Differences in dry eye questionnaire symptoms in two different modalities of contact lens wear: silicone-hydrogel in daily wear basis and overnight orthokeratology

Purpose. To compare the ocular surface symptoms and signs in an adult population of silicone-hydrogel (Si-Hy) contact lens (CL) wearers with another modality of CL wear, overnight orthokeratology (OK). Materials and Methods. This was a prospective and comparative study in which 31 myopic subjects were fitted with the same Si-Hy CL and 23 underwent OK treatment for 3 months. Dry eye questionnaire (DEQ) was filled in at the beginning of the study and then after 15 days, 1 month, and 3 months using each CL modality. The tear quality was evaluated with noninvasive tear break-up time. Tear production was measured with Schirmer test. Tear samples were collected with Schirmer strips being frozen to analyze the dinucleotide diadenosine tetraphosphate (Ap4A) concentration with High-Performance Liquid Chromatography (HPLC). Results. After refitting with ortho-k, a reduction in discomfort and dryness symptoms at the end of the day ( < 0.05, 2 ) was observed. No significant changes were observed in Ap4A concentration in any group. Bulbar redness, limbal redness, and conjunctival staining increased significantly in the Si-Hy group ( < 0.05, Kruskal–Wallis test). Conclusion. Discomfort and dryness symptoms at the end of the day are lower in the OK CL group than in the Si-Hy CL group.The authors thank Paragon Vision Science and CooperVision for donating the lenses. This work was partially supported by the Xunta de Galicia by a predoctoral grant of the Plan I2C 2011–2015 and the Spanish SAF2013-44416-R and RETICS RD12/0034/0003. It was also partially supported by Portuguese Foundation for Science and Technology (FCT) in the framework of projects PTDC/SAU-BEB/098391/2008 and PTDC/SAU-BEB/098392/2008

Performance of three multipurpose disinfecting solutions with a silicone hydrogel contact lens

"Article ID 216932"To evaluate the clinical performance of a silicone hydrogel (Si-Hy) soft contact lens (CL) in combination with three differentmultipurpose disinfecting solutions (MPDSs).Methods.Thiswas a prospective, randomized, single-masked, crossover, and comparative study in which 31 habitual soft CL wearers were randomly assigned to one of the three MPDSs (Synergi, COMPLETE RevitaLens, and OPTI-FREE PureMoist) for 1 month with a 1-week wash-out period between each exposure. All subjects were successfully refitted with a Si-Hy CL (Biofinity). Subjects were then scheduled for follow-up visits after 1 month of lens wear, being evaluated at 2 and 8 hours after lens insertion. Visual Analogue Scales (VAS) were used to gauge comfort rating. Results. The tarsal conjunctiva showed a significantly different degree of lid redness between the MPDSs at the 2-hour visit (P < 0.05, Kruskal- Wallis test), being lower for COMPLETE RevitaLens compared to the other two MPDSs (Mann-Whitney U test). Furthermore, a significantly different degree of lid roughness at the 8-hour visit was seen (P < 0.05, Kruskal-Wallis test), being higher for Synergi (Mann-Whitney U test).Thesubjective comfort was similar with the threeMPDSs. Conclusion. Tarsal conjunctival response should be also considered in the context of the clinical performance of MPDs at the ocular surface.This work has been funded by an unrestricted grant from AMO Germany GmbH and it was also partially supported by Xunta de Galicia, Spain (Predoctoral Grant) and Fundacao para a Ciencia e Tecnologia, Portugal

Light distortion and spherical aberration for the accommodating and nonaccommodating eye

To evaluate how different amounts of induced spherical aberration (SA) affect the light distortion (LD) phenomena, tests were performed using an experimental device to measure the distortion (haloes, glare, and so on) of a point source. To simulate the effect of SA, eight different phase plates between þ0.300 and −0.300 μm of SA for a 5-mm aperture were used in a random and double-masked experimental design. Measurements were performed at a distance of 2 m in a darkened room in 10 eyes of five subjects with a mean age of 26.4 6.1 years and a mean refractive error of −0.50 0.70 D. Data were obtained with natural pupil and after pupil dilatation. The measurements with this experimental system showed a significant increase in all distortion parameters with cycloplegia for the phase plates with the higher positive SA (þ0.300 and þ0.150 μm). The disturbance index increased from 14.86 6.12% to 57.98 36.20% (p < 0.05) with the þ0.300 μm plate. The same effect was observed through at a much lower rate when the eye could accommodate. Plates inducing negative SA did not change the LD compared to the control condition without induction of SA or even decreased the effect of distortion. Pupillary dilation and cyclopegia led to a significant increase in the size of the LD when increasing values of SA were induced. Accommodation and pupillary constriction are capable of compensating the degradation of the optical quality induced.This study was funded by the FEDER through the COMPETE Program and by the Portuguese Foundation for Science and Technology (FCT) in the framework of projects PTDC/SAUBEB/098391/2008, PTDC/SAU-BEB/098392/2008 and the Strategic Project PEST-C/FIS/UI607/2011. The authors thank the assistance of Professor Norberto López-Gil for the loan of the SA plates and the discussion of the results. R.M.A, J. M.G.M., H.F.N., L.R.V., and S.C.P.M have applied for a patent on the experimental device. Other authors declare that they do not have any proprietary or financial interest in any of the materials mentioned in this article

