Purpose: The main goal of this current work is to use an updated calculation paradigm, and updated boundary conditions, to provide theoretical guidelines to assist the clinician whose goal is to improve his or her scleral gas permeable (GP) contact lens wearing patients' anterior corneal oxygen supply.
Methods: Our model uses a variable value of corneal oxygen consumption developed through Monod equations that disallows negative oxygen tensions within the stroma to predict oxygen tension at the anterior corneal surface of scleral GP contact lens wearing eyes, and to describe oxygen tension and flux profiles, for various boundary conditions, through the lens, tears, and cornea. We use several updated tissue and boundary parameters in our model.
Objective: We calculated corneal surface oxygen tension under hybrid contact lenses (CLs) by extending existing models of CL oxygen diffusion to the circumstances of hybrid CL designs with tear vaults.
Methods: Theoretical oxygen tensions at the corneal surface, if tear mixing and exchange are excluded, are calculated for hybrid CL (modern, high oxygen-permeable rigid center) designs with a single chamber corneal model using a computer software spreadsheet. Several specific in vivo instances of hybrid CL tear vaults are measured by both slitlamp biomicroscopy and optical coherence tomography (OCT).
Cont Lens Anterior Eye
February 2015
Background/purpose: Over the past decade, utilization of scleral gas permeable (GP) contact lenses has steadily increased. Scleral GP lenses offer yet another option for patients suffering from visually debilitating corneal and tear conditions. Oxygen delivery to the cornea in the presence of a contact lens system continues to be a subject of interest, and scleral GP lenses are no exception.
View Article and Find Full Text PDFCont Lens Anterior Eye
June 2011
Toric soft contact lenses have been in the marketplace for more than 30 years. Over this period of time, substantial improvements have been made in the areas of lens reproducibility, lens material permeability, frequency of lens replacement, and availability of lens design and parameter options. This article will review the methods used to stabilize lens rotation and their effectiveness as reported in the literature.
View Article and Find Full Text PDFPurpose: Use of polyhexanide based multipurpose solutions (MPSs) for contact lens disinfection has been linked to low-grade corneal staining. In vitro data suggest that carboxymethylcellulose (CMC) may neutralize polyhexanides. The purpose of this investigation was to determine whether a pre-application drop of CMC reduces polyhexanide staining in vivo.
View Article and Find Full Text PDFPurpose: To identify baseline demographic and clinical factors associated with undergoing penetrating keratoplasty (PK) in a prospective cohort of 1,065 keratoconus patients followed for eight years in the Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study.
Design: Multicenter, prospective, observational cohort study.
Methods: We report the rate of PK over eight years and baseline factors predictive of PK in 1,065 patients who, at the time of study enrollment, had not undergone PK in either eye.
Purpose: This study was designed to identify factors that predict longitudinal increases in corneal curvature as measured by the First Definite Apical Clearance Lens (FDACL) and flatter keratometric reading (Flat K) in keratoconus.
Methods: The Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study is a long-te rm evaluation of the natural history of keratoconus involving 1209 patients. This report uses 8 years of follow-up data from 1032 patients who had penetrating keratoplasty in neither eye at baseline and who provided enough data to compute the slope of the change with time in the FDACL or the Flat K.
Purpose: The purpose of this article is to compare the safety and efficacy of flat- and steep-fitting rigid contact lenses in keratoconus.
Methods: The Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study is a 16-center observational study. Cross-sectional results at baseline were generated for 1091 subjects with longitudinal results from the 871 subjects who completed 8 years of follow up.
Purpose: There are numerous reports of corneal ectasia after laser in situ keratomileusis (LASIK) for myopia without a consistent definition of this condition or a definitive etiology. We conducted a retrospective analysis of published case reports to describe common characteristics of this postoperative event and compared them with findings from a group of successful LASIK patients.
Methods: A MEDLINE search for "LASIK" and "ectasia" yielded 21 relevant articles published before May 2003 (n = 86 eyes, 59 patients).
Purpose: To identify factors associated with rigid contact lens comfort in keratoconus.
Methods: Baseline data from the 16 Collaborative Longitudinal Evaluation of Keratoconus (CLEK) Study clinical sites were analyzed for all patients wearing a rigid contact lens in their more severely keratoconic eye (as determined by steep keratometry). Corneal transplant patients, patients who did not wear a rigid contact lens in either eye, patients who did not wear a rigid lens in their worse eye, and patients with missing contact lens comfort data were excluded from the sample.
Purpose: The purpose of this study was to determine the factors that contribute to corneal staining in hydrogel lens wearers by examining the following variables: type of lens worn, wearing time and lens replacement schedule, lens care system, and topical and systemic medication use.
Methods: Five hundred full-time, successful hydrogel contact lens wearers were evaluated for corneal fluorescein staining at 20 clinical sites. Corneal staining was evaluated in five regions and was graded on a scale of 0 (no staining) to 4 (severe staining) in 0.