Refractive index of soft contact lens materials measured in packaging solution and standard phosphate buffered saline and the effect on back vertex power calculation

PurposeTo measure the refractive index (RI) of commonly available soft contact lens (CL) materials, their packaging solutions and compare to the manufacturers’ nominal RI. The relationship between RI versus water content, and the effect of inaccurate RI when converting lens power measured in solution to in-air back vertex power were examined.MethodsThe RI of 18 single vision soft CL materials were measured using CLR 12–70 digital refractometer. Three lenses of each material were measured, in their packaging solution and then after soaking in standard phosphate buffered saline (PBS). The RIs of packaging solution were also measured. Accuracy requirements for correct wet to dry power conversion based on thick lens formula were projected.ResultsThe standard deviation between three samples was less than 0.005. The measured RI ranged from 1.3744 ± 0.001–1.4265 ± 0.0004 for PBS soaked and from 1.3739 ± 0.0003–1.4264 ± 0.0024 for packaging solution soaked materials. Comparing nominal with mean measured PBS and packaging solution RIs, 5 and 3 lens materials, respectively, fell outside ISO tolerance. The packaging solution RI of DailiesAquaComfortPlus had the largest difference of 0.0040, compared to RI of standard PBS. For converting lens power measured in PBS to in-air power, the difference between measured and nominal RI of 0.0104 would result in wrongly calculated in-air power 0.99 D for a -6.00 D lens.ConclusionThe CLR 12–70 is reliable and accurate refractometer for the measurement of soft CL materials. Accurate RI measurements are of relevance with increased use of wavefront sensors to measure lens power while they are immersed in solution. Even small errors in solution or material RI can lead to significant errors in converted in-air power. To obtain valid in-air lens power results, measurement conditions must match the material and solution RIs used for the conversion.     

Use of silicone hydrogel material for daily wear.

Silicone hydrogel contact lenses were initially developed to optimise oxygen transmissibility for extended wear use. The concerns with such contact lenses have been their higher elastomeric and hydrophobic characteristics associated with the incorporation of silicone type monomers. The use of silicone hydrogel has most recently been suggested for daily wear to eliminate all hypoxic related problems. The primary aim of the investigation was to test in vivo wetting performance and subjective acceptance of the first silicone hydrogel contact lens developed for daily wear, ACUVUE ADVANCE with HYDRACLEAR (galyfilcon A), compared to a conventional hydrogel contact lens for the same application SofLens 66 (alphafilcon A). The investigation was a randomised, subject masked bilateral cross over investigation testing of the two contact lens materials over their approved replacement periods (galyfilcon A 2 weeks and alphafilcon A 2 weeks (USA) and 4 weeks (Europe)). In all cases ReNu Multiplus lens care system was used. The investigation carried out on 24 contact lens wearers showed that: (i) in vivo wettability was superior for galyfilcon A which had a thicker lipid layer (thin layer incidence: galyfilcon A 54%; alphafilcon A 70-86%, p<0.05), a thicker aqueous layer (thick layer incidence: galyfilcon A 88%; alphafilcon A 35-64%, p<0.05) and a more stable tear film (galyfilcon A 7.8s; alphafilcon A 2 weeks 5.6s, p=0.022; 4 weeks 7.4s, p=0.276); (ii) for the intended replacement period, comfort was better with galyfilcon A (2 weeks) compared to alphafilcon A (4 weeks) at insertion (p=0.001) and, throughout the day (daytime and evening p=0.008). Contact lenses made from galyfilcon A and replaced two weekly achieved better in vivo wettability than contact lenses made from alphafilcon A and replaced either two and four weekly; the better wettability was associated with an overall better comfort for galyfilcon A.     

Process capability measurement of frequent replacement spherical soft contact lenses.

