Eye & contact lens (Eye Contact Lens )

Publisher: Contact Lens Association of Ophthalmologists, Lippincott, Williams & Wilkins

Description

Dedicated to the medical and surgical management of refractive disorders, Eye and Contact Lens: Science and Clinical Practice is published for ophthalmologists, optometrists, and other eye care specialists. Each quarterly issue provides original peer-reviewed articles and online dialogue on leading developments and practical clinical applications of contact lenses, refractive surgery, cornea, ocular surface disease, glaucoma, and related anterior segment subjects.

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  • Website
    Eye and Contact Lens: Science and Clinical Practice website
  • Other titles
    Eye & contact lens (Online), Eye & contact lens, Eye and contact lens, Journal of the Contact Lens Association of Ophthalmologists
  • ISSN
    1542-233X
  • OCLC
    50854203
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Lippincott, Williams & Wilkins

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    • 12 months embargo
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    • Published source must be acknowledged with full citation
    • Must link to publisher version
    • NIH, Wellcome Trust and HHMI authors will have their accepted manuscripts transmitted to PubMed Central on their behalf (see policy for details)
  • Classification
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Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: To monitor corneal epithelial healing under bandage contact lens (BCL) using ultrahigh-resolution optical coherence tomography (UHR-OCT) after pterygium surgery. Thirty-nine eyes of 39 patients undergoing pterygium excision and conjunctival autografting were randomly allocated into 2 groups: 20 eyes were covered with silicone hydrogel BCLs at the end of surgery and 19 eyes served as a control. Ultrahigh-resolution optical coherence tomography scans of the cornea were performed sequentially at 1, 2, and 3 days, and then every other day until the end of re-epithelialization after surgery. Complete epithelial healing was verified with fluorescein staining examination after removal of BCLs. Postsurgery pain was evaluated using the visual analog scale. All BCLs were successfully fit without any contact lens-related complications. Ultrahigh-resolution optical coherence images clearly revealed the architectural features of postoperative cornea with BCL in situ and showed epithelial healing process. Ultrahigh-resolution optical coherence tomography imaging agreed with the fluorescein staining examinations in detecting corneal epithelial defect. Based on the assessment by UHR-OCT, the average time course of re-epithelialization in the BCL group was 3.9±1.2 days, whereas in the control group, it was 5.7±1.8 days (P=0.001). Visual analog scale scoring showed lower pain levels in the BCL group comparing with the control group at each point of time (all P<0.05). Ultrahigh-resolution optical coherence tomography is an excellent tool in monitoring corneal epithelial healing under BCLs and determining the appropriate time for lens removal. Silicone hydrogel BCL is recommended as an adjuvant therapy after pterygium surgery for its efficacy in improving re-epithelialization and postoperative comfort.
    Eye & contact lens 05/2014; 40(3):175-80.
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    ABSTRACT: The aim of this study was to analyze the influence of different lens care systems in surface roughness and refractive index (RI) of contact lenses (CL). This information provides us with a better understanding of how care solutions affect CL materials. Several CL and three commercially available and appropriate lens care solutions were used (two polyhexamethylene biguanide and one hydrogen peroxide care systems). Lenses were immersed in the lens care systems, and then measurements with CLR 12-70 digital automated refractometer and atomic force microscopy analysis on Tapping mode were recorded. The measurements were performed before and after the lenses were immersed in each care solution. Significant changes were observed on the CL materials when exposed to lens care systems. All the materials changed, to a greater or lesser extent, their roughness and RI, after being immersed in the different solutions. The water content varied between 0% (Nelfilcon A in ReNu Multiplus, Senofilcon A in AOSEPT Plus, and Methafilcon A in Solocare Aqua) and 4.1% (Hilafilcon B in Solocare Aqua) The higher change in roughness was obtained with ReNu Multiplus in the lens Comfilcon A (with an increase of 27.2 nm) and Senofilcon A (with an increase of 16.7 nm). This study suggests that lens care systems play an important role in surface roughness and RI of CL.
