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1.
Jennie Diec Thomas Naduvilath Daniel Tilia Eric B. Papas Percy Lazon de la Jara 《Contact lens & anterior eye》2017,40(6):367-381
Purpose
To describe a ranked symptoms scale (RSS) discriminating subjective responses in contact lens (CL) wear in various situations.Method
Forty experienced clinical trial participants were interviewed for their perceptions of ocular comfort scales, resulting in a numerical RSS. For further evaluation, 20 CL wearers enrolled into a prospective, randomised, crossover trial. Two silicone-hydrogel CLs and a lens care solution (LCS) [Combinations A & B] were selected based on prior performance identifying best/worst combinations for end-of-day comfort. The RSS and a numerical rating scale (NRS) were administered at two time-points (insertion/removal) on alternating days for 6 days.Results
Both NRS and RSS showed acceptable internal consistency for comfort, vision and handling (Cronbach alpha = 0.71 for both scales) and similar repeatability for comfort and handling (coefficients-of-repeatability within 0.1 and 0.2 units, respectively, for each scale). The NRS and RSS discriminated differences between combinations for comfort (p ≤ 0.031) and vision (p ≤ 0.026) at both time-points. Additionally, the RSS showed lens/edge awareness influenced discomfort the most, ranking higher at insertion (p = 0.038) and higher for Combination-B at both time-points (p ≤ 0.002). Symptoms of dryness and tired eyes increased for both combinations at removal (p < 0.02). The RSS also showed haziness and blurred distance vision influenced vision dissatisfaction with Combination-B at lens removal (p ≤ 0.038) while eye strain/headache increased for both combinations by time of removal (p ≤ 0.013).Conclusions
The RSS is able to discriminate subjective responses between combinations and time-of-day. The RSS’s ability to rank symptoms may be a useful tool in understanding perceptions of discomfort or dissatisfaction with CL wear. 相似文献2.
Alexander Leube Imre Kovats Siegfried Wahl Wolfgang Sickenberger 《Contact lens & anterior eye》2017,40(6):394-400
Purpose
Pilot study to investigate the feasibility of an axis-free correction approach of regular astigmatism using soft, bifocal contact lenses (CL).Methods
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 J0 = ? 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 5 days (3FUP).Results
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 DAst = 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 J0 from baseline to 3FUP (ΔJ0 = ?0.46 D, p = 0.04). Wearing the CL for 5 days did not result in a significant difference of VA (ΔVA3FUP = +0.01 logMAR, p = 0.99).Conclusion
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. 相似文献3.
Purpose
To compare the current optometric practices and attitudes in the management of keratoconus patients in the UK and Spain.Methods
An online survey (adapted to optometric practices) was distributed via a newsletter emailed by various professional organizations in the UK and Spain.Results
Four hundred and sixty-four practitioners (126 in the UK; 338 in Spain) who prescribed gas permeable GP contact lenses (CLs) more than once per month (54.8% of UK practitioners and 28.1% of practitioners in Spain; p < 0.01) responded to the questionnaire. A combination of multiple factors is considered necessary in the keratoconus detection (79.4% in the UK, 75% in Spain; p = 0.68), and the use of classification criteria is considered relevant (67.5% in the UK, 70.7% in Spain; p = 0.49). There is a high consensus on the consideration that GP CL fitting is more difficult in keratoconus (79.4% in the UK, 80.5% in Spain; p = 0.79) requiring more diagnostic lenses (3.2 ± 1.4 and 3.4 ± 1.2 in the UK and Spain, respectively; p = 0.72) than are necessary for healthy eyes. Using corneal topography is uncommon from both countries (38.1% in the UK, 59.8% in Spain; p < 0.01), with a similar ophthalmologist referral pattern (at initial diagnosis, 50% in both the UK and Spain; p = 1.00). Few cases of co-management with ophthalmologists were noted (no co-management reported by 60.3% in the UK and 72.8% in Spain, p = 0.01).Conclusion
This study provides initial observations and evidence regarding keratoconus management by optometrists in the UK and Spain and shows similarity in the professional practices and attitudes of practitioners in these two countries. 相似文献4.
