Comparative study of silicone-hydrogel contact lenses surfaces before and after wear using atomic force microscopy

Purpose: The aim of this study was to analyze surface changes of three silicone-hydrogel contact lenses after daily wear. The lenses used in this study were balafilcon A, lotrafilcon B (both surface-treated), and galyfilcon A (non surface-treated). Methods: To understand how and where proteins, lipids, and other contaminants change contact lenses, surface roughness was assessed through Atomic Force Microscopy Tapping ModeTM. Roughness parameters were Mean Surface roughness (Ra), Mean-square-roughness (Rq), and Maximum roughness (Rmax). The surface topography of unworn and worn lenses was also mapped in great detail. Results: Contact lenses roughness parameters exhibited different values before and after wear and the surface appearance also changed. After wear, balafilcon A and galyfilcon A showed a significant increase on surface roughness parameters, being this increase more accentuated to galyfilcon A. In lotrafilcon B materials no significant changes were observed with wear. Conclusions: The present study suggests that surface treatment of silicone-hydrogel contact lenses can play a role in the prevention of a significant increase in roughness, and contribute to the better clinical tolerance of these lenses.University of PortoIBM

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.Vision and Johnson & Johnson.Bausch & Lom

The effect of silicone-hydrogel and conventional hydrogel contact lenses wear on the tear film: a comparison between de lenses

Purpose: The aim of this study was to evaluate the effect of one conventional hydrogel and four silicone-hydrogel contact lenses of 6-months daily wear on the quantity and stability of the tear film. The tests were performed with a group of patients with no previous contact lenses experience before and after wear on 96 eyes. Methods: The contact lenses tested were: 19 Galyfilcon A (Acuvue® Advance™), 15 Balafilcon A (PureVision™), 20 Lotrafilcon A (Focus® Night & Day™), 14 Lotrafilcon B (O2Optix™) and 28 Etalfilcon A (Acuvue®). Each silicone-hydrogel contact lens was used for 1 month and the conventional hydrogel for 15 days. Every patient used a different lens in each eye. Tear film stability was monitored by tear Break-up-time (BUT) and Non Invasive Break Up Time (NiBUT) and tear volume was measured by the Total Tear Meniscus Height and the Red Phenol Test. Results: The following tables summarize the difference between the measurements obtained in the first and in the last day of wear of each contact lens brand and the results were analyzed comparing the conventional hydrogel and the siliconehydrogel contact lenses (Table 1, 2, and 3), the lenses belonging to the first generation of silicone-hydrogel contact lenses (table 4) and the lenses belonging to the second generation of silicone-hydrogel (Table 5). The significance (p value) of 0.05 is considered statistically significant. Conclusions: Although there are some differences between the lenses, there are no statistically significant differences between the lenses and measurements obtained before and after contact lenses wear on the tear film tests.Objectivo: Avaliar o efeito de 6 meses de uso diário de uma lente de contacto de hidrogel convencional e quatro lentes de contacto de silicone-hidrogel na qualidade e estabilidade do filme lacrimal. Os testes foram realizados num grupo de pacientes (96 olhos) sem experiência prévia de uso de lentes de contacto, antes e depois do período de uso das lentes. Material e Métodos: As lentes de contacto estudadas foram: 19 Galyfilcon A (Acuvue® Advance™), 15 Balafilcon A (PureVision™), 20 Lotrafilcon A (Focus® Night & Day™), 14 Lotrafilcon B (O2Optix™) e 28 Etalfilcon A (Acuvue®). Cada lente de silicone-hidrogel foi usada durante 1 mês e a lente de hidrogel convencional durante 15 dias. Todos os pacientes usaram uma lente diferente em cada olho. A estabilidade do filme lacrimal foi avaliada pelo teste de ruptura lacrimal (BUT) e pelo teste de ruptura lacrimal não invasivo (NIBUT). O volume lacrimal foi medido pala altura total do menisco lacrimal e pelo teste vermelho fenol (Red Phenol Test) Resultados: Nas tabelas seguintes apresenta-se a diferença entre as medidas obtidas no 1º e último dia de uso para cada marca de lente de contacto e os resultados foram analisados comparando a lente de contacto hidrogel convencional com as lentes de silicone-hidrogel (Tabela 1, 2 e 3), as lentes pertencentes à 1ª geração de lentes de silicone-hidrogel (Tabela 4) e as lentes que pertencem à 2ª geração das lentes de silicone-hidrogel (Tabela 5). O valor da significância (p) é considerada estatisticamente significativa quando ≤0.05. Conclusões: Embora existam algumas diferenças entre as lentes de contacto estudadas, não há diferenças estatisticamente significativas entre os valores obtidos nos testes de avaliação do filme lacrimal antes e depois do uso das lentes de contacto

