Welcome to our monthly Research Update, available exclusively to IACLE and BCLA members to support your teaching and practice.

As the world continues to fight the ongoing COVID-19 pandemic, patients look to their contact lens practitioners for eye health guidance. We begin this month’s issue with a review that discusses important considerations for contact lens practitioners.

Tear osmolarity has been reported as one of the best diagnostic tests for dry eye disease and contact lens wear is thought to influence tear osmolarity. We include a paper that assesses changes in tear osmolarity with daily disposable lenses. Another explores the utility of anterior corneal high-order aberrations in keratoconus classification.

A Turkish group studies the performance of new generation hybrid lenses. A Spanish team reviews advantages and disadvantages of small diameter scleral lenses. And finally, we include a paper that summarizes the impact of contact lenses and refractive surgeries on dry eye in an ageing population. 

Happy reading!!

The IACLE Education Team

Journals reviewed in this issue:

Contact Lens & Anterior Eye 43:2, In Press 

Optometry and Vision Science 97:3 

Eye & Contact Lens 46:2 

Considerations for CL practitioners in COVID-19 pandemic

Jones et al reviewed the current literature to investigate the safety of contact lens wear in the COVID-19 pandemic. There is no evidence suggesting contact lens wearers who are asymptomatic should cease contact lens wear due to an increased risk of developing COVID-19, or that wearing prescription spectacles provides protection against SARS-CoV-2. Practitioners must remain vigilant about reminding CL wearers of the need to maintain good hand hygiene practices when handling lenses. Patients should also avoid touching their face, including their eyes, nose and mouth, with unwashed hands, and avoid CL wear altogether if unwell (particularly with any cold or flu-like symptoms).

Contact Lens and Anterior Eye 2020 Apr 3. DOI: 10.1016/j.clae.2020.03.012. Read the full text.

Tear osmolarity and contact lens wear

To investigate potential changes in tear osmolarity during wear of daily disposable soft contact lenses over 12 months, Garaszczuk et al recruited 50 subjects to this prospective, longitudinal study. Habitual contact lens wearers were refitted with either silicone hydrogel or hydrogel daily disposable lenses and were instructed to follow strict wearing rules. An impedance-based osmometer was used to collect samples from the lower tear menisci. Refitting with daily disposables lowered tear osmolarity, which is considered a positive effect.

Optom Vis Sci 2020;97:3 178-185. Read the abstract.

Corneal aberrations in keratoconus

Ortiz-Toquero et al assessed corneal topography of 70 normal and 77 keratoconic eyes using Placido disc-based videokeratography to analyze the usefulness of anterior corneal high-order aberrations in keratoconus classification. All wavefront aberrations were significantly different between the normal and keratoconus groups. The coma and third-order root mean square (RMS) values provided better sensitivity and specificity than other values to discriminate keratoconus (stage 1) from healthy eyes. These new cut-off values could improve discrimination of different stages of keratoconus.

Optom Vis Sci 2020;97:3 169-177. Read the abstract.

Irregular astigmatism and new-generation hybrid lenses

Uçakhan & Yeşiltaş evaluated the safety, efficacy and on-eye performance of new-generation hybrid contact lenses (HCLs) in visual rehabilitation of eyes with irregular astigmatism and RGP intolerance or failure. Records of patients who had been fitted with the EyeBrid silicone and Airflex were retrospectively reviewed (47 eyes of 33 patients). The new-generation HCLs provided satisfactory visual improvement in selected patients. Ease of fitting and high patient satisfaction seem to be their major advantages.

Eye & Contact Lens 2020;46:2 91-98. Read the abstract.

Fitting scleral lenses less than 15mm diameter

Porcar et al conducted this literature review of 11 case series (258 eyes) of fitting small scleral lenses (diameter <15mm) to clarify their advantages, disadvantages and clinical applications. Better corneal physiology and visual quality, easier fitting procedure and lens handling, and prolonged hours of wear may be the main advantages of small scleral lenses (compared with larger lenses). However, fitting these lenses is not suggested in severe cases or when it is not a reasonable clinical option.

Eye & Contact Lens 2020;46:2 63-69. Read the abstract.

Impact of refractive approaches on dry eye in ageing population

This review by Lafosse et al summarizes current understanding of how contact lens wear, and cataract and refractive surgery, influence signs and symptoms of ocular dryness in an ageing population. Ocular surface integrity can be jeopardized through surgical interventions involving the cornea and CL fitting, potentially initiating a closed loop of inflammation leading to dry eye disease (DED). Clinicians must consider the potentially greater adverse effects of surgery on the tear film and ocular dryness with increasing age. Newer CL designs, including soft lenses, may be particularly useful for presbyopes with DED.

Cont Lens Anterior Eye 2020;43:2 103-114.  Read the full text.

© International Association of Contact Lens Educators 2020

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