Crystalline lens thickness change is associated with axial length elongation and myopia progression in orthokeratology

AimsConsidering individual variability in regards to the effects of orthokeratology (ortho-k) on myopia progression and controversies regarding the precise underlying mechanism, the aim of this study was to investigate several ocular measurements associated with axial length (AL) growth in children wearing ortho-k lenses.MethodsIn this retrospective chart review, medical records of 53 Chinese children who wore ortho-k lenses over the course of 12 months were reviewed. Baseline variables included age at initiation of ortho-k wear, refractive error (spherical equivalent, SE), central corneal thickness (CCT), and flat and steep keratometry of corneal principal meridians. The change of anterior chamber depth (ACD) and the change of crystalline lens thickness (CLT) between baseline and the 12-month follow-up were also analyzed. The contributions of all analyzed variables to AL change were assessed using univariate and multivariate regression analyses.ResultsInitially, the results of paired t-test showed that CLT and AL were significantly increased after 12 months of ortho-k wear compared with that at baseline (P = 0.001 and < 0.001). The ACD did not change significantly after 12 months compared with that at baseline (P = 0.491). Subsequently, univariate analyses showed that a reduced rate of AL elongation was found in children who were older age at initiation of ortho-k wear (P = 0.028), had greater SE (higher degree of myopia) at baseline (p = 0.006), had thicker CCT at baseline (P = 0.04), and had greater increase of CLT (P = 0.001) in 12 months. At last, only greater SE (higher degree of myopia) and greater increase of CLT were associated with smaller increases of AL in multivariable analyses, (P = 0.003 and 0.001).ConclusionsBoth CLT and AL were significantly increased in children with overnight ortho-k wear after 12 months of follow-up. Greater baseline SE and greater increase of CLT were associated with less increase in AL during ortho-k wear in children with myopia.     

煤油气共生矿井底板油型气赋存特征及防治

为了提高煤油气共生矿井油型气灾害治理的科学性，以黄陵二矿为例，采用现场测试、钻探取芯、跟踪观测、地质分析等多种方法，研究了采掘工作面煤层底板油型气分布特征、涌出规律和运移机理，并初步探讨了底板油型气体灾害防治措施。结果表明:底板油型气涌出点多位于底板砂岩储层上倾尖灭端和砂岩透镜体附近，呈现不连续区带状分布特征，涌出的油型气主要来自富县组砂岩层，涌出的动力主要为地层流体压力差，底板油型气通过地层中存在大量的断裂和裂缝、微裂缝系统进入采掘空间，采掘扰动是底板油型气异常涌出的工程诱导因素。建议加强油型气综合探查技术、油型气灾害预测预报技术、油型气综合抽采技术和智能化矿井建设等方面的研究。     

红外菲涅尔透镜的注射超声辅助成型优化

为了提升聚合物红外菲涅尔透镜的光学性能,以其表面微沟槽的成型质量为目标,提出了一种高效的注射超声辅助成型方法,并对工艺参数进行了综合质量优化。首先分析了超声振动对聚合物的加热和加压效应,设计了一套一模两腔的对比试验模具;接着以红外菲涅尔透镜的调制传递函数MTF和齿形平均高度h为优化质量目标,设计了四步骤的多目标优化流程,通过试验设计、基于BP神经网络的质量目标与注射工艺参数关系建模、基于NSGA-Ⅱ的多目标优化和试验验证进行工艺参数的综合优化。实验结果表明:该多目标优化流程具有很高的精度,MTF和h的平均预测误差MPE分别为4.16%和3.32%;注射超声辅助成型的菲涅尔透镜微沟槽具有更高的复制质量,其齿沟槽平均高度h增加了15.6%,且h值的波动量随着h值的增大而增大,MTF值受齿高h均匀性的影响大于齿高h对其的影响。     

镜头成像畸变的MTF像高测试法研究

为了解决传统标板拍摄测试广角镜头成像畸变的不准确、复现性差问题,提出了基于调制传递函数(MTF)理论的成像畸变测试方法。通过研究镜头畸变测试国内外的研究现状,重点分析了成像镜头特别是广角镜头采用传统标板拍摄测试成像畸变的缺陷。提出了一种通过测试镜头轴上有效焦距和不同角度的离轴有效焦距,并导入畸变计算公式从而得到镜头成像相对畸变的MTF测试方法。研究结果表明,采用MTF测试方法可以实现对镜头成像畸变的快速、准确的测量。     

Does placebo effect exist in contact lens discomfort management?

