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Contact Lens & Anterior Eye
Contact Lens & Anterior Eye RSS feed: Current Issue.
Contact Lens & Anterior Eye is a research-based journal covering all aspects of contact lens theory and practice, including
original articles on invention and innovations, as well as the regular features of: Case Reports; Literary Reviews; Editorials; Instrumentation
and Techniques and Dates of Professional Meetings.
To order this journal online, visit http://intl.elsevierhealth.com/journals/clae
Editorial Board
1 Jun 2009 at 12:00am
Optometry and optics in Europe
by Shehzad A. Naroo, Feike Grit
1 Jun 2009 at 12:00am
The Latin motto of the European Union (EU) is ?In Varietate Concordia? or translated in English ?United in Diversity?. The motto comes to life when you realise the vast array of cultural differences that exist in the EU. It is estimated that over 200 languages exist and with migrant populations from Africa and Asia pretty much all racial groups are represented. In terms of size the EU is the size of Australia or ten times the size of Japan or a third the size of China. It has a population of around 455 million people (compared to approximately 290 million in the United States of America). Add to this the economic variations of the twenty-seven member states, of which 16 countries have adopted the Euro, and the four time zones. The EU has worked towards developing a single market which applies in all member states, ensuring the freedom of movement of goods, services and people.
Enhancing the approach to selecting eyewear (EASE): A multi-centre, practice-...
by Nick P. Atkins, Sarah L. Morgan, Philip B. Morgan
18 Mar 2009 at 12:00am
Abstract: Purpose: To examine the impact of contact lens application in non-contact lens wearers prior to spectacle dispensing.Methods: Ninety-one eligible subjects with no previous contact lens experience were randomly assigned into either a test group (52 subjects) or control group (39 subjects). The former group was offered contact lenses before spectacle dispensing. The latter group proceeded to spectacle dispensing in the normal way without being offered contact lenses. The response to the offer of contact lenses, fit success, the impact on the spectacle dispensing process and the longer term purchase of contact lenses were measured and compared for the test and control groups.Results: Of the test group, 46 (88%) agreed to try contact lenses. All subjects were suitable for contact lenses after a slit lamp examination and lenses were successfully fitted to 45 of the 46 subjects (98%). The test group reported a superior subjective spectacle dispensing experience and spent £267±143 (mean±standard deviation) on their spectacle frames and lenses, 32% more than the control group (£202±128). At 3 months post dispensing, 17 test patients (33% of original cohort) had purchased contact lenses compared with five control subjects (13%) (p=0.001).Conclusions: The opportunity to try contact lenses prior to spectacle dispensing was well received by subjects who generally reported a very positive experience. In particular, contact lenses assisted in seeing frame detail and suitability for wear. One third of subjects proceeded to purchase contact lenses. We recommend that practitioners consider offering contact lenses to all suitable patients who are proceeding to spectacle dispensing to optimise the dispensing process and to provide an opportunity to try contact lenses.
Hyaluronic acid in hydrophilic contact lenses: Spectroscopic investigation of...
by Matteo Fagnola, Marco Paolo Pagani, Silvio Maffioletti, Silvia Tavazzi, Antonio Papagni
26 Mar 2009 at 12:00am
Abstract: Two experimental spectroscopic methods for the determination of the content of hyaluronic acid in solution are provided based on the formation of complexes between the hyaluronic acid and cationic dyes with sensitivity down to concentrations of either 0.25 or 2.5?g/ml. These techniques were applied to commercial hydrophilic contact lenses and allowed (i) distinguishing among contact lenses either loaded or non-loaded with hyaluronic acid, (ii) determining, for the loaded ones, the content of hyaluronic acid, (iii) evaluating the release of hyaluronic acid by the lens in solution, and (iv) determining the role of the hyaluronic acid in preventing the adsorption and the successive release by the contact lens of other components which can be present, for example, in the conservation solutions and/or in the blisters of the lenses. The results represent new physical chemistry insights for the field of contact lenses with impact on the advancement of current technology.