Validation of a method to measure light distortion surrounding a source of glare

Our objective was to validate a new device dedicated to measure the light disturbances surrounding bright sources of light under different sources of potential variability. Twenty subjects were involved in the study. Light distortion was measured using an experimental prototype (light distortion analyzer, CEORLab, University of Minho, Portugal) comprising twenty-four LED arrays panel at 2 m. Sources of variability included: intrasession and intersession repeated measures, pupil size (3 versus 6 mm), defocus (þ0.50) correction for the working distance, angular resolution (15 deg versus 30 deg), temporal stimuli presentation, and pupil size. Size, shape, location, and irregularity parameters have been obtained. At a low speed of presentation of the stimuli, changes in angular resolution did not have an effect on the results of the parameters measured. Results did not change with pupil size. Intensity of the central glare source significantly influenced the outcomes. Examination time was reduced by 30% when a 30 deg angular resolution was explored instead of 15 deg. Measurements were fast and repeatable under the same experimental conditions. Size and shape parameters showed the highest consistency, whereas location and irregularity parameters showed lower consistency. The system was sensitive to changes in the intensity of the central glare source but not to pupil changes in this sample of healthy subjects.This study has been funded by the FEDER through the COMPETE Program and by the Portuguese Foundation for Science and Technology in the framework of projects PTDC/ SAU-BEB/098391/2008, PTDC/SAU-BEB/098392/2008, and the Strategic Project PEST-C/FIS/UI607/2011

“Mix and match” vs symmetrical adaptation of multifocal soft contact lenses in presbyopes

