Guillermo Carrillo

24 September 20184 November 2018

Research Update Issue 21

September 2018

Eye & Contact Lens, the ofﬁcial journal of the Contact Lens Association of Ophthalmologists (CLAO), and Myopia Society Japan collaborated to present the symposium …

September 2018

Welcome to our monthly research update

Research Update is a resource available exclusively to IACLE and BCLA members to support your teaching and practice. Each month we send you a summary of some of the interesting findings appearing in peer-reviewed journals that month. Our aim is to help you keep up to date with the latest contact lens and anterior eye research, and to locate articles when you want to know more about a particular topic.

More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.

Special Issue – September 2018

Controlling Myopia Progression: Where Do We Stand Today?

Eye & Contact Lens, the ofﬁcial journal of the Contact Lens Association of Ophthalmologists (CLAO), and Myopia Society Japan collaborated to present the symposium: Controlling Myopia Progression: Where Do We Stand Today? These reviews and original studies arose from the symposium, and include additional articles commissioned to expand on some topics.

This second and concluding issue is devoted to myopia and orthokeratology topics. The ability of initial assessment to predict short-term visual performance with myopia control lenses and the potential for manipulating light environments to prevent myopia are explored. Orthokeratology studies include the use of trial fitting vs software fitting, compliance behaviour, and vision performance and optical quality after treatment.

Here are some excerpts from the issue.

The IACLE Education Team

Journal reviewed in this issue

	JOURNAL	VOLUME AND ISSUE NUMBER
	Eye & Contact Lens	44:5

MYOPIA CONTROL

Does initial assessment predict vision performance?

Diec et al conducted this randomized, cross-over, dispensing trial to investigate whether initial assessment of contact lenses prescribed for myopia control (MC) predicts short-term visual performance. Analysis of 43 participants wearing at least one lens: single-vision (SV) lens or MC lenses was performed. Initial performance at ﬁtting did not predict short-term performance for SV or MC lenses. A signiﬁcant increase in willingness to purchase if lenses slowed myopia progression was observed while wearing MC lenses. Educating patients on the beneﬁts might increase acceptability of MC lenses.

Eye & Contact Lens 2018;44:5 308-315. Click here for abstract

ENVIRONMENTAL FACTORS

Myopia control by light environments

In this review, Jiang et al discuss the evidence and possibilities for controlling myopia through light environments. The difference between indoor and outdoor light environments, such as intensity and wavelength of modern electronic lighting equipment, may be a cue for myopia control. Less than 40 min per day of outdoor light exposure may be a risk factor in faster axial eye growth in children. Manipulating light environment is the most practical way to prevent myopia. Generally, approximately 2 h of outdoor light exposure per day is recommended.

Eye & Contact Lens 2018;44:5 273-278. Click here for full text

ORTHOKERATOLOGY

Trial fitting vs software fitting for OrthoK

To compare the efﬁcacy of 1-year trial ﬁtting and software ﬁtting for orthokeratology lenses, Lu et al randomly assigned 100 myopes (-1.00 to -4.50DS, up to -1.50DC) aged 8-14 years into two groups: a trial ﬁtting group and software ﬁtting group. Both approaches were effective in temporarily reducing myopia, providing good uncorrected VA and delaying elongation of axial length for moderate and high myopic adolescents. Trial ﬁtting checks whether wearing an OrthoK lens is acceptable for patients, whereas the software approach would improve the efﬁciency of ﬁtting and reduce the difﬁculty of training for clinicians.

Eye & Contact Lens 2018;44:5 339-343. Click here for abstract

ORTHOKERATOLOGY

OrthoK and CL Quality of Life (OCL-QoL) questionnaire

McAlinden et al developed a 45-item OCL-QoL questionnaire from literature review, focus groups, and interviews. A total of 234 participants ﬁtted with contact lenses (OrthoK, soft and gas permeable) or spectacles completed the pilot questionnaire. After Rasch analysis, the ﬁnal questionnaire contained 23 items. The questionnaire had exceptional psychometric properties and is valid for use in clinical practice, clinical trials, and research studies. The tool is scored on a 0-100 interval level scale with higher scores indicating better QoL.

Eye & Contact Lens 2018;44:5 279-285. Click here for abstract

ORTHOKERATOLOGY

Non-compliant behaviours in OrthoK

To investigate compliance with orthokeratology guidelines, Jun et al surveyed 1,500 patients in China aged 9-22 years who had worn OrthoK lenses for more than 1 year. Among the 405 respondents, the full compliance rate was 14%, compliance with wear and care behaviors was 18%, and compliance with follow-up visits was 63%. The most common non-compliant behaviors were exposure to non-sterile solution, not removing lens deposits and inadequate hand washing. Practitioners need to emphasize the details of lens wear and care, especially avoiding exposing lenses to non-sterile solution, and the importance of follow-up.

Eye & Contact Lens 2018;44:5 330-334. Click here for full text

ORTHOKERATOLOGY

Effects on visual performance and optical quality

This prospective study by Liu et al investigated the correlation between amount of lens decentration, size of treatment zone (TxZ), and changes in visual performance and optical quality in myopes (-0.75 to -5.50DS, up to -1.50DC) aged 9-14 years undergoing OrthoK. Visual performance of 27 eyes of 27 patients wearing OrthoK lenses was compared before and 1 month after OrthoK treatment. Visual and optical quality decreases after OrthoK, which can be alleviated by a larger TxZ diameter and a smaller lens decentration.

Eye & Contact Lens 2018;44:5 316-321. Click here for full text

For more information on Research Update visit www.iacle.org.

7 August 20184 November 2018

Research Update Issue 20

August 2018

Outdoor light has been debated as an important factor in the onset and progression of myopia. In this issue, we include a vital study on myopia prevention and outdoor light intensity …

August 2018

Welcome to our monthly research update

More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.

Issue 20 – August 2018

Controlling Myopia Progression: Where Do We Stand Today?

Outdoor light has been debated as an important factor in the onset and progression of myopia. In this issue, we include a vital study on myopia prevention and outdoor light intensity. In another study, a Chinese group compares excimer laser refractive surgery and phakic intraocular lenses (PIOLs) for the treatment of myopia and astigmatism.

An Australian team attempts to understand the role of cohesion, coaggregation and growth in the build-up of bioﬁlm formation of commonly isolated case contaminants. We include a study that ascertains the relationship between scleral asymmetry and corneal astigmatism in both astigmatic and non-astigmatic eyes.

Another paper reviews spectacle prescriptions to determine the prevalence of ametropia and coverage of frequent replacement soft toric contact lenses. And finally, we describe research that measures the effects of two diﬀerent lens care systems on the integrity of eyelid tissue in silicone hydrogel contact lens wear.

Happy reading!

The IACLE Education Team

Journal reviewed in this issue

	JOURNAL	VOLUME AND ISSUE NUMBER
	Ophthalmology	125:8
	Eye & Contact Lens	44:3
	Investigative Ophthalmology & Vision Science	59:7
	Cornea	37:8
	Contact Lens & Anterior Eye	Articles in Press, 41:4

MYOPIA CONTROL

Could artificial lighting be effective in preventing myopia?