Frequent replacement soft contact lenses must have good reproducibility in order to avoid clinical problems arising from manufacturing variations in lens parameters. This study assessed the actual and potential process capability of eight frequent replacement lenses (monthly or 2-weekly replacement) in relation to back vertex power, back optic zone radius, total diameter and centre thickness. Twenty-four lenses in three powers (-1.00, -3.00, -6.00 D) were measured for eight frequent replacement lenses: Acuvue, Acuvue 2, Biomedics 55, Encore, Focus, Optima FW, Soflens 66, Surevue. In general, the lenses showed adequate reproducibility in respect of those parameters likely to affect lens fit, namely back optic zone radius, total diameter and centre thickness. The process capability results showed some variation in reproducibility of BVP between lens types and between lens powers. Process capability was found to be a useful measure of contact lens reproducibility.     

Chromatic dispersion of soft contact lens materials

PurposeTo investigate and evaluate the chromatic dispersion of various hydrogel and silicon hydrogel contact lens materials.MethodsEighteen different soft contact lens materials with high and low water content in lens power of −1.00 DS were measured by one operator at temperature of 20 °C ± 0.5° soaked in ISO standard phosphate-buffered saline (PBS) and in their respective packaging solutions (PS). An analogue Abbe refractometer (Model Zuzi 320, AUXILAB, S.L., Navarra, Spain) was used for refractive index (RI) measurements at 5 different wavelengths. All contact lenses were presented in a random and masked order to the operator. The Bland-Altman method with 95 % limits of agreement (LoA) and coefficient of repeatability (CoR) was used to characterise the repeatability of refractive index measurements. The Abbe numbers for each material were calculated by entering the measured and interpolated refractive indices into the Abbe number equation. One-way ANOVA analysis was used to test if there were significant differences between the 5 different wavelengths (470 nm–680 nm) within each material. An unpaired t-test was used to determine if there were differences in refractive index or dispersion between packaging solution and PBS results.ResultsNelfilcon A (Dailies Aqua Comfort Plus) soaked in PS showed the best repeatability of all 18 examined soft contact lenses across all wavelengths with an average refractive index of 1.3848 for all 6 contact lenses with a standard deviation of 0.00064. The 95 % limits of agreement were between 1.3835 and 1.3860. The mean coefficient of repeatability for nelfilcon A was 0.00125. For contact lenses soaked in ISO Standard PBS comfilcon A (Biofinity) had the best repeatability. The average refractive index of all 6 contact lenses was 1.4041 with a standard deviation of 0.00031 and a coefficient of repeatability of 0.00060. The 95 % limits of agreement were between 1.4035 and 1.4047. The analysis with One-way ANOVA with multiple comparisons involving Holm-Sidak post-hoc, showed that there are significant differences (p < 0.001, F_ratio = 376.2 between wavelengths and F_ratio = 1559 between different refractive indices) in the refractive index of most common lens materials across the visible wavelength range. Based on unpaired t-test, there is no significant difference (p > 0.05) in the Abbe numbers of the tested lens materials whether they have been placed in the packaging solution or in standard PBS (p > 0.05, 95 % CI = −4.8070 to 5.8680, t = 0.2054). The Abbe numbers for the calculated contact lenses soaked in PS ranged between 43.7 and 89.9. For contact lenses stored in PBS the range was between 46.3 and 81.6.ConclusionThere is a good repeatability between repeated RI measurements taken from the same lens and from the same material. The significant differences between the refractive indices across the 5 different wavelengths showed the presence of chromatic dispersion in the 18 evaluated soft contact lens materials. Furthermore, it could be shown that there is no significant difference in dispersion whether the contact lenses are soaked in standard PBS or in their respective packaging solutions. With no other published data available as a reference, absolute accuracy of the calculated Abbe numbers remains to be confirmed, however, this study did confirm that significant chromatic dispersion exists in soft contact lens materials.     

