlay and LASIK/inlay meet the U.S. Food and Drug Administration standards for efficacy and safety based on 6-month preliminary results and have similar outcomes to emmetropic eyes. [J Refract Surg. 2018;34(5):310-315.]. Copyright 2018, SLACK Incorporated.

  11. Contact lens wearers' experiences while trekking in the Khumbu region/Nepal: a cross-sectional survey.

    PubMed

    Bauer, Irmgard L

    2015-01-01

    Safe contact lens wear depends on a hygiene regime and lens-appropriate wear patterns which may be compromised during travel in remote and wilderness areas. The purpose of this study was to describe the experience of contact lens wearers while trekking at high-altitude in Nepal. For this descriptive study, trekkers with contact lenses were recruited in Lukla and invited to complete an online-questionnaire on trip preparation, contact lens use, care and experiences, and possible changes for future travel. Quantitative data were analysed using SurveyMonkey; content analysis applied to qualitative responses. The majority of the 158 participants (124; 78.48%) reported no problems with their lenses (daily disposables, soft lenses, extended-wear lenses, hard/rigid lenses) during their stay although dry air, dust, wind, cold temperatures, and difficult hygiene maintenance were challenging. Freezing lenses and freezing solutions were additional challenges. Thirty-four (21.52%) experienced a variety of problems. Improvements were requested from manufacturers. Lodges should provide better access to clean water, mirrors and lighting. Almost 60% of participants had not sought any pre-travel health advice. Remote and wilderness areas provide a challenge for appropriate contact lens wear and care. The decision between the potential risk of infection due to touching lenses (daily disposables, soft/hard lenses) and the potential risk of corneal erosion (extended-wear lenses) needs to be made in pre-travel consultations. Travel health professionals and travel agencies should remind CL-wearing trekkers to carefully assess their wear and care routine to accommodate potentially challenging conditions. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. [Characteristics, stability and in vitro efficacy of cleaning products for contact lenses].

    PubMed

    Coiffard, L; Rivalland, P; De Roeck-Holtzhauer, Y

    1995-01-01

    We characterized some market products designed for cleaning contact lenses and we compared their properties to the main requirements of eye-washes. We performed several physicochemical controls including pH determination, viscosity with a Baume apparatus and the decreasing of the freezing point following the method described by the French Pharmacopea. In addition, we carried out certain analytical controls, concerning three active principles (thiomersal, chlorhexidin digluconate, hydrogen peroxide), at the opening of the different package and after accelerated aging. A microbiological control was performed when opening the product and after a simulation of a 5-day aging. We finally determined the efficacy of the products on four bacterial strains for tests and of deproteinizing products on artificial dust. The pH values obtained ranged from 4.0 (oxygenated water solutions) to 7.8. The viscosity was close to a water solution one. Contents in active substances were usually similar to those stated on the package. At opening, the bacteriological quality was excellent. But, the multidose package were highly contaminated when used. Finally decontaminating efficacy against some germs was very good for the products tested. The results obtained show that the rincing products best answer the eye-wash criteria taken as references. Their main disadvantage is their contamination in the case of multidose packaging.

  13. Evaluation of the Tear Function Tests and the Ocular Surface in First-Time Users of Silicone Hydrogel Contact Lenses.

    PubMed

    Yildiz Tasci, Yelda; Gürdal, Canan; Sarac, Ozge; Onusever, Aykut

    2017-07-01

    To evaluate the effects of three different silicone hydrogel contact lenses (SHCL), (balafilcon A, senofilcon A, and comfilcon A) on tear function tests, corneal thickness, and ocular surface cytology in first time contact lens users. In this prospective study, 120 eyes of 60 subjects were evaluated. Balafilcon A users were designated as group 1, senofilcon A users as group 2, and comfilcon A users as group 3. In all cases, before and after 6 months of contact lens wear, ocular surface disease index score (OSDI), tear breakup time (TBUT), Schirmer 1 test, central corneal thickness (CCT), central corneal epithelium thickness (CCET), and conjunctival impression cytology samples were evaluated. In group 1, 40 eyes of the 20 patients, in group 2, 40 eyes of the 20 patients, and in group 3, 40 eyes of the 20 patients were evaluated. The mean OSDI scores did not differ between the three groups after contact lens wear (p > 0.05). In group 1 and group 2, significant decrease was found in the mean TBUT 6 months after contact lens wear (p = 0.04, p < 0.001, respectively). In group 3, after 6 months of contact lens wear, the mean Schirmer 1 tear test was decreased significantly (p = 0.021). In all 3 groups, no significant change was observed in the mean CCT and CCET after contact lens wear (p > 0.05). After 6 months, the morphological changes in temporal and superior conjunctival epithelial cells were found to be significant in all groups (p < 0.001). Six months after SHCL wear, marked morphological changes occurred in the conjunctival epithelium. Tear function tests were also affected, while corneal thickness did not show any significant difference.

  14. LASIK vs LASEK vs PRK: advantages and indications.

    PubMed

    Ambrósio, Renato; Wilson, Steven

    2003-03-01

    The advent of the excimer laser as an instrument for use in reshaping the corneal stroma was a great step forward in refractive surgery. Laser energy can be delivered on the stromal surface in the photorefractive keratectomy (PRK) procedure or deeper on the corneal stroma by the means of a lamellar surgery in which a flap is created with the microkeratome in the laser in situ keratomileusis (LASIK) procedure. LASIK is currently the dominant procedure in refractive surgery. The main advantage of LASIK over PRK is related to maintaining the central corneal epithelium. This increases comfort during the early post-operative period, allows for rapid visual recovery, and reduces the wound healing response. Reduced wound healing correlates with less regression for high corrections and a lower rate of complications such as significant stromal opacity (haze). PRK, however, remains as an excellent option for mild to moderate corrections, particularly for cases associated with thin corneas, recurrent erosions, or a predisposition for trauma (Martial arts, military, etc.). Recently, a modification of PRK, laser subepithelial keratomileusis (LASEK), was introduced. In the LASEK procedure, an epithelial flap is created and replaced after the ablation. The benefits, if any, of the creation of an epithelial flap compared to traditional PRK are not fully appreciated. Advocates of LASEK suggest that there is less discomfort in the early postoperative period, faster visual recovery, and less haze compared to standard PRK for correction of similar levels of refractive error. Additional long-term clinical studies, along with laboratory research, will be crucial to validate these potential advantages of LASEK procedure.

  15. An evaluation of 1-day disposable contact lens wear in a population of allergy sufferers.

    PubMed

    Hayes, Valérie Y; Schnider, Cristina M; Veys, Jane

    2003-06-01

    This was a multi-site, 128-subject, bilateral crossover study to evaluate subjective comfort and slit-lamp findings with 1-day disposable contact lenses in a population of allergy sufferers during periods when allergen levels were elevated. The study involved 1-month of single-use daily wear with a 1-day disposable test lens (1. DAY ACUVUE Brand Contact Lenses, Johnson & Johnson Vision Care) and 1-month of daily wear with subjects' habitual lenses replaced to their usual replacement schedule. Pollen and mould counts were obtained for each site 1 week prior to the study and twice weekly throughout the study period. Subjective comfort and slit-lamp findings were recorded at baseline and after 1-month's wear of each modality. Sixty-seven percent of subjects agreed that the 1-day disposable lenses provided improved comfort when compared to the lenses they wore prior to the study, compared with 18% agreeing that the new pair of habitual lenses provided improved comfort. The 1-day disposable lenses showed greater improvement in slit-lamp findings from baseline than new habitual lenses. The use of 1-day disposable lenses is an effective strategy for managing allergy-suffering contact lens wearers.

  16. Bacterial adhesion to unworn and worn silicone hydrogel lenses.

    PubMed

    Vijay, Ajay Kumar; Zhu, Hua; Ozkan, Jerome; Wu, Duojia; Masoudi, Simin; Bandara, Rani; Borazjani, Roya N; Willcox, Mark D P

    2012-08-01

    The objective of this study was to determine the bacterial adhesion to various silicone hydrogel lens materials and to determine whether lens wear modulated adhesion. Bacterial adhesion (total and viable cells) of Staphylococcus aureus (31, 38, and ATCC 6538) and Pseudomonas aeruginosa (6294, 6206, and GSU-3) to 10 commercially available different unworn and worn silicone hydrogel lenses was measured. Results of adhesion were correlated to polymer and surface properties of contact lenses. S. aureus adhesion to unworn lenses ranged from 2.8 × 10 to 4.4 × 10 colony forming units per lens. The highest adhesion was to lotrafilcon A lenses, and the lowest adhesion was to asmofilcon A lenses. P. aeruginosa adhesion to unworn lenses ranged from 8.9 × 10 to 3.2 × 10 colony forming units per lens. The highest adhesion was to comfilcon A lenses, and the lowest adhesion was to asmofilcon A and balafilcon A lenses. Lens wear altered bacterial adhesion, but the effect was specific to lens and strain type. Adhesion of bacteria, regardless of genera/species or lens wear, was generally correlated with the hydrophobicity of the lens; the less hydrophobic the lens surface, the greater the adhesion. P. aeruginosa adhered in higher numbers to lenses in comparison with S. aureus strains, regardless of the lens type or lens wear. The effect of lens wear was specific to strain and lens. Hydrophobicity of the silicone hydrogel lens surface influenced the adhesion of bacterial cells.

