BCLA CLEAR presbyopia: Management with scleral techniques, lens softening, pharmaceutical and nutritional therapies.

The aging eye undergoes the same progressive crosslinking which occurs throughout the body, resulting in increased rigidity of ocular connective tissues including the lens and the sclera which impact ocular functions. This offers the potential for a scleral treatment that is based on restoring normal biomechanical movements. Laser Scleral Microporation is a laser therapy that evaporates fractional areas of crosslinked tissues in the sclera, reducing ocular rigidity over critical anatomical zones of the accommodation apparatus, restoring the natural dynamic range of focus of the eye.

Review of clinical outcomes of a cationic emulsion tear substitute in patients with dry eye disease.

First-line options for the treatment of dry eye disease (DED) rely on artificial tears (ATs), among which cationic emulsion (CE)-based ATs have been developed in order to mimic the healthy tear film for an improved restoration of the ocular surface homeostasis. In this review, we describe the outcomes reported in several studies, assessing the mode of action, ocular tolerance and clinical performance of a CE-based AT. Pilot studies have revealed that CE-based ATs can increase the volume and stability of the tear film while limiting its evaporation rate.

Multifocal contact lens success predictability.

Purpose: The current multi-study analysis combined data from three studies to quantify the relationship between the initial reaction to soft multifocal contact lens (MFCL) design types at dispensing and evaluate the predictability of overall vision satisfaction (OVS) and intention to purchase (ITP) after 1 week of wear.

Method: Three prospective studies tested MFCLs over 1-week of wear following the same protocol, using a range of potentially predictive ratings at dispensing, and both OVS and ITP at 1-week as an indicator acceptance level. In each study, two of MyDay® multifocal, clariti® 1 day multifocal, Biofinity® multifocal (worn as a daily disposable lens) or 1 DAY ACUVUE® MOIST MULTIFOCAL were dispensed for 1-week of daily wear.

Symptom Relief Following a Single Dose of Propylene Glycol-Hydroxypropyl Guar Nanoemulsion in Patients with Dry Eye Disease: A Phase IV, Multicenter Trial.

Purpose: To evaluate symptom relief in patients with dry eye disease (DED) following a single drop of propylene glycol-hydroxypropyl guar (PG-HPG) nanoemulsion (Systane Complete) lubricant eye drops.

Methods: This was a Phase IV, multicenter, open-label, interventional study in adult patients with DED of aqueous-deficient, evaporative, and mixed subtypes. Patients instilled one drop of PG-HPG in each eye at Day 1.

Efficacy and Safety of Phospholipid Nanoemulsion-Based Ocular Lubricant for the Management of Various Subtypes of Dry Eye Disease: A Phase IV, Multicenter Trial.

Purpose: To evaluate the clinical efficacy and safety of propylene glycol/hydroxypropyl-guar (PG-HPG)-based nanoemulsion (Systane Complete) lubricant eye drops in participants with dry eye disease (DED).

Participants And Methods: In this phase IV, open-label, single-arm, interventional, multicenter study, adult participants with DED - subtyped into aqueous deficient, evaporative, and mixed dry eye - were instructed to instill one drop of PG-HPG in each eye twice a day for 28 days. Endpoints included change from baseline in tear film break-up time (TFBUT) (primary) and ocular discomfort visual analog scale (VAS) score at Day 14 and TFBUT at Day 28 (secondary).

Quantification of contact lens wettability after prolonged visual device use under low humidity conditions.

Purpose: Discomfort of silicone hydrogel (SiHy) contact lenses (CL) is associated with longer wearing time, demanding visual tasks, and dry environments. This study investigated the impact of challenging environmental conditions on thewettability of four daily disposable SiHy CL.

Methods: Habitual wearers of delefilcon A (n=32) and somofilcon A (n=32) were tested with their habitual lenses and with stenfilcon A and narafilcon A lenses.

Pre-contact lens and pre-corneal tear film kinetics.

