Anatomical and physiological considerations in scleral lens wear: Eyelids and tear film

Scleral lenses can affect a range of anterior segment structures including the eyelids and the tears. The eyelids, consisting of the outer skin layer, the middle tarsal plate, and the posterior palpebral conjunctiva, provide physical protection and house the meibomian glands and cilia which have important and unique functions. Tears consist of a mix of aqueous, mucus, and lipidomic components that serve vital functions of lubricity, protection, and nourishment to the ocular surface. Both the eyelids and the tear film interact directly with scleral lenses on the eye and can affect but also be impacted by scleral lens wear. The purpose of this paper is to review the anatomy and physiology of the eyelids and tear film, discuss the effects and impacts of the scleral lenses on these structures, and identify areas that require further research.     

Antimicrobial susceptibility of isolated pathogens from patients with contact lens-related bacterial keratitis in Crete,Greece: A ten-year analysis

PurposeTo evaluate the bacterial spectrum and antimicrobial susceptibilities of pathogens isolated from contact lens-related bacterial keratitis cases in a large academic Greek hospital.MethodsAll adult patients with positive corneal scrapings or contact lens culture between 2007 and 2016 at the University Hospital of Heraklion, Greece, were retrospectively identified through a local microbiology database and their medical records were reviewed.ResultsA total of 240 isolates were recovered from 131 patients with culture-proven contact lens-associated bacterial keratitis. The most common microorganism identified was Serratia marcescens (17.1% of total isolates), followed by Pseudomonas aeruginosa, Klebsiella spp. and coagulase-negative staphylococci (CoNS). Rates of aztreonam-resistant P. aeruginosa and erythromycin-resistant CoNS decreased in recent years, while the decrease in oxacillin-resistant CoNS was statistically significant (p=0.009). More than 90% of the isolated organisms (S. marcescens, P. aeruginosa, Klebsiella spp. and CoNS) were susceptible to ciprofloxacin or gentamicin.ConclusionGram-negative microorganisms are the most common causative pathogens of contact lens-related keratitis in the region of Crete. Topical antibacterials containing quinolones or gentamicin represent an effective empirical treatment for the majority of the cases. This is quite encouraging, considering that the present study was conducted in a country characterised by high antimicrobial resistance rates. However, culture-driven antimicrobial treatment is mandatory for this sight-threatening infection.     

In vitro affinity for nicotine of soft contact lenses of different materials

Smoking is a risk factor for the development of microbial keratitis and corneal infiltrates in contact lens (CL) wearers. It is still unknown if this risk is directly associated with the presence of nicotine in the eye and if adherence of nicotine on the CL can enhance these effects. A better understanding of the interaction between nicotine and CL materials could offer insights to explain this risk associated with smoking. The aim of this work was to compare the affinity of nicotine to different soft CL materials. CLs from FDA groups I, II, IV, and V were incubated in a 2-mM nicotine solution for 24 h and then in a 0.9% saline solution for the next 24 h. The amount of absorbed and released nicotine per CL was deduced as a function of time (t) by ultraviolet (UV) spectrophotometry and normalised to the mass of the hydrated CL. The data were described by the equation y = b –a t^?1, where a and b are constants, and b represents the mass reached at the plateau after ~ 10 min of exposure. Groups IV and V displayed the highest (0.80 ± 0.09 µg) and lowest (0.27 ± 0.08 µg) nicotine absorption per mg of hydrated CL, respectively. The CL affinity for nicotine could be ascribed to the interaction between the positive charge of nicotine pyrrolidine nitrogen and the negative charges of the CLs, especially for the ionic IV group.     

The impact of COVID-19 on soft contact lens wear in established European and US markets

PurposeTo characterise changes in soft contact lens wearing habits during the COVID-19 pandemic.MethodsA detailed online questionnaire was circulated to individuals aged 40–70 years, during the period April to May 2021. Data sampling took place in the United Kingdom (UK), United States of America (USA), Netherlands, Germany, France, Spain and Italy. Only data pertaining to individuals who were soft contact lens wearers were included. Data were extracted for questions relating to contact lens wearing habits pre- and during the COVID-19 pandemic, and expectations for future lens wear beyond the pandemic.ResultsSeven-hundred and twenty-eight individuals were identified as soft contact lens wearers of which six-hundred and nineteen wore a combination of contact lenses and spectacles. Most respondents indicated contact lens wear times had either remained the same (57.3%) or increased (9.8%) during the pandemic. The country with the greatest proportion of respondents decreasing wear time during COVID-19 was the UK (45.3%), and the least in the Netherlands (20.0%). The primary cause of decreased lens wear was attributed to leaving the home less often (70.0%), and the second most common reason due to concerns about hygiene (10.8%). Most respondents (83.9%), however, expressed a desire to return to pre-pandemic wear times once the pandemic was over.ConclusionsPractitioner concerns about contact lens market recovery ought to be assuaged by the survey outcomes which show most individuals to have maintained lens wear during the pandemic. In view of the continued lens wear, as and when restrictions ease, ECPs may wish to encourage patients to return for routine check-ups that may have been missed due to the pandemic.     

