Oxygen demands with hybrid contact lenses.

PURPOSE: The purpose of this study was to assess the corneal response, as measured by corneal oxygen uptake, of keratoconic corneas to SoftPerm and SynergEyes hybrid contact lenses at the central cornea, 2.0 and 4.5 mm temporal to the central cornea, and 1 mm temporal to the limbus. METHODS: Corneal oxygen uptake rates were measured with a Clark-type polarographic electrode on the right eyes of 14 subjects and the left eye of 1 subject, all with keratoconus. Measurements were made at the central cornea, 2.0 and 4.5 mm temporal to the central cornea, and 1 mm temporal to the limbus. They were made for the open eye condition, as well as following 300 s of SoftPerm and SynergEyes hybrid contact lens wear. A one-way analysis of variance (ANOVA) was used to determine the effect of measurement location on oxygen uptake rates under uncovered eye conditions. To determine the difference among oxygen uptake rates relative to those of the uncovered eye at each measurement location for each hybrid lens, a two-way repeated measures ANOVA was used. Multiple comparisons with Tukey-Kramer adjustment were used post hoc to determine which locations were significantly different. RESULTS: For the uncovered keratoconic cornea, there was no significant difference among the oxygen uptake rates associated with the three corneal locations; however, the oxygen uptake rates measured 1 mm temporal to the limbus were significantly higher than those measured at the three corneal locations. Comparison of oxygen uptake rates measured with the SoftPerm and SynergEyes lenses relative to those of the uncovered eye at each location revealed significantly higher rates at the peripheral cornea than at the central cornea. At all locations, the relative oxygen uptake rates obtained with the SynergEyes lenses were lower than those obtained with the SoftPerm lenses. CONCLUSIONS: The SynergEyes lens allows significantly more oxygen to reach the cornea during wear than the SoftPerm lens at the central cornea, as well as 2.0 mm and 4.5 mm temporal to the central cornea.     

An evaluation of the keratoconic cornea using computerised corneal mapping and ultrasonic measurements of corneal thickness

Reports indicate the presence of up to three independent cone shapes in keratoconus (round/oval/global) but the preponderance of one cone over another is unclear. This work evaluates keratoconic corneal topography and corneal thickness using videokeratoscopy and ultrasound pachometry, respectively. An EyeSys™ videokeratoscope (VKS) (EyeSys Laboratories, Houston, TX, USA) was used to assess the topography of 54 keratoconic eyes (27 subjects) and 27 age-matched normals. In addition, ultrasonic pachometry measurements were made over 14 known areas in normal and keratoconic eyes. Corneal thinning was significant for all keratoconic areas measured except for the far temporal cornea. A correlation between corneal radius and thickness was evident. Analysis of cone shape revealed a potential fourth variety: the asymmetric bow-tie cone. Further topographic evaluation of this cone entity using the VKS revealed its dependence on gaze direction which may account for apparent differences in progression patterns between round and bow-tie cones.     

Corneal thickness indices discriminate between keratoconus and contact lens-induced corneal thinning