Purpose: Contact lenses (CL) insulate the corneal surface from the environment. It is possible that they influence the corneal sensory mechanism that contribute to spontaneous blinking. The study objective was to quantify the pre-CL and pre-corneal tear film kinetics (TFK) over blink period.

Efficacy and safety of dual-polymer hydroxypropyl guar- and hyaluronic acid-containing lubricant eyedrops for the management of dry-eye disease: a randomized double-masked clinical study.

Background: An artificial-tear formulation containing the dual polymers hydroxypropyl guar (HPG) and hyaluronic acid (HA) is approved for the treatment of dry-eye disease (DED). The present study compared the efficacy and safety of the HPG-HA dual-polymer formulation vs a sodium hyaluronate (SH)-containing artificial-tear formulation in patients with DED.

Methods: In a prospective, 6-week, multicenter, double-masked, parallel-group study, patients with DED aged ≥18 years and total ocular surface staining (TOSS) score ≥4 and ≤9 were randomized (1:1) to receive either HPG-HA or SH four times a day for 42 days.

The influence of lens care systems on eyelid tissue changes during silicone hydrogel contact lens wear.

Purpose: To compare the effects of a hydrogen peroxide (HO)-based lens care solution and a polyhexamethylene biguanide (PHMB) multi-purpose solution on the eyelids when used with silicone hydrogel (SiHy) contact lenses.

Methods: A total of 74 symptomatic wearers of ACUVUE OASYS (senofilcon A; n = 39) or PureVision (balafilcon A; n = 35) contact lenses were randomised 1:1 to either CLEAR CARE Cleaning & Disinfecting Solution or renu fresh™ multi-purpose solution (n = 37 each). Assessments of hyperaemia, papillae and lid margin staining of eyelid tissue were evaluated subjectively by a masked investigator at enrolment (with the subjects' habitual SiHy contact lenses and PHMB-preserved care systems), at dispensing visit (when no lenses were worn) and at 3-months' follow-up.

Clinical evaluation of an oil-based lubricant eyedrop in dry eye patients with lipid deficiency.

Purpose: To evaluate and compare the efficacy of a lipid-based lubricant eyedrop formulation (hydroxypropyl guar/propylene glycol/phospholipid [HPG/PG/PL]) with preservative-free saline for the treatment of dry eye.

Methods: This was a prospective, multicenter, randomized, single-masked, parallel-group phase 4 clinical study. Patients ≥18 years diagnosed with dry eye received 1 drop of saline 4 times daily (QID) for 15 days during a run-in phase, followed by randomization.

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

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.

Diurnal Variation in Comfort in Contact Lens and Non-contact Lens Wearers.

Purpose: The purpose of this investigation was to evaluate the diurnal variation in symptoms associated with ocular discomfort in contact lens (CL) wearers and non-CL wearers.

Methods: The study population comprised 604 individuals attending pre-screening visits at the OTG-i research clinic; 60% were current soft CL wearers (hydrogel and silicone hydrogel) and 40% were non-CL wearers. Symptomatology status was determined by the OSDI questionnaire (58% asymptomatic, 42% symptomatic).

The Effects of Age, Refractive Status, and Luminance on Pupil Size.

Purpose: Pupil size is critical for optimal performance of presbyopic contact lenses. Although the effect of luminance is well known, little information is available regarding other contributing factors such as aging and refractive status.

Methods: The cohort population comprised 304 patients (127 male, 177 female) aged 18 to 78 years.

Association Between Contact Lens Discomfort and Pre-lens Tear Film Kinetics.

Purpose: The relationship between contact lens wettability and comfort has been extensively evaluated; however, a direct correlation between the characteristics of the pre-lens tear film and the symptoms associated with contact lens discomfort has yet to be established. In addition, there is relatively limited knowledge relating to the entire tear film kinetics during the inter-blink period in contact lens wearers. The purpose of this analysis was to identify the characteristics of the pre-lens tear film kinetics that may be associated with the symptoms of contact lens discomfort.

Ocular Dominance and Handedness in Golf Putting.

