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Research Update

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

Issue 36 – December 2019

We begin the last issue of 2019 with a paper that evaluates the efficacy of low-dose atropine in slowing myopia progression in European children. A team from Israel reports on the factors associated with clinically significant dry eye after kerato-refractive surgery. As lid eversion is an essential component of contact lens aftercare, we include a study that assesses the best technique for clinicians.

A Chinese team investigates the characteristics of infectious keratitis in patients wearing bandage contact lenses. We include a review that discusses how the optics differ in scleral lenses from those in corneal/small diameter lenses. A Canadian group studies corneal endothelial bleb response to transient scleral lens wear. And finally, we bid goodbye to the year by enlisting the wishes that could take the contact lens field closer to the perfect lens. Is Santa listening?

Wishing you happy holidays and a very happy 2020!

The IACLE Education Team

JOURNALS

Journals reviewed in this issue:

Acta Ophthalmologica 97:8
Cornea 38:12  
Contact Lens & Anterior Eye 42:6
Eye & Contact Lens 45:6  
Optometry and Vision Science 96:11
Contact Lens Spectrum (non-peer reviewed) 34:12

MYOPIA

Low-dose atropine for treating myopia

To evaluate the efficacy and safety of atropine 0.01% in slowing myopia progression in European children, Sacchi et al retrospectively reviewed records of 52 myopic children with progression >0.5 D/year treated with atropine 0.01% for at least 1 year. The rate of myopia progression in treated and untreated patients (control group, 50 children) was compared and adverse events recorded. The only adverse event was temporary photophobia in five patients. Low-dose atropine significantly slowed the rate of myopia progression.

Acta Ophthalmol 2019;97:8 e1136-e1140. Read the abstract

DRY EYE

Risk factors for dry eye after refractive surgery

Shehadeh-Mashor et al conducted this large retrospective study including 25,317 right eyes of 25,317 patients to determine the incidence and risk factors associated with clinically significant dry eye disease after kerato-refractive surgery [photorefractive keratectomy (PRK) or LASIK]. Postoperative dry eye developed in 1,518 eyes (6%). Patients who were older, of female gender, and had a lower preoperative refractive error and those undergoing LASIK were more likely to develop dry eye disease after kerato-refractive surgery.

Cornea 2019;38:12 1495-1499. Read the abstract

EYELIDS

Best technique for upper lid eversion

To determine the best method of lid eversion based on comfort, speed of administration and the area of the palpebral conjunctiva exposed, Wolffsohn et al applied six different techniques to evert the upper eyelids of 25 young adults. The authors recommend the silicone everter placed at the top of the tarsal plate to clinicians because it was the most comfortable for patients, quick to perform and exposed the greatest area of tarsal plate compared to the other techniques.

Cont Lens Anterior Eye 2019;42:6 666-669. Read the full text

BANDAGE LENSES

Infectious keratitis in bandage lens wear

In this retrospective study, Zhu et al reviewed bandage contact lenses (BCL) related infectious keratitis (IK) cases (6,385 eyes of 6,188 patients) to investigate their clinical characteristics. Out of eight patients identified with infectious keratitis, seven were older than 50 years, three were noncompliant with their eye drop use and two extended their BCL wearing time past 30 days. BCL-related IK is more likely to occur in older patients. The most common risk factor for BCL-related IK was post-keratoplasty use. Appropriate indications, good compliance, and close follow-up are required for BCL use.

Eye & Contact Lens 2019;45:6 356-359. Read the full text

SCLERAL LENSES

Optical considerations for scleral lenses

Vincent & Fadel provide a comprehensive overview of lens and fitting characteristics unique to scleral lenses, and how these factors may influence optical performance based on theoretical modelling. Due to different fitting characteristics of scleral lenses, the thin lens optics traditionally applied to corneal rigid lenses may be inaccurate in certain clinical scenarios. Dynamic changes within the post-lens tear layer such as a reduction in apical clearance and reservoir debris or air bubbles, may also alter optical performance.

Cont Lens Anterior Eye 2019;42:6 598-613. Read the full text

Endothelial blebs and scleral lens clearance

To determine whether blebs appear after scleral lens wear and if their appearance is influenced by lens clearance, Giasson et al recruited 21 adults to this clinical study. Subjects were fitted with two similar scleral lenses with different targeted clearances of 200μm and 400μm for 25 mins each. Clearance of 400μm induced significantly more blebs than 200μm, suggesting reduced oxygen and/or increased carbon dioxide levels under scleral lenses fitted with excessive clearance.

Optom Vis Sci 2019;96:11 810-817. Read the full text

TECHNOLOGY

A contact lens wish list

In this article, Morgan outlines his wishes that could get us closer to an ideal CL or, at least, increase the number of new lens wearers while reducing dropouts. The four wishes are: a long-term effort to better understand the local biological sequelae of a CL on the ocular surface; for practitioners, industry and researcher to focus on dropouts; further evidence of the success of CLs as a myopia therapy in children; and for CLs for presbyopia to continue to advance and practitioners to consider the suitability of CLs for each presbyope they examine.

Contact Lens Spectrum 2019;34:12 18-23. Read the full text

© International Association of Contact Lens Educators 2019

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