    Eye & contact lens 05/2014; 40(3):140-7.
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    ABSTRACT: To conduct a survey of contact lens (CL) wearers who use their CLs with satisfaction in Japan and to establish the actual circumstances of CL use. An Internet survey was conducted in 1,000 CL wearers in Japan with questionnaires concerning CL purchase/change, compliance with the duration of wear, and occurrence of complications of CL use. Replies from 636 women (63.6%) and 364 men (36.4%) were received. The largest source of CL purchase was CL specialty stores (eyeglass chains, 41.3%). The most frequent CL types were 2-week frequent replacement (2WFR) soft CLs (SCLs) (32.1%), daily disposable (DD) (31.0%), and other lenses. The main determining factors of purchase were "price" (38.0%), "recommendation of a doctor/staff" (37.6%), and "comfort" (34.1%). The number of wearers who changed their CLs was 372 (37.2%), and the main reasons for change were "inexpensive" (34.9%) and "recommendation of a doctor/staff" (31.2%). In DD and 2WFR/planed replacement SCLs, 270 (42.7%) of 632 wearers were compliant with the recommended duration of use, and the remainder were self-identified as noncompliant. The main reason given for noncompliant behavior was "no harm in extending the duration of use" (60.3%). The number of wearers with eye complications related to lens was 373 (37.3%). The choice of CLs by wearers seems to be price driven rather than being safety focused. Despite being aware of noncompliant behaviors regarding CL use, there were many noncompliant wearers. Clearly, ophthalmologists, optometrists, CL manufacturers, and other CL-related practitioners should cooperate and better educate patients to promote the importance of compliance with safe lens use.
    Eye & contact lens 05/2014; 40(3):169-74.
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    ABSTRACT: 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.
    Eye & contact lens 05/2014; 40(3):148-56.
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    ABSTRACT: The antimicrobial effects of multipurpose contact lens solutions (MPSs) have been evaluated according to ISO 14729 standards. The aim of this study was to assess the efficacy of commercially available MPSs against extended-spectrum beta lactamases (ESBL)-producing Escherichia coli, methicillin-resistant Staphylococcus aureus (MRSA), and Candida albicans clinical isolates. Three commercially available contact lens solutions (Opti-Free Expresss, ReNu MultiPlus, and Solo Care Aqua) were tested against 18 ESBL-positive E. coli clinical strains, 20 MRSA clinical strains, and 20 C. albicans clinical strains. The stand-alone assays for bacteria and fungi were performed according to ISO 14729 criteria, and all samples were evaluated after 2, 4, and 24 hours of incubation. The numbers of viable microorganisms were evaluated by the plate-counting method. All MPSs demonstrated at least 3 log reduction in colony-forming units (CFU) for all bacterial isolates and 1 log reduction in CFU for all yeast isolates, which meets ISO 14729 standards. Although no statistically significant differences were obtained among MPSs for bacterial isolates, variable responses were observed against clinical isolates: 5% povidone-iodine was more effective compared with Solo Care Aqua for C. albicans clinical strains (P<0.05); and all solutions were effective after an incubation time of only 2 hrs. The MPSs showed good activity against S. aureus, E. coli, and C. albicans. Although effective log reductions were provided with all MPSs, the reduction was variable depending on the strains tested. Multipurpose contact lens solutions should be tested under ISO 14729 standards for both standard and clinical strains.
    Eye & contact lens 05/2014; 40(3):157-60.
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    ABSTRACT: 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.