Purpose: In golf, the impact of eye-hand dominance on putting performance has long been debated. Eye-hand dominance is thought to impact how golfers judge the alignment of the ball with the target and the club with the ball, as well as how golfers visualize the line of the putt when making decisions about the force needed to hit the ball. Previous studies have all measured ocular dominance in primary gaze only, despite golfers spending a significant amount of their time in a putting stance (bent at the hips, head tilted down).

Effect of lens care system on silicone hydrogel contact lens wettability.

Purpose: The purpose was to compare the effect of the repeated usage of two care systems (one hydrogen peroxide cleaning and disinfecting system and one polyaminopropyl biguanide (PHMB) containing multi-purpose system) with silicone hydrogel contact lenses worn for three months on a daily wear modality. A specific aspect of interest was of the effect of the care systems on contact lens wettability.

Methods: Seventy-four symptomatic contact lens wearers, habitually wearing either ACUVUE(®) OASYS(®) (n=37) or PureVision™ (n=37), constituted the study population.

Contact lens lipid spoliation of hydrogel and silicone hydrogel lenses.

Purpose: The purpose of the study was to measure contact lens lipid spoliation of silicone hydrogel PureVision (balafilcon A) and hydrogel Acuvue 2 (etafilcon A) contact lenses worn for 10 hours single use (DD) and 7 days of extended wear (EW).

Methods: Two similar study populations (DD, n = 55; EW, n = 53), were enrolled at four study sites. In each population, a bilateral, randomized, crossover (lens material), subject-masked experimental design was followed.

Are silicone hydrogel contact lenses more comfortable than hydrogel contact lenses?

The current literature review was intended to investigate whether the use of silicone hydrogel contact lenses has resulted in improved comfort compared with that of hydrogel contact lenses when both are used for daily wear. The conclusion reached is that silicone hydrogel contact lenses, which were initially developed to eliminate hypoxia during overnight wear, have not significantly improved comfort compared with the comfort achieved with hydrogel contact lenses when worn on a daily wear basis, even though a body of the published literature would suggest to the contrary. A careful review and consideration of the literature demonstrates that the relative comfort achieved with the two types of contact lenses is in fact highly dependent on the study methodology: Although refitting studies have concluded enhanced comfort with silicone hydrogels, the more robust study designs involving concurrent controls and masking were not able to show a difference, and some even concluded an inferior performance.

Eyelid margin modification associated with eyelid hygiene in anterior blepharitis and meibomian gland dysfunction.

Objective: To assess the changes in eyelid margins associated with eyelid hygiene using Blephaclean eye pads to manage anterior blepharitis or meibomian gland dysfunction (MGD) associated with dry eye complaints.

Method: The investigation was a bilateral, prospective, interventional, open-label investigation of 3-month duration. The test population included dry eye sufferers with at least mild symptoms (Ocular Surface Disease Index ≥ 13) who presented with mild to moderate anterior blepharitis or MGD.

Symptomatic relief associated with eyelid hygiene in anterior blepharitis and MGD.

Objective: The principal objective of this investigation was to assess the symptomatic relief associated with eyelid hygiene using Blephaclean eye pads, a cosmetic product, to manage anterior blepharitis or Meibomian gland dysfunction (MGD) associated with dry eye complaints.

Method: The investigation was a bilateral, prospective, interventional open label investigation of 3-month duration. The test population was made up of dry eye sufferers with at least mild symptoms (Ocular Surface Disease Index [OSDI] ≥13) who presented with mild to moderate anterior blepharitis or MGD.

Long term effects of the daily wear of senofilcon a silicone hydrogel contact lenses on eyelid tissues.

Purpose: Eyelid changes have been reported with silicone hydrogel contact lenses. It is hypothesized that those changes are associated with the mechanical interaction between the contact lens front surface and eyelid tissues and, are specific to contact lens type rather than a general effect of the lens category. The purpose of this study was to assess the effect of refitting into a silicone hydrogel on a daily wear basis to current contact lens wearers, lapsed wearers and neophytes on eyelid physiology.

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

Objectives: 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.

Methods: 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.