Sarah La Porta Weber Rossen Mihaylov Hazarbassanov Alex Nasaré José Álvaro Pereira Gomes Ana Luisa Hofling-Lima 《Contact lens & anterior eye》2017,40(3):151-156
Purpose
To evaluate conjunctival impression cytology and HLADR expression changes after wearing scleral contact lenses (ScCLs) for moderate to severe dry eye disease (DED).Design
Prospective interventional case series.Methods
Forty-one eyes from 25 patients with moderate to severe DED were evaluated for Esclera ScCL treatment. Best-corrected visual acuity (BCVA) and slit-lamp findings were assessed. Impression cytology specimens were obtained from DED patients at the baseline and after wearing ScCLs for 12 months. The impression cytology specimens were analyzed using morphological results score, and HLA-DR positive cells were detected and quantified. The values were compared to assess the IC changes after wearing ScCLs.Results
Forty-one eyes from 25 patients were fitted with ScCLs to manage DED. The underlying diseases were Stevens-Johnson syndrome (22 eyes), Sjogren’s syndrome (11 eyes), graft-versus-host disease (2 eyes), dry eye after keratomileusis (2 eyes) and undifferentiated ocular surface disease (4 eyes). The HE-PAS impression cytology score did not differ significantly before and after wearing ScCLs for 12 months in DED patients (p > 0.05). The percentage of eyes expressing the HLA-DR antigen in the temporal conjunctiva after wearing ScCL for 12 months significantly increased in patients with Sjogren’s syndrome (11.11% to 66.66%; p = 0.0498). In groups with Stevens Johnson syndrome and other ocular surface disorders, we did not observe statistically significant differences (p > 0.05).Conclusions
The ScCLs did not change the parameters used to evaluate inflammatory processes, which were measured using conjunctival impression cytology and HLA-DR expression, except in Sjogren syndrome, in which there was an unexpected increase in HLA expression. 相似文献5.
Purpose
The aim of this work was to investigate the locus and extent of vitronectin (Vn) deposition on ex vivo contact lenses and to determine the influence of wear modality together with surface and bulk characteristics of the lens material.Methods
The quantity and location of Vn deposition on the surfaces of contact lens materials was investigated using a novel on-lens cell attachment assay technique.Results
Vn mapping showed that deposition resulted from lens-corneal interaction rather than solely from the tear film. Higher cell counts on the posterior surface of the lenses were determined in comparison to the anterior surface. Overall gross Vn deposition was greater for high water content-low modulus materials (117 ± 4 average cell count per field) than low water content-high modulus materials (88 ± 6 average cell count per field).Conclusions
The role of Vn in plasmin regulation and upregulation is widely recognised. The findings in this paper suggest that the locus of Vn on the contact lens surface, which is affected by material properties such as modulus, is potentially an important factor in the generation of plasmin in the posterior tear film. Consequently, the potential for materials to affect Vn deposition will influence lens-induced inflammatory processes. 相似文献6.
Aoife Lloyd-McKernan Luisa Simo Mannion Veronica O’Dwyer 《Contact lens & anterior eye》2017,40(5):301-310
Purpose
To examine the influence of previous soft contact lens (SCL) wear on corneal refractive surgery (CRS) outcomes when SCL wear is ceased for two weeks versus twenty-four hours, and also when compared to no wear, prior to CRS.Methods
A retrospective examination of CRS patient records was carried out for two groups of patients- who ceased SCL wear for two weeks (n = 45) and for twenty-four hours (n = 49) prior to CRS and compared to a non-contact lens (NCL) control group (n = 45 and n = 49, respectively). CRS outcomes (efficacy, predictability, visual acuity and refractive error) were compared pre-operatively and one and six months post-operatively.Results
One month post-operative results found unaided distance visual acuity (UDVA) was significantly better for LASEK/PRK patients who had ceased SCL wear for two weeks prior to CRS (?0.05 ± 0.09), compared with the NCL group (0.02 ± 0.09; p = 0.04). Furthermore, six month post-operative results found UDVA was significantly better for both LASIK and LASEK/PRK patients who had ceased SCL wear for two weeks prior to CRS, and for LASEK/PRK patients who had ceased SCL wear for twenty-four hours prior to CRS compared with the NCL group.Conclusions
Given the current setup and methods followed, it was concluded that previous SCL wear had no negative impact on visual outcomes following CRS compared with a NCL control group, regardless of previous SCL cessation time prior to CRS. 相似文献7.