Struggle with hydrogel CL wear increases with age in young adults
by Robin L. Chalmers, Chris Hunt, Sheila Hickson-Curran, Graeme Young
9 Feb 2009 at 12:00am
Abstract: Purpose: To report the symptoms and experiences associated with habitual hydrogel (Hyd) and silicone hydrogel (SiHy) contact lenses (CLs) among young adults and measure their association with age.Methods: Questionnaire responses from 699 Hyd and 183 SiHy wearers were analyzed to test the association of age with features indicating struggle with CL wear. Prevalence by age was compared between groups with Pearson's chi-square and within groups with Spearman's correlation coefficient.Results: Hyd and SiHy groups were similar for sex and age distribution. Diagnosis of dry eye increased with age in the Hyd wearers from 10.6% to 21.1% (18?24 vs. 30?35 years), but was approximately 19% in the SiHy wearers across age. Adverse environments caused more discomfort with Hyd than SiHy lenses and Hyd wearers? discomfort increased with age (smoky (p=0.0001), dry air environments (p=0.002), after napping or sleeping (p=0.004). More Hyd wearers considered discontinuation of CL wear with age, from 4.6% to 14.2% (18?24 vs. 30?35 years, p<0.04), but the proportion remained steady at 9% across age for SiHy wearers (p=0.46).Conclusions: From 18 to 35 years, hydrogel CL wearers reported increasing struggle with CL wear and more negative ratings compared to SiHy wearers. Older hydrogel CL wearers were also more likely to consider discontinuing CL wear compared with younger hydrogel or silicone hydrogel CL wearers in general. Young adult CL wearers should be routinely queried directly about specific aspects of CL wear in order to determine whether different lens types should be prescribed to avoid abandonment of CL wear.
Trace elements and blephar?t?s
by Fatma Yülek, Hasan Basri Çakmak, ?aban ?im?ek, Utku Serkant, ?ebnem Kösebalaban
8 Apr 2009 at 12:00am
Abstract: Introduct?on: Investigating the relationship between the serum levels of zinc and copper with blepharitis.Methods: Twenty seven patients with blepharitis and 24 control group patients were evaluated for Schirmer, fluorescein break up time (FBUT) scores and serum levels of zinc and copper. Symptoms and clinical examination scores of blepharitis patients were also assessed.Results: The serum level of zinc (65.78±15.51 in patients with blepharitis and 65.71±10.43 in patients without blepharitis, normal values in the laboratory: 70?127?g/dl) and copper (67.17±22.24 in patients with blepharitis and 69.35±14.44 in patients without blepharitis, normal values in the laboratory: 70?150?g/dl) were not different between the two groups. The symptom and clinical examination scores of blephraritis patients were not correlated with the serum levels of either zinc or copper.D?scuss?on: The zinc and copper levels in serum do not seem to be related to blepharitis. Their tear levels and sensory status of cornea should also be evaluted to better evaluate a possible relation.
The use of the Ocular Response Analyser to determine corneal hysteresis in ey...
by Sunil Shah, Mohammad Laiquzzaman, Ian Yeung, Xueliang Pan, Cynthia Roberts
25 Mar 2009 at 12:00am
Abstract: Purpose: To compare corneal biomechanical parameters and two measures of intraocular pressure (IOP) in eyes before and after excimer laser refractive surgery, with the Ocular Response Analyser (ORA).Materials and methods: Eighty normal eyes of 41 patients undergoing excimer laser refractive surgery in Birmingham, U.K. were recruited into three groups: Laser Assisted-Epithelial Keratomileusis (LASEK) (Myopes), Laser Assisted in Situ Keratomileusis (LASIK) (myopes) and LASIK (hyperopes). The preop and 3 months postop Goldmann correlated IOP (IOPg), corneal compensated IOP (IOPcc), corneal hysteresis (CH), and corneal resistance factor (CRF) were measured by the ORA. Central corneal thickness (CCT) was measured using ultrasonic pachymeter. The differences of the changes in IOPg, IOPcc, CH, CRF and CCT between the three groups were estimated. A General Linear Model was selected to investigate the influence of gender, age, initial conditions (CH, CRF, CCT, IOPcc and IOPg) and changes in CCT on the measured IOP.Results: The differences between the mean IOPg, CH and CRF after refractive surgery were statistically significant for all three groups. The hyperopic LASIK group had a significantly smaller change compared to the other groups (which had no statistical significance). The preop IOPg, preop CH and gender were significant predictors of the changes in measured pressure and biomechanical parameters after surgery in the myopic groups only.Conclusion: CH and CRF were found to decrease after both myopic and hyperopic refractive surgery. CH and CRF measurement may prove important tools to clarify the role of corneal biomechanics for refractive surgery.