  17. In vivo performance of a drug-eluting contact lens to treat glaucoma for a month

    PubMed Central

    Ciolino, Joseph B.; Stefanescu, Cristina F.; Ross, Amy E.; Salvador-Culla, Borja; Cortez, Priscila; Ford, Eden M.; Wymbs, Kate A.; Sprague, Sarah L.; Mascoop, Daniel R.; Rudina, Shireen S.; Trauger, Sunia A.; Cade, Fabiano; Kohane, Daniel S.

    2013-01-01

    For nearly half a century, contact lenses have been proposed as a means of ocular drug delivery, but achieving controlled drug release has been a significant challenge. We have developed a drug-eluting contact lens designed for prolonged delivery of latanoprost for the treatment of glaucoma, the leading cause of irreversible blindness worldwide. Latanoprost-eluting contact lenses were created by encapsulating latanoprost–poly(lactic-co-glycolic acid) films in methafilcon by ultraviolet light polymerization. In vitro and in vivo studies showed an early burst of drug release followed by sustained release for one month. Contact lenses containing thicker drug–polymer films demonstrated released a greater amount of drug after the initial burst. In vivo, single contact lenses were able to achieve, for at least one month, latanoprost concentrations in the aqueous humor that were comparable to those achieved with topical latanoprost solution, the current first-line treatment for glaucoma. The lenses appeared safe in cell culture and animal studies. This contact lens design can potentially be used as a treatment for glaucoma and as a platform for other ocular drug delivery applications. PMID:24094935

  18. Colonization of hydrogel lenses with Streptococcus pneumoniae: risk of development of corneal infiltrates.

    PubMed

    Sankaridurg, P R; Sharma, S; Willcox, M; Sweeney, D F; Naduvilath, T J; Holden, B A; Rao, G N

    1999-05-01

    To report the association between colonization of contact lenses with Streptococcus pneumoniae and the observation of corneal infiltrative events in a group of patients wearing disposable hydrogel lenses on an extended-wear schedule. In a prospective clinical trial, 330 patients wore disposable hydrogels on a 6-night extended-wear and replacement schedule. The contact lens, lid, and conjunctival microbiota of these subjects was analyzed at frequent intervals and at the time of an adverse event. Streptococcus pneumoniae was an uncommon isolate and was recovered from only one of the 3,763 conjunctival samples, five (0.1%) of the 3,764 lid samples, and 33 (0.8%) of the 4,315 contact lens samples. Of the 33 lens samples, 10 (30%) were associated with corneal infiltrative events. Many of the events were mild inflammatory responses and resolved rapidly on discontinuation of lens wear. The presence of S. pneumoniae on the contact lens was associated with a significant risk of development of corneal infiltrates (odds ratio, 3.0; p = 0.0227, logistic-regression analysis). Presence of S. pneumoniae on hydrogel lenses is a significant risk factor for the development of corneal infiltrates.

  19. Asymptomatic corneal staining associated with the use of balafilcon silicone-hydrogel contact lenses disinfected with a polyaminopropyl biguanide-preserved care regimen.

    PubMed

    Jones, Lyndon; MacDougall, Nancy; Sorbara, L Gina

    2002-12-01

    To compare subjective symptoms and signs in a group of individuals who wear silicone-hydrogel lenses on a daily wear basis while they sequentially used two differing care regimens. Fifty adapted soft-lens wearers were fitted with a silicone-hydrogel lens material (PureVision, Bausch & Lomb). The lenses were worn on a daily wear basis for two consecutive 1-month periods, during which the subjects used either a Polyquad (polyquaternium-1) -based system or a polyaminopropyl biguanide (PHMB) -based system, using a double-masked, randomized, crossover experimental design. Significant levels of relatively asymptomatic corneal staining were observed when subjects used the PHMB-based system, with 37% of subjects demonstrating a level of staining consistent with a classical solution-based toxicity reaction. Only 2% of the subjects exhibited such staining when using the Polyquad-based system. These results were significantly different (p < 0.001). Significant symptoms were not correlated with the degree of staining, with no differences in lens comfort or overall preference being reported between the regimens (p = NS). The only statistically significant difference in symptoms related to minor differences in stinging after lens insertion being reported, with the Polyquad-based system demonstrating less stinging (p < 0.008). Practitioners who fit silicone-hydrogel contact lenses on a daily wear basis should be wary of the potential for certain PHMB-containing multipurpose care systems to invoke corneal staining. Switching to non-PHMB based regimens will eliminate this complication in most instances.

  20. Ten years after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) for moderate to high myopia (control-matched study).

    PubMed

    Alió, J L; Ortiz, D; Muftuoglu, O; Garcia, M J

    2009-10-01

    To compare the long-term outcomes of photorefractive keratectomy (PRK) and laser in situ keratomilesis (LASIK) for myopia between -6 and -10 D. A retrospective, control-matched study including 68 eyes, 34 which underwent PRK and 34 LASIK, with myopia between -6 and -10 D, operated using the VISX 20/20 excimer laser, was performed. Optical zones of 5.5 to 6 mm were used. All PRK-treated eyes were matched with LASIK-treated eyes of the same age, spherical equivalent within +/-1.25 D, sphere within +/-1.5 D and cylinder within +/-2.5 D. All patients were evaluated 3 months, 1 year, 2 years, 5 years and 10 years after surgery. The main outcomes measures were refractive predictability and stability, safety, efficacy and re-treatment rate. At 10 years, 20 (71%) and 23 (88%) were within +/-1.00 D after PRK and LASIK respectively. The re-treatment rate was 35% and 18% respectively. No eye lost more than two lines of BSCVA in both groups. The efficacy was 0.90 for PRK and 0.95 for LASIK. Both PRK and LASIK were safe for moderate myopia. LASIK demonstrated slightly better efficacy, predictability, and less rate of re-treatment after 10 years. The technical improvements should be taken into account when comparing these results with those obtained more recently.

  1. Phospholipids and their degrading enzyme in the tears of soft contact lens wearers.

    PubMed

    Yamada, Masakazu; Mochizuki, Hiroshi; Kawashima, Motoko; Hata, Seiichiro

    2006-12-01

    Low tear phospholipids levels are associated with tear film instability in soft contact lens wearers. We assayed levels of phospholipids and their degrading enzyme secretory phospholipase A2 (sPLA2) both in tears and deposited on contact lenses composed of 2 hydrophilic materials after 1 day of routine use. Polymacon (Medalist; FDA group 1, low water/nonionic) and Etafilcon A (One Day Acuvue; group 4, high water/ionic) contact lenses were worn for 12 hours by 16 experienced contact lens wearers. Phospholipids in tear fluids and deposited on contact lenses were estimated by phosphorus determination with ammonium molybdate through enzymatic digestion. Double-antibody sandwich ELISA was used to determine group IIa sPLA2 concentrations, and sPLA2 activity was assayed using 1,2-diheptanoyl thio-phosphatidylcholine as substrate. Phospholipids concentrations in tears with Polymacon and Etafilcon A were 186 +/- 39 and 162 +/- 33 microg/mL, respectively. The latter concentration was significantly lower than that observed in the same subjects when not wearing contact lenses (P = 0.0023). In tears, both group IIa sPLA2 concentrations and enzymatic activity remained unchanged, regardless of lens wearing. However, Etafilcon A (0.57 +/- 0.09 microg/lens) showed more group IIa sPLA2 deposition than Polymacon (0.01 +/- 0.01 microg/lens; P < 0.001). Furthermore, group IIa sPLA2 deposited on Etafilcon A but not on Polymacon lenses retained its enzymatic activity. Significant differences of group IIa sPLA2 deposition were found in the 2 lenses tested. Such deposition might induce phospholipid hydrolysis in tears and thereby promote tear film instability in hydrophilic contact lens wearers.

  2. Visual Outcomes After LASIK Using Topography-Guided vs Wavefront-Guided Customized Ablation Systems.

    PubMed

    Toda, Ikuko; Ide, Takeshi; Fukumoto, Teruki; Tsubota, Kazuo

    2016-11-01

    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.

  3. Comparison of Higher Order Aberrations after Wavefront-guided LASIK and PRK: One Year Follow-Up Results.

    PubMed

    Jahadi Hosseini, Seyed Hamid Reza; Abtahi, Seyed Mohammad Bagher; Khalili, Mohammad Reza

    2016-01-01

    To evaluate the changes and predictability of higher order aberrations (HOAs) after personalized laser in situ keratomileusis (LASIK) and personalized photorefractive keratectomy (PRK) for simple myopia and compound myopic astigmatism. In this prospective cross-sectional study, 100 eyes were included. A total of 50 eyes underwent personalized LASIK and 50 eyes underwent personalized PRK. Preoperative and postoperative wavefront data were compared between the two groups. The influential factors and predictability of HOAs were also assessed. Total HOA increased in the amount of 0.01 ± 0.14 μm for the 5 mm pupil ( P = 0.55) and 0.08 ± 0.22 μm for the 6 mm pupil ( P = 0.02) after PRK; however after LASIK the corresponding values for the 5 and 6 mm pupil sizes were 0.05 ± 0.12 and 0.15 ± 0.18 μm, respectively ( P < 0. 001). Mean changes were not significantly different between the PRK and LASIK groups for both 5 and 6 mm pupil sizes ( P = 0.21 and P = 0.13, respectively). Spherical aberration increased following LASIK more than following PRK ( P < 0.001). Changes in the root mean square (RMS) of total HOA had a statistically significant negative correlation ( P < 0.001) with its preoperative value. HOA and spherical aberration reduced in majority of eyes when the preoperative spherical equivalent refraction was low. For the 6mm pupil size, the total HOA increased following both personalized PRK and LASIK with no significant difference between the two groups. Change of the total HOA RMS was influenced by the preoperative values. The known influencing factors could predict nearly 50% of the changes in total HOA.