Corneo-scleral contact lenses in an uncommon case of keratoconus with high hyperopia and astigmatism
Esteban Porcar Juan Carlos Montalt Enrique España-Gregori Cristina Peris-Martínez 《Contact lens & anterior eye》2017,40(5):351-356
Purpose
To analyse the visual quality achieved by fitting corneo-scleral contact lenses (CScL) in an uncommon case of bilateral keratoconus, high hyperopia and astigmatism.Methods
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 1 year.Results
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 13 h a day. The total high order aberrations decreased by approximately 79% in the RE (2.37–0.50 μm) and 47% in the LE (1.04–0.55 μm) after CScL fitting. Visual quality and wearing time were maintained after 1 year wearing CScL. In addition, no adverse ocular effects were found during this period.Conclusion
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. 相似文献8.
Purpose
To assess the repeatability and reproducibility of Visante? OCT and Oculus Pentacam HR® in measuring central (CCT) and topographic corneal thickness (TCT) along the principle meridians in keratoconus (KC) corneae.Method
Twenty participants diagnosed with KC were recruited. There were two study visits. On the first study visit, two repeated corneal thickness measurements were obtained with each instrument. Measurements were repeated at least 48hrs later in the same order. TCT were recorded in the 90, 180, 45 and 135 meridians at 1mm intervals across 8mm chord.Results
Mean CCT for Visante? OCT was 484.97 ± 43.14 μm (range: 484.84–486.09) and Oculus Pentacam HR® was 478.86 ± 45.31 μm (range: 477.20–480.53). No significant difference in TCT between the two visits (p = 0.54) and measurements (p = 0.63) for Visante? OCT. For Oculus Pentacam HR®, no significant difference was found for each visit (p = 0.18) but differences existed in the measurements outside of the central region (p = 0.001). Tukey post-hoc analysis shows the differences (p ? 0.05) were found in the +1 and +4 (supero-temporal) locations in the 135 meridian. Significant differences were found comparing the two instruments, (p < 0.05). Bland Altman plots were used to demonstrate the differences between the two instruments and indicate their limits of agreement.Conclusion
Both instruments gave repeatable measurements as no significant differences were found in most locations in all meridians. Comparing the two instruments, they were not reproducible in all locations. 相似文献9.
Michael T.M. Wang Irene Cho Soo Hee Jung Jennifer P. Craig 《Contact lens & anterior eye》2017,40(4):236-241
Purpose
To compare the effects on tear film parameters and contamination in cosmetic eyeliner wearers, after single application of two lipid-based dry eye treatments: a lipid-containing lubricant eye drop and a phospholipid liposomal spray.Methods
Fifty participants were enrolled in a prospective, randomised, paired-eye, investigator-masked trial. Pencil eyeliner (Body Shop® Crayon Eye Definer) was applied to the upper eyelid periocular skin of both eyes, anterior to the lash line. Baseline tear film quality was assessed fifteen minutes after eyeliner application. A lubricant drop (Systane® Balance) was then applied to one eye (randomised), and liposomal spray (Tears Again®) to the contralateral eye. Tear film contamination, lipid layer grade, non-invasive tear film break-up time and tear evaporation rate were evaluated fifteen minutes post-treatment and compared to pre-treatment values.Results
Pre-treatment measurements did not differ between eyes assigned to lubricant drop and liposomal spray. Tear film contamination was observed in a greater proportion of eyes following both treatments (both p < 0.05), with no significant difference between treatments (p = 0.41). Both treatments improved lipid layer thickness (both p ≤ 0.01), but effected no significant change in non-invasive tear film break-up time or tear evaporation rate (all p > 0.05). Changes in tear film parameters did not differ between treatments (all p > 0.05).Conclusions
Both the lipid-containing lubricant eye drop and phospholipid liposomal spray result in clinically apparent tear film contamination in eyeliner cosmetic wearers. Although both treatments effected an increase in lipid layer thickness, neither displayed clinical efficacy in improving tear film stability. 相似文献10.