    Eye & contact lens 04/2014;
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    ABSTRACT: To analyze the demographics, risk factors, and clinical and microbiological characteristics of triple infection keratitis. Retrospective case series. Five patients (five eyes) with triple infection keratitis were identified. Eyes with polymicrobial keratitis were identified from January 2002 to December 2010. Only culture-positive cases and eyes infected by three different organisms were included. Demographics, risk factors, clinical and microbiological characteristics, and treatment outcomes were analyzed. The size of the corneal infiltrate, presence of hypopyon, pre- and post-treatment best-corrected visual acuity, antibiotic regimen and sensitivity, types of isolated pathogens, duration of infection, and treatment outcomes. The mean age was 39 years (SD, ±23.4; range, 21-74). Use of topical steroids was the commonest risk factor (80%). Multiple risk factors were identified in four eyes. The average size of corneal infiltrate was 23.5 mm (SD, ±35.2; range, 2.08-85.5), and all eyes developed hypopyon. A total of 15 organisms belonging to 10 species (bacteria=7, fungi=3) were isolated. Pseudomonas aeruginosa and Candida albicans were the most frequently isolated bacteria (n=3) and fungi (n=3), respectively. All patients had at least one type of fungal isolate. Infection resolved with medical treatment in four eyes and one eye had to be eviscerated as the patient developed panophthalmitis. The average time taken for infection to resolve was 30 days (SD, ±19.3; range, 13-61). A high index of suspicion of polymicrobial keratitis should be made in patients with multiple and systemic risk factors. Use of topical steroid was the most common risk factor. Prolonged course of disease, relatively large infiltrate, and presence of hypopyon and fungal isolates are typical features of triple infection keratitis.
    Eye & contact lens 03/2014;
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    ABSTRACT: To investigate changes of corneal thickness at the vertical and horizontal meridians and of wavefront aberrations (WA) over a 30-day period of overnight myopia orthokeratology (OK) lens wear. Sixteen subjects (11 women, 5 men, 26.3±3.2 years) were enrolled and fitted for OK lenses. Long scan depth optical coherence tomography was used to measure corneal thickness profiles at both horizontal and vertical meridians at baseline and on days 1, 7, and 30 days. Corneal and ocular WA of a 6-mm pupil were measured and the root-mean-square (RMS) of the astigmatism, coma, spherical aberration (SA), and total higher-order aberrations (HOAs) were determined. During the 30-day period, the central cornea thinned in the horizontal and vertical meridians, whereas corneal thickening occurred in the temporal, nasal, and inferior mid-peripheries. In contrast, the cornea thinned in the mid-peripheral superior. There were significant increases in RMS for astigmatism, SA, coma, and positive horizontal coma during the study period. After OK, there were significant positive correlations between the midperipheral-central thickness change difference and the changes in corneal and ocular RMS of total HOAs and SA (r range: 0.281 to 0.492, P<0.05). Only the change of corneal coma RMS was correlated with midperipheral-central thickness change difference (r=0.270, P<0.05). The change in corneal horizontal coma was correlated with the temporal-nasal thickness change difference (r=-0.289, P<0.05). Overnight OK caused unique changes in corneal thickness profiles at the vertical and horizontal meridians and increased corneal and ocular HOAs related to corneal reshaping.
    Eye & contact lens 03/2014;
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    ABSTRACT: Contact lens-induced papillary conjunctivitis (CLPC) continues to be a major cause of dropout during extended wear of contact lenses. This retrospective study explores risk factors for the development of CLPC during extended wear of silicone hydrogel lenses. Data from 205 subjects enrolled in the Longitudinal Analysis of Silicone Hydrogel Contact Lens study wearing lotrafilcon A silicone hydrogel lenses for up to 30 days of continuous wear were used to determine risk factors for CLPC in this secondary analysis of the main cohort. The main covariates of interest included substantial lens-associated bacterial bioburden and topographically determined lens base curve-to-cornea fitting relationships. Additional covariates of interest included history of adverse events, time of year, race, education level, gender, and other subject demographics. Statistical analyses included univariate logistic regression to assess the impact of potential risk factors on the binary CLPC outcome and Cox proportional hazards regression to describe the impact of those factors on time-to-CLPC diagnosis. Across 12 months of follow-up, 52 subjects (25%) experienced CLPC. No associations were found between the CLPC development and the presence of bacterial bioburden, lens-to-cornea fitting relationships, history of adverse events, gender, or race. Contact lens-induced papillary conjunctivitis development followed the same seasonal trends as the local peaks in environmental allergens. Lens fit and biodeposits, in the form of lens-associated bacterial bioburden, were not associated with the development of CLPC during extended wear with lotrafilcon A silicone hydrogel lenses.