  4. Small incision lenticule extraction (SMILE) and femtosecond laser LASIK: comparison of corneal wound healing and inflammation

    PubMed Central

    Dong, Zixian; Zhou, Xingtao; Wu, Jihong; Zhang, Zhehuan; Li, Tao; Zhou, Zimei; Zhang, Shenghai; Li, Gang

    2014-01-01

    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

  5. Health beliefs affect the correct replacement of daily disposable contact lenses: Predicting compliance with the Health Belief Model and the Theory of Planned Behaviour.

    PubMed

    Livi, Stefano; Zeri, Fabrizio; Baroni, Rossella

    2017-02-01

    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.

  6. Focus-tunable low-power electrowetting lenses with thin parylene films.

    PubMed

    Watson, Alexander M; Dease, Kevin; Terrab, Soraya; Roath, Christopher; Gopinath, Juliet T; Bright, Victor M

    2015-07-10

    Electrowetting lenses with record low power consumption (microwatts) have been demonstrated using high-quality parylene AF-4 dielectric layers and large dodecyl sulfate ions. Water and propylene glycol are interchanged as the polar liquid to enable diverging and converging lens operation achievable with the application of 15 V. The optical quality of the lenses is comparable to conventional microlenses and the tuning exhibits very little (<0.5°) contact angle hysteresis.

  7. Microbial flora of tears of orthokeratology patients, and microbial contamination of contact lenses and contact lens accessories.

    PubMed

    Boost, Maureen V; Cho, Pauline

    2005-06-01

    The purpose of this study is to determine if there are changes in the ocular flora of overnight orthokeratology (ortho-k) patients, and the levels of contamination of their lenses and lens accessories, and to correlate compliance with levels of contamination. Normal ocular flora of 41 subjects was determined twice before commencing ortho-k lens wear by culture of the lower conjunctiva. Further specimens were collected on six follow-up visits after beginning lens wear, as were samples from their lenses, cases, and suction holders. A questionnaire on lens care was administered after the fifth visit. Three subjects provided conjunctival samples yielding Staphylococcus aureus on one occasion before lens wear, one being positive for this organism after beginning lens wear. Of 38 subjects yielding no growth or only normal eye flora before use, 28 remained free of ocular pathogens after beginning lens wear. Only four subjects had positive cultures on more than one occasion after lens wear. There was no significant difference in isolation levels of pathogens with lens wear (p = 0.423). Lens culture of 54% of subjects yielded no growth or normal flora only; lenses of 16 subjects yielded potential pathogens, including three subjects contaminated on more than one occasion. Lens isolates did not match the organisms transiently colonizing the eye. Lens case, the most frequently contaminated item, was associated with lens contamination (p < 0.001), the same organism being isolated from both items in 11 subjects. Lens suction holder was less frequently contaminated. Neither lens case nor suction holder contamination was associated with isolates from the eye. Reported good compliance correlated with lack of contamination in all but one subject. The most frequent breaches in the lens care protocol were failure to clean, disinfect, and replace the lens case. Ocular flora was not altered by ortho-k lens wear over an extended period, and patients remained free of infection

  8. Anterior chamber gas bubble emergence pattern during femtosecond LASIK-flap creation.

    PubMed

    Robert, Marie-Claude; Khreim, Nour; Todani, Amit; Melki, Samir A

    2015-09-01

    To characterise the emergence pattern of cavitation bubbles into the anterior chamber (AC) following femtosecond laser-assisted in situ keratomileusis (LASIK)-flap creation Retrospective review of patients undergoing femtosecond LASIK surgery at Boston Laser, a private refractive surgery practice in Boston, Massachusetts, between December 2008 and February 2014. Patient charts were reviewed to identify all cases with gas bubble migration into the AC. Surgical videos were examined and the location of bubble entry was recorded separately for right and left eyes. Five thousand one hundred and fifty-eight patients underwent femtosecond LASIK surgery. Air bubble migration into the AC, presumably via the Schlemm's canal and trabecular meshwork, occurred in 1% of cases. Patients with AC bubbles had an average age of 33±8 years with a measured LASIK flap thickness of 96±21 μm. The occurrence of gas bubbles impaired iris registration in 64% of cases. Gas bubbles appeared preferentially in the nasal or inferior quadrants for right (92% of cases) and left (100% of cases) eyes. This bubble emergence pattern is significantly different from that expected with a random distribution (p<0.0001) and did not seem associated with decentration of the femtosecond laser docking system. The migration of gas bubbles into the AC is a rare occurrence during femtosecond laser flap creation. The preferential emergence of gas bubbles into the nasal and inferior quadrants of the AC may indicate a distinctive anatomy of the nasal Schlemm's canal. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Longitudinal Evaluation of Cornea With Swept-Source Optical Coherence Tomography and Scheimpflug Imaging Before and After Lasik

    PubMed Central

    Chan, Tommy C.Y.; Biswas, Sayantan; Yu, Marco; Jhanji, Vishal

    2015-01-01

    Abstract Swept-source optical coherence tomography (OCT) is the latest advancement in anterior segment imaging. There are limited data regarding its performance after laser in situ keratomileusis (LASIK). We compared the reliability of swept-source OCT and Scheimpflug imaging for evaluation of corneal parameters in refractive surgery candidates with myopia or myopic astigmatism. Three consecutive measurements were obtained preoperatively and 1 year postoperatively using swept-source OCT and Scheimpflug imaging. The study parameters included central corneal thickness (CCT), thinnest corneal thickness (TCT), keratometry at steep (Ks) and flat (Kf) axes, mean keratometry (Km), and, anterior and posterior best fit spheres (Ant and Post BFS). The main outcome measures included reliability of measurements before and after LASIK was evaluated using intraclass correlation coefficient (ICC) and reproducibility coefficients (RC). Association between the mean value of corneal parameters with age, spherical equivalent (SEQ), and residual bed thickness (RBT) and association of variance heterogeneity of corneal parameters and these covariates were analyzed. Twenty-six right eyes of 26 participants (mean age, 32.7 ± 6.9 yrs; mean SEQ, −6.27 ± 1.67 D) were included. Preoperatively, swept-source OCT demonstrated significantly higher ICC for Ks, CCT, TCT, and Post BFS (P ≤ 0.016), compared with Scheimpflug imaging. Swept-source OCT demonstrated significantly smaller RC values for CCT, TCT, and Post BFS (P ≤ 0.001). After LASIK, both devices had significant differences in measurements for all corneal parameters (P ≤ 0.015). Swept-source OCT demonstrated a significantly higher ICC and smaller RC for all measurements, compared with Scheimpflug imaging (P ≤ 0.001). Association of variance heterogeneity was only found in pre-LASIK Ant BFS and post-LASIK Post BFS for swept-source OCT, whereas significant association of variance heterogeneity was noted

  10. Astigmatism induced by conventional spherical ablation after PRK and LASIK in myopia with astigmatism < 1.00 D

    PubMed Central

    Christiansen, Steven M; Mifflin, Mark D; Edmonds, Jason N; Simpson, Rachel G; Moshirfar, Majid

    2012-01-01

    Background The purpose of this study was to evaluate surgically-induced astigmatism after spherical ablation in photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) for myopia with astigmatism < 1.00 D. Methods The charts of patients undergoing spherical PRK or LASIK for the correction of myopia with minimal astigmatism of <1.00 D from 2002 to 2012 at the John A Moran Eye Center in Salt Lake City, UT, were retrospectively reviewed. Astigmatism was measured by manifest refraction. The final astigmatic refractive outcome at 6 months postoperatively was compared with the initial refraction by Alpins vector analysis. Results For PRK, average cylinder increased from 0.39 ± 0.25 (0.00–0.75) preoperatively to 0.55 ± 0.48 (0.00–1.75) postoperatively (P = 0.014), compared with an increase in LASIK eyes from 0.40 ± 0.27 (0.00–0.75) preoperatively to 0.52 ± 0.45 (0.00–2.00) postoperatively (P = 0.041). PRK eyes experienced an absolute value change in cylinder of 0.41 ± 0.32 (0.00–1.50) and LASIK eyes experienced a change of 0.41 ± 0.31 (0.00–1.50, P = 0.955). Mean surgically-induced astigmatism was 0.59 ± 0.35 (0.00–1.70) in PRK eyes, with an increase in surgically-induced astigmatism of 0.44 D for each additional 1.00 D of preoperative cylinder; in LASIK eyes, mean surgically-induced astigmatism was 0.55 ± 0.32 (0.00–1.80, P = 0.482), with an increase in surgically-induced astigmatism of 0.29 D for each 1.00 D of preoperative cylinder. Conclusion Spherical ablation can induce substantial astigmatism even in eyes with less than one diopter of preoperative astigmatism in both PRK and LASIK. No significant difference in the magnitude of surgically-induced astigmatism was found between eyes treated with PRK and LASIK, although surgically-induced astigmatism was found to increase with greater levels of preoperative astigmatism in both PRK and LASIK. PMID:23277735

  11. Opaque bubble layer incidence in Femtosecond laser-assisted LASIK: comparison among different flap design parameters.