Impact of a low molecular weight hyaluronic acid derivative on contact lens wettability

PurposeTo investigate the interaction of a novel low molecular weight hyaluronic acid derivative containing hydrophobic groups with soft contact lenses and its effect on lens hydrophilicity compared with a conventional form of hyaluronic acid.MethodsThis investigation studied the uptake of fluorescently-labelled hyaluronic acid and a low molecular weight hyaluronic acid derivative to four types of contact lenses using fluorescent microscopy and confocal laser scanning microscopy. Further, the four lens types were used to compare efficacy in improving hydrophilicity, as well as maintenance of contact angle measurements, in commercially available multipurpose solutions that contained either hyaluronic acid, the low molecular weight hyaluronic acid derivative, or an alternative wetting agent.ResultsThe low molecular weight hyaluronic acid derivative was found to sorb more readily to silicone hydrogel lenses and exhibit a greater accumulation over time than conventional hyaluronic acid. Multipurpose solutions containing the low molecular weight hyaluronic acid derivative showed an increase in lens hydrophilicity through decreases in contact angle measurements when compared with those obtained from lenses treated with multipurpose solutions containing conventional hyaluronic acid or alternative wetting agents. This increase in lens hydrophilicity associated with the low molecular weight hyaluronic acid derivative was also maintained over multiple cycles in phosphate buffered saline, while alternative solutions with conventional hyaluronic acid did not.ConclusionOverall, lens treatment using a low molecular weight hyaluronic acid derivative-based solution lead to improved in vitro lens hydrophilicity.     

Acanthamoeba keratitis in patients wearing scleral contact lenses

Purpose

To report a series of cases of Acanthamoeba keratitis (AK) in scleral lens wearers with keratoconus to determine whether this type of contact lens presents a greater risk for development of infection. Methods: This study reports three patients who wore scleral contact lenses to correct keratoconus and developed AK. The diagnoses of AK were established based on cultures of the cornea, scleral contact lenses, and contact lens paraphernalia. This study investigated the risk factors for infections. Results: The possible risks for AK in scleral contact lens wearers are hypoxic changes in the corneal epithelium because of the large diameter and minimal tear exchange, use of large amounts of saline solution necessary for scleral lens fitting, storing the scleral lens overnight in saline solution rather than contact lens multipurpose solutions, not rubbing the contact lens during cleaning, and the space between the cornea and the back surface of the scleral lens that might serve as a fluid reservoir and environment for Acanthamoeba multiplication. Two patients responded well to medical treatment of AK; one is still being treated. Conclusions: The recommendations for use and care of scleral contact lenses should be emphasized, especially regarding use of sterile saline (preferably single use), attention to rubbing the lens during cleaning, cleaning of the plunger, and overnight storage in fresh contact lens multipurpose solutions without topping off the lens solution in the case.     

Applanation tonometry in silicone hydrogel contact lens wearers

INTRODUCTION: Previous studies have investigated intraocular pressure (IOP) measurements through conventional soft (hydrogel) therapeutic contact lenses, and have found that an accurate IOP can be recorded in normal eyes, and in eyes with abnormal anterior segments. The IOP measurement through soft contact lenses may be affected by the water content and centre thickness of the lens. Silicone hydrogel contact lenses are now being used as therapeutic contact lenses due to their high oxygen permeability. The purpose of this study is to investigate if IOP can be accurately measured in a subject wearing a silicone hydrogel contact lens. METHODS: In a cohort study, the IOP was measured with a Goldmann applanation tonometer without a contact lens and then repeated with a hydrogel contact lens in situ. RESULTS: The IOP of 20 eyes of 10 volunteers with no ocular pathology was measured. The mean difference (+/-S.D.) found between IOP measurement with (mean 15.55+/-1.70 mmHg) and without (mean 16.05+/-1.90 mmHg) contact lens was found to be -0.5+/-0.89 mmHg. Statistical analysis was performed which revealed a correlation coefficient of 0.89. No significant statistical difference was found between the two groups with paired t-test (p=0.19). CONCLUSION: Accurate measurement of IOP by applanation tonometry can be achieved through a silicone hydrogel contact lens.     

The effect of contact lens wear on dynamic ocular surface temperature.