In his commentary on a study by Wu et al on myopia prevention and outdoor light intensity in a school-based cluster randomized trial, Morgan examines some important findings. The study reports protection from progression in children who were already myopic at baseline, with reduced myopic shifts and axial elongation. The daily light exposures measured objectively were quite low, with most of the outdoor exposures concentrated at less than 5000 lux. The findings raise two possibilities: the first is that increased time outdoors may slow the progression of myopia; the second is that lower than expected light exposures may be effective, enhancing the possibility of protection with bright light devices.

Ophthalmology 2018;125:8 1239-1250 (Wu et al) and 1251-1252 (Morgan). Click here for study abstract and here for full text of commentary

REFRACTIVE SURGERY

Excimer laser vs phakic intraocular lenses

To compare excimer laser refractive surgery and phakic intraocular lenses (PIOLs) for the treatment of myopia and astigmatism, Chen et al conducted a meta-analysis of randomized controlled trials (RCTs). From 219 initially identified studies, five RCTs were reviewed including 405 eyes. The range of myopia was 6.00D to 20.00D with up to 4.00DC of astigmatism. On the whole, there was no signiﬁcant difference in efﬁcacy and complications between the two kinds of surgeries. However, the analysis indicated that PIOLs were safer and more accurate within 12 months of follow-up compared with excimer laser procedures.

Eye & Contact Lens 2018;44:3 137-143. Click here for abstract

MICROBIOLOGY

Interactions between bacteria from CL cases

Datta et al examined cohesion, coaggregation, and coculture between bacteria commonly isolated from contact lens cases. Staphylococcus epidermidis and haemolyticus, Micrococcus luteus, and Acinetobacter radioresistens (two strains each) were isolated from cases of two asymptomatic wearers. The degree of coaggregation varied between 30% and 54%. The highest coaggregation was seen between A radioresistens 22-1 and S epidermidis 22-1, isolated from the same lens case. Coaggregation, cohesion, and growth promotion may facilitate bacterial colonization of cases, raising the possibility of adding substances to CL disinfecting solutions that could prevent aspects of cohesion or coaggregation.

Invest Ophthalmol Vis Sci 2018;59:7 2729-2735. Click here for full text

ASTIGMATISM

Scleral shape and astigmatism

To assess the correlation between the scleral shape and corneal astigmatism, Consejo & Rozema investigated 22 participants: 16 females and six males (11 non-astigmatic and 11 astigmatic), aged from 19 to 36 years. Three-dimensional (3D) corneoscleral maps from both eyes (44 eyes) were acquired using a corneoscleral topographer. In astigmatic eyes, corneal and scleral asymmetry are highly correlated, but both appear independent of each other in non-astigmatic eyes. The findings suggest that astigmatism is not restricted to the cornea but should rather be considered a property of the entire eye globe.

Cornea 2018;37:8 1047-1052. Click here for abstract

ASTIGMATISM

Ametropia and coverage of soft torics

To determine the prevalence of ametropia and astigmatism in a clinic population and to estimate the coverage of frequent replacement soft toric lenses, Luensmann et al reviewed and analyzed prescription data from three clinical sites (for patients 14 to 70 years of age) to determine prevalence of ametropia and astigmatism. Of the 101,973 patients, astigmatism in at least one eye was found in 87% of the population, with 37% of the patients exhibiting astigmatism of at least −1.00DC in at least one eye. Currently available frequent replacement soft toric CLs provide coverage for up to 96% of potential patients.

Cont Lens Anterior Eye (2018), https://doi.org/10.1016/j.clae.2018.05.006. Click here for full text

LENS CARE

Lens care system and eyelid tissue in SiHy lens wear

Guillon et al compared the eﬀects of a hydrogen peroxide (H₂O₂)-based lens care solution and a polyhexamethylene biguanide (PHMB) multipurpose solution on the eyelids when used with two different silicone hydrogel (SiHy) contact lenses in a total of 74 symptomatic CL wearers. Hyperemia, papillae and lid margin staining of eyelid tissue were evaluated at enrolment, at dispensing and at 3-months’ follow-up. An H₂O₂-based lens care solution used with senoﬁlcon A and balaﬁlcon A lenses was better tolerated by eyelid tissues than was a PHMB-based solution and led to a decrease in clinical markers of eyelid inﬂammation.

Cont Lens Anterior Eye 2018;41:4 362-368. Click here for full text

For more information on Research Update visit www.iacle.org.

23 June 20184 November 2018

Research Update Issue 18

June 2018

In this issue, we continue our quest to understand keratoconus and its treatment. A group of researchers from Israel attempts to determine the association of keratoconus with blepharitis and eye rubbing. Another paper reviews the success of corneal cross-linking in pediatric keratoconus …

June 2018

Welcome to our monthly research update

More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.

Issue 18 – June 2018

We include a study that compares the clinical performance of large diameter soft lenses with optimally ﬁt lenses in the same material and mono-curve back surface design. Another addresses the clinical performance of a large diameter rigid gas-permeable lens in low to moderate astigmats.

A Japanese group evaluates a novel povidone-iodine disinfection system. We report on a study that presents a link between contact lens wear and cell changes to the lid wiper epithelium, which were not visible by lip wiper staining. And finally, we include a review that provides an overview of the clinical management of digital eyestrain.

Happy reading!

The IACLE Education Team

Journals reviewed in this issue

	JOURNAL	VOLUME AND ISSUE NUMBER
	Clinical and Experimental Optometry	101:3, Early view
	Cornea	37:6
	Contact Lens & Anterior Eye	Articles in Press, 41:1
	Eye & Contact Lens	44:3
	Optometry and Vision Science	95:6

KERATOCONUS

Is blepharitis more prevalent with keratoconus?

To determine the association between blepharitis and keratoconus, Mostovoy et al conducted this prospective, observational study. A thorough survey of the eyelids – scales and foam on the eyelashes, missing eyelashes and meibomian gland expression – was performed on 50 keratoconus subjects and 72 controls. Blepharitis was more common in keratoconus than in the control group (24% vs 3%). A higher proportion of keratoconus participants reported rubbing their eyes more than once a day (36% vs 11%). Blepharitis-related inflammation and associated eye rubbing may contribute to keratoconus progression.

Clin Exp Optom 2018;101:3 339-344. Click here for abstract

KERATOCONUS

Corneal cross-linking for pediatric keratoconus

Perez-Straziota et al conducted a comprehensive review of the literature on cross-linking in the pediatric population. Out of 210 shortlisted publications, 115 were considered relevant to this review. The standard Dresden protocol is at least temporarily effective in halting progression and even improving keratometry values in pediatric patients. Some studies demonstrate regression up to 3 years after treatment. Long-term effects and regression rates remain unclear, and further studies are needed in this population.

Cornea 2018;37:6 802-809. Click here for abstract

FITTING

Comparing optimum and large diameter soft lenses

To compare the clinical eﬀect of large diameter soft lenses with those of optimally ﬁt lenses (in the same material and design), Wolffsohn et al recruited 25 myopes to this randomized, bilateral, unmasked, crossover study. Subjects wore optimum diameter lenses and large diameter lenses (1.2mm larger in diameter than the optimal lens and 0.6mm ﬂatter in base curve to give a clinically equivalent ﬁtting) in random order for 1 week each. The ﬁndings suggest that larger than optimal soft lenses may be worn without detriment to either comfort or ocular physiology, provided an optimal ﬁt is otherwise maintained.