    Eye & contact lens 03/2014;
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    ABSTRACT: To evaluate the effect of room illumination on the measurement of anterior segment parameters. In this comparative study, measurements of anterior segment parameters of 25 eyes of 25 healthy patients were performed by optical low-coherence reflectometry (OLCR). Measurements were taken under photopic conditions (150 lux) and under mesopic conditions (3 lux). Paired t test by SPSS 16.0 was used to compare the anterior segment measurements performed in both conditions. A P value lower than 0.05 was accepted as statistically significant. The mean age of the patients was 27.09±1.72 years (range, 20-40 years). Of the anterior segment parameters, axial length and keratometry did not show significant difference between photopic and mesopic conditions (P=0.541 and P=0.812, respectively). The mean anterior chamber depth measurements was 3.04±0.35 mm and 3.06±0.35 mm, whereas the mean lens thickness was 3.75±0.36 mm and 3.77±0.36 mm in the mesopic and photopic conditions, respectively. The mean pupil diameter measurement was 4.86±0.70 mm under photopic conditions and 6.36±0.94 mm under mesopic conditions. The anterior chamber depth, lens thickness, and pupil diameter showed significant difference between photopic and mesopic conditions (P=0.01, P=0.006, and P=0.0001, respectively). Anterior chamber depth, lens thickness, and pupil diameter were affected by the changes in luminance while performing measurements with OLCR. Considering the age of the study group, further studies are needed to test the measurement of accommodation amplitude.
    Eye & contact lens 03/2014;
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    ABSTRACT: To assess the clinical performance of Systane Ultra lubricant eye drops in daily disposable soft contact lens wearers who experience contact lens-related dryness. In this randomized, investigator-masked study, daily disposable lens wearers with symptoms of dryness were randomized to use Systane Ultra lubricant eye drops or to no treatment. The lubricant regimen was applied twice a day, 10 minutes before lens insertion and after lens removal, for the 2-week study period. Subjective comfort, wear time, and visual acuity were assessed at baseline and after 2 weeks. A total of 89 daily disposable lens wearers were randomly assigned to the Systane Ultra group (n=44) or the control group (n=45). Two weeks of Systane Ultra lubricant eye drop use resulted in a significant increase in comfortable lens wear time when compared with baseline assessment (P=0.001) and a trend toward significant improvement compared with the control group (P=0.078). End-of-the-day comfort was significantly improved in the Systane Ultra group compared with the control group (P=0.007). A significant reduction in the overall dryness (P<0.001) and end-of-day dryness (P=0.047) was observed in subjects using the Systane Ultra lubricant eye drops compared with the control group. The study demonstrates that Systane Ultra lubricant eye drops applied before and after contact lens wear is an effective artificial tear for alleviating symptoms of contact lens-related dry eye.
    Eye & contact lens 03/2014; 40(2):106-110.