Purpose
To evaluate a novel fitting algorithm for estimation of alignment curve (AC) radius during orthokeratology lens trial.Methods
Fifty myopic children were recruited in this study. AC radii were estimated by both traditional method using flat K readings and eccentricity values and by a novel fitting algorithm, which was composed of 256 circle fittings using corneal elevation data from the corresponding AC region and a succedent toric fitting based on these calculated AC curvatures. Parameters of the final ordered lenses were determined by fluorescein analysis and corneal topography. The number of lens trials was recorded for each patient, and the consistencies of AC radius and astigmatism between the first trial lenses and the final ordered lenses were tested by Pearson correlations and Bland-Altman plots.Results
The numbers of trials for the novel algorithm and traditional method were 1.2 ± 0.4 times vs. 1.8 ± 0.7 times, respectively, and Mann-Whitney test showed significant difference (z = ?3.27, p = 0.001). AC radii of the first trial lenses estimated by the novel fitting algorithm were more close to that of the final ordered lenses, showing a R square value of 0.994 for the fitting algorithm and 0.927 for the traditional method, respectively. Similar results could also be noticed for astigmatism estimation.Conclusion
AC radius and astigmatism of ortho-k lens could be better estimated by two steps of fitting algorithm using corneal elevation data, which may shorten the time needed for ortho-k lens trial and achieve better lens fitting status. 相似文献11.
Zhouyue Li Dongmei Cui Yin Hu Sichun Ao Junwen Zeng Xiao Yang 《Contact lens & anterior eye》2017,40(6):417-423
Purpose
To analyze the change in subfoveal choroidal thickness (SFChT) and its relationship with changes in axial length (AL) in myopic children treated with Orthokeratology (Ortho-k).Methods
Fifty myopic children participated in this study: 29 subjects were treated with Ortho-k lenses and 21 with single vision distance spectacles. The SFChT and ocular biometrics, including AL, were measured at baseline, one month, and six months after lens wear in both groups.Results
AL significantly increased in both groups over time. In the Ortho-k group, SFChT also increased; however, there was no significant change in SFChT in the control group over time. At the six-month visit, the magnitude of eye growth was significantly reduced in the Ortho-k group compared to the control group (0.06 ± 0.10 mm vs. 0.17 ± 0.10 mm, P < 0.001). SFChT was significantly thicker in the Ortho-k group compared to the control group at the one-month and six-month visits (15.78 ± 11.37 μm vs. ?2.98 ± 8.96 μm, P < 0.001 (one-month visit); 21.03 ± 12.74 μm vs. ?2.50 ± 14.43 μm, P < 0.001 (six-month visit)), although there was no significant difference between the two follow-up visits (P = 0.102 for the Ortho-k group; P = 0.898 for the control group). Changes in the large choroidal vascular layer (LCVL) accounted for the majority of subfoveal choroidal thickening (approximately 77% and 80% at one-month and six-month visits, respectively).Conclusion
Ortho-k treatment induced significant choroidal thickening and a slowing of eye growth. LCVL thickening accounted for the majority of SFChT thickening. However, its potential mechanism in myopia control requires further investigation. 相似文献12.
Michael J. Doughty 《Contact lens & anterior eye》2017,40(2):109-115
Purpose
To assess if polymegethism and pleomorphism were evident in corneal endothelium after medium-term rigid gas permeable (RGP) contact lens wear.Methods
In a cross-sectional observational study over 12 years, single images of the central region of the corneal endothelium of one eye of 46 subjects were taken with a non-contact specular microscope, along with a measure of central corneal thickness (CCT). The images were printed onto A3-sized paper and 100 cells/image measured by planimetry.Results
Subjects aged between 20 and 32 years, with an average cumulative RGP wear of 6.0 +/? 1.6 years (range 3–9 years) were assessed; 26 of the subjects were Caucasian and 20 were Asian. The mean CCT was 0.515 +/? 0.027 mm. The group cell area value was 401 +/? 42 sq micron to give an estimated endothelial cell density (ECD) of 2520 +/? 273 cells/sq mm. As compared to a historical database, most endothelia (37/46) showed some changes with the mean coefficient of variation on cell area (COV) being 36.7 +/? 8.0% and the percentage of 6-sided (HEX) being 51.8 +/? 8.8%. There were modest correlations between years of RGP wear and both COV (p = 0.009, r spearman = 0.424) and HEX (p = 0.025, r spearman = ?0.291), but not for ECD or CCT.Conclusions
Corneal endothelial polymegethism appears to be a commonplace consequence of RGP lens wear with the magnitude of the change being related to the cumulative duration of the lens wear. 相似文献13.