Cont Lens Anterior Eye (2018). DOI: https://doi.org/10.1016/j.clae.2018.03.004. Click here for full text

ASTIGMATISM

Large diameter RGP vs soft torics in refractive astigmatism

In this multisite, prospective, cross-over study, Michaud et al compared the clinical performance of a large diameter rigid gas-permeable (LRGP) lens (Boston XO, 14.3mm diameter miniscleral) with soft toric lenses in 36 low to moderate astigmats. 75% preferred the vision with the LRGP lens as compared to the soft torics. Wear time, subjective comfort, and subjective vision ratings showed no signiﬁcant difference between the two groups. In asymptomatic contact lens wearers, LRGP lenses can be considered a good alternative to soft toric lenses for correcting refractive astigmatism.

Eye & Contact Lens 2018;44:3 164-169. Click here for abstract

LENS CARE

Antimicrobial efficacy of a novel disinfection system

Yamasaki et al evaluated a novel povidone-iodine (PI) contact lens disinfection system (cleadew, Ophtecs, Japan) against a range of bacteria, fungi and Acanthamoeba. Antimicrobial assays were conducted according to ISO 14729 using the recommended strains of bacteria and fungi, with and without the presence of organic soil. Activity on bioﬁlms formed from Stenotrophomonas maltophilia and Achromobacter sp was evaluated. Eﬃcacy against A castellanii trophozoites and cysts was also investigated. The PI system was eﬀective against a variety of pathogenic microorganisms under a range of test conditions, including challenging conditions of use.

Cont Lens Anterior Eye 2018;41:3 277-281. Click here for full text

PHYSIOLOGY

Contact lens wear and lid wiper epithelium

Alghamdi et al attempted to establish whether the duration of contact lens (CL) wear affects the cellular morphology of the lid wiper (LW) epithelium in this cross-sectional study of 100 individuals with different exposures to CL wear and non-wearers as controls. Impression cytology samples were collected from the central upper lid margin (LW area). Metaplasia of the LW epithelium was significantly greater in the early to moderate stages with CLs. This supports the view that mechanical irritation is responsible for LW changes in CL wear. Ceasing CL wear seems to lead to recovery.

Optom Vis Sci 2018;95:6 491-497. Click here for abstract

DIGITAL EYESTRAIN

Management of digital eyestrain

Coles-Brennan et al provide an overview of the extensive literature on digital eye strain with particular reference to managing symptoms. Management strategies suggested are: (i) appropriate correction of refractive error, including astigmatism and presbyopia; (ii) managing accommodation and vergence anomalies; (iii) training to maintain normal blinking pattern; (iv) use of lubricating eye drops to help alleviate dry eye-related symptoms; (v) CLs with enhanced comfort, particularly at end-of-day and in challenging environments; (vi) prescription of color ﬁlters in all vision correction options, especially blue light absorbing ﬁlters. Prevention is the main strategy for management of digital eye strain.

Clin Exp Optom (2018). DOI:10.1111/cxo.12798. Click here for abstract

For more information on Research Update visit www.iacle.org.

26 May 20184 November 2018

Research Update Issue 19

July 2018

Welcome to our monthly research update

More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.

Special Issue – July 2018

Controlling Myopia Progression: Where Do We Stand Today?

In this ﬁrst of two issues devoted to myopia topics, the myopia epidemic, new revelations from ongoing research, as well as new and emerging treatments to address and slow myopia progression, are explored.

Here are some excerpts from the issue.

The IACLE Education Team

Journals reviewed in this issue

	JOURNAL	VOLUME AND ISSUE NUMBER
	Eye & Contact Lens	44:4

MYOPIA CONTROL

Current thoughts and future research

Asbell & Tsubota set the scene by asking some relevant, hard hitting questions: How would you design a trial to determine the safety and efﬁcacy of a treatment to prevent myopia progression? What result would be clinically significant? What is a reasonable risk/safety ratio? How long should treatment be continued? What about rebound when treatment is stopped? What outcome measures are important? What should be the key safety criteria: vision (distance and near), corneal thickness, glare, pupil size, and corneal health?

Eye & Contact Lens 2018;44:4 203-204. Click here to access

STUDY DESIGN

Principles of myopia control studies

This workshop, sponsored by the US Food and Drug Administration and academic bodies, invited myopia experts from around the world to discuss principles to consider in the design of clinical trials investigating the effectiveness and safety of myopia control devices. Experts discussed parameters such as study endpoints, duration, enrolment criteria, patient-reported outcomes, recruitment and retention. These discussions should help to facilitate the development and evaluation of reasonably safe and effective myopia control devices. The panel recommended a 50% reduction in refractive error progression as clinically meaningful, although the audience suggested allowing for smaller treatment effects, ie a 30% reduction.

Eye & Contact Lens 2018;44:4 205-211. Click here for full text

CLINICAL TRIALS

How to assess published studies

Although some contact lens clinical trials have demonstrated promising results in slowing the progression of myopia, many of these studies have signiﬁcant limitations, including short follow-up times, limited randomization and incomplete masking. More robust clinical study designs are needed so that future studies can demonstrate whether CLs, and other medical devices, can be used safely and effectively to control myopia progression. Robboy et al review key studies, and discuss study design and regulatory issues relevant to future trials.

Eye & Contact Lens 2018;44:4 212-219. Click here for abstract

CURRENT CONCEPTS

Etiology: genetic and environmental

To provide the latest information on etiology and treatment strategies aimed at preserving ocular health, Cooper & Tkatchenko review studies of current treatments for myopia. Animal and human research demonstrates that myopia development is a result of interplay between genetic and environmental factors. Myopia seems to progress most between ages 8-15 and then begins to slow down. Based on ongoing research, new drug targets and drugs for treating myopia are expected soon. Parents should be aware of what is and is not effective, including the risks and beneﬁts associated with each treatment option.

Eye & Contact Lens 2018;44:4 231-247. Click here for full text

ORTHOKERATOLOGY

Role of OrthoK in myopia control

This review by Lipson et al covers the development of OrthoK, its mechanism of action, evolution and refinement from a refractive option, to its use as a means of slowing myopic progression. Theories and studies as to how OrthoK slows myopia progression in children are also explained. Individual studies and meta-analyses on myopia control with OrthoK have shown a 40-60% mean reduction in rate of refractive change compared with controls using spectacles. OrthoK provides excellent vision, improves vision-related quality of life, is safe, and is able to slow the myopic progression in children, the authors say.

Eye & Contact Lens Lens 2018;44:4 224-230. Click here for full text

AXIAL ELONGATION

Axial length in myopic progression

Hou et al describe results from the COMET (Correction of Myopia Evaluation Trial) cohort. This trial aimed to describe axial elongation using 14-year longitudinal data in a large (n=431), ethnically diverse group of myopic children, estimate age and axial length (AL) at stabilization, and evaluate associations between the progression and stabilization of AL and myopia. In most participants, AL increased rapidly at younger ages and then slowed and stabilized. The findings support a major role for axial elongation in the progression and stabilization of myopia, and AL as the ocular component whose change is a primary determinant of refractive error.