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    ABSTRACT: To examine the types of contact lenses used as bandage lenses in the postoperative management of patients with Boston type 1 keratoprosthesis (K-Pro). We examined the lens parameters, the number of trial lenses used to achieve successful fit, and lens replacement schedule. The strategies to achieving a successful fit in these complex patients are reviewed. This was a single-center, retrospective chart review of patients who had undergone implantation of the Boston keratoprosthesis in 1 or more eyes from January 2006 to December 2011. Patients included male and female subjects aged 18 years or older who had been fit with bandage contact lenses as part of their postoperative management. Twenty-two eyes of 15 patients met the criteria for this review. The age range was 30 to 90 years. There were eight men and seven women. The average number of lenses to achieve a successful fit varied from 1 to 8, with an average of 2.22 trial lenses used per patient. By 6 months after the surgery, 12 K-Pro eyes showed visual acuity of 20/200 or better, with 7 of those eyes attaining better than 20/80 best-corrected Snellen distance acuity. Our results show that it is often necessary to use custom contact lenses for K-Pro patients. Management of poor tear film quality, protein deposition, inflammation, lens replacement schedule, and antibiotic resistance are related considerations.
    Eye & contact lens 02/2014;
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    ABSTRACT: To assess the perceptions of eye care providers regarding the clinical management of dry eye. Invitations to complete a 17-question online survey were mailed to 400 members of the North Carolina Ophthalmology and Optometry Associations including community optometrists, comprehensive ophthalmologists, and cornea specialists. The survey was completed by 100 eye care providers (25% response rate). Providers reported burning (46.5%) as the most frequent symptom described by patients, followed by foreign body sensation (30.3%) and tearing (17.2%). Most respondents (80.8%) listed artificial tears as the recommended first-line treatment, even though providers reported high failure rates for both artificial tears and cyclosporine A (Restasis). Rheumatoid arthritis, Sjögren syndrome, affective disorders such as anxiety and depression, history of photorefractive surgery, smoking, and thyroid disease were acknowledged as common comorbid conditions. The survey provided an informative snapshot into the preferences of eye care providers concerning the diagnosis and management of dry eye disease. Overall, burning was the most common symptom reported by patients. Providers relied more on patient history in guiding their clinical decisions than objective signs. The survey underscores the incongruence when comparing subjective symptoms with objective signs, thereby highlighting the urgent need for the development of reliable metrics to better quantify dry eye symptoms and also the development of a more sensitive and specific test that can be used as the gold standard to diagnose dry eye.
    Eye & contact lens 02/2014;
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    ABSTRACT: To assess refractive and biometric changes 1 week after discontinuation of lens wear in subjects who had been wearing orthokeratology (OK) contact lenses for 2 years. Twenty-nine subjects aged 6 to 12 years and with myopia of -0.75 to -4.00 diopters (D) and astigmatism of ≤1.00 D participated in the study. Measurements of axial length and anterior chamber depth (Zeiss IOLMaster), corneal power and shape, and cycloplegic refraction were taken 1 week after discontinuation and compared with those at baseline and after 24 months of lens wear. A hyperopic shift was found at 24 months relative to baseline in spherical equivalent refractive error (+1.86±1.01 D), followed by a myopic shift at 1 week relative to 24 months (-1.93±0.92 D) (both P<0.001). Longer axial lengths were found at 24 months and 1 week in comparison to baseline (0.47±0.18 and 0.51±0.18 mm, respectively) (both P<0.001). The increase in axial length at 1 week relative to 24 months was statistically significant (0.04±0.06 mm; P=0.006). Anterior chamber depth did not change significantly over time (P=0.31). Significant differences were found between 24 months and 1 week relative to baseline and between 1-week and 24-month visits in mean corneal power (-1.68±0.80, -0.44±0.32, and 1.23±0.70 D, respectively) (all P≤0.001). Refractive change at 1 week in comparison to 24 months strongly correlated with changes in corneal power (r=-0.88; P<0.001) but not with axial length changes (r=-0.09; P=0.66). Corneal shape changed significantly between the baseline and 1-week visits (0.15±0.10 D; P<0.001). Corneal shape changed from a prolate to a more oblate corneal shape at the 24-month and 1-week visits in comparison to baseline (both P≤0.02) but did not change significantly between 24 months and 1 week (P=0.06). The effects of long-term OK on ocular biometry and refraction are still present after 1-week discontinuation of lens wear. Refractive change after discontinuation of long-term OK is primarily attributed to the recovery of corneal shape and not to an increase in the axial length.