AIM: To determine the dynamic emitted temperature changes of the anterior eye during and immediately after wearing different materials and modalities of soft contact lenses. METHOD: A dynamic, non-contact infrared camera (Thermo-Tracer TH7102MX, NEC San-ei) was used to record the ocular surface temperature (OST) in 48 subjects (mean age 21.7 +/- 1.9 years) wearing: lotrafilcon-A contact lenses on a daily wear (LDW; n=8) or continuous wear (LCW; n=8) basis; balafilcon-A contact lenses on a daily wear (BDW; n=8) or continuous wear (BCW; n=8) basis; etafilcon-A contact lenses on a daily disposable regimen (EDW; n=8); and no lenses (controls; n=8). OST was measured continuously five times, for 8s after a blink, following a minimum of 2h wear and immediately following lens removal. Absolute temperature, changes in temperature post-blink and the dynamics of temperature changes were calculated. RESULTS: OST immediately following contact lens wear was significantly greater compared to non-lens wearers (37.1 +/- 1.7 degrees C versus 35.0 +/- 1.1 degrees C; p < 0.005), predominantly in the LCW group (38.6 +/- 1.0 degrees C; p < 0.0001). Lens surface temperature was highly correlated (r=0.97) to, but lower than OST (by -0.62 +/- 0.3 degrees C). There was no difference with modality of wear (DW 37.5 +/- 1.6 degrees C versus CW 37.8+/-1.9 degrees C; p=0.63), but significant differences were found between etafilcon A and silicone hydrogel lens materials (35.3 +/- 1.1 degrees C versus 37.5 +/- 1.5 degrees C; p < 0.0005). Ocular surface cooling following a blink was not significantly affected by contact lens wear with (p=0.07) or without (p=0.47) lenses in situ. CONCLUSIONS: Ocular surface temperature is greater with hydrogel and greater still with silicone hydrogel contact lenses in situ, regardless of modality of wear. The effect is likely to be due to the thermal transmission properties of a contact lens.     

Verification of the vertex powers of varifocal rigid contact lenses.

INTRODUCTION: Increasingly aspherical optics are used in contact lens designs to produce a varifocal effect to correct presbyopia. Whilst no current ISO standard describes a method to verify these products, the vertex power needs to be verified by the manufacturer and optometrist. Visionix claim that the VC2001 instrument is able to resolve the vertex power of complex contact lenses and that it has been adopted by contact lens manufacturers as their "gold standard" method of measure. Practitioners rely on the focimeter for contact lens verification and accept that it has poorer resolution. This raises the question of whether practitioners can verify the vertex powers of varifocal contact lenses to a sufficient sensitivity. The purpose of this study is to determine whether a focimeter can differentiate between various vertex powers incorporating differing degrees of asphericity that are used in contact lens designs. METHODS: A range of varifocal contact lenses were used with single vision contact lenses as controls. Three types of focimeters were used: a manual focimeter, a projector focimeter and a computerised focimeter (standard and contact lens modes). The VC2001 assessed the vertex powers over the optical zone and was used as a reference for the focimeters. The measures from the VC2001 and the focimeters were analysed by discrepancy analysis. RESULTS: All discrepancy measures fell outside two standard deviations for either the varifocal contact lenses or the single vision contact lenses when the focimeters were compared to the VC2001. This raises the issue of whether the focimeters are measuring the same parameter as the VC2001. Only the analysis of the repeated measurements from the manual focimeter for single vision contact lenses demonstrated an acceptable measure of precision (+/-0.21, 2S.D.) with a very small degree of bias (mean difference -0.024, +/-0.02 [2S.E.]). CONCLUSION: These results suggest that the manual focimeter can measure the vertex powers for single vision contact lenses to an acceptable degree of precision. The vertex powers of varifocal lenses cannot be verified using standard practice equipment. The VC2001 has poor precision for power measurements and may not be measuring the same parameter as the focimeters and therefore questions the validity of the VC2001 as the "gold standard" for vertex power measurement.     

Clinical performance of 'no rub' multi-purpose solutions.