    PubMed

    Mastropasqua, Leonardo; Calienno, Roberta; Lanzini, Manuela; Salgari, Niccolò; De Vecchi, Sergio; Mastropasqua, Rodolfo; Nubile, Mario

    2017-06-01

    The purpose of this study was to evaluate the incidence of opaque bubble layer (OBL) in femtosecond laser-assisted in situ keratomileusis (LASIK) flaps created with the support of Visumax Carl Zeiss femtosecond laser, planned with different flap diameters (7.90, 8.0, and 8.20 mm) and the same laser energy and power settings. Incidence of intraoperative OBL in flaps of consecutive 108 patients (216 eyes) subjected to bilateral femtosecond-assisted LASIK was considered. Flap creation was performed with the same laser design parameters (spot distance and energy offset) and different presetting diameters of 7.90 mm (72 eyes, group 1), 8 mm (72 eyes, group 2), and 8.20 mm (72 eyes, group 3). The incidence of OBL was considered and its extension was reported measuring involvement of different four corneal flap quadrants in which was theoretically divided the entire flap area; based on these data, OBL presence was classified as none (no evidence of OBL), minimal (minimal presence in not more that one quadrants corneal flap), mild (OBL presence in almost two or three quadrants without tendency to invade central cornea), and moderate (OBL presence in almost three quadrants with tendency to invade central cornea). In group 1, the incidence of OBL was of 23.6 % (17 eyes) with a mild/moderate presence; in group 2, incidence was 20.8 % (15 eyes) with mild presence. Group 3 presented a reduced OBL incidence (4.1 %, 3 eye) with a minimal presence. No statistically significant difference was found between group 1 and 2 (p = 0.8414).We found statistically significant differences between group 1 and group 3 (p = 0.0012) and between groups 2 and 3 (p = 0.0044). A significant reduction and extension of OBL incidence were evident when LASIK flap settings diameter was increased, and flap edge was closer to the contact glass border; this is probably consequent to a more effective gas dispersion outside of corneal flap.

  12. Axis-free correction of astigmatism using bifocal soft contact lenses.

    PubMed

    Leube, Alexander; Kovats, Imre; Wahl, Siegfried; Sickenberger, Wolfgang

    2017-12-01

    Pilot study to investigate the feasibility of an axis-free correction approach of regular astigmatism using soft, bifocal contact lenses (CL). The investigation covers an optical simulation and a pilot study for the assessment of visual performance (over refraction OR, monocular visual acuity VA). The power of the two zones was adjusted according to the power of the astigmatic meridians, individually. Subjective performance was assessed in 30 participants with a mean horizontal cylindrical component of J 0 =- 0.65±1.29 D (cylinder from -0.75 to -4.00 DC). OR and VA were measured directly after fitting the CL, after one hour and after 5days (3FUP). Evaluating the modulation transfer function, CL increased the Strehl ratio by 10% and the transferred spatial frequency was improved from 6.6 cpd to 21.3 cpd. Analysis of Sturm's interval revealed a residual astigmatism of D Ast =0.73 D. OR revealed a statistically significant reduction of spherical error between baseline and all follow up (ΔM=-2.14 D, p<0.001) and between the J 0 from baseline to 3FUP (ΔJ 0 =-0.46 D, p=0.04). Wearing the CL for 5days did not result in a significant difference of VA (ΔVA 3FUP =+0.01 logMAR, p=0.99). Axis-free correction of astigmatism using bifocal CL resulted in reasonable performance based on computer simulation. Participants showed no clinically reduced visual acuity or contrast sensitivity. Further clinical studies are needed to show if this approach provides a good alternative to conventional astigmatic correction. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  13. Corneal collagen cross-linking in the stabilization of PRK, LASIK, thermal keratoplasty, and orthokeratology.

    PubMed

    Nguyen, Michelle K; Chuck, Roy S

    2013-07-01

    To describe the use of corneal collagen cross-linking (CXL) and its efficacy in the stabilization of keratorefractive procedures, including PRK, laser in-situ keratomileusis (LASIK), thermal keratoplasty, and orthokeratology. Since its introduction, CXL has quickly gained interest in the treatment of ectactic disorders due to its ability to increase the biomechanical stability of the cornea. In its earliest use, it has shown to be effective in the treatment of both keratoconus and post-LASIK ectasia. More recent studies of CXL in combination with keratorefractive procedures have shown varying degrees of success. CXL with PRK has shown to be effective in slowing or halting the progression of keratoconus, pellucid marginal degeneration, and post-LASIK ectasia, in addition to potentially decreasing or delaying the need for penetrating keratoplasty. Several small case series have also demonstrated improved stability and efficacy of PRK and LASIK when combined with CXL, as well as a potentially decreased risk of postprocedure ectasia. In conjunction with thermokeratoplasty and orthokeratology, CXL has shown improved but only temporary results in the treatment of keratoconus. Future studies are needed to determine the efficacy and long-term stability of CXL in combination with keratorefractive procedures, as well as to address possible complications.

  14. Restrictions of the sale of pharmaceuticals and medical devices such as contact lenses over the internet and the free movement of goods.

    PubMed

    de Sadeleer, Nicolas

    2012-03-01

    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.

  15. Comparison of Higher Order Aberrations after Wavefront-guided LASIK and PRK: One Year Follow-Up Results

    PubMed Central

    Jahadi Hosseini, Seyed Hamid Reza; Abtahi, Seyed Mohammad Bagher; Khalili, Mohammad Reza

    2016-01-01

    Purpose: To evaluate the changes and predictability of higher order aberrations (HOAs) after personalized laser in situ keratomileusis (LASIK) and personalized photorefractive keratectomy (PRK) for simple myopia and compound myopic astigmatism. Methods: In this prospective cross-sectional study, 100 eyes were included. A total of 50 eyes underwent personalized LASIK and 50 eyes underwent personalized PRK. Preoperative and postoperative wavefront data were compared between the two groups. The influential factors and predictability of HOAs were also assessed. Result: Total HOA increased in the amount of 0.01 ± 0.14 μm for the 5 mm pupil (P = 0.55) and 0.08 ± 0.22 μm for the 6 mm pupil (P = 0.02) after PRK; however after LASIK the corresponding values for the 5 and 6 mm pupil sizes were 0.05 ± 0.12 and 0.15 ± 0.18 μm, respectively (P < 0. 001). Mean changes were not significantly different between the PRK and LASIK groups for both 5 and 6 mm pupil sizes (P = 0.21 and P = 0.13, respectively). Spherical aberration increased following LASIK more than following PRK (P < 0.001). Changes in the root mean square (RMS) of total HOA had a statistically significant negative correlation (P < 0.001) with its preoperative value. HOA and spherical aberration reduced in majority of eyes when the preoperative spherical equivalent refraction was low. Conclusion: For the 6mm pupil size, the total HOA increased following both personalized PRK and LASIK with no significant difference between the two groups. Change of the total HOA RMS was influenced by the preoperative values. The known influencing factors could predict nearly 50% of the changes in total HOA. PMID:27994802

  16. Silicone derivatives for contact lenses: functionalization, chemical characterization, and cell compatibility assessment.

    PubMed

    Migonney, V; Lacroix, M D; Ratner, B D; Jozefowicz, M

    1995-01-01

    Epoxy ring-opening functionalization of polymers at random sites along chains with various chemical groups has been demonstrated. The reaction is performed in an aqueous solution under mild conditions in order to minimize degradation of the macromolecular chains. Silicone lenses made of copolymers with epoxy side chains were functionalized with 4-hydroxybutyric acid, sodium salt. The carboxylated silicone derivatives were characterized by ESCA and radiotracers. A mean value of 30% reaction yield was concluded, based upon data from both methods; nevertheless, the latter can be improved up to 50% or more if the conditions of preparation of the epoxydized silicone lenses are optimized. Derivatized silicones were coated in the wells of culture plates to evaluate the cell compatibility of these new polymers with a fibroblast cell line (McCoy's). No cellular toxicity was observed.

  17. Contact Lens Anterior Surface pH

    DTIC Science & Technology

    1991-02-01

    greenhouse effect and contact lenses, in Trans- 4. Nom MS: Tear fluid pH in normals, contact lens wearers, actions of the British Contact Lens...Invest 3. Fullard R), Carney LG: Diurnal variation in human tear en- Op/hdanmol Vis Sci 1978;17:810-813. ymes. Exp Eye Res 1984;38:15-26. 20. Efron N: The

  18. Finite element analysis of blunt foreign body impact on the cornea after PRK and LASIK.

    PubMed

    Mousavi, Seyed Jamaleddin; Nassiri, Nariman; Masoumi, Nafiseh; Nassiri, Nader; Majdi-N, Mercede; Farzaneh, Solmaz; Djalilian, Ali R; Peyman, Gholam A

    2012-01-01

    To investigate the effect of blunt foreign body impact on a human cornea after photorefractive keratectomy (PRK) and LASIK using a simulation model. Computational simulations were performed using a finite element analysis program (LS-Dyna, Livermore Software Technology Corp). The blunt foreign body was set to impact at the center of the corneal surface models (after PRK and LASIK) with thicknesses of 500, 450, 400, 350, and 300 μm. Corneal rupture was assumed to occur at a peak stress of 9.45 MPa and at a strain of 18%. The foreign body projectile was blunt in shape, made from aluminum, contained plastic-kinematic properties, and had a density of 2700 kg/m(3). The projectile was launched at the center of the cornea with velocities ranging from 20 to 60 m/s. The threshold of impact velocities creating rupture in corneal thicknesses of 500, 450, 400, 350, and 300 μm were 33, 32.8, 30.7, 27.9, and 22.8 m/s, respectively, in the PRK model. In the LASIK model, the thresholds creating rupture in the stromal bed of the corneas with thicknesses of 500, 450, 400, 350, and 300 μm were 40, 38.1, 35.6, 31.5, and 26.7 m/s, respectively. The 110-μm corneal flap in the LASIK model ruptured at all velocities. Ruptures occurred at lower velocities in the PRK cornea model than in the corneal stromal bed of the LASIK model following blunt foreign body impact. Copyright 2012, SLACK Incorporated.