Symptoms in a population of contact lens and noncontact lens wearers under different environmental conditions

None of the authors has a commercial or financial interest in the instruments or materials used in the study. The authors wish to thank the assistance of AP Almeida, AP Costa, A, Fernandes, A Teixeira, C Marques, C Pinho and J Matos for their assistance in data acquisition, and Dr. Ana Costa from the program of Support to the Edition of Scientific Papers at the University of Minho for help with English editing of the manuscript.PURPOSE: To investigate ocular symptoms related to dryness in an adult population of contact lens (CL) and non contact lens wearers (n-CL) using video display terminals (VDT) for different periods of time under different indoor conditions related to air conditioning (AC) and heating units (HU) exposure. METHODS: A questionnaire was distributed to 334 people within a university population of which 258 were part of the n-CL group and 76 of the CL wearers to assess symptoms of ocular discomfort potentially related to dryness. Only soft contact lens (SCL) wearers (n = 71) were included for further statistical analysis because of the reduced number of people wearing other lens types. A 2:1 match by gender group of 142 subjects in the n-CL group was used as a control sample. RESULTS: There was a marked difference between the prevalence of symptoms and the way they are reported by CL and n-CL wearers. Red eye, itching, and scratchiness are more common among CL wearers, but the difference is statistically significant only for scratchiness (p < 0.01, chi(2)). The vast majority of subjects who reported symptoms often and at the end of the day are significantly more prevalent among CL wearers (p < 0.01, chi(2)). Gender differences were also encountered. Female CL wearers reported more scratchiness than males in the n-CL wearing group (p = 0.029, chi(2)) and in the CL group (p < 0.008, chi(2)). Females wearing CL reported symptoms of red eye (p = 0.043, chi(2)) and scratchiness (p < 0.001, chi(2)) more significantly than those in the n-CL group. Within the CL group, the prevalence of symptoms occurring sometimes or often and at the end of the day was higher among females (p < 0.001, chi(2)). The use of VDT was associated with a higher level of scratchiness among CL wearers (p < 0.05, chi(2)). The number of hours working with VDTs seemed to be associated with an increase in the prevalence of burning sensation in the CL group (p < 0.01, chi(2)), whereas symptoms like red eye and scratchiness also increased significantly among n-CL wearers. Compared to n-CL wearers, all symptoms increase in CL wearers in environments with AC and HU, except excessive tearing. However, these differences are only statistically significant for scratchiness. CONCLUSIONS: Our results show that people who wear soft CL and work with VDTs for longer periods of time are more likely to develop symptoms like eye burning and scratchiness than n-CL wearers. This risk could be higher for women than men. Scratchiness and the appearance of symptoms near the end of the day are typically associated with ocular discomfort during CL wear in this sample, and clinicians should question their patients about these symptoms to anticipate serious discomfort.This study was partially supported by a grant from the Science and Technology Foundation (FCT) - Ministry of Science and Superior Education (MCES) under contract 8281/2002 from the European Social Funding granted to JMG-M

Correlation between tear osmolarity and tear meniscus

Purpose. To examine the relationship between tear meniscus height (TMH) and subjective meniscus grading (subjective TM) with tear osmolarity. Methods. Tear osmolarity measurements (using TearLab) and digital images of the tear meniscus were obtained in 177 consecutive patients undergoing an eye examination at our optometry clinic (Universidad de Santiago de Compostela, Spain) who fulfilled the study's inclusion criteria. Participants were also administered the McMonnies and Ocular Surface Disease Index (OSDI) questionnaires for the detection of dry eye disease. The lower tear meniscus was videotaped by a digital camera attached to a slit lamp in its central portion without fluorescein instillation. After the study, a masked observer extracted an image from each video, and measured the TMH using open source software (NIH ImageJ). Subsequently, the masked observer subjectively graded the appearance of each meniscus. For statistical analysis, subjects were stratified by age and by dry eye symptoms as indicated by their scores in the two questionnaires. Results. In the whole study population, a significant relationship was observed between osmolarity and TMH (-0.41, p<0.001) and osmolarity and subjective TM (r = 0.35, p<0.001). A cluster analysis revealed similar correlations when subjects were stratified by age or dry eye symptoms, these correlations being more pronounced in older and more symptomatic individuals. Objective TMH measurements and subjective meniscus quality were also correlated (r=-0.75, p<0.001). Conclusions. Osmolarity and both objective TMH measurements and subjective interpretation of the meniscus showed high correlation, especially in older symptomatic subjects.Estudio patrocinado por el Ministerio de Educación y Ciencia y el Instituto de Salud Carlos III a través del proyecto PI10/01098.S