Eye & Contact Lens 2018;44:4 248-259. Click here for abstract

ORTHOKERATOLOGY

Corneal power and axial elongation in OK

Santodomingo-Rubido et al examine the correlation between changes in axial length and short-term (3 months post-OK) and long-term (24 months post-OK) changes in corneal power induced by OK with reference to data from their previous MCOS (Myopia Control with Orthokeratology contact lenses in Spain) study. Differences in refractive power 3 and 24 months post-OK in comparison with baseline and relative to the change in central corneal power of 31 white, European, 6-12-year-old subjects were determined. Reduction in central corneal power and relative increase in paracentral and pericentral power induced by OK over 2 years did not correlate with changes in axial length in these white European children.

sEye & Contact Lens 2018;44:4 260-267. Click here for abstract

For more information on Research Update visit www.iacle.org.

25 May 20184 November 2018

Research Update Issue 17

May 2018

The eye care community is acknowledging the threat posed by the growing prevalence of myopia and its sequelae. An editorial in Ophthalmology invites stakeholders to collaborate and design a strategy to control myopia. Another review discusses optical and pharmacological interventions, and future research directions …

May 2018

Welcome to our monthly research update

More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.

Issue 17 – May 2018

We include a study that assesses how effective multifocal contact lenses are at removing foveal hyperopic defocus during binocular near viewing in young eyes. A Spanish group evaluates visual function in patients with irregular corneas fitted with scleral contact lenses. We report on a study that investigates the effect of soft contact lens modality and lens material on ocular surface physiology.

In this issue, we explore topics that are outside mainstream contact lenses yet very relevant to contact lens practice. A review article discusses the prevalence of and interventions for digital eye strain (DES). And finally, from the archives we include a useful report on smart phone assisted, slit lamp free anterior segment imaging.

For almost all of this month’s articles, we are able to supply full text. Happy reading!

The IACLE Education Team

Journals reviewed in this issue

	JOURNAL	VOLUME AND ISSUE NUMBER
	Ophthalmology	125:5
	Clinical and Experimental Optometry	101:3
	Optometry and Vision Science	95:5
	Eye & Contact Lens	44:3
	Contact Lens & Anterior Eye	41:3, 39:1
	BMJ Open Ophthalmology	3:1

MYOPIA

Public health burden and potential interventions for myopia

In their editorial, Modjtahedi et al appeal to ophthalmologists and optometrists to determine a collaborative framework for myopia control. An estimated 1.406bn people in the world are myopic (22.9% of the population) and 163m have high myopia (2.7%). Uncorrectable visual impairment is seen in 4% of 75-year-olds with myopia and 39% with high myopia. There is also a tremendous economic impact, with a loss in global gross domestic product from uncorrected refractive error of around $202bn annually. Until we better refine our understanding of myopia, and interventions to lower its prevalence and severity, current interventions are readily available and inexpensive.

Ophthalmology 2018;125:5 628-630. Click here for full text

MYOPIA

Optical and pharmacological strategies for myopia control

This review by Kang discusses the efficacy of various myopia control interventions and potential future research directions. Currently there are no guidelines for the selection of the ideal myopia control treatment for an individual child. The optimal age to start myopia control, and which treatment options are better suited to which children, is unknown. There are limited studies on the influence of ethnicity on treatments. To improve the efficacy of current myopia control treatments, the impact of combining two treatment options is being explored, including combining orthokeratology with atropine eye drops.

Clin Exp Optom 2018;101:3 321-332. Click here for full text

MULTIFOCALS

Accommodation with multifocal contact lens designs

Altoaimi et al examined accommodative behavior of eight young adults fit bilaterally with an aspheric single-vision contact lens, and center-distance and center-near multifocal contact lenses (MFCL), to assess the effectiveness of these lenses at removing foveal hyperopic defocus during binocular near viewing. Young eyes fit with MFCLs incorporating significant transition zones accommodated to focus pupil regions between the near and distance optics, which resulted in less than optimal retinal image quality, and myopic or hyperopic defocus in either the pupil center or pupil margins. Convergence accommodation, as well as pupil size and zonal geometry, is likely to contribute to the final accommodative responses.

Optom Vis Sci 2018;95:5 416-427. Click here for abstract

SCLERAL LENSES

Vision function in patients with irregular corneas

To assess visual function and patient satisfaction in patients with irregular corneas who did not tolerate gas permeable (GP) corneal lenses, Eguileor et al recruited 15 subjects (15 eyes) who were fitted with scleral GP lenses (Rose K2 XL). Visual function was assessed using visual acuity and the visual function index (VF-14). The VF-14 was used as an indicator of patient satisfaction. Both visual acuity and VF-14 improved after fitting with the scleral contact lenses. Also, patients used these scleral lenses for longer comfortable hours of wear than GP corneal lenses.

Eye & Contact Lens 2018;44:3 159-163. Click here for abstract

PHYSIOLOGY

Replacement schedule and ocular surface physiology

In this longitudinal clinical trial, Sapkota et al investigated the effect of soft contact lens wearing modality and lens material on changes in conjunctival bulbar and limbal redness, conjunctival and corneal staining, and comfort. Forty-seven neophyte subjects were fitted with one of three monthly lenses in one eye and one of three daily disposable lenses in the other eye, randomly selected. Changes in ocular surface physiology and comfort score were similar with daily and monthly wear modalities. CL practitioners are advised to recommend lenses according to material characteristics rather than wearing modality.

Cont Lens Anterior Eye (2017); https://doi.org/10.1016/j.clae.2017.12.005. Click here for full text

DIGITAL EYESTRAIN

DES: prevalence, measurement and amelioration

In this review, Sheppard and Wolffsohn discuss prevalence and interventions for digital eye strain (DES) including recent data and information on usage of digital devices, assessment techniques and management. Estimates suggest the prevalence of DES may be 50% or more among computer users. With ≥6h of computer use, CL wearers were more likely to be affected than non-wearers, with prevalence of 65% and 50% respectively. With high prevalence of DES and near-universal use of digital devices, it is important that the condition is considered by practitioners, and treatment options are supported by research evidence.

BMJ Open Ophth 2018;3:e000146. DOI:10.1136/bmjophth-2018-000146. Click here for full text

PHOTOGRAPHY

The smart way to capture the anterior segment

Mohammadpour et al introduced a user-friendly technique to simplify anterior segment image capture with a smartphone that does not require a slit lamp or specialized training. A smart phone with resolution of at least 8 megapixel can be used by holding a 90D double aspheric lens manually or attaching by clear tape. Although slit-lamp images are more informative, this method is designed for situations where photo-documentation with slit lamp is not available, especially in rural areas in developing countries.

Cont Lens Anterior Eye 2016;39:1 80-81. Click here for full text

For more information on Research Update visit www.iacle.org.

30 April 20184 November 2018

Research Update Issue 16

April 2018

Welcome to our monthly research update

More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.