This was a multi-site, 231-subject double-masked, bilateral crossover study to evaluate subjective comfort and satisfaction, corneal staining and lens deposits with two 'no rub' multi-purpose solutions (MPS) used with FDA Group II (alphafilcon A, SofLens 66, Bausch & Lomb) and Group IV (etafilcon A, SUREVUE, Johnson & Johnson Vision Care) soft contact lenses. Subjects used each of the two MPS, Regimen 1 (OPTI-FREE EXPRESS Multi-Purpose Disinfecting Solution No Rub Lasting Comfort Formula, Alcon Laboratories) and Regimen 2 (ReNu MultiPlus Multi-Purpose Solution, Bausch & Lomb), for 28 days. They wore the same lens type for the duration of the study and were evaluated on days 0, 14 and 28 of each treatment period. Subjective ratings of comfort and satisfaction were significantly different between regimens, with the majority of variables in favour of Regimen 1 (P < 0.05). Corneal staining was significantly greater with the Group II, Regimen 2 combination (P < 0.0001). Group IV lenses cared for with Regimen 1 had significantly less residual lysozyme on Day 28 (562 microg) than lenses cared for with Regimen 2 (1145 microg; P < 0.0001). While both products offer the convenience of a 'no rub' regimen, differences in performance should be considered when recommending these solutions to patients.     

Osmolality and pH of commercially available contact lens care solutions and eye drops

PurposeThe physical properties of contact lens care solutions and Eye Drops (ED) may affect initial comfort and dry eye symptomatology in contact lens wearers, although these properties are not always provided by manufacturers. The present study aimed to measure and compare the osmolality and pH of commercially available contact lens care solutions and ED.MethodsForty-four solutions were tested (17 lens care solutions and 27 ED) and classified by the presence and/or combination of the viscosity/lubrication-enhancing ingredients. Solution osmolality was obtained with the Fiske 110 osmometer and pH was measured with a micro-pH 2000. Each measurement was taken ten times, following the manufacturer's instructions, while controlling for room temperature and humidity. Differences between the values of the physical properties of the solutions were analysed by type and viscosity/lubrication-enhancing agent subclassification.ResultsOsmolality ranged from 192.6 ± 2.17 to 364.6 ± 2.88 mOsm/Kg, while pH ranged from 6.35 [6.35–6.26] to 7.99 [7.99–8.00]. A significant difference in the osmolality and pH values of contact lens care solutions and ED was found when classified by type or viscosity/lubrication-enhancing agent (ANOVA and Kruskal-Wallis respectively, both p < 0.001).ConclusionsThe physical properties of some contact lens care solutions and ED are not readily available. The osmolality and pH values of various commercially available lens care solutions and ED vary significantly both by type and viscosity/lubrication-enhancing ingredients.     

Non-contact tonometry over soft contact lenses: effect of contact lens power on the measurement of intra-ocular pressure.

PURPOSE: To perform non-contact applanation tonometry over soft contact lenses and to examine any differences between the measured IOPs with and without the contact lens. METHOD: IOP was measured at one eye of eight subjects and re-evaluated through a soft lens in situ over the cornea. Seventy percent (ES70, Lunelle) water contact lenses or powers ranging from -15.00 D to +13.00 D were used. RESULTS: Mean IOP without lenses was 15.2 mmHg (S.D. = +/-4.2) and this did not change significantly for lenses ranging from -15.00 D to +3.00 D (P > 0.01) but did change for lens powers +6.00 D and above (P<0.01). The least squares line describing the change in measured IOP (deltaIOP) as a function of lens power (x) has the following characteristics, deltaIOP = 0.022 + 0.591x + 0.11x2 + 0.005x3 (r = 0.985, P = 0.0001). CONCLUSION: Non-contact tonometry can be performed with sufficient accuracy over a soft lens on condition: (a) lens centre thickness is no more 0.30 mm and (b) power is not greater than +3D.     

Feasibility of contact lens fitting on keratoconus patients with INTACS inserts.