On the analysis of local and global features for hyperemia grading

In optometry, hyperemia is the accumulation of blood flow in the conjunctival tissue. Dry eye syndrome or allergic conjunctivitis are two of its main causes. Its main symptom is the presence of a red hue in the eye that optometrists evaluate according to a scale in a subjective manner. In this paper, we propose an automatic approach to the problem of hyperemia grading in the bulbar conjunctiva. We compute several image features on images of the patients' eyes, analyse the relations among them by using feature selection techniques and transform the feature vector of each image to the value in the adequate range by means of machine learning techniques. We analyse different areas of the conjunctiva to evaluate their importance for the diagnosis. Our results show that it is possible to mimic the experts' behaviour through the proposed approach.S

Alterações na transmitância UV-Visível induzidas pelo uso de lentes de contacto de silicone-hidrogel

Fundação para a Ciência e a Tecnologia (FCT) through Centro de Física da U

Meibomian gland loss area and its relationship with age and ocular surface disease index

Purpose: Meibography images bring information about the status and integrity of the meibomian glands (MG). This study aimed to correlate the meibomian gland loss area (MGLA) with age and dry eye symptomatology. Material and methods: A total of 110 subjects were recruited for the study. From the Meibography images obtained with the Topcon® CA-800 topographer, MGLA was calculated as the difference between the total area of the tarsus and the MG presence area measured by using the ImageJ software. Before the examination, all subjects completed an OSDI questionnaire. OSDI scores were grouped in 4 severity categories: normal (score ≤12), mild (score 12–22), moderate (score 22–32) and severe (score ≥32). Age was categorised into 3 subgroups: ≤25 years, from 25 to 45 years and ≥45 years. MGLA was also grouped in 4 categories of loss: ≤25 %, from 25 to 50%, from 50 to 75% and ≥75%. Results: Analysis was performed by dividing the sample into the 4 MGLA subgroups; these subgroups showed age differences (p=0.029; Kruskal-Wallis test) and differences in OSDI scores (p=0.001; Kruskal-Wallis test). The sample was divided into 3 age subgroups and differences were obtained in MGLA values among subgroups (p<0.001; Kruskal-Wallis test). Samples were divided in 4 OSDI subgroups and differences were obtained in MGLA values among subgroups (p=0.003; Kruskal-Wallis test). Positive correlation (Spearman Correlation) was obtained for both, MGLA vs. age (r=0.329, p<0.001) and MGLA vs. OSDI (r=0.380, p<0.001). Conclusion: In the present study MGLA showed a relationship with age and OSDI.S

Evaluation of the relationship between symptomatic assessment, corneal staining and tear meniscus by image analysis

Purpose: Vital staining is one of the most widely tests used to evaluate corneal damage. This study aimed to assess the relationship of corneal damage with tear meniscus height (TMH) and dry eye symptomatology. Material and methods: 530 subjects were recruited among patients of the Optometry Clinic (USC). Previously, all of them completed an OSDI questionnaire. Two videos of the ocular surface were recorded from each patient by a digital camera attached to a slit-lamp. Firstly, a video of the central tear meniscus under 40x with the Tearscope device illumination was recorded. From those videos, a masked observer extracted one image and TMH was measured by using the ImageJ software. Secondly, after fluorescein instillation, the corneal surface was recorded by another experienced masked observer, who assigned a category to the corneal damage based on the Oxford Scheme. The evaluation was stratified by corneal zones based on the CCLRU grading scales (central, superior, inferior, nasal and temporal). Results: When the sample was grouped by the corneal staining Oxford Grade, there was a statistical difference between groups in OSDI and TMH value (ANOVA: both p≤0.006). There was a difference in OSDI value when corneal damage was in nasal or inferior areas (t-test; both p≤0.015), and a difference in TMH value arose when damage was in the central, nasal or inferior areas (t-test; all p≤0.013). Conclusions: There is a relationship between corneal damage grade and corneal zones with dry eye symptomatology and tear film volume.This study was funded by the Spanish Ministry of Science and Education and the Institute of Health Carlos III (ISCIII) through research project PI10/01098.S