PurposeTo study the effect of daily disposable contact lens (DDCL) refitting in monthly contact lens (CL) wearers suffering from contact lens discomfort (CLD), and to assess if there is a placebo effect associated with this CLD intervention.MethodsSymptomatic CL wearers, according to the Contact Lens Dry Eye Questionnaire 8 (CLDEQ-8 ≥ 12 points), were divided into two groups. The study group was provided with DDCLs (delefilcon A) and the control group with a masked pair of their habitual monthly CLs (placebo effect) and were assessed after one month. Then, the control group was provided with the same DDCLs and evaluated one month later. The symptoms were recorded with the CLDEQ-8 and global rating of change scale (GRCS). Non-invasive tear break-up time (NITBUT), conjunctival hyperaemia, fluorescein staining, and lid wiper epitheliopathy (LWE) were evaluated. Changes between visits, groups, and the effect of each intervention were analysed.ResultsThirty-one participants (mean age: 23.2 ± 5.3 years) were recruited. The study group (n = 14) showed an improvement of -39.6 ± 25.8 % (p < 0.001) in CLDEQ-8 and 31.3 ± 14.6 points in GRCS (p < 0.001) after one month of DDCL use, while no changes in clinical tests were found. In the control group (n = 17), symptoms improved significantly after wearing the masked monthly CL (CLDEQ-8: -26.1 ± 31.0 %, p = 0.03; GRCS: 14.9 ± 17.0, p = 0.002), however a worsening in bulbar (26.5 ± 40.0 %; p = 0.02) and limbal hyperaemia (21.6 ± 34.7 %, p = 0.02) and an improvement of -19.1 ± 37.0 % (p = 0.049) in LWE was found. When the control group was fitted with the DDCL, improvements in GRCS (20.5 ± 25.5, p = 0.02), NITBUT (37.9 ± 42.3 %, p = 0.002), and conjunctival staining (-47.1 ± 59.9 %, p = 0.005) were noted.ConclusionsRefitting symptomatic monthly CL wearers with Delefilcon A DDCL is effective in reducing symptoms related to CLD. However, clinicians and researchers must be aware of the existence of a placebo effect when assessing the effectiveness of any CL refitting.     

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.     

BCLA CLEAR - Effect of contact lens materials and designs on the anatomy and physiology of the eye

This paper outlines changes to the ocular surface caused by contact lenses and their degree of clinical significance. Substantial research and development to improve oxygen permeability of rigid and soft contact lenses has meant that in many countries the issues caused by hypoxia to the ocular surface have largely been negated. The ability of contact lenses to change the axial growth characteristics of the globe is being utilised to help reduce the myopia pandemic and several studies and meta-analyses have shown that wearing orthokeratology lenses or soft multifocal contact lenses can reduce axial length growth (and hence myopia).However, effects on blinking, ptosis, the function of Meibomian glands, fluorescein and lissamine green staining of the conjunctiva and cornea, production of lid-parallel conjunctival folds and lid wiper epitheliopathy have received less research attention. Contact lens wear produces a subclinical inflammatory response manifested by increases in the number of dendritiform cells in the conjunctiva, cornea and limbus. Papillary conjunctivitis is also a complication of all types of contact lenses. Changes to wear schedule (daily disposable from overnight wear) or lens materials (hydrogel from SiHy) can reduce papillary conjunctivitis, but the effect of such changes on dendritic cell migration needs further study. These changes may be associated with decreased comfort but confirmatory studies are needed. Contact lenses can affect the sensitivity of the ocular surface to mechanical stimulation, but whether these changes affect comfort requires further investigation.In conclusion, there have been changes to lens materials, design and wear schedules over the past 20+ years that have improved their safety and seen the development of lenses that can reduce the myopia development. However, several changes to the ocular surface still occur and warrant further research effort in order to optimise the lens wearing experience.     

Clinical significance of contact lens related changes of ocular surface tissue observed on optical coherence images

PurposeTo investigate the relationship between the real contact lens imprint into the conjunctival tissue, observed by optical coherence tomography (OCT) and conjunctival staining and contact lens wearing comfort.Methods17 participants (mean age = 26.6 SD ± 3.6 years; 7 females) were fitted with three different contact lenses base curves of the same silicone hydrogel custom lens type (Visell 50; Hecht Contactlinsen, Au, Germany) in a randomised order. One lens was optimally fitted according to the manufacturer's recommendation, one fitted 0.4 mm flatter and one fitted 0.4 mm steeper. After 4 h of lens wear the contact lens edge in the area of the conjunctiva was imaged nasally and temporally using OCT (Optovue iVue SD-OCT). To correct the artefact due to optical distortion with OCT, the imprint of all worn lenses was measured on a glass plate afterwards. Conjunctival staining in the limbal region after 4 h of lens wear was classified using the CCLRU Grading Scale. Comfort scoring was based on visual analog scales from 0 (very poor) to 100 (excellent).ResultsThe mean conjunctival imprint of all contact lens edges was 32.0 ± 8.1 μm before and 7.3 ± 6.5 μm after distortion correction of the OCT images. The distortion corrected conjunctival imprint with the 0.4 mm steeper lens (11.5 ± 6.2 μm) was statistically significantly greater compared to the optimally fitted lens (6.5 ± 5.9 μm) (One-way ANOVA followed Tukey-test; p = 0.017) and greater compared to the 0.4 mm flatter lens (3.9 ± 5.3 μm) (p < 0.001). There was no statistically significant difference between the optimally fitted lens and the 0.4 mm flatter lens (p = 0.209). The nasally measured imprint (11.4 ± 9.0 μm) was significantly greater than the temporally measured (3.3 ± 7.6 μm) (p < 0.001). There was no statistically significant correlation between the amount of conjunctival imprint and the graded conjunctival staining (p = 0.346) or the wearer’s comfort (p = 0.735).ConclusionsContact lens edges imaged by OCT exhibited displacement artefacts. The observed conjunctival imprints are a combination of real conjunctival compression and artefacts. A deeper imprint of the contact lens into the conjunctiva caused by a steeper base curve was not related to clinically significant staining or changes in comfort after 4 h of lens wear. The observed differences between nasal and temporal imprint are likely to be caused by variations of conjunctival thickness and the shape of the underlying sclera.