Comparison of corneal biomechanics in pre and post-refractive surgery and ker...
by Sunil Shah, Mohammed Laiquzzaman
24 Feb 2009 at 12:00am
Abstract: Purpose: To compare biomechanical parameters measured by the Ocular Response Analyser (ORA) in the form of corneal hysteresis (CH), corneal resistance factor (CRF) and central corneal thickness (CCT) in eyes before and after excimer laser refractive surgery and keratoconic eyes.Setting: Teaching Hospital and private eye clinic in Solihull, UK.Methods: Prospective case comparison of 110 eyes selected for refractive surgery and 132 keratoconic eyes. The CH and CRF of each eye was measured by the ORA. The CCT was measured using ultrasonic pachymetry.Results: The mean preoperative (pre-op) CH for the normal refractive surgery eyes was 11.4±1.9mmHg, CRF 10.0±1.6mmHg and CCT 546.5±33.0?m. Post-operatively CH was 9.2±2.1mmHg, CRF 7.6±1.8mmHg and CCT 483.1±40.8?m. The values for keratoconic eyes were 9.4±2.2mmHg, 7.7±2.6mmHg and 488.1±52.6?m, respectively. The CH, CRF and CCT decreased as the severity of keratoconic eyes increased. All these parameters showed statistically significant difference between normal eyes and keratoconic eyes. This was also the case between post-operative eyes.Conclusion: The biomechanical parameters measured were very similar when comparing keratoconic and post-refractive surgery eyes.
Assessment of computer generated vision charts
by Klaus Ehrmann, Cathleen Fedtke, Alexa Radi?
13 Apr 2009 at 12:00am
Abstract: Introduction: New opportunities for vision assessment in the consulting room are given with the application of computers. This study cross-validated high and low contrast visual acuity (VA) data measured using traditional paper charts and new computerised technology applying the chart design of Bailey and Lovie. In addition, subjects? contrast sensitivity (CS) was tested with a computerised CS test, and the effect of memorisation was determined using a traditional chart.Methods: The habitual vision of 40 adult subjects (mean age 36) was measured with both low and high contrast methods as well as with the CS test. For testing the memorisation effect, 17 (mean age 33.1) of the 40 subjects were tested with the traditional high contrast chart five times in 1 day, at least 1h apart. The fifth test and a control test, conducted 4 weeks later, were accomplished under low illumination. All tests were conducted three times, both binocular and monocular right and left. Also, testing times were recorded.Results: Both methods were very repeatable in terms of high and low contrast VA. The mean VA of both methods did not differ by more than one letter. The testing times of the paper charts were not more than 2s faster than with the new method. A memorisation effect could not be demonstrated after five repeat visits within 1 day. The computerised CS test was repeatable but showed only poor correlation with the low contrast VA test.Conclusion: This investigation showed that results from high and low contrast paper charts are directly comparable to computerised vision testing in terms of repeatability, accuracy and testing time. Given the additional advantages of better contrast control, more flexibility and test options, together with the general acceptance and positive feedback from patients, paper charts can be replaced by computer monitors without any adverse implications.
Episcleritis: An association with IgA nephropathy
by V. Hegde, Izabela Mitrut, H. Bennett, J. Singh
6 Apr 2009 at 12:00am
Abstract: Purpose: To report an unusual case of recurrent episcleritis secondary to IgA nephropathy.Design: Observational case report.Methods: A 39-year-old man was seen with recurrent episodes of red and painful left eye suggestive of episcleritis.Results: On routine investigations the patient was found to have haematuria and proteinuria. Further investigations led to the diagnosis of IgA nephropathy on kidney biopsy.Conclusion: IgA nephropathy may present with various eye signs without any other systemic clues. This case highlights the importance of some of the basic tests in clinical practice such as urine examination. This can be conveniently done with testing strip and should be considered in the routine investigation of patients with inflammatory eye diseases.