PURPOSE: To evaluate two indices generated from measurements obtained from the Orbscan Corneal Topography System (CTS; Orbscan, Inc., Salt Lake City, UT) to distinguish contact lens-induced corneal thinning from keratoconus. The corneal thickness index (CTI) was used to compare central and peripheral corneal thicknesses. The discriminant function 1 (DF1) was used to evaluate corneal thickness and central keratometry measurements. DESIGN: Case-control study. PARTICIPANTS: Fifty-four patients with keratoconus or suspected keratoconus, 75 contact lens wearers, and 67 normal controls. METHODS: In the initial model-building study, the central and peripheral corneal thickness and central keratometry (K) readings were evaluated retrospectively in 1 eye each of 23 patients with clinically defined keratoconus, 31 contact lens wearers, and 43 normal patients with the Orbscan CTS. Two methods (corneal thickness index [CTI] and discriminant function 1 [DF1]) were evaluated for their efficacy in classifying these conditions. The CTI was designed as the ratio between mean peripheral corneal thickness and the central corneal thickness, and the formula for the DF1 was as follows: DF1 = 0.044 x central thickness - 0.030 x nasal thickness + 9.210 x CTI - 0.157 x Max K - 8.9. In the subsequent validation study, the results were verified in a separate group of keratoconus patients (n = 23), keratoconus suspects (n = 8), contact lens wearers (n = 44), and normal patients (n = 24). MAIN OUTCOME MEASURES: Corneal thickness index (CTI) and discriminant function 1 (DF1). RESULTS: The corneal thickness in patients with keratoconus and contact lens wearers was significantly thinner than that of normal eyes in the central and eight peripheral measured sites (P < 0.001). The corneal thickness in contact lens wearers was significantly greater than in keratoconus patients in the inferotemporal (P = 0.013), inferior (P = 0.003), and central (P < 0.001) sites and was borderline different in the superior site (P = 0.07). In the model-building study, the CTI in keratoconus patients (1.28 +/- 0.15) was significantly greater than in contact lens-wearing (1.10 +/- 0.03; P < 0.001) and normal eyes (1.09 +/- 0.04; P < 0.001). The CTI was not significantly different between normal and contact lens-wearing eyes (P = 0.68). A CTI value of 1.16 or more showed a sensitivity of 91% and specificity of 99% in differentiating keratoconus from contact lens-wearing and normal eyes. The DF1 value was significantly lower in keratoconic eyes than in contact lens-wearing and normal eyes. A DF1 value of -0.6 showed a 96% sensitivity and 99% specificity in differentiating keratoconus from contact lens-wearing and normal eyes. Similar results were obtained in the validation study. CONCLUSIONS: Corneal thickness indices generated from the Orbscan CTS appear to be sensitive and specific for diagnosing keratoconus. These indices may prove to be clinically useful parameters for distinguishing keratoconus from contact lens-induced corneal thinning.     

The effects of long-term contact lens wear on corneal thickness, curvature, and surface regularity

PURPOSE: To evaluate the effect of long-term contact lens wear on corneal thickness, curvature, and surface regularity. DESIGN: A prospective, clinic-based, case-control study. PARTICIPANTS: A total of 40 eyes of 20 normal subjects and 64 eyes of 35 subjects wearing contact lenses for more than 5 years were evaluated. METHODS: The Orbscan Corneal Topography System was used to evaluate the entire corneal thickness and curvature, anterior curvature and the anterior and posterior elevation topographic patterns in normal eyes and subjects wearing contact lenses on a regular basis for more than 5 years. Indices of TMS-1 Corneal Topography System were used to determine corneal surface regularity in subjects wearing contact lenses and normal eyes. All topographic examinations were performed after contact lenses had been removed for at least 2 weeks. MAIN OUTCOME MEASURES: The entire corneal thickness, curvature, surface regularity index (SRI), surface asymmetry index (SAI), potential visual acuity (PVA) and topographic patterns were compared between normal eyes and subjects wearing contact lenses for more than 5 years. RESULTS: The 64 eyes of 35 subjects evaluated by the Orbscan instrument had an average of 13.45 +/- 6.42 years of contact lens wear. The mean corneal thickness in the center and in eight peripheral areas measured in contact lens wearing subjects was significantly reduced by about 30 to 50 microm compared to normal subjects (P < 0.001 for central and peripheral sites). No correlation was noted between central corneal thickness and degree of myopia in diopters (r = 0.15, 0.10 < P < 0.25). The corneal curvature, maximum keratometry (Max K) and minimum keratometry (Min K) readings, were significantly steeper in eyes wearing contact lenses than normal eyes (P < 0.01 for Max K and Min K measured by both instruments). No difference in the mean corneal astigmatism was noted between groups. The SRI and SAI, but not the PVA index, of the TMS-1 were significantly greater in contact lens wearers than in the control group (P < 0.01 for both SRI and SAI, P = 0.15 for PVA). The color-coded patterns of all curvature and elevation maps made with both instruments showed no significant difference between subjects wearing contact lenses and the control group. There was no significant difference between corneal curvature measurements taken with the Orbscan System or the TMS-1 System in both normal and contact lens groups. CONCLUSIONS: Long-term contact lens wear appears to decrease the entire corneal thickness and increase the corneal curvature and surface irregularity.     