  19. The role of type III secretion system and lens material on adhesion of Pseudomonas aeruginosa to contact lenses.

    PubMed

    Shen, Elizabeth P; Tsay, Ruey-Yug; Chia, Jean-San; Wu, Semon; Lee, Jing-Wen; Hu, Fung-Rong

    2012-09-21

    To determine the distribution of invasive and cytotoxic genotypes among ocular isolates of P. aeruginosa and investigate the influence of the type III secretion system (T3SS) on adhesion to conventional, cosmetic, and silicone hydrogel contact lenses (CL). Clinical isolates from 2001 to 2010 were analyzed by multiplex PCR for exoS, exoU, and exoT genes. Bacterial adhesion to etafilcon, nelfilcon (gray colored), balafilcon, and galyfilcon CL with or without artificial tear fluid (ATF) incubation were compared. Surface characteristics were determined with scanning electron microscopy (SEM). Among 87 total isolates, 64 strains were from microbial keratitis cases. CL-related microbial keratitis (CLMK) isolates were mostly of the cytotoxic genotype (expressing exoU) (P = 0.002). No significant differences were found in bacterial adhesion to all types of CL between the genotypes under T3SS-inducing conditions. A trend for least bacterial adhesion of galyfilcon compared to the other CL was noted for both genotypes. Needle complex pscC mutants adhered less to all materials than the wild type (P < 0.05), indicating a role of the T3SS in contact lens adhesion. ATF-incubated CL had significantly more bacterial adhesion (P < 0.05). SEM showed most of the bacteria adhering on CL surfaces. CLMK isolates were mostly of cytotoxic genotype. Different genotypes did not significantly differ in its adhesion to various CL. T3SS and other adhesins are involved in bacteria-contact lens adhesion through complex interactions. Contact lens materials may also play an important role in the adherence of both genotypes of P. aeruginosa.

  20. Slit lamps and lenses: a potential source of nosocomial infections?

    PubMed

    Sobolewska, Bianka; Buhl, Michael; Liese, Jan; Ziemssen, Focke

    2018-01-30

    The aim of the study was to evaluate the bacterial contamination level of contact surfaces on slit lamps and the grip areas of lenses. Within unannounced audits, two regions of the slit lamps (headrest and joystick), indirect ophthalmoscopy devices, and ultrasound probes were obtained with rayon-tipped swab. Non-contact lenses used for indirect fundoscopy were pressed on RODAC (Replicate Organism Detection and Counting) plates. One hundred and eighty-one surfaces were sampled. The total number of colony-forming units was assessed and bacterial species were identified. Spa-typing and antimicrobial susceptibility testing were performed from Staphylococcus aureus isolates. Among the total bacterial isolates from ophthalmological equipment (lenses: 51 of 78, slit lamps: 43 of 88, ophthalmoscopy helmets: 3 of 8, ultrasound probes: 2 of 7), coagulase-negative staphylococci (CNS) was most frequently found, followed by Micrococcus spp. (lenses vs. slit lamps: P < 0.001 and P = 0.01, respectively). The bacterial contamination of lenses (76%) was significantly higher than that of slit lamps (54%) (P < 0.003). A significantly higher contamination with CNS was observed on lenses from residents vs. from consultants (78% vs. 35%, P = 0.01). A total of seven different spa-types of S. aureus were isolated. No correlation was found between S. aureus contamination of different ophthalmological equipments (Spearman's rank correlation coefficient, ρ = 0.04, P = 0.75). Methicillin-resistant S. aureus was not detected. Bacterial species of the normal skin flora were isolated from the ophthalmological equipment. The bacterial contamination of the portable devices was significantly higher than that of slit lamps. Therefore, proper hygiene of the mobile instruments should be monitored in order to prevent transmission of bacteria in residents and consultants.

  1. Mathematical model to compare the relative tensile strength of the cornea after PRK, LASIK, and small incision lenticule extraction.

    PubMed

    Reinstein, Dan Z; Archer, Timothy J; Randleman, J Bradley

    2013-07-01

    To develop a mathematical model to estimate the relative differences in postoperative stromal tensile strength following photorefractive keratectomy (PRK), LASIK, and small incision lenticule extraction (SMILE). Using previously published data where in vitro corneal stromal tensile strength was determined as a function of depth, a mathematical model was built to calculate the relative remaining tensile strength by fitting the data with a fourth order polynomial function yielding a high correlation coefficient (R(2) = 0.930). Calculating the area under this function provided a measure of total stromal tensile strength (TTS), based only on the residual stromal layer for PRK or LASIK and the residual stromal layers above and below the lenticule interface for SMILE. Postoperative TTS was greatest after SMILE, followed by PRK, then LASIK; for example, in a 550-μm cornea after 100-μm tissue removal, postoperative TTS was 75% for SMILE (130-μm cap), 68% for PRK, and 54% for LASIK (110-μm flap). The postoperative TTS decreased for thinner corneal pachymetry for all treatment types. In LASIK, the postoperative TTS decreased with increasing flap thickness by 0.22%/μm, but increased by 0.08%/μm for greater cap thickness in SMILE. The model predicted that SMILE lenticule thickness could be approximately 100 μm greater than the LASIK ablation depth and still have equivalent corneal strength (equivalent to approximately 7.75 diopters). This mathematical model predicts that the postoperative TTS is considerably higher after SMILE than both PRK and LASIK, as expected given that the strongest anterior lamellae remain intact. Consequently, SMILE should be able to correct higher levels of myopia. Copyright 2013, SLACK Incorporated.

  2. Kinetics of Competitive Adsorption between Lysozyme and Lactoferrin on Silicone Hydrogel Contact Lenses and the Effect on Lysozyme Activity.

    PubMed

    Hall, Brad; Jones, Lyndon; Forrest, James A

    2015-05-01

    To determine the effect of competitive adsorption between lysozyme and lactoferrin on silicone hydrogel contact lenses and the effect on lysozyme activity. Three commercially available silicone hydrogel contact lens materials (senofilcon A, lotrafilcon B and balafilcon A) were examined, for time points ranging from 10 s to 2 h. Total protein deposition was determined by I(125) radiolabeling of lysozyme and lactoferrin, while the activity of lysozyme was determined by a micrococcal activity assay. Senofilcon A and balafilcon A did not show any relevant competitive adsorption between lysozyme and lactoferrin. Lotrafilcon B showed reduced protein deposition due to competitive adsorption for lactoferrin at all time points and lysozyme after 7.5 min. Co-adsorption of lactoferrin and lysozyme decreased the activity of lysozyme in solution for senofilcon A and lotrafilcon B, but co-adsorption had no effect on the surface activity of lysozyme for all lens types investigated. Competition between lysozyme and lactoferrin is material specific. Co-adsorption of lysozyme and lactoferrin does not affect the activity of surface-bound lysozyme but can reduce the activity of subsequently desorbed lysozyme.

  3. Sustained Ocular Delivery of Ciprofloxacin Using Nanospheres and Conventional Contact Lens Materials

    PubMed Central

    Garhwal, Rahul; Shady, Sally F.; Ellis, Edward J.; Ellis, Jeanne Y.; Leahy, Charles D.; McCarthy, Stephen P.; Crawford, Kathryn S.

    2012-01-01

    Purpose. To formulate conventional contact lenses that incorporate nanosphere-encapsulated antibiotic and demonstrate that the lenses provide for sustained antibacterial activity. Methods. A copolymer composed of pullulan and polycaprolactone (PCL) was used to synthesize core-shell nanospheres that encapsulated ciprofloxacin. Bactericidal activity of the nanosphere-encapsulated ciprofloxacin (nanosphere/cipro) was tested by using liquid cultures of either Staphylococcus aureus or Pseudomonas aeruginosa. Nanosphere/cipro was then incorporated into HEMA-based contact lenses that were tested for growth inhibition of S. aureus or P. aeruginosa in liquid cultures inoculated daily with fresh bacteria. Lens designs included thin or thick lenses incorporating nanosphere/cipro and ciprofloxacin-HCl-soaked Acuvue lenses (Acuvue; Johnson & Johnson Vision Care, Inc., Jacksonville, FL). Results. Less than 2 μg/mL of nanosphere/cipro effectively inhibited the proliferation of cultures inoculated with 107 or 108 bacteria/mL of S. aureus and P. aeruginosa, respectively. HEMA-based contact lenses polymerized with nanosphere/cipro were transparent, effectively inhibited the proliferation of greater than 107/mL of bacteria added daily over 3 days of culture, and killed up to 5 × 109 total microbes in a single inoculation. A thicker lens design provided additional inhibition of bacterial growth for up to 96 hours. Conclusions. Core-shell nanospheres loaded with an antibiotic can be incorporated into a conventional, transparent contact lens and provide for sustained and effective bactericidal activity and thereby provide a new drug delivery platform for widespread use in treating ocular disorders. PMID:22266514

  4. Knowledge, usage and barriers associated with contact lens wear in Ghana.

    PubMed

    Abokyi, Samuel; Manuh, George; Otchere, Heinz; Ilechie, Alex

    2017-10-01

    Despite findings that contact lens wear for vision correction provides better quality of life than spectacles, contact lens use in developing countries is low. This study evaluated knowledge, usage and barriers associated with contact lens wear among spectacle wearers in Cape Coast, Ghana. A cross-sectional survey using a structured questionnaire was conducted on an adult population of spectacle wearers to assess their knowledge of contact lens wear for vision correction. The participants were proportionately sampled from three eye clinics in the Cape Coast Metropolis, Ghana. Questionnaires were either self-administered or completed with the help of a research assistant. Of the 422 participants, only 147 (34.8%) knew of contact lens wear for vision correction. The proportion of spectacle wearers reporting history of contact lens wear was 14 (3.3%). Barriers to contact lens wear reported were satisfaction with vision through spectacles 102 (25.0%), lack of adequate information 111 (27.2%), fear of side effects 94 (23.0%) and cost 78 (19.1%). The younger adults and those with higher number of changes of spectacles were more likely to know of contact lenses. Knowledge and usage of contact lenses among spectacle wearers was low. Contact lens education and demonstration of visual performance through fitting of trial contact lenses on potential candidates may help overcome barriers to contact lens wear. Published by Elsevier Ltd.