Efficacy,predictability and safety of long-term orthokeratology: An 18-year follow-up study

PurposeTo determine the efficacy, predictability and safety of long-term orthokeratology in children and adults.MethodsCase histories of 300 orthokeratology patients (596 eyes; 34.3% children; 65.7% adults) were reviewed to collect information on demographics, corneal and refractive parameters, visual acuity, residual refraction and adverse effects. Predictability was defined as the percentage of eyes with absolute values of spherical equivalent refraction ≤ 0.5 D of emmetropia, and efficacy as the ratio of post-orthokeratology uncorrected and pre-orthokeratology corrected distance visual acuity.ResultsMedian duration of treatment was 37 and 28.5 months in children and adults, respectively (p = 0.022). During the first year, 17.2% of children and 33% of adults ceased lens wear (p < 0.001). For children and adults with a successful ortho-k treatment of at least one year of duration, 88.7% and 95.9% of eyes had a predictable refractive outcome, and efficacy was 0.98 and 1.01, respectively. A larger percentage of children (65.7%) were free of complications than of adults (55.4%) (p = 0.015). One event of microbial keratitis occurred in adults (6.8 cases per 10,000 patient-years) and none in children. Corneal staining was the most frequent complication, with a higher incidence in adults (p = 0.007) and in higher myopia (p < 0.001), higher anterior corneal eccentricity (p = 0.019) and smaller anterior horizontal radius (p = 0.027).ConclusionOrthokeratology is a safe and predictable long-term procedure in children and adults, with a low incidence of serious adverse effects. Corneal staining episodes are relatively frequent throughout the course of the treatment, thus highlighting the relevance of education of experienced users.     

低温精馏法提纯三氟化硼的工艺研究

针对三氟化硼气体由2.5 N(摩尔分数99.5%)提纯至4 N(摩尔分数99.99%)的技术工艺进行研究,采用双塔连续低温精馏的技术路线;通过Aspen Plus模拟计算,利用灵敏度分析得到最佳的工艺参数,包括操作压力、操作温度、理论板数和回流比等工艺参数,为三氟化硼精制工艺的实验研究奠定了理论基础。     

低温甲醇用系列缠绕管式换热器的研究与开发

针对煤制甲醇等煤化工领域内的低温甲醇用系列缠绕管式换热器的研究开发现状及进展进行论述;举例说明甲醇-甲醇冷却器、低温循环甲醇冷却器、未变换气冷却器、变换热气冷却器及原料气冷却器等多股流、多相流、低温高压交叉换热用缠绕管式换热设备的基本设计方法和内部多股流换热工艺流程;对不同介质、不同用途的低温甲醇用缠绕管式换热器和螺旋缠绕管束总体结构特征及其工作原理进行阐述;为低温甲醇领域内缠绕管式换热器的设计计算提供参考;展望低温甲醇用系列缠绕管式换热器的重要研究方向和需要进一步解决的关键科学问题。     

焦炉气甲烷化制LNG工业化装置运行技术分析

简述了国内首套焦炉气甲烷化制LNG的工艺原理、工艺流程,介绍了其重点工艺单元和催化剂:焦炉煤气净化、甲烷合成催化剂、甲烷合成工艺、合成气低温液化等。利用自主研发的预还原催化剂以及绝热型反应器和换热型反应器组合形成的焦炉煤气甲烷合成新工艺,可保证合成气中CO2体积分数小于50×10-6,甲烷合成反应更完全。工业运行结果表明,该装置具有工艺简单、操作平稳、设备投资少、能耗低等特点。     

Control structure synthesis for operational optimization of mixed refrigerant processes for liquefied natural gas plant

The best control structures for the energy optimizing control of propane precooled mixed refrigerant (C₃MR) processes were examined. A first principles‐based rigorous dynamic model was developed to analyze the steady‐state and dynamic behaviors of the C₃MR process. The steady‐state optimality of the C₃MR process was then examined in a whole operation space for exploring the feasibility of the energy optimizing control for possible control structures. As a result, the temperature difference (TD) between the warm‐end inlet and outlet MR streams was exploited as a promising controlled variable to automatically keep the liquefaction process close to its optimum. The closed‐loop responses were finally evaluated for every possible control structure candidate. Based on the steady‐state optimality and the dynamic performance evaluation, several control structures with a TD loop were proposed to be most favorable for the energy optimizing control of the C₃MR process. The proposed optimality approach can be applied to any natural gas liquefaction process for determining a proper controlled variable for optimizing operation. © 2014 American Institute of Chemical Engineers AIChE J, 60: 2428–2441, 2014