Pilot study on the influence of corneal biomechanical properties over the short term in response to corneal refractive therapy for myopia

PURPOSE: To study the short-term corneal response to corneal refractive therapy for myopia and correlate it with corneal biomechanical properties as measured with the ocular response analyzer. METHODS: Eight eyes from 8 young subjects were fitted with a reverse geometry contact lens, attempting a myopic correction of -4.00 D. Corneal resistance factor and corneal hysteresis (CH) were measured before contact lens fitting with the ocular response analyzer. These parameters were correlated with the degree of change in apical curvature, simulated keratometry, and central corneal thickness after 3 hours of contact lens wear (effect) and 3 hours after lens removal (recovery). RESULTS: There was a trend toward a faster effect and faster recovery of the orthokeratologic effect for corneas with less resistance in terms of biomechanical properties. Corneal resistance factor did not correlate significantly, however, with any of the topographic and pachymetric parameters. Conversely, CH was significantly correlated with changes in steep keratometry (0.758; P = 0.029) and central corneal thickness (0.755; P = 0.030) during lens wear and with changes in steep keratometry (-0.835; P = 0.010) during recovery. Overall, higher values of CH meant slower effect and recovery of the orthokeratologic effect. CONCLUSIONS: Short-term response of human cornea to corneal refractive therapy is correlated with the biomechanical properties of the cornea. Of the different theories supporting such involvement of corneal response to reverse geometry contact lenses, the most likely one seems to be the one assuming a faster response and faster recovery for corneas with lower resistance. Larger sample studies would be needed to clarify the involvement of corneal biomechanical properties on corneal response to orthokeratology.     

配戴软性角膜接触镜对角膜中央厚度影响的临床研究

目的:探讨配戴软性角膜接触镜对中央角膜厚度的影响。方法:应用超声角膜测厚仪检测中央角膜厚度,在我院近视患者中随机抽取配戴软性角膜接触镜者及不戴镜者各100例200眼,做统计分析。再在近视患者中按戴镜时间<1a,1～3a,3～5a,5～7a,≥7a分组,每组随机抽取60例120眼,做统计分析。结果:配戴软性角膜接触镜者与不戴镜者的角膜厚度比较,差异有统计学意义(P<0.05)。戴镜时间<1a,1～3a,3～5a,5～7a者的角膜厚度比较,差异有统计学意义(P<0.05)。结论:配戴软性角膜接触镜者平均中央角膜厚度薄于不戴角膜接触镜者,并且配戴软性角膜接触镜的时间越长中央角膜厚度越薄。     