PURPOSE: To demonstrate the feasibility of contact lens fitting in keratoconus patients with INTACS inserts. METHODS: A chart review was conducted of all patients with bilateral keratoconus who were treated with INTACS inserts on one eye and who were subsequently referred for contact lens fitting in a university based contact lens practice between April 2000 and April 2002. The study was a retrospective, non-comparative case series. The uncorrected and best spectacle corrected visual acuity (BSCVA) after INTACS implantation surgery, postoperative best contact lens-corrected visual acuity (BCLVA), number of diagnostic contact lenses used, number of contact lenses ordered within a 4-month follow-up period, contact lens complications encountered, final base curves, final lens powers, and final wearing times were determined. RESULTS: Three keratoconic patients meeting the selection criteria were found through the chart review. Prior to surgery, all patients had uncorrected visual acuity (UCVA) of 2.0 logMAR (counting fingers). This improved to a mean of 0.81+/-0.25 logMAR (20/125-1) after surgery. Mean BSCVA also improved from 0.51+/-0.30 logMAR (20/60-2) to 0.30+/-0.16 logMAR (20/40). The mean postoperative best contact lens-corrected visual acuity was 0.02+/-0.10 logMAR (20/20-1). The number of diagnostic lenses ranged from 1 to 7. The numbers of contact lenses ordered during the 4-month follow up period ranged from 1 to 3. Two eyes were fitted with larger than usual lens designs made of rigid gas-permeable material and one eye was fitted with a toric soft lens. The final lens power ranged from +1.25 to -21.0D with a mean spherical equivalent of -7.46+/-11.89 D. Final wearing times ranged from 2.5 to 12.0h. CONCLUSION: Fitting contact lenses on keratoconus patients who have INTACS inserts is feasible and has a role in augmenting their vision.     

In-eye performance of soft contact lenses made from different materials.

The in-eye performance of soft contact lenses may be affected by the material from which they are fabricated and may alter during wear. This study describes clinical and laboratory experiments that were conducted in order to examine the in-eye performance of eight soft contact lenses manufactured from different materials; these materials (and nominal water contents) were: HEMA/VP 40%, HEMA/VP 55%, HEMA/VP 70%, VP/MMA 55%, VP/MMA 70%, HEMA 40%, HEMA/MAA 55% and HEMA/MAA 70% (HEMA: 2-hydroxy-ethyl methacrylate, VP: vinyl pyrrolidone, MMA: methyl methacrylate, MAA: methacrylic acid). Two lenses from each of the eight soft contact lens groups were used in experiments concerning their parameter stability. Six subjects were fitted with lenses for 1 day. Verification of back optic zone radius, total diameter, back vertex power, centre thickness and water content was undertaken at 20 degrees C. In vitro measurements of total diameter were taken at 35 degrees C before lens fitting and after 6 h of lens wear. In vivo measurements of lens centration, up-gaze lag, post-blink movement, total diameter and subjective assessment of comfort were taken (a) immediately after lens insertion (1 min), (b) 20 min later and (c) 6 h later (same day). The majority of differences of the in vivo parameters between lens types (with respect to lens centration, lag, movement on blink, lens total diameter and comfort) were not found to be statistically significant throughout the 6 h wearing period. It was also found that lenses increase in diameter when first placed on the eye and decrease in diameter when they were removed from the eye. The information generated in study concerning the in-eye performance of soft contact lens materials may assist the contact lens industry and contact lens practitioners in developing and prescribing soft lenses with optimal performance characteristics.     

Is contact lens "T" still important?

We studied oxygen supply to the contact lens covered cornea by means of a complex calculation method. We measured lens thicknesses, both centrally and at a 3mm peripheral location, of a range of optical powers of two different spherical silicone hydrogel contact lens designs (manufactured by Ciba Vision and Bausch & Lomb) and one "traditional" hydrogel. Using the measured values of lens thickness and the nominal oxygen permeabilities of these three plastics, we calculated the oxygen tension level in the tear layer posterior to the contact lens and anterior to the cornea and the oxygen flux through these contact lenses, under both open- and closed-eye conditions. We conclude that variable thicknesses of the silicone hydrogel contact lenses does not significantly affect the oxygen tension in the entrapped tear layer, given their high oxygen diffusion coefficients, under open-eye conditions, and probably only minimally under closed-eye conditions as well.     