    Eye & contact lens 02/2014;
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    ABSTRACT: To assess the tear function in a young to middle age myopic population and finding possible associations of abnormal tear function with gender and age. Dry eye workup was conducted in patients undergoing screening for myopic laser keratorefractive surgery. All patients completed the McMonnies dry eye questionnaire (MQ) and also underwent evaluation of the fluorescein break-up time (FBUT) and the Schirmer tests with anesthesia (STA). Patients with contraindications for keratorefractive surgery or any condition interfering with tear function were excluded from the database. In this prospective study, we evaluated 655 eyes of 216 women and 116 men with a mean age of 27.3±6.1 years. Results of right eyes only are reported. The FBUT and STA were abnormal in 30.8% (95% confidence interval [CI]: 25.7-35.8) and 14.6% (95% CI 10.7-18.4) of cases, respectively. According to MQ scores, 15.9% (95% CI: 11.8-20.0) of patients showed abnormal results. In the assessment of abnormal cases, MQ scores were significantly higher (P<0.001) and FBUT was significantly lower in women (P=0.003) and older ages. Abnormal STA results were not significantly correlated with age or gender. In an otherwise normal population seeking keratorefractive surgery for myopia, some cases may demonstrate abnormal tear functions, especially women and older ages. A timely diagnosis and treatment can help avoid complications related to such abnormalities after refractive surgery.
    Eye & contact lens 01/2014;
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    ABSTRACT: Using a custom-developed segmentation algorithm, agreement of corneal epithelial thickness profile measurements between two spectral domain optical coherence tomography (SD-OCT) systems was assessed. Eighteen left eyes (18 subjects; mean±standard deviation; age, 23.2±0.9 years) were imaged twice on nonconsecutive days by a custom-built ultra-high resolution OCT (UHR-OCT) system and a commercial RTVue OCT system. A segmentation algorithm based on axial gradient information and a shortest path search was developed to measure corneal epithelial thickness profiles from the SD-OCT images. There was good correlation between the automated and manual segmentation positions of the epithelium. The epithelial thickness differences between automated and manual segmentations by the UHR-OCT and RTVue OCT systems were 0.4±0.3 μm and 1.1±0.5 μm, respectively. The intraclass correlation coefficients (ICCs) and coefficients of repeatability for repeated UHR-OCT measurements of epithelial thickness were 0.90±0.05 μm and 1.44±0.01 μm, respectively. For RTVue OCT, the ICCs and coefficients of repeatability were 0.88±0.04 μm and 2.16±0.01 μm, respectively. The epithelial thickness measured by RTVue OCT was 1.1±0.2 μm greater than that by UHR-OCT (P<0.05, paired t test), and ICC for the agreement between the 2 systems was 0.85±0.06. The average 95% limit of agreement was -1.67 to 3.79 μm. For images of different qualities from both SD-OCT systems, the custom-developed automated segmentation of the corneal epithelium had good repeatability for thickness profile measurements. The accurate and precise algorithm also demonstrated good agreement of epithelial thickness profile measurements between the two SD-OCT systems.