Issue 16 – April 2018

Keratoconus seems to be the flavour of the season. In this issue, we include a paper that compares vision and stereoacuity in keratoconus corrected with spectacles and with rigid gas-permeable lenses. A group from Jordan assesses the barriers to rigid gas-permeable lens wear for vision rehabilitation in keratoconus. And we review a longitudinal study that assesses the 10-year follow-up efﬁcacy and safety of riboﬂavin ultraviolet A-induced cross-linking.

Continuing our quest to understand myopia, we report on diet and risk of myopia in children. Another study evaluates the effect of transient glare on shape discrimination threshold in myopic adults.

Since contact lens users are growing worldwide, and awareness and better diagnostics are available, Acanthamoeba keratitis will become increasingly important over time. Hence, we include a review that focuses on the present status and future prospects of its re-emerging pathology. And finally, we look at the important clinical implications of environmental pollution for the ocular surface.

Happy reading!

The IACLE Education Team

Journals reviewed in this issue

	JOURNAL	VOLUME AND ISSUE NUMBER

	Optometry and Vision Science	95:4
	Contact Lens & Anterior Eye	Articles in press
	Cornea	37:5
	Clinical and Experimental Optometry	Early view; 101:2
	The Ocular Surface	16:2

KERATOCONUS

Vision in keratoconus: spectacles or RGP lenses?

Nilagiri et al compared changes in logMAR and stereoacuity from best corrected sphero-cylindrical spectacles to rigid gas-permeable contact lenses (RGPCL) in 30 bilateral and 10 unilateral keratoconus versus 20 age-matched control subjects. Monocular and binocular logMAR and stereoacuity improved from spectacles to RGPCL in bilateral keratoconus. Only monocular acuity of the affected eye and stereoacuity improved from spectacles to RGPCL in uniocular keratoconus. Clinicians can consider RGPCL as a management modality in keratoconus patients complaining of depth-related difficulties with spectacles.

Optom Vis Sci 2018;95:4 391-398. Click here for abstract

KERATOCONUS

Patient-related barriers to RGP lens wear

To assess potential patient-related barriers to rigid gas-permeable (RGP) lens wear for vision rehabilitation in keratoconus (KC) patients in Jordan, Bakkar et al identiﬁed barriers after a focus group discussion and used them to design a questionnaire. A total of 204 KC patients (86 females, 118 males), who had never tried RGP lenses, were involved in a semi-structured interview to complete the questionnaire. Major barriers identified were: lack of awareness of the beneﬁts of RGP lenses, fear of possible lens complications, lack of medical insurance and high cost of the lenses.

Cont Lens Anterior Eye 2017; https://doi.org/10.1016/j.clae.2017.12.007. Click here for full text

KERATOCONUS

Corneal collagen cross-linking: 10-year results

A prospective longitudinal cohort study by Mazzotta et al assessed the 10-year follow-up efﬁcacy and safety of riboﬂavin ultraviolet A-induced cross-linking (CXL) in patients aged 18 years and younger with progressive keratoconus (KC). CXL slowed down KC progression in pediatric patients, improving functional performance. KC stability was recorded after 10 years of follow-up in nearly 80% of patients, but there was a 24% regression rate in patients aged 15 years and younger. Parents of these younger patients must be clearly informed that, 7-10 years after therapy, nearly one in four patients may need to be re-treated.

Cornea 2018;37:5 560-566. Click here for abstract

MYOPIA

Diet and risk of myopia: the GUSTO cohort

Chua et al investigated the relationship between dietary intakes at 6, 9 and 12 months and risk of myopia in 317 three-year-old children in the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) birth cohort. Dietary intake was recorded using 24-hour recalls or three-day food diaries completed by parents. There was no evidence that diet at 6, 9 and 12 months was related to spherical equivalent, axial length or myopia at three years. Further studies are needed to understand the inﬂuence of diet on children’s eye development.

Clin Exp Optom 2018; https://doi.org/10.1111/cxo.12677. Click here for abstract

MYOPIA

Transient glare and myopia

Su et al evaluated the effect of transient glare on shape discrimination threshold (SDT) in 162 myopic adults. SDTs were measured under two conditions, with and without the presence of transient glare, while the stimulus was displayed. SDT was increased by the presence of transient glare in myopic subjects. The increment in SDTs among subjects with high myopia was signiﬁcantly larger than with low-mid myopia. Further work is needed to see if the patients who cannot cope well with post-surgery glare are those who show a larger increase in SDT under transient glare.

Clin Exp Optom 2018;101:2 220-224. Click here for abstract

PATHOLOGY

Acanthamoeba in the eye: latest developments

A review by Juárez et al highlights current information about Acanthamoeba keratitis (AK) including general characteristics, epidemiology, clinical aspects, diagnosis and treatment. Recent discoveries in the biology of the parasite involve changes in the prognosis and treatment of AK. Recent studies have reported diﬀerent genotypes that have not been previously associated with this disease. In addition, Acanthamoeba can act as a reservoir for phylogenetically diverse microorganisms. Giant viruses called Pandoravirus have been found within genotypes producing keratitis. What potential risk this poses is not yet known.

Cont Lens Anterior Eye 2017; https://doi.org/10.1016/j.clae.2017.12.017. Click here for full text

ENVIRONMENT

Ocular surface effects of pollution

Jung et al reviewed the literature over the past 10 years to determine the effects of environmental pollution on the ocular surface. Sources of pollution are varied, ranging from gases (such as ozone and NO2) and particulate matter from traffic, to other hazards associated with indoor environments. Mechanisms causing ocular surface disease involve toxicity, oxidative stress, and inflammation. Certain occupations with high exposure to irritants require regular screening and protective measures, as do those with atopy/allergies.

Ocul Surf 2018;16:2 198-205. Click here for abstract

For more information on Research Update visit www.iacle.org.

21 March 20184 November 2018

Research Update Issue 15

March 2018

In this issue, we continue our efforts to understand myopia. A group from Denmark investigates the association of physical activity and myopia in Danish children …

March 2018

Welcome to our monthly research update

More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.

Issue 15 – March 2018

In this issue, we continue our efforts to understand myopia. A group from Denmark investigates the association of physical activity and myopia in Danish children.

We include a review that presents updated tables of tear evaporation rates. Researchers in Spain evaluate the impact of a high-water daily disposable hydrogel lens on the ocular surface. We report on a study that attempts to understand the relationship between subjective ratings and satisfaction in CL wear. And a group from the US quantifies the tear elimination rate underneath silicone hydrogel and scleral gas-permeable contact lenses.

Many practitioners and researchers are intrigued by visual performance in keratoconus patients. A Spanish team assesses the vision quality achieved by corneo-scleral lenses in keratoconus. Finally, we include a study that evaluates the antimicrobial efficacy of various multipurpose disinfecting solutions in the presence of contact lenses and lens cases. Access the full text to see how each MPS performs.

Happy reading!