  5. High-efficency stable 213-nm generation for LASIK application

    NASA Astrophysics Data System (ADS)

    Wang, Zhenglin; Alameh, Kamal; Zheng, Rong

    2005-01-01

    213nm Solid-state laser technology provides an alternative method to replace toxic excimer laser in LASIK system. In this paper, we report a compact fifth harmonic generation system to generate high pulse energy 213nm laser from Q-switched Nd:YAG laser for LASIK application based on three stages harmonic generation procedures. A novel crystal housing was specifically designed to hold the three crystals with each crystal has independent, precise angular adjustment structure and automatic tuning control. The crystal temperature is well maintained at ~130°C to improve harmonic generation stability and crystal operation lifetime. An output pulse energy 35mJ is obtained at 213nm, corresponding to total conversion efficiency ~10% from 1064nm pump laser. In system verification tests, the 213nm output power drops less than 5% after 5 millions pulse shots and no significant damage appears in the crystals.

  6. Fungal Keratitis Due to Beauveria bassiana in a Contact Lenses Wearer and Review of Published Reports.

    PubMed

    Lara Oya, Ana; Medialdea Hurtado, María Eloisa; Rojo Martín, María Dolores; Aguilera Pérez, Antonia; Alastruey-Izquierdo, Ana; Miranda Casas, Consuelo; Rubio Prats, Marina; Medialdea Marcos, Santiago; Navarro Marí, José María

    2016-10-01

    Fungal keratitis is a severe ocular infection that primarily affects subjects engaged in outdoor activities. Risk factors include allergic conjunctivitis, previous eye surgery, previous treatment with wide-spectrum antimicrobial agents and corticosteroids and using contact lenses. Corneal infection is usually secondary to trauma involving organic material, which is often the only predisposing factor. Early diagnosis based on clinical examination and microbiological investigation (microscopy, cultures and molecular techniques) is crucial to selecting the appropriate antifungal therapy and prevent progression. We report the case of a patient with keratitis due to Beauveria bassiana, an opportunistic and entomopathogenic filamentous fungus that is used as a biological insecticide and which is a rare cause of corneal infection. We review previous cases reports of B. bassiana keratitis published and its main features to compare with our case, a female occasional agriculture worker who had not suffered any trauma involving organic material. The patient received topical and oral antifungal therapy and debridement surgery, with a satisfactory outcome.

  7. The influence of lens power and center thickness on the intraocular pressure measured through soft lenses: a comparison of two noncontact tonometers.

    PubMed

    Ogbuehi, Kelechi C

    2012-06-01

    To quantify the influence of soft contact lens power and thickness on the intraocular pressure (IOP). Thirty-nine young, healthy adult volunteers completed this study. One eye of each subject was randomly assigned either a +6D or a -6D high water content daily disposable lens. The other eye was fitted with the second lens. Triplicate measurements of IOP were taken before, during, and after contact lens wear. Each time, IOP was assessed in a randomized order with two noncontact tonometers. The lenses were swapped between eyes during a second session of measurements, one week later. In the first session with the +6D lenses, the average IOPs (±SDs) before, with the lenses fitted, and after the lenses were removed, were: 14.3 ± 2.9 mmHg, 17.0 ± 3.3 mmHg and 13.9 ± 3.1 mmHg, respectively, for the CT80 and 13.6 ± 3.1 mmHg, 17.1 ± 4.5 mmHg and 13.3 ± 2.9 mmHg, respectively, for the PT100. The corresponding values for the first session with the -6D lenses were: 14.3 ± 3.1 mmHg, 13.1 ± 3.1 mmHg and 14.1 ± 3.3 mmHg, respectively, for the CT80 and 13.6 ± 3.2 mmHg, 13.0 ± 3.0 mmHg and 13.6 ± 3.2 mmHg, respectively, for the PT100. IOP significantly (P<0.05) increased (+ΔIOP=2.7 ± 0.4 mmHg with the CT80 in the first session) with the +6D lenses, but decreased (P<0.05) when the -6D lenses were fitted (-ΔIOP=0.6 ± 0.2 mmHg with the PT100 in the first session). The soft contact lens-induced changes were consistent between sessions but varied between tonometers. The measurement of IOP through soft contact lenses resulted in consistent, statistically significant differences in IOP, which were not uniform across tonometers and which did not appear to be solely related to the central thickness of the soft contact lenses. Copyright © 2012 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  8. Contact-eutectic-lens fabrication technique

    NASA Technical Reports Server (NTRS)

    Allen, F. G.; Yue, A. S.; Yu, J. G.

    1975-01-01

    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.

  9. The effect of multifocal soft contact lenses on peripheral refraction.

    PubMed

    Kang, Pauline; Fan, Yvonne; Oh, Kelly; Trac, Kevin; Zhang, Frank; Swarbrick, Helen A

    2013-07-01

    To compare changes in peripheral refraction with single-vision (SV) and multifocal (MF) correction of distance central refraction with commercially available SV and MF soft contact lenses (SCLs) in young myopic adults. Thirty-four myopic adult subjects were fitted with Proclear Sphere and Proclear Multifocal SCLs to correct their manifest central refractive error. Central and peripheral refraction were measured with no lens wear and subsequently with the two different types of SCL correction. At baseline, refraction was myopic at all locations along the horizontal meridian. Peripheral refraction was relatively hyperopic compared with center at 30 and 35 degrees in the temporal visual field (VF) in low myopes, and at 30 and 35 degrees in the temporal VF, and 10, 30, and 35 degrees in the nasal VF in moderate myopes. Single-vision and MF distance correction with Proclear Sphere and Proclear Multifocal SCLs, respectively, caused a hyperopic shift in refraction at all locations in the horizontal VF. Compared with SV correction, MF SCL correction caused a significant relative myopic shift at all locations in the nasal VF in both low and moderate myopes and also at 35 degrees in the temporal VF in moderate myopes. Correction of central refractive error with SV and MF SCLs caused a hyperopic shift in both central and peripheral refraction at all positions in the horizontal meridian. Single-vision SCL correction caused the peripheral retina, which initially experienced absolute myopic defocus at baseline with no correction to experience an absolute hyperopic defocus. Multifocal SCL correction resulted in a relative myopic shift in peripheral refraction compared with SV SCL correction. This myopic shift may explain recent reports of reduced myopia progression rates with MF SCL correction.

  10. Effect of single vision soft contact lenses on peripheral refraction.

    PubMed

    Kang, Pauline; Fan, Yvonne; Oh, Kelly; Trac, Kevin; Zhang, Frank; Swarbrick, Helen

    2012-07-01

    To investigate changes in peripheral refraction with under-, full, and over-correction of central refraction with commercially available single vision soft contact lenses (SCLs) in young myopic adults. Thirty-four myopic adult subjects were fitted with Proclear Sphere SCLs to under-correct (+0.75 DS), fully correct, and over-correct (-0.75 DS) their manifest central refractive error. Central and peripheral refraction were measured with no lens wear and subsequently with different levels of SCL central refractive error correction. The uncorrected refractive error was myopic at all locations along the horizontal meridian. Peripheral refraction was relatively hyperopic compared to center at 30 and 35° in the temporal visual field (VF) in low myopes and at 30 and 35° in the temporal VF and 10, 30, and 35° in the nasal VF in moderate myopes. All levels of SCL correction caused a hyperopic shift in refraction at all locations in the horizontal VF. The smallest hyperopic shift was demonstrated with under-correction followed by full correction and then by over-correction of central refractive error. An increase in relative peripheral hyperopia was measured with full correction SCLs compared with no correction in both low and moderate myopes. However, no difference in relative peripheral refraction profiles were found between under-, full, and over-correction. Under-, full, and over-correction of central refractive error with single vision SCLs caused a hyperopic shift in both central and peripheral refraction at all positions in the horizontal meridian. All levels of SCL correction caused the peripheral retina, which initially experienced absolute myopic defocus at baseline with no correction, to experience absolute hyperopic defocus. This peripheral hyperopia may be a possible cause of myopia progression reported with different types and levels of myopia correction.