Alejandra Consejo Maciej M. Bartuzel D. Robert Iskander 《Contact lens & anterior eye》2017,40(5):293-300
Purpose
To assess whether short-term soft contact lens wear alters the anterior eye surface.Methods
Twenty-two neophyte subjects wore soft contact lenses for a period of five hours. Topography based corneo-scleral limbal radius estimates were derived from height measurements acquired with a corneo-scleral profilometer. Additionally, central corneal thickness (CCT), anterior chamber depth (ACD), corneal curvature radius (R) and white-to-white (WTW) diameter were acquired with an OCT-assisted biometer. Measurements were obtained without lens wear (baseline), immediately after lens removal following five hours of wear and three hours after lens removal.Results
Short-term soft contact lens wear significantly modifies corneo-scleral limbal radius (mean ± SD: 130 ± 74 μm, p << 0.001) and the changes are repeatable. In contrast, the WTW diameter and R were not modified. ACD and CCT were significantly affected but no significant correlations were found between the increment of the limbal radius and the decrease in ACD and CCT. Limbal radius increment was reversed three hours after lens removal for 68% of the subjects but the time course of this reversal was not uniform.Conclusions
It is possible to accurately quantify limbal radius changes as a consequence of soft contact lens wear. The increment in the limbal diameter could reach over 0.5 mm but that alteration does not correspond to changes in WTW diameter and it was not observable to the examiner using a slit lamp. Assessing topographical limbus after contact lens wear could be a tool to optimize the selection of the contact lens, from the perspective of anterior eye surface changes. 相似文献14.
Jennifer K. Mooi Michael T.M. Wang Joevy Lim Andreas Müller Jennifer P. Craig 《Contact lens & anterior eye》2017,40(3):170-174
Purpose
To compare clinical tear film break-up time measurements obtained non-invasively, with those measured following minimal and conventional volumes of fluorescein instillation.Methods
Forty-one subjects (20 male, 21 female, mean ± SD age 34 ± 11 years), with or without dry eye, participated in a prospective cross-over study. Tear film break-up time was measured by the Tearscope Plus? with fine grid insert. Measurements were made in triplicate, with no fluorescein instillation (NIBUT), then following application of a minimal volume of 1 μl fluorescein from the Dry Eye Test? (mTBUT), and finally with 15–30 μl of fluid instilled via a conventional fluorescein strip (TBUT). A fifteen-minute interval between each set of measurements minimised the risk of residual contamination effects.Results
All three techniques displayed statistically significant pairwise correlation (all p < 0.001). TBUT values were significantly shorter than both NIBUT (geometric mean 8.6 s versus 10.9s, p = 0.03) and mTBUT (geometric mean 8.6 s versus 10.6s, p = 0.03), and demonstrated narrower spread (both p < 0.05). No significant differences were detected between NIBUT and mTBUT (all p > 0.05).Conclusions
Tear film break-up time values measured with conventional fluorescein instillation were shortened, while minimal fluorescein instillation and non-invasive methods produced comparable readings. This suggests that minimising instilled volumes can reduce the impact of fluorescein on clinical measurements of tear film stability. 相似文献15.
Purpose
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.Method
A multi-centre survey was conducted using a questionnaire completed anonymously by contact lens wearers during the purchase of DDCLs.Results
Three hundred and fifty-four questionnaires were returned. The survey comprised 58.5% females and 41.5% males (mean age 34 ± 12 years). 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).Conclusions
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. 相似文献16.
Purpose
To report a case of lens discontinuation in a long term orthokeratology (OK) lens wearer and describe regression in refraction, corneal topography, and corneal thickness over 408 days after lens discontinuation. Furthermore, the outcome of subsequent LASIK treatment is also reported.Case report
A 41 year old Caucasian female who had been previously wearing OK lenses for 13 years discontinued lens wear in the left eye to consider refractive surgery in that eye. The greatest changes in subjective and objective refractions, corneal topography and thickness occurred during the first 28 days after lens discontinuation. Subjective refraction did not reach baseline values, but corneal topography parameters returned to pre-OK values after 408 days of no lens wear. The patient then received successful refractive surgery treatment in that eye, achieving uncorrected visual acuity of 0.00 LogMAR units, and residual refractive error within ±0.50 D of emmetropia.Conclusion
The period of lens discontinuation required for long term OK lens wearers before refractive surgery is likely to vary between individuals and the patient described in this case report required a significant period of lens discontinuation of at least one year before being considered suitable for refractive surgery. 相似文献17.