The IACLE Education Team

Journals reviewed in this issue

	JOURNAL	VOLUME AND ISSUE NUMBER

	Acta Ophthalmologica	96:2
	Contact Lens & Anterior Eye	Articles in press
	Clinical and Experimental Optometry	101:2
	Optometry and Vision Science	95:3
	Eye & Contact Lens	44:2

MYOPIA

Physical activity and myopia: the CHAMPS Eye Study

This prospective study with longitudinal data on physical activity (PA) in 307 Danish children aged 14-17 years was conducted by Lundberg et al to determine associations between PA and myopia. PA was measured objectively by repeating ActiGraph accelerometer measurement four times with diﬀerent intervals (1-2.5 years). The prevalence of myopia was 17.9% (SE ≤-0.5D) and mean axial length (AL) was 23.5+0.9mm. By logistic regression and slope analysis, authors found no association between PA and myopia.

Acta Ophthalmol 2018;96:2 134-141. Click here for abstract

TEAR FILM

Tear evaporation rates recalculated

This review by Wong et al presents updated tables of tear evaporation rates (TERs) using values from papers cited in a previous literature review (1941-2003), in addition to incorporating new studies published 2003-2016. Each paper cited in the literature review was checked against the TER reported. PubMed and Scopus searches were conducted to ﬁnd papers published on tear evaporimetry since 2003. Two new tables of TERs are compiled to provide an accurate representation of the values reported in the original papers.

Cont Lens Anterior Eye 2018;DOI 10.1016/j.clae.2017.12.003. Click here for full text

LENS MATERIALS

Impact of high-water hydrogel DD on the ocular surface

A crossover study by Ruiz-Alcocer et al evaluates the impact on the ocular surface of a daily disposable (DD), high water content (78%) hydrogel CL compared with two silicone hydrogel DDs in 20 eyes of 20 patients. Lens thickness was measured to assess material stability during daily wear, and tear ﬁlm osmolarity, tear meniscus area and central corneal thickness were also assessed. The hydrogel lens adequately resisted dehydration and did not impact signiﬁcantly on tear ﬁlm and corneal swelling after 1 day of use in ﬁrst-time wearers, despite being the thinnest lens with the highest water content of those tested.

Clin Exp Optom 2018;101:2 188-192. Click here for abstract

COMFORT

Contact lens ratings and satisfaction

To understand the relationship between subjective ratings and satisfaction in CL wear, Diec et al performed retrospective analysis of two daily disposable CL trials on 64 participants 40 years or younger followed over 3 months. Subjective ratings included comfort (insertion, during the day and end of day), vision clarity and binary response (yes/no) for satisfaction with comfort and vision. Satisfaction in CL wear was influenced by both comfort and vision. A higher rating for comfort during the day compared with end of the comfort was required to attain satisfaction. Comfort on insertion was not associated with comfort satisfaction.

Optom Vis Sci 2018;95:3 256-263. Click here for abstract

SCLERAL LENSES

Tear exchange: SiHys verses sclerals

To quantify tear elimination rate (ER) underneath silicone hydrogel (SiHy) and scleral gas-permeable (GP) CLs, Paugh et al recruited 14 soft SiHy and 12 scleral GP lens wearers. An objective ﬂuorometer measured decay of ﬂuorescein isothiocyanate dextran dye signal (70 kD MW) from which the tear ER in %/min was calculated. Data demonstrated signiﬁcantly less ER in well-ﬁt scleral GP CL wearers compared with soft SiHy CL wearers for both settling and longer wear periods. Also, slightly greater tear exchange was observed during the scleral GP CL settling period than later.

Eye & Contact Lens 2018;44:2 97-101. Click here for abstract

KERATOCONUS

Visual quality with corneo-scleral lenses

To assess visual quality achieved by ﬁtting corneo-scleral contact lenses (CScL) for keratoconus management, Montalt et al ﬁtted CScL to 30 keratoconic patients and monitored 27 of them for 1 year. Objective eye examination was performed, and subjective visual quality and comfort, and wearing time reported. Signiﬁcant diﬀerences were found in logMAR VA between the best spectacle-corrected VA and after CScL ﬁtting. Total high-order aberrations decreased signiﬁcantly. CScL were safe and healthy, providing optimal visual quality, comfort and prolonged usage times.

Cont Lens Anterior Eye 2018;DOI 10.1016/j.clae.2018.01.002. Click here for full text

LENS CARE

Antimicrobial efficacy and compatibility of MPS

Gabriel et al used antimicrobial efﬁcacy endpoint methodology (AEEMC), developed as a result of the 2006 Fusarium keratitis outbreak, to determine the compatibility of multipurpose disinfecting solutions (MPS), lens cases and hydrogel CLs, for disinfection against ISO-speciﬁed microorganisms and also S maltophilia. Six MPS were tested with three CL materials and lens cases. AEEMC results varied with challenge microorganism, CLs, and MPS. Hence it is important to evaluate MPS for compatibility with lenses and lens cases.

Eye & Contact Lens 2018;44:2 125-131. Click here for full text

For more information on Research Update visit www.iacle.org.

22 February 20184 November 2018

Research Update Issue 14

February 2018

In this issue, we continue our quest to understand the effects of soft contact lens wear on the tear film and include a review that summarizes key changes to the tears in CL wear. A group from Japan investigates the relationship between changes in ocular surface temperature and tear film stability …

February 2018

Welcome to our monthly research update

More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.

Issue 14 – February 2018

From a special issue of Contact Lens & Anterior Eye on New Dry Eye Research – building on the latest TFOS report, DEWS II – we include a study that explores osmolarity, comfort and lid wiper epitheliopathy in CL wear. Proactive contact lens prescribing has been believed to result in converting spectacle wearers to CL users. A group of Indian FIACLEs compares two approaches to proactive prescribing.

We report on a scleral lens study that evaluates turbidity and thickness of the post-lens tear layer and effects on visual quality in patients with keratoconus. Finally, we include research that examines accommodation in early presbyopes fit with a bilateral or unilateral near add.

Happy reading!

The IACLE Education Team

Journals reviewed in this issue

	JOURNAL	VOLUME AND ISSUE NUMBER

	Clinical and Experimental Optometry	100:5, 100:6
	Investigative Ophthalmology & Vision Science	59:2
	Contact Lens & Anterior Eye	41:1, Articles in press
	Optometry and Vision Science	95:1

TEAR FILM

Tear film in soft contact lens wear: a review

Soft contact lens (SCL) wear has the potential to adversely affect the tear ﬁlm and anterior ocular surface. This review by Downie and Craig summarises current knowledge relating to the effects of SCL wear on the tear ﬁlm and ocular surface. The review guides the clinician to recommend appropriate management of any tear ﬁlm abnormalities. It describes a diagnostic approach to assessing tear ﬁlm and ocular surface health, and includes a tear ﬁlm lipid layer grading scale. The authors also summarize key changes to the tear ﬁlm in CL wear and management strategies to improve tear ﬁlm and ocular surface health.

Clin Exp Optom 2017;100:5 438-458. Click here for full text

TEAR FILM

Ocular surface temperature and tear film stability

To investigate the association between changes in ocular surface temperature (OST) and tear film stability over soft contact lenses (SCLs), Itokawa et al measured OST of 20 eyes of 20 SCL wearers. Measurements were taken every second for 10s without blinking. Tear film stability was evaluated by non-invasive tear break-up time (NIBUT) and tear interference patterns on the contact lenses (TIPCL). The difference in OST correlated signiﬁcantly with NIBUT without and with SCL. OST can be used to evaluate tear ﬁlm stability in SCL wearers.