Parameter stability of soft contact lenses made from different materials.

The parameters of soft contact lenses may alter during wear. A series of clinical and laboratory experiments were conducted in order to examine the parameter stability of eight soft contact lenses manufactured from different materials. The following materials (and nominal water contents) were used: HEMA/VP 40%, HEMA/VP 55%, HEMA/VP 70%, VP/MMA 55%, VP/MMA 70%, HEMA 40%, HEMA/MAA 55% and HEMA/MAA 70% (HEMA: 2-hydroxy-ethyl methacrylate, VP: vinyl pyrrolidone, MMA: methyl methacrylate, MAA: methacrylic acid). Two lenses from each of the eight soft contact lens groups were used in experiments concerning the parameter stability. Six subjects were fitted with lenses for 1 day. Verification of back optic zone radius, total diameter, back vertex power, centre thickness and water content was undertaken at 20 degrees C. In vitro measurements of water content, oxygen transmissibility, total diameter and back optic zone radius were taken at 35 degrees C before lens fitting and after 6h of lens wear. Distortion, discolouration and lens quality were assessed before and after lens wear. When the temperature was raised from 20 to 35 degrees C, a significant reduction in lens water content for all the lens types was observed, as well as a significant reduction in total lens diameter for the majority of the lens types. Water content, oxygen transmissibility, total diameter and back optic zone radius of all the lens types reduced, following a 6h open eye wearing period. For the majority of the lens types, these changes were found to be statistically significant. Distortion, discolouration and quality of the lenses remained unchanged throughout the study with the exception of the HEMA/MAA 70% lens. Correlating a number of parameters generated in this study, gave the following conclusions. High water content materials exhibit a low relative change in oxygen transmissibility following a 6h wear period. Soft contact lens dehydration leads to a decrease in oxygen transmissibility and total diameter, following a 6h wear period. These results will assist practitioners in predicting the alterations that occur in soft contact lens parameters and oxygen performance as a result of lens wear.     

Lens parameter changes under in vitro and ex vivo conditions and their effect on the conjunctiva

PurposeTo quantify changes in contact lens parameters induced by lens wear and determine whether these changes are associated with contact lens-induced conjunctival staining (CLICS).MethodsIn vitro: Lens diameter, sag, edge shape, base curve of six contact lens brands (balafilcon, comfilcon, etafilcon, lotrafilcon B, omafilcon and senofilcon) measured at 21 °C and 35 °C (eye temperature). Ex vivo: Diameter of lenses collected from a prospective, randomised, contra-lateral, cross-over clinical trial from 36 subjects wearing all lens types for 1 week daily wear, measured in 35 °C PBS after removal. Ocular surface was examined for lens-induced conjunctival staining by masked examiner.ResultsIn vitro: Changes in diameter and base curve outside ISO tolerance were found with etafilcon A and omafilcon A. Ex vivo: Comfilcon A and etafilcon A had greatest shrinkage in diameter (0.18 mm) and base curve (0.11 mm steeper) with temperature increase from 21 °C to 35 °C. Senofilcon A, lotrafilcon B and balafilcon A maintained most stable parameters between 21 °C and 35 °C. Changes in diameter and base curve from lens wear were not correlated with CLICS (p > 0.49). Multivariate analysis showed significantly greater levels of lens induced staining were associated with lens modulus (p < 0.001) and knife (p < 0.001) and chisel (p < 0.001) edge shapes.ConclusionsParameter changes induced by lens wear were associated with increasing temperature, but these changes in lens diameter and base curve did not induce CLICS. Modulus and edge shape were associated with increased CLICS. The susceptibility of etafilcon A and omafilcon A lenses to parameter changes might be related to their high water content.     