Reversal of steroid induced raised intraocular pressure following removal of ...
by Y. Athanasiadis, G.A.L. Nithyanandrajah, B. Kumar, A. Sharma
9 Feb 2009 at 12:00am
A 56 year old myopic female underwent routine right cataract extraction and lens implant. There was no pre existing predisposition towards glaucoma. She was given 20mg of subconjunctival triamcinolone acetonide (TA) (Kenalog, Bristol-Myers Squibb) and chloramphenicol drops qds for one week to the right eye post operatively. Her right intraocular pressure was 15mmHg pre operatively and rose to 25mmHg one month postoperatively. She was started on brinzolamide 2% drops (Azopt, Alcon) and then switched to timolol 0.5% and dorzolamide 2% drops (Cosopt, Merck Sharp & Dohme). The IOP was reduced to 19mmHg. The optic disc was healthy.
Rotational importance of descemet endothelial rolls used for descemet membran...
by Y. Athanasiadis, D.W. de Wit, Chitra Sambare, B.M.H. Al Barwani, A. Sharma
9 Feb 2009 at 12:00am
Corneal transplant surgery is evolving so that only the diseased part of the cornea is removed and replaced/transplanted with a similar part of the donor cornea. As opposed to the conventional full thickness penetrating keratoplasty for all corneal disease. This is particularly applicable to corneal endothelial failure where only descemet's membrane with endothelium is removed and replaced. This technique is called descemet membrane endothelial keratoplasty (DMEK). Special techniques are being used to retrieve the donor material which is composed from descemet's membrane and endothelium only. This material forms a roll due its elastic properties and in this form is used in DMEK. Descemet's endothelial rolls are being used for DMEK transplantations . These rolls are very delicate and transparent () with the endothelium on the outside of the roll ().
Corneal conjunctivalization management with high Dk RGP contact lenses
by Raul Martin
5 Feb 2009 at 12:00am
Abstract: Purpose: To describe the management of corneal conjunctivalization with a high Dk RGP contact lens (CL) fitting.Methods: A high Dk RGP CL (Menicon Z-alpha Dk=189, Japan) was fitted, after temporary suspension of CL wear (6 months and 3 weeks), in two patients (a 36-year-old female and a 38-year-old male) who had corneal conjunctivalization secondary to low Dk soft CL wear. Both patients had worn their soft CLs 12?14h per day without symptoms for the previous 18?20 years.Results: After 9?15 months of high Dk RGP wear, all signs of corneal conjunctivalization had disappeared (corneal vascularization, late fluorescein stain, etc.) and patients wore their RGP CL comfortably. Corneal conjunctivalization was resolved with non-invasive procedures (temporary discontinuation, preservative-free artificial tears and high Dk RGP CL fitting) and thus other treatments (topical or surgical treatments such as limbus transplantation, amniotic membrane transplant or others) were not necessary.Conclusions: Short temporary suspension of CL wear (3 weeks), preservative-free artificial tears and refitting with high oxygen permeability RGP CL may be an alternative for the management of corneal conjunctivalization secondary to CL wear.
Comparison of corneal biomechanics in pre and post refractive surgery and ker...
1 Jun 2009 at 12:00am
Comparison of corneal biomechanics in pre and post refractive surgery and ker...
1 Jun 2009 at 12:00am
Corrigendum to ?A comparison of regimen methods for the removal and inactivat...
by Simon Kilvington, James Lonnen
10 Apr 2009 at 12:00am
The authors regret that two errors exist in the data presented in the tables. In , the value for Serratia marcescens with ReNu Multi Purpose should read 35 and not 9. In , the value for A. castellanii cysts and Oasys lenses should read 1 and not 16.
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