Invest Ophthalmol Vis Sci 2018;59 771-775. Click here for full text

COMFORT

Contact lens comfort, osmolarity and lid wiper staining

To explore osmolarity, comfort and lid wiper epitheliopathy in CL wear, Stahl & Jalbert conducted this randomized, cross-over study where two different silicone hydrogel lens types were each worn for 10 days by 20 subjects. Comfort and tear stability decreased and upper lid wiper staining and foreign-body sensation increased with lens wear and were not affected by lens type. Relationships between comfort and CL osmolarity, and between tear osmolarity and tear stability and production, were found. The study could not demonstrate an association between comfort and tear osmolarity or lid wiper epitheliopathy.

Cont Lens Anterior Eye 2018;41:1 110-116. Click here for full text

CL PRACTICE

Proactive contact lens prescribing

In this prospective, randomized, controlled, multi-centre study, Thite et al evaluated the impact of optometrists’ proactivity on the prescribing of CLs by assigning 60 neophytes each to two groups: conventional proactive recommendation (CPR), where subjects were offered CLs as a mode of vision correction; and the EASE (Enhancing the Approach to Eyewear Selection) approach, where CLs were offered as an aid to spectacle selection. Of these 120 subjects, 53% were prescribed CLs as a mode of vision correction within the 3-month study period. CPR showed a higher conversion rate from CL experience to prescribing than the EASE approach.

Cont Lens Anterior Eye 2018. DOI 10.1016/j.clae.2018.01.001. Click here for full text

SCLERAL LENSES

Scleral lenses and tear turbidity

This experimental, short-term study was conducted by Carracedo et al to evaluate the turbidity (cloudiness or haziness) and thickness of the post-lens tear layer and its effect on visual quality in patients with keratoconus fit with scleral lenses. Distance visual acuity (VA), contrast sensitivity, pachymetry, post-lens tear layer height and post-lens tear layer turbidity were evaluated with optical coherence tomography in 26 patients before and after lens wear. VA decrease during wear of a scleral lens ﬁlled with preserved saline was due to increasing post-lens tear layer turbidity.

Clin Exp Optom 2017;100:6 577-582. Click here for abstract

PRESBYOPIA

Accommodation in early presbyopes

Almutairi et al examined accommodation behavior, pupil responses, and resultant image quality in early presbyopes fit with either bilateral or unilateral (monovision) near vision adds. Accommodative response and pupil size of 19 subjects were measured with an aberrometer. Subjects were fit with different strategies: bilateral distance, bilateral +2D near add and unilateral +2D near add. Findings suggest many early presbyopes will not adopt an accommodation strategy to optimize image quality with monovision but accommodate to focus the distance-corrected eye.

Optom Vis Sci 2018;95:1 43-52. Click here for abstract

For more information on Research Update visit www.iacle.org.

26 January 20184 November 2018

Research Update Issue 13

January 2018

We begin the new year with diverse topics in the field of contact lenses, in this our first issue of 2018.

January 2018

Welcome to our monthly research update

More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.

Issue 13 – January 2018

We begin the new year with diverse topics in the field of contact lenses, in this our first issue of 2018.

Contact lenses in youth have been drawing the industry’s attention. In this issue, we include a study that differentiates behaviors of young patients presenting with serious and non-serious adverse events. Bringing the focus onto multifocal contact lenses, we review a paper that explores the relationship between discontinuation and lens design. Another study investigates the eﬀect of multifocal lens design on contrast sensitivity and disability glare.

A group from the UK identifies the characteristics of keratoconic patients lost to follow-up. We also report on a study that validates the accuracy of observers’ ability to estimate central corneal clearance in scleral lens fitting. Finally, we include a paper that investigates whether lysozyme deposition on soft lenses could act as a barrier against subsequent albumin adsorption.

Happy reading!

The IACLE Education Team

Journals reviewed in this issue

	JOURNAL	VOLUME AND ISSUE NUMBER

	Eye & Contact Lens	44:1
	Contact Lens & Anterior Eye	Articles in press
	Clinical and Experimental Optometry	100:6
	Optometry and Vision Science	95:1, 94:11

ADVERSE EVENTS

Risky behaviours among young SCL wearers

Sorbara et al tested the ability of the Contact Lens Assessment in Youth Contact Lens Risk Survey to differentiate behaviors among those with serious and signiﬁcant (S&S, n=96) CL-related corneal inﬂammatory events, from those with other events (non-S&S, n=68) and controls (n=207). Patients with S&S were more likely to report overnight wear or purchase SCLs on the internet, versus patients with non-S&S and versus controls. Patients with S&S were less likely to regularly discard leftover solution compared with controls. The study also reafﬁrmed the use of DD lenses as a means to reduce S&S risk.

Eye & Contact Lens 2018;44:1 21-28. Click here for abstract

MULTIFOCALS

Fitting success for different multifocal designs

To determine whether discontinuation from simultaneous-vision multifocal soft contact lenses (MFCL) is independent of the multifocal design, Novillo-Díaz et al conducted a multicenter, single-blinded, randomized, controlled trial among 150 single-vision SCL wearers. At one month, a spherical near centered lens (S-CN) had a signiﬁcantly higher risk of discontinuation than a distance centered lens (CD) and aspherical near centered lens (A-CN). Discontinuation from MFCLs is dependent on the design. The most common cause of dropout was poor distance vision and psychosocial factors did not have an impact.

Contact Lens and Anterior Eye 2017; DOI: 10.1016/j.clae.2017.12.012. Click here for full text

MULTIFOCALS

Disability glare with soft multifocal lenses

To investigate the eﬀect of multifocal contact lenses (MFCL) designs on contrast sensitivity (CS) and disability glare, Wahl et al recruited 16 young adults and measured contrast sensitivity under two conditions: no-glare and glare. Two MFCL designs – center near (CN) and center distance (CD) – were used to simulate correction for presbyopia. The CN design resulted in the lowest contrast sensitivities, compared to the CD design, trial frame correction and single vision CL. MFCL design has a signiﬁcant impact on CS and on disability glare.

Contact Lens & Anterior Eye 2017; DOI: 10.1016/j.clae.2017.10.002. Click here for full text

KERATOCONUS

Why do keratoconic contact lens wearers drop out?

In this retrospective analysis of 102 keratoconic CL wearers lost to follow-up, Russell et al identiﬁed characteristics of patients who discontinued or continued attendance. They then investigated how discontinued cases were managing, along with the reasons for discontinuation. Lens BOZR was not associated with non-attendance. In general, neophytes and those wearing a lens in one eye were more likely to discontinue. Poor comfort, handling problems and the ability to manage without lenses were the most common reasons cited for discontinuation.

Clin Exp Optom 2017;100:6 616-622. Click here for abstract

SCLERAL LENSES

Assessing scleral lens clearance

Yeung & Sorbara compared the accuracy of observers’ ability to estimate scleral CL central corneal clearance (CCC) with biomicroscopy to measurements using slit-lamp imaging and anterior segment optical coherence tomography (AS-OCT). Sixty-six novice, intermediate and advanced fitters estimated CCC by viewing images of four scleral lens fits obtained with a slit-lamp video imaging system. Responses were compared with known values of CCC. Results validated the ability of practitioners to estimate CCC using biomicroscopy.