Confocal microscopy in vivo in corneas of long-term contact lens wearers

PURPOSE: To compare keratocyte density, stromal backscatter, epithelial thickness, and corneal sensitivity between corneas of long-term contact lens wearers and those of non-contact lens wearers. METHODS: Twenty corneas of 20 daily contact lens wearers (>10 years' duration) and 20 corneas of 20 age-matched (+/-5 years) control subjects who had never worn contact lenses, were examined by confocal microscopy in vivo. The contact lens wearers removed their lenses 12 to 24 hours before the examination. Full-thickness images were recorded from the central and temporal cornea, and bright objects (keratocyte nuclei) in images were manually counted to calculate keratocyte density. Stromal intensity (backscatter) was measured by calculating the mean grayscale value (corrected for camera and light source variations) from the center of stromal images. Epithelial thickness was determined from the distance between images of the surface epithelium and subbasal nerve plexus. Central corneal sensitivity was measured by Cochet-Bonnet esthesiometry and correlated with the number of nerve fiber bundles in the subbasal nerve plexus. RESULTS: Full-thickness central and temporal keratocyte densities in contact lens wearers were 22,122 +/- 2,676 cells/mm(3) (mean +/- SD) and 20,731 +/- 2,627 cells/mm(3), respectively, and were not significantly different from central and temporal keratocyte densities in control subjects (P = 0.29). The minimum detectable difference in cell density was 11% (2346 cells/mm(3) and 2235 cells/mm(3) in central and temporal stroma, respectively). Temporal epithelial thickness was 46.3 +/- 4.7 microm in contact lens wearers and 50.9 +/- 4.7 microm in control subjects (P = 0.02). Central epithelial thickness and stromal backscatter did not differ between contact lens wearers and control subjects (P > 0.05). Corneal sensitivity was lower in contact lens wearers than it was in control subjects (P = 0.05) and did not correlate with the number of nerve fiber bundles in the subbasal nerve plexus. CONCLUSIONS: Long-term daily contact lens wear and its associated stromal hypoxia and acidosis have no demonstrable effect on keratocyte density. The temporal epithelium is thinner in corneas of long-term contact lens wearers than in control subjects. Decreased corneal sensitivity in contact lens wearers is not accompanied by decreased nerve fiber bundle density.     

Constancy of the Orbscan acoustic factor to detect contact lens‐induced corneal swelling

Purpose: The aim of the present study was to compare central and peripheral corneal thickness measurements in corneas with and without contact lens (CL)‐induced corneal swelling, in order to establish the constancy of the Orbscan acoustic factor (AF) for reliability in detection of CL‐induced corneal swelling. Methods: Corneal thickness was measured in five corneal locations (central, superior, inferior, nasal and temporal) using both ultrasonic and Orbscan pachymetry before and after one week of high Dk (lotrafilcon A) and low Dk (etafilcon A) contact lens continuous wear (CW). Lenses were randomly fitted for CW in the right and left eyes of 20 healthy subjects to induce various amounts of corneal swelling. Results: Etafilcon A contact lenses induced greater corneal swelling than the lotrafilcon A contact lenses (p < 0.05, paired Student t‐test). Equal corneal swelling percentages (with and without the application of the acoustic factor) were determined from Orbscan measurements. Application of the 0.92 AF did not permit adjustment to all corneal locations. The correlations between Orbscan with and without the 0.92 AF and ultrasonic pachymetry were higher for central pachymetry (r² > 0.88; p < 0.01) and lower for peripheral pachymetry (r² < 0.58; p < 0.01) with similar trends in corneas with and without CL‐induced swelling. Conclusions: The acoustic factor proposed by the manufacturer to obtain corneal thickness with the Orbscan compared with those from ultrasonic pachymetry was not valid for all corneal topographic positions. The AF is unnecessary when determining CL‐induced corneal swelling.     

Corneal trauma from overnight wear of rigid or soft contact lenses.

To evaluate the mechanical or biochemical insult to the cornea induced by overnight rigid gas permeable (RGP) or soft contact lens (SCL) wear, punctate, stipple staining and corneal blotting were evaluated by biomicroscopy in a group of 23 subjects who participated in a single overnight in-laboratory test session. The soft lens-wearing corneas typically showed greater area of staining along with corneal blotting in comparison to RGP-wearing corneas which showed smaller areas of corneal staining, even in the presence of RGP adherence, and no corneal blotting. We investigated the effect of hypoxia on corneal staining by having subjects wear an RGP lens of Dk = 150 on one eye and a soft lens of Dk = 9 on the fellow eye. Pachometry measurements immediately following eye opening showed an average central corneal swelling of 5 percent for the RGP lens-wearing eye and an average of 11 percent for the SCL-wearing eye. It is likely that the differences in corneal effects of RGP and SCL overnight lens wear are the result of differences in the nature of rigid versus soft contact lens adherence.     