  11. Interface fluid syndrome in human eye bank corneas after LASIK: causes and pathogenesis.

    PubMed

    Dawson, Daniel G; Schmack, Ingo; Holley, Glenn P; Waring, George O; Grossniklaus, Hans E; Edelhauser, Henry F

    2007-10-01

    To evaluate the effects of corneal edema on human donor corneas that had previous LASIK using a laboratory model with histologic and ultrastructural correlations. Experimental study. Thirty human eye bank corneas from 15 donors (mean age +/- standard deviation, 49.9+/-8.9 years) who had had previous LASIK surgery (2-8 years before death). The corneas were mounted in an artificial anterior chamber and the corneal endothelium was perfused for up to 5.0 hours with 0.9% saline solution (endothelial cell damage group) or BSS Plus at a pressure of 15 mmHg (control group), or BSS Plus at a pressure of 55 mmHg (high-pressure group). The corneas were evaluated by confocal and specular microscopy before, during, and at the end of the experimental period. Subsequently, the specimens were evaluated by light and electron microscopy. Corneal thickness, reflectivity, histology, and ultrastructure. Endothelial cell damage resulted in an increased (141.5+/-38.8 microm) total corneal thickness relative to controls (52.3+/-33.7 microm), whereas high pressure resulted in a decreased thickness (24.8+/-14.1 microm) relative to controls. This ultimately was due to swelling of the LASIK interface in both groups and swelling of the residual stromal bed (RSB) in the endothelial cell damage group or compression of the RSB and, possibly, the flap in the high-pressure group. A significant increase in corneal reflectivity at the LASIK interface occurred in both groups, primarily due to varying degrees of fluid accumulation and associated hydropic keratocyte degeneration, as well as increased corneal reflectivity in the RSB only in the endothelial cell damage group. After LASIK surgery, edematous corneas preferentially hydrate and swell in the paracentral and central interface wound, commonly resulting in a hazy corneal appearance primarily due to keratocyte hydropic degeneration. More severe corneal edema is characterized by the formation of an optically empty space corresponding to an

  12. Measuring patient's expectation and the perception of quality in LASIK services.

    PubMed

    Lin, Deng-Juin; Sheu, Ing-Cheau; Pai, Jar-Yuan; Bair, Alex; Hung, Che-Yu; Yeh, Yuan-Hung; Chou, Ming-Jen

    2009-07-10

    LASIK is the use of excimer lasers to treat therapeutic and refractive visual disorders, ranging from superficial scars to nearsightedness (myopia), and from astigmatism to farsightedness (hyperopia). The purposes of this study are to checking the applicability and psychometric properties of the SERVQUAL on Lasik surgery population. Second, use SEM methods to investigate the loyalty, perceptions and expectations relationship on LASIK surgery. The method with which this study was conducted was questionnaire development. A total of 463 consecutive patients, attending LASIK surgery affiliated with Chung Shan Medical University Eye Center, enrolled in this study. All participants were asked to complete revised SERVQUAL questionnaires. Student t test, correlation test, and ANOVA and factor analyses were used to identify the characters and factors of service quality. Paired t test were used to test the gap between expectation and perception scores and structural equation modeling was used to examine relationships among satisfaction components. The effective response rate was 97.3%. Validity was verified by several methods and internal reliability Cronbach's alpha was > 0.958. The results from patient's scores were very high with an overall score of 6.41(0.66), expectations at 6.68(0.47), and perceptions at 6.51(0.57). The gap between expectations and perceptions was significant, however, (t = 6.08). Furthermore, there were significant differences in the expectation scores among the different jobs. Also, the results showed that the higher the education of the patient, the lower their perception score (r = -0.10). The factor loading results of factor analysis showed 5 factors of the 22 items of the SERVQUAL model. The 5 factors of perception explained 72.94% of the total variance there; and on expectations it explained 77.12% of the total variance of satisfaction scores.The goodness-of-fit summary, of structure equation modeling, showed trends in concept on expectations

  13. Measuring patient's expectation and the perception of quality in LASIK services

    PubMed Central

    Lin, Deng-Juin; Sheu, Ing-Cheau; Pai, Jar-Yuan; Bair, Alex; Hung, Che-Yu; Yeh, Yuan-Hung; Chou, Ming-Jen

    2009-01-01

    Background LASIK is the use of excimer lasers to treat therapeutic and refractive visual disorders, ranging from superficial scars to nearsightedness (myopia), and from astigmatism to farsightedness (hyperopia). The purposes of this study are to checking the applicability and psychometric properties of the SERVQUAL on Lasik surgery population. Second, use SEM methods to investigate the loyalty, perceptions and expectations relationship on LASIK surgery. Methods The method with which this study was conducted was questionnaire development. A total of 463 consecutive patients, attending LASIK surgery affiliated with Chung Shan Medical University Eye Center, enrolled in this study. All participants were asked to complete revised SERVQUAL questionnaires. Student t test, correlation test, and ANOVA and factor analyses were used to identify the characters and factors of service quality. Paired t test were used to test the gap between expectation and perception scores and structural equation modeling was used to examine relationships among satisfaction components. Results The effective response rate was 97.3%. Validity was verified by several methods and internal reliability Cronbach's alpha was > 0.958. The results from patient's scores were very high with an overall score of 6.41(0.66), expectations at 6.68(0.47), and perceptions at 6.51(0.57). The gap between expectations and perceptions was significant, however, (t = 6.08). Furthermore, there were significant differences in the expectation scores among the different jobs. Also, the results showed that the higher the education of the patient, the lower their perception score (r = -0.10). The factor loading results of factor analysis showed 5 factors of the 22 items of the SERVQUAL model. The 5 factors of perception explained 72.94% of the total variance there; and on expectations it explained 77.12% of the total variance of satisfaction scores. The goodness-of-fit summary, of structure equation modeling, showed trends

  14. Surface modification of model hydrogel contact lenses with hyaluronic acid via thiol-ene "click" chemistry for enhancing surface characteristics.

    PubMed

    Korogiannaki, Myrto; Zhang, Jianfeng; Sheardown, Heather

    2017-10-01

    Discontinuation of contact lens wear as a result of ocular dryness and discomfort is extremely common; as many as 26% of contact lens wearers discontinue use within the first year. While patients are generally satisfied with conventional hydrogel lenses, improving on-eye comfort continues to remain a goal. Surface modification with a biomimetic, ocular friendly hydrophilic layer of a wetting agent is hypothesized to improve the interfacial interactions of the contact lens with the ocular surface. In this work, the synthesis and characterization of poly(2-hydroxyethyl methacrylate) surfaces grafted with a hydrophilic layer of hyaluronic acid are described. The immobilization reaction involved the covalent attachment of thiolated hyaluronic acid (20 kDa) on acrylated poly(2-hydroxyethyl methacrylate) via nucleophile-initiated Michael addition thiol-ene "click" chemistry. The surface chemistry of the modified surfaces was analyzed by Fourier transform infrared spectroscopy-attenuated total reflectance and X-ray photoelectron spectroscopy. The appearance of N (1s) and S (2p) peaks on the low resolution X-ray photoelectron spectroscopy spectra confirmed successful immobilization of hyaluronic acid. Grafting hyaluronic acid to the poly(2-hydroxyethyl methacrylate) surfaces decreased the contact angle, the dehydration rate, and the amount of nonspecific sorption of lysozyme and albumin in comparison to pristine hydrogel materials, suggesting the development of more wettable surfaces with improved water-retentive and antifouling properties, while maintaining optical transparency (>92%). In vitro testing also showed excellent viability of human corneal epithelial cells with the hyaluronic acid-grafted poly(2-hydroxyethyl methacrylate) surfaces. Hence, surface modification with hyaluronic acid via thiol-ene "click" chemistry could be useful in improving contact lens surface properties, potentially alleviating symptoms of contact lens related dryness and discomfort during

  15. Outcomes of photorefractive keratectomy enhancement after LASIK.

    PubMed

    Lee, Bryan S; Gupta, Preeya K; Davis, Elizabeth A; Hardten, David R

    2014-08-01

    To report the outcomes of photorefractive keratectomy (PRK) enhancement after LASIK for patients diagnosed as having hyperopic and myopic refractive errors. In this retrospective case series at a single private practice in the United States, all patients undergoing PRK enhancement after LASIK were identified. Patients with visually significant cataract, non-plano targets, and follow-up of fewer than 226 days were excluded. The primary outcome measure was uncorrected distance visual acuity (UDVA) with secondary measures of corrected distance visual acuity (CDVA) and postoperative refractive error. Linear regression analysis was performed for actual versus targeted change in spherical equivalent. Mean UDVA improved from 20/39 to 20/24 for hyperopes (n = 14; P < .002) and from 20/45 to 20/22 for myopes (n = 29; P < .0000001) after enhancement. All patients had a UDVA of 20/40 or better at their most recent follow-up visit. Fifty percent of hyperopes and 65.5% of myopes were 20/20 or better. The mean refractive error for hyperopes changed from +1.10 ± 0.71 (range: +0.13 to +2.25 diopters [D]) to +0.38 ± 0.66 D (range: -0.75 to +1.38 D) and from -1.21 ± 0.61 (range: -3.25 to -0.38 D) to +0.34 ± 0.45 D (range: -0.25 to +1.75 D) for myopes. The manifest refraction cylinder decreased from 0.84 to 0.46 D in hyperopes (P = .02) and from 0.64 to 0.26 D in myopes (P < .002). CDVA was maintained in both groups, with only one patient in each worse than 20/20. There was a nonsignificant trend toward less haze in the patients receiving mitomycin C (5.1% vs 25%, P = .14). Linear regression showed a tendency toward overtreatment in the myopic group. PRK is safe and highly effective for patients who previously underwent LASIK and in whom the surgeon would prefer not to perform a flap-lift enhancement. Copyright 2014, SLACK Incorporated.