Local oxygen transmissibility of disposable contact lenses.

AIM: Despite global standardisation in measurement of oxygen transmissibility (Dk/t), in our clinic we continue to see limbal vasculature changes in patients wearing some disposable lenses. The use of central Dk/t as a simple designator of a contact lens oxygen performance has clearly failed, it being acknowledged as often unrelated to the oxygen performance of the lens periphery. This study investigates a new criterion for contact lens oxygen transmissibility, the local Dk/t. METHOD: The study measured 20 spherical disposable lens brands (power range: -15.00 to +8.00 D) and 8 toric lens brands (power range: -8.00 to +4.00 D sphere, with a -1.00 D/-1.25 D x 180). An electro-mechanical gauge (Heidenhain, Germany) was used to measure lens thickness (t) at different positions on the lens. Oxygen permeability (Dk) of each lens material was calculated from the equation Dk =1.67 e (0.0397 x water content) of Morgan and Efron [Contact Lens Anterior Eye 21 (1998) 3] who used ISO/ANSI standard methodologies. The local Dk/t value was calculated from the point of maximum thickness on the lens and compared to the criterion of 12 Fatt units set by Benjamin [Int. Contact Lens Clin. 23 (1996) 188], to provide corneal oxygenation greater than or comparable to that available in the normal closed eye. RESULTS: All lens types with a water content over 65% had a local Dk/t of 12 Fatt units or more for most or all lens powers: CIBAVision FocusDailies, Bausch & Lomb Soflens66, CooperVision Actifresh400, and CIBAVision PrecisionUV. In addition, some lenses in the 55-62% water content range had some lens powers with a local Dk/t in excess of 12: CooperVision Proclear, Johnson & Johnson Acuvue 1 and CIBAVision Focus 2 week. None of the disposable toric lenses had a minimum Dk/t of 12 or more. The silicone-hydrogels, Bausch & Lomb PureVision and CIBAVision Focus Night&Day, comfortably exceeded Dk/t of 50 for all lens powers. CONCLUSION: Some current disposable soft lenses have local Dk/t values below physiological requirements. Contact lens manufacturers and international standards organisations should consider introducing the labelling of local Dk/t values on lens packaging so that clinicians can make informed prescribing decisions.     

A novel in-vitro method for assessing contact lens surface dewetting: Non-invasive keratograph dry-up time (NIK-DUT)

Purpose

This study was designed to develop a novel technique called non-invasive keratograph dry-up time (NIK-DUT), which used an adapted corneal topographer, to analyse in-vitro contact lens surface dewetting and the effects of combinations of lenses and lens care solutions on dewetting.

The effect of lens wear on refractive index of conventional hydrogel and silicone-hydrogel contact lenses: a comparative study.

PURPOSE: The purpose of this work was to evaluate the ability of four silicone-hydrogel contact lenses (galyfilcon A, balafilcon A, lotrafilcon A and lotrafilcon B) to retain their equilibrium water content before and after wear, through measurements of refractive index and compare with that of a conventional disposable hydrogel contact lens (etafilcon A). METHODS: The refractive indices of 115 contact lenses were measured using an automated refractometer (CLR 12-70, Index Instruments, Cambridge, U.K.) before and after a schedule of daily wear by 58 patients for 30 days in the case of silicone-hydrogel lenses and 15 days for the conventional contact lenses. RESULTS: In the silicone-hydrogel contact lenses the changes on the refractive indices were not statistically significant, however after being worn the refractive index of the conventional etalfilcon A hydrogel contact lens increased significantly (p<0.001). CONCLUSION: The results presented here show that after being worn the silicone-hydrogel contact lens, show more capacity to retain or to reach their initial equilibrium water content than conventional hydrogel contact lenses. This suggests that the silicone-hydrogel contact lenses are less susceptible to spoilation over time maintaining its biocompatibility and contributing to the clinical success of lens performance.