Optom Vis Sci 2018;95:1 13-20. Click here for abstract

MATERIALS

Albumin deposition on contact lenses

Babaie Omali et al investigated whether lysozyme deposition on soft CLs in vitro could act as a barrier against albumin adsorption. Albumin adsorption may increase the risk of bacterial binding and reduce comfort. Six hydrogel lens types were lysozyme coated and uncoated lenses were used as control. Lysozyme-coated etafilcon A lenses exhibited lower levels of deposited albumin than uncoated etafilcon A lenses. There were no differences in albumin adsorption between coated and uncoated lenses for the other lens types tested.

Optom Vis Sci 2018;94:11 1047-1051. Click here for abstract

For more information on Research Update visit www.iacle.org.

19 December 20174 November 2018

Research Update Issue 12

December 2017

It gives us immense pleasure to present the last issue of 2017. Surface lubricity has been considered as a main factor influencing contact lens comfort. In this issue, we include a study that isolates the contribution of surface properties to comfort. Another paper explores the association between characteristics of lid margins and tear film …

December 2017

Welcome to our monthly research update

Welcome to Research Update, a new resource available to IACLE and BCLA members to support your teaching and practice. Each month we will send you a summary of some of the interesting findings appearing in peer-reviewed journals that month. Our aim is to help you keep up to date with the latest contact lens and anterior eye research, and to locate articles when you want to know more about a particular topic.

More information on Research Update and how to use it in your contact lens teaching here. Access archived issues via Member Login under Research.

Issue 12 – December 2017

A group from South Korea evaluates the efficacy of eyelid management in meibomian gland dysfunction. We review a study that unearths pre-inflammatory signs in reusable and disposable lens wearers. We also report on a potential next-generation one-step hydrogen peroxide disinfection system with a case-based catalyst. And a group in Australia investigates whether initial performance of multifocal contact lenses predicts their short-term dispensing performance. Finally, we end the year by peeking into contact lens technology to 2020 and beyond.

We wish you a very happy new year 2018!

The IACLE Education Team

Journals reviewed in this issue

	JOURNAL	VOLUME AND ISSUE NUMBER

	Contact Lens & Anterior Eye	Articles in press
	Clinical and Experimental Optometry	100:6, 100:5
	Optometry and Vision Science	94:11
	Eye & Contact Lens	43:6

CL COMFORT

Eﬀect of contact lens surface properties on comfort

In this randomized double-masked cross-over study, Vidal-Rohr et al attempted to isolate the influence of lens surface properties on contact lens comfort using an ultra-thin coating technology. Breakup time and ocular redness of 19 habitual CL wearers wearing the same monthly replacement soft lens with and without coating were evaluated. Symptoms were assessed after 1 week and 1 month of wear. Enhancing the physical surface properties of a soft contact lens was found to improve subjectively rated wearer comfort. This study suggests the importance of considering the coefficient of friction when fitting a contact lens.

Cont Lens Anterior Eye 2017;DOI:http://dx.doi.org/10.1016/j.clae.2017.09.009 Click here for full text

CL COMFORT

Lid margins and tear film in contact lens discomfort

To determine whether characteristics of the eyelid margins, meibomian glands and tear ﬁlm are related to contact lens discomfort, Siddireddy et al conducted this cross-sectional study among 30 existing daily wear soft CL wearers. Morphological irregularities of the meibomian glands and alterations to tear ﬁlm secretions that aﬀect tear evaporative dynamics were associated with discomfort among symptomatic wearers. Upper lid-wiper epitheliopathy (LWE), meibomian gland acini reﬂectivity and tear meniscus height showed signiﬁcant correlations with comfort scores in both symptomatic and asymptomatic wearers.

Cont Lens Anterior Eye 2017;DOI:http://dx.doi.org/10.1016/j.clae.2017.10.004. Click here for full text

EYELIDS

Meibomian gland squeezing for MGD

Lee et al carried out this prospective, intervention study to investigate the efficacy of eyelid management in meibomian gland dysfunction (MGD). Eyes of 32 subjects with moderate or severe MGD were treated with mechanical squeezing of meibomian glands, combined with eyelid scrubs and warm compresses. Tear ﬁlm break-up time (TBUT), corneal and conjunctival staining, biomicroscopic examination, Ocular Surface Disease Index (OSDI) and tear ﬁlm lipid layer thickness were evaluated before and after 1 month of treatment. This treatment could provide clinical beneﬁts without serious adverse events.

Clin Exp Optom 2017;100:6 598-602. Click here for abstract

PHYSIOLOGY

Pre-inflammatory signs and soft lens wear modality

This study by Chao et al compared the concentrations of tear cytokines and conjunctival cell morphology in 14 habitual daily disposable (DD) and 22 habitual reusable CL wearers in this cross-sectional single-visit study. Symptoms and ocular surface integrity were evaluated. Concentrations of tear cytokines were determined using multiplex assays. The study found higher tear cytokine concentration and conjunctival cell metaplasia in reusable CL wear as compared to DD CL wear. The balance of proinflammatory and anti-inflammatory cytokines may be helpful to assess the inflammatory status of the eye.

Optom Vis Sci 2017;94:11 1003-1008. Click here for abstract

LENS CARE

Enhancing peroxide efficacy against Acanthamoeba

Kilvington & Winterton studied whether the addition of an iron-containing catalyst bound to a non-functional fabric matrix could enhance the antimicrobial efficacy of one-step H2O2 systems. Two systems (based on 3% H2O2) were tested with and without the presence of catalyst fabric, using Acanthamoeba cysts as challenge organism. After 6 hours’ disinfection, the number of viable cysts was determined. Both systems produced approximately 1-log kill without and 3-log kill in presence of the catalyst. The catalyst significantly increased the efficacy of one-step H2O2 disinfection systems against highly resistant Acanthamoeba cysts.

Optom Vis Sci 2017;94:11 1022-1028. Click here for abstract

MULTIFOCALS

Predicting short-term performance of multifocal CLs

To investigate whether initial multifocal contact lens (MFCL) performance predicts short-term dispensing performance, Diec et al followed 55 subjects using two different brands of multifocal CL in a masked, crossover, clinical trial. Vision clarity, lack of ghosting at distance, and intermediate and near vision at day/night time were surveyed at ﬁtting and assessment visits. Initial performance at ﬁtting was not able to predict short-term performance of MFCLs. Subjective measures peaked at ﬁtting and declined thereafter whereas acuity-based measures remained constant.

Eye & Contact Lens 2017;43:6 340-345. Click here for abstract

TECHNOLOGY

Contact lens technology to 2020 and beyond

To gain insights into the way inventors are thinking about how contact lenses might be used in future, Papas reviewed over 300 patents submitted between January 2014 and February 2017. Vision correction, myopia, presbyopia and myopia control are likely to see new developments. Service delivery is the focus of some patents and they may hint at the way contact lens practice will be managed in the years to come. The other main areas where contact lenses will be applied include drug delivery, visual augmentation and biosensing.

Clin Exp Optom 2017;100:5 529-536. Click here for full text

For more information on Research Update visit www.iacle.org.