    Eye & contact lens 01/2014;
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    ABSTRACT: To evaluate eyelid and eye contour factors that can influence the fitting of toric soft contact lenses (TSCLs). Thirty-two subjects (64 eyes) were enrolled and fitted with Lo-Torque design TSCLs. One eye of each subject was randomly selected. High-resolution digital images were acquired after the subjects had worn the lens for 20 minutes, and the images were then processed with Adobe Photoshop. The palpebral aperture (PA), various angles of the eyelid, horizontal visible iris diameter (HVID), and lens parameters were obtained. Finally, lens fitting was evaluated. During the assessment of the correlations between the eyelid and eye contour factors and the lens fitting, there were four pairs of significant correlations: (1) the PA and rotational direction of the lens: larger eye PA was associated with a greater possibility of nasal rotation of the corresponding lens (P=0.03); (2) the angle of the central lower lid (θ3) and the rotational stability of the lens: the larger the angle was, the worse the rotational stability was (P=0.02); (3) the lower lid angle of the medial canthus (θ5) and temporal rotational recovery: the smaller the angle was, the more quickly the lens recovered (P=0.05); and (4) HVID and routine fitting assessments: the larger the HVID was, the looser the lens fitting (P=0.00). Finally, when assessing correlations between some lens parameters and the orientation of the lens, we found that lower sphere values were associated with quicker lens recovery (P=0.04). Several eye factors, as well as lens characteristics, had impacts on the TSCLs fitting, including the PA, the angle of the central lower lid (θ3), the lower lid angle of the medial canthus (θ5), and the sphere of the lens. These factors should receive particular attention when fitting TSCLs.
    Eye & contact lens 01/2014;
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    ABSTRACT: This study sought to evaluate the efficacy of the isolated use of tacrolimus compared with the combined use of tacrolimus and olopatadine for the treatment of severe vernal keratoconjunctivitis (VKC). Twenty-one patients with severe VKC were randomized into two groups: one treated with 0.03% tacrolimus ointment combined with 1% olopatadine ophthalmic solution and the other with 0.03% tacrolimus ointment combined with placebo eye drops. The clinical signs and symptoms were graded from 0 to 3, and the efficacy of treatment was determined by the difference between the score at the beginning of treatment and after 30 days. The clinical impression of improvement as perceived by the evaluator and the self-assessment provided by the patient were scored at day 30 of treatment and compared between the groups. The scores for symptoms decreased between the assessments in both groups (-1.7±3.9 in the experimental group; -0.6±1.6 in the control group), with no significant difference between groups (P=0.205). The scores for clinical signs decreased between the assessments in the experimental group (-1.1±2.7) and increased in the control group (0.3±0.9) but with no significant differences (P=0.205). There was no significant difference between the groups regarding the self-assessment (P=0.659) and the clinical impression of the evaluator (P=0.387). The isolated use of tacrolimus and the combined use of tacrolimus and olopatadine seems to have the same efficacy, although controlled studies with larger samples are required to confirm this hypothesis.
    Eye & contact lens 01/2014;
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    ABSTRACT: The aim of this study was to report and discuss the clinical experience with PROSE (Prosthetic Replacement of Ocular Surface Ecosystem) practice at a tertiary eye care hospital. Retrospective data of patients who were prescribed PROSE during April 2011 to March 2012 in a tertiary eye care center in south India were analyzed. Data collected include patient demographics, indications of scleral lens fitting, previous correction modality, PROSE parameters, best-corrected visual acuity (BCVA) with spectacles, and BCVA with PROSE at initial assessment and few hours of wear. The BCVA before (with glasses) and after PROSE fitting was recorded in logMAR units. The age of the patients ranged between 13 and 68 years (male:female 60:25) with a mean age of 32.44±13.45 years. Mean BCVA improved by 0.3 logMAR units (3 lines) after fitting with PROSE. There was a statistically significant difference between pre- and post-PROSE BCVA (P=0.0001). Failure of rigid gas-permeable lens fitting or intolerance was the common indication for PROSE in corneas with irregular astigmatism (refractive conditions). The other reasons for which PROSE was prescribed were pain, photophobia, comfort, ghosting of images, and frequent loss of smaller lenses. Toric scleral haptic was indicated in 62 eyes. The diameter, vault, and haptic measurements of PROSE in ocular surface disorders were much less and flatter than that of refractive conditions. PROSE device is a very useful alternative for irregular corneas to improve visual acuity, to improve comfort, and for symptomatic relief.
    Eye & contact lens 01/2014;

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