Purpose
To describe a new methodology for tear-film dynamics assessment by observing fluorescein decay rate over time and to understand the relationship between the newly defined tear fluorescein washout rate (TFWR) and other measures of the tear film behaviour.Methods
Forty subjects (24F/16M) aged (mean ± standard deviation) 31.8 ± 14.2 years volunteered for the study. It consisted of the review of medical history, McMonnies questionnaire (McMQ), slit lamp examination, and TFWR using a newly-developed fluorescein profilometry. The repeatability of TFWR measurements was assessed. TFWR estimates were contrasted against patient age, McMQ score, daytime, fluorescein tear film break-up time (FTBUT), tear meniscus height (TMH) and blink frequency.Results
Mean repeatability of the method was 28.13 ± 9.59%. The group mean TFWR was 39 ± 23% at 30-s mark after the beginning of measurements, ranging from 1.4% to 83%. This indicates that TFWR is highly subject-dependent. Statistically significant correlations were found between the percentage TFWR and McMQ score (r2 = 0.214, p = 0.001) as well as FTBUT (r2 = 0.136, p = 0.009). No statistically significant correlations were found between TFWR and age, daytime, TMH, and blink frequency.Conclusions
Fluorescein profilometry allows clinicians to follow dynamic changes in the tear film on the entire ocular surface and may be used for qualitative assessment of the tear film dynamics. 相似文献18.
Hassan Hashemi Asghar Beiranvand Abbasali Yekta Amir Asharlous Mehdi Khabazkhoob 《Contact lens & anterior eye》2017,40(2):104-108
Purpose
To examine the diagnostic validity of different corneal biomechanical parameters for the detection of early keratoconusMethods
Sixty-one eyes with a diagnosis of early keratoconus and 61 topographically normal eyes were enrolled in the study. All participants underwent testing with the Ocular Response Analyzer (ORA), and 40 indices from each cornea were included in the analysis.Results
The mean (standard deviation: SD) of keratometry and central corneal thickness in keratoconic corneas was 46.9 (2.5) diopter (D) and 473 (31) μm, respectively. Of the 40 evaluated indices, 32 showed a significant difference between the two groups using t-test (p < 0.05). According to the results of logistic regression, the indices of height from the lowest to the highest point in peak 2 (H21) and corneal resistance factor (CRF) with R2 = 0.79 were the best predictors of early keratoconus (p < 0.001). H21 ≤190 with a sensitivity and specificity of 87% and 91.8%, respectively, and CRF ≤ 8.6 with sensitivity and specificity of 87% and 85.3%, respectively, yielded an overall diagnostic accuracy of 97.3%.Conclusion
This study results point to the important role of novel waveform-derived indices measured by ORA, along with conventional biomechanical indices, for the early diagnosis of keratoconus. The best predictors of keratoconus in its early stages are H21 and CRF which showed very high sensitivity and specificity for the detection of early keratoconus. 相似文献19.
Aim
To analyze the demographics, risk factors, clinical and microbiological characteristics of cases of bilateral simultaneous infective keratitis.Methods
In this retrospective case series, patients with clinical evidence of bilateral simultaneous infective keratitis were identified from January 1, 2011 to August 31, 2016. Demographics, risk factors, clinical and microbiological characteristics, and treatment outcomes were analyzed.Results
Five patients (ten eyes) with bilateral simultaneous infective keratitis were identified. The mean age was 32.8 years (SD, ± 8.8; range, 24–44). All the patients were disposable soft contact lens wearers before presentation. The average size of the infiltrate was 4.76 mm2 (SD ± 9.0; range, 0.2–31.34). A total of 4 types of bacteria were isolated, with Pseudomonas aeruginosa being the most frequently isolated bacteria involving 5 eyes of four patients. Infection resolved with medical treatment in 9 eyes, 1 patient required therapeutic corneal transplantation for impending corneal perforation. The average time taken for infection to resolve was 6.7 days (SD ± 4.5; range, 2–16).Conclusions
In this case series, the most common risk factor of bilateral simultaneous microbial keratitis was use of soft disposable contact lens and the most commonly isolated bacteria was Pseudomonas aeruginosa. Bilateral simultaneous infective keratitis is uncommon and is a serious complication of contact lens use in immunocompetent adult patients. 相似文献20.