  16. PALS, MIR and UV-vis-NIR spectroscopy studies of pHEMA hydrogel, silicon- and fluoro-containing contact lens materials

    NASA Astrophysics Data System (ADS)

    Filipecka, Katarzyna; Budaj, Mariusz; Chamerski, Kordian; Miedziński, Rafał; Sitarz, Maciej; Miskowiak, Bogdan; Makowska-Janusik, Małgorzata; Filipecki, Jacek

    2017-11-01

    Studies on polymeric materials used in contactology for manufacturing of contact lenses are presented in the paper. Different types of brand new contact lenses were investigated: hydrogel, silicone-hydrogel and rigid gas permeable. Positron annihilation lifetime spectroscopy (PALS) was used to characterize geometrical sizes and fraction of the free volume holes in the investigated samples. Measurements reveal significant differences between the materials. Namely differences in size and fraction of free volume were observed. These changes are strongly correlated with oxygen permeability in contact lenses. Middle infrared (MIR) spectroscopy was carried out in order to investigate the internal structure of materials. Furthermore, UV-vis-NIR studies were performed in order to determine the transmittance properties of contact lenses.

  17. Contrasting cellular damage after Blue-IRIS and Femto-LASIK in cat cornea.

    PubMed

    Wozniak, Kaitlin T; Elkins, Noah; Brooks, Daniel R; Savage, Daniel E; MacRae, Scott; Ellis, Jonathan D; Knox, Wayne H; Huxlin, Krystel R

    2017-12-01

    Blue-intra-tissue refractive index shaping (Blue-IRIS) is a new approach to laser refractive correction of optical aberrations in the eye, which alters the refractive index of the cornea rather than changing its shape. Before it can be implemented in humans, it is critical to establish whether and to what extent, Blue-IRIS damages the cornea. Here, we contrasted the impact of -1.5 D cylinder refractive corrections inscribed using either Blue-IRIS or femtosecond laser in-situ keratomileusis (femto-LASIK) on corneal cell viability. Blue-IRIS was used to write a -1.5 D cylinder gradient index (GRIN) lens over a 2.5 mm by 2.5 mm area into the mid-stromal region of the cornea in six freshly-enucleated feline eyes. The same correction (-1.5 D cylinder) was inscribed into another four cat eyes using femto-LASIK. Six hours later, all corneas were processed for histology and stained for terminal deoxynucleotidyl transferase-mediated dUTP-digoxigenin nick end labeling (TUNEL) and p-γ-H2AX to label damaged cells. In Blue-IRIS-treated corneas, no tissue was removed and TUNEL-stained cells were confined to the laser focal zone in the stroma. In femto-LASIK, photoablation removed 14 μm of anterior stroma, but in addition, TUNEL-positive cells clustered across the femto-flap, the epithelium at the flap edges and the stroma below the ablation zone. Keratocytes positive for p-γ-H2AX were seen adjacent to all Blue-IRIS focal zones, but were completely absent from femto-LASIK-treated corneas. Unlike femto-LASIK, Blue-IRIS attains refractive correction in the cornea without tissue removal and only causes minimal, localized keratocyte death within the laser focal zones. In addition, Blue-IRIS induced DNA modifications associated with phosphorylation of γ-H2AX in keratocytes adjacent to the laser focal zones. We posit that this p-γ-H2AX response is related to alterations in chromatin structure caused by localized changes in osmolarity, a possible mechanism for the induced

  18. Acanthamoeba keratitis in Scotland: risk factors for contact lens wearers.

    PubMed

    Seal, D V; Kirkness, C M; Bennett, H G; Peterson, M

    1999-01-01

    To investigate risk factors for Acanthamoeba keratitis amongst contact lens wearers in Scotland. Patients with Acanthamoeba keratitis in the Scottish study, all of whom wore contact lenses, were compared with 46 healthy asymptomatic contact lens-wearing controls. They were all visited at home for contact lens and environmental microbiological sampling. In addition, all 288 optical practices in the West of Scotland were polled for contact lens types and disinfecting solutions sold in 1995, and a sample, each of whom fitted more than 500 contact lenses per year, were polled for a second time. Independently, a poll was commissioned by the Eyecare Information Service in July/August 1995 to estimate the numbers of contact lens wearers in Scotland and the UK. Industry was polled for numbers of each contact lens disinfecting regimen sold in Scotland in 1995. West of Scotland, UK. All contact lens wearers among the 3 million population of the West of Scotland Health Board Areas. Risk factors for Acanthamoeba infection and recommendations for its prevention. When Acanthamoeba infection occurred, patients' home water systems were frequently (54%) found to be colonised by this amoeba. Patients more frequently washed their storage cases in tap water than controls (P<0.05) with resulting contamination, kept storage cases wet rather than air drying them (P<0.05), and had coliform bacteria cultured from the storage case (P<0.05) and had viable Acanthamoeba within the storage case (P<0.0001). Overall, patients were found to have significantly more risk factors than controls (P<0.0001). The noncompliant use of chlorine tablet disinfection, or failure to disinfect contact lenses at all, was associated with increased risk (P<0.05). Ionic high water content contact lenses (FDA group 4 material), when used without disinfection or with non-compliant use of low chlorine (Soflab) tablet-based disinfection, were associated with increased risk of Acanthamoeba infection (P<0.05). In log

  19. Antimicrobial Efficacy of Contact Lens Care Solutions Against Neutrophil-Enhanced Bacterial Biofilms

    PubMed Central

    Hinojosa, Jorge A.; Patel, Naiya B.; Zhu, Meifang; Robertson, Danielle M.

    2017-01-01

    Purpose Neutrophil-derived extracellular debris has been shown to accelerate bacterial biofilm formation on hydrogel and silicone hydrogel contact lens surfaces compared to lenses inoculated with bacteria alone. The purpose of this study was to evaluate the disinfection efficacy of four standard commercial contact lens cleaning regimens against neutrophil-enhanced bacterial biofilms formed on silicone hydrogel contact lenses. Methods Four reference strains were used: Pseudomonas aeruginosa, Serratia marcescens, Stenotrophomonas maltophilia, and Staphylococcus aureus. Human neutrophils were isolated from peripheral blood by venipuncture. Unworn Lotrafilcon B lenses were incubated overnight in each respective strain with stimulated neutrophils. Contact lenses were then cleaned using one of four contact lens care solutions according to manufacturer instructions. Bacterial viability was assessed by colony counts and confocal microscopy. Volume of residual debris on lens surfaces after cleaning was quantified using IMARIS software. Results All four solutions tested showed effective antimicrobial activity against each bacterial strain; however, substantial amounts of nonviable bacteria and cellular debris remained on the lens surface despite concomitant digital cleaning. Conclusions Necrotic cellular debris that accumulates under the posterior lens surface during wear of an inoculated contact lens is not fully removed during routine cleaning and disinfection. Translational Relevance The accumulation of residual cellular debris on the contact lens surface may contribute to new colonization of the lens and represents a significant risk factor for a contact lens–related adverse event. Additional studies are needed to correlate these findings with risk for corneal infiltrative and/or infectious events in a standard animal model. PMID:28473944

  20. Evaluation of point-of-care test for elevated tear matrix metalloproteinase 9 in post-LASIK dry eyes.

    PubMed

    Chan, Tommy C Y; Ye, Cong; Chan, Kwok Ping; Chu, Kai On; Jhanji, Vishal

    2016-09-01

    To evaluate the performance of a point-of-care test for detection of matrix metalloproteinase 9 (MMP-9) levels in post-laser-assisted in situ keratomileusis (LASIK) dry eyes. A comparative study between patients with mild to moderate post-LASIK dry eyes and age-matched normal subjects was conducted. Ocular surface disease index (OSDI), tear break-up time (TBUT), and tear film MMP-9 and total protein levels were compared between the two groups. A point-of-care test device (RPS InflammaDry, Sarasota, Florida, USA) was utilised to confirm elevated MMP-9 levels in tear film. Fourteen post-LASIK dry eyes and 34 normal eyes were included. There was no significant difference in age and gender between both groups (p>0.175). The OSDI was significantly higher (25.5±7.7 vs 7.4±2.5; p<0.001) and TBUT levels were significantly lower (5.4±0.9 vs 13.5±2.3; p<0.001) in patients with dry eye compared with normal subjects. The tear film MMP-9 levels were 52.7±32.5 ng/mL in dry eyes and 4.1±2.1 ng/mL in normal eyes (p<0.001). MMP-9 levels were >40 ng/mL in 7/14 (50.0%) post-LASIK dry eyes. The InflammaDry was positive in 8/14 (57.1%) post-LASIK eyes. All positive cases had tear film MMP-9 levels ≥38.03 ng/mL. Agreement between InflammaDry and MMP-9 was excellent with Cohen κ value of 0.857 in post-LASIK dry eyes. Only half of post-LASIK dry eyes were found to have significant inflammation associated with elevated MMP-9. The OSDI is useful to non-specifically identify patients with symptomatic dry eye while the InflammaDry determined which patients with dry eye were associated with significant inflammation that may guide therapeutic management decisions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/