Publicado em "Abstract book CIOCV 2014"Objetivo: O objetivo deste estudo foi avaliar o desempenho visual de pacientes presbitas com a combinação de diferentes desenhos de lentes de contacto multifocais (LCM) em cada olho do mesmo pa ciente (" k and match"), comparando com uma adaptação tradicional na qual é utilizado o mesmo desenho de LCM em ambos os olhos. Métodos: Participaram 13 pacientes (7 mulheres), com idade média de 49,77±2,91 anos. Para a adaptação “mix and match” (M&M) foi adaptada no olho dominante a lente AirOptix Multifocal (Ciba Vision, Duluth, GA), que é uma LCM de silicone hidrogel asférica de centro - perto (Lotrafilcon B, 33% ECW, FDA grupo I) e no olho não dominante foi adaptada a lente Acuvue Oasys for Presbiopia (Johnson & Joh nson, Jacksonville, FL), que é uma lente de silicone hidrogel (Senofilcon A, 38% ECW, FDA grupo I), com 5 zonas anulares concêntricas alternando a potência de longe (centro - longe) e a potência de perto. A adaptação convencional foi feita com a lente Purevi sion2 Multifocal (PV2M) (Bausch & Lomb, Rochester, NY), que é uma lente de silicone hidrogel de desenho centro - perto. Foi medida a acuidade visual (AV) de visão de longe e visão de perto em condições de alto e baixo contraste com o teste ETDRS (Precision V ision, USA, Cat. No. 2110 com Cabinet Illuminator No. 2425), curvas de desfocado e estereopsia (Stereo Fly SO - 001 142 143, StereoOptical Co. ). Foi também realizado um questionário subjetivo relativo à dificuldade em realizar tarefas diárias (escala analógi ca visual de 0 - 10, onde 10 significa menos dificuldade). As medições foram feitas com a melhor correção em óculos (Baseline) e no final de 7 dias de uso (Day_7). Resultados: No final de 7 dias de uso, e em condições binoculares, não foram encontradas dife renças estatisticamente significativas entre a AV medida nas diferentes condições entre os dois tipos de adaptação de LCM ( p> 0. 05). Quando comparando com a melhor correção em óculos, foi encontrada ligeira diminuição de cerca de uma linha da AV de longe e m baixo contraste com ambas as adaptações ( p <0 ,05, Bonferroni). As curvas de desfocado mostram que ambas as lentes são efetivas permitindo visão de longe semelhante à obtida com a melhor correção em óculos ( p> 0. 05, Bonferroni), boa visão intermédia e de perto. Não existem diferenças entre as lentes para nenhum nível de desfocado. A estereopsia média com as lentes PV2M e M&M foi de 49±25 segundos de arco e 64±49 segundos de arco, respetivamente. Apesar do ligeiro decréscimo de estereopsia com a adaptação M &M, as diferenças encontradas entre as lentes não são estatisticamente significativas ( p> 0 ,05, Bonferroni), assim como se consegue manter a estereopsia semelhante à medida com a melhor correção em óculos (p>0,05, Kruskal Wallis). Em geral, os pacientes re ferem pouca dificuldade em realizar tarefas quotidianas como conduzir de dia e à noite (mais de 8/10), trabalhar no computador ou ler email , ver o telemóvel ou a hora num relógio (mais de 7/10). Conclusões: A adaptação ""mix and match"" com LCM mostrou um bom desempenho clínico comparável a uma adaptação tradicional de adaptação de LCM. Permitem uma boa visão a diferentes distâncias, satisfazendo os pacientes nas suas tarefas do quotidiano, sem afetar o equilíbrio da visão binocular. A possibilidade de atin gir resultados satisfatórios utilizando diferentes desenhos ópticos de lentes pode abrir novas possibilidades na correção da presbiopia com lentes de contacto hidrofílicasAims: To assess the visual performance of presbyopic patients with a combination of different designs of multifocal contact lenses (MFCL) in each eye of the same patient ("mix and match") in comparison with a traditional adaptation where the same MFCL design is used in both eyes. Methods: Thirteen (13) patients (7 female) participated in this study, with mean age of 49.77±2.91 years. For the “mix and match” (M&M) condition, it was fitted the AirOptix Multifocal lens (Ciba Vision, Duluth, GA) in the dominant eye, which is a center - near aspheric silicone hydrogel MFCL (Lotrafilcon B, 33% ECW , FDA group I) and in the non - dominant eye was fitted the Acuvue Oasys for Presbyopia lens (Johnson & Johnson, Jacksonville, FL), which is a multiconcentric silicone hydrogel lens (Senofilcon A, 38% ECW, FDA group I), with 5 concentric annular areas of alt ernating distance (center - distance) and near power (add). The conventional MFCL’s fitting was done with the Purevision2 Multifocal lens (PV2M) (Bausch&Lomb, Rochester, NY), which is a simultaneous vision center - near silicone - hydrogel lens. The outcome meas ures consisted in the high and low contrast distance and near visual acuities (VA) with the ETDRS (Precision Vision, USA, Cat. No. 2110 with Cabinet Illuminator No. 2425), defocus curves and stereopsis (Stereo Fly SO - 001 142 143, StereoOptical Co.). Also, the patients had to fill a subjective questionnaire regarding the difficulty in performing daily - life tasks (visual analogue scale of 0 - 10, where 10 means less difficulty). The measurements were done with the best correction in spectacles (Baseline) and at the end of 7 days of MFCLs use (Day_7). Results: After 7 days of wearing MFCLs, and in binocular conditions, no statistically significant differences were found between the measured VA in the different conditions between the two types of adaptation (p>0.0 5). When comparing with the best correction in spectacles, a slight decrease of about a line in low contrast VA was found with both lenses (p<0.05, Bonferroni). The defocus curves show that both lenses are effective, providing similar distance visual acuit y to the measured in the Baseline visit (p>0.05, Bonferroni), good intermediate and near vision. There were found no differences between both lenses for any level of focus. The average stereopsis with PV2M and M&M lenses was 49±25 seconds of arc and 64±49 seconds of arc, respectively. Despite the slight decrease in stereopsis with the M&M, the differences between the lenses are not statistically significant (p>0.05, Bonferroni), and it was maintained similar to the measured with the best corrected in specta cles (p>0.05, Kruskal Wallis test). In general, patients report little difficulty in performing daily life tasks such as driving during the day and night (over 8/10), working on the computer or reading email, using a phone or seeing the time on a watch (more than 7/10). Conclusions: The "mix and match" fitting showed a good clinical performance, being comparable to a conventional symmetrical MFCLs fitting. They allow good vision at different distances, satisfying patients in their activities of their daily living, without affecting the binocular vision balance. The possibility of achieving satisfactory results using different optical lens designs can open up new possibilities for the correction of presbyopia with hydrophilic contact lenses