Effects of contact lens wearing on keratoconus: a confocal microscopy observation

AIM: To evaluate the corneal cell morphology of new keratoconus patients wearing two different types of rigid gas-permeable (RGP) contact lenses for 1y. METHODS: Thirty nine eyes of 39 new keratoconus patients were selected and randomly fitted with two types of RGP contact lenses. Group 1 had 21 eyes with regular rigid gas-permeable (RRGP) contact lens and rest 18 eyes were in group 2 with specially designed rigid gas-permeable (SRGP) contact lens. Corneal cell morphology was evaluated using a slit scanning confocal microscope at no-lens wear and after 1y of contact lens wearing. RESULTS: After 1y of contact lens wearing in group 1, the mean anterior and posterior stromal keratocyte density were significantly less (P=0.006 and P=0.001, respectively) compared to no-lens wear. The mean cell area of anterior and posterior stromal keratocyte were also significantly different (P=0.005 and P=0.001) from no-lens wear. The anterior and posterior stromal haze increased by 18.74% and 23.81%, respectively after 1y of contact lens wearing. Whereas in group 2, statistically significant changes were observed only in cell density & area of anterior stroma (P=0.001 and P=0.001, respectively) after 1y. While, level of anterior and posterior stromal haze increased by 16.67% and 11.11% after 1y of contact lens wearing. Polymegathism and pleomorphism also increased after 1y of contact lens wearing in both the contact lens groups. CONCLUSION: Confocal microscopy observation shows the significant alterations in corneal cell morphology of keratoconic corneas wearing contact lenses especially in group 1. The type of contact lens must be carefully selected to minimize changes in corneal cell morphology.     

The relationship between corneal oxygen tension and hypoxic corneal edema.

PURPOSE: We sought to develop a direct, noninvasive measurement of tear oxygen tension behind soft contact lenses, and to use the tear oxygen tension data to determine if subjects with greater comeal oxygen consumption experience more comeal edema under hypoxic conditions. The relationship between tear oxygen tension and comeal thickness was also analyzed to determine if thicker comeas have higher metabolic rates. METHODS: Tear oxygen tension measurement was based on the quenching of a phosphorescent dye by oxygen. By coating a soft contact lens with the dye and placing it in the eye, the rate of decay of phosphorescence could be measured and the tear oxygen tension calculated. Corneal oxygen consumption could then be calculated from the tear oxygen tension. Central corneal swelling was measured after 3 hours of hypoxia induced by contact lens wear under closed-eye conditions. RESULTS: Seven right eyes of seven subjects were tested. Baseline central corneal thickness ranged from 517 to 616 microns. After 3 hours of hypoxia, central corneal swelling ranged from 24.5 to 74.3 microns (3.9% to 13.4%). Steady-state open-eye tear PO2 behind the lens varied between 42.7 and 67.1 torr Pearson correlation suggested possible inverse relationship between open-eye tear oxygen tension and central comeal swelling during hypoxia (r = -0.711, p = 0.0734). CONCLUSIONS: Phosphorescent-based measurements provided a measure of tear oxygen tension in human beings. Low tear film oxygen tensions (high corneal metabolic demand) appeared to predict greater amounts of swelling in subjects' corneas. No relation was found between corneal thickness and tear oxygen tension, suggesting that epithelial and endothelial metabolic rates are more important than stromal thickness in determination of comeal oxygen demand.     

Soft and hard contact lenses worn in combination

Each of 5 subjects with normal corneas was fitted with a Bausch & Lomb F3-series Soflens contact lens and with an experimental F3-series ultrathin Soflens. A best-fit PMMA lens was worn in combination with each of the soft lenses. In addition, a best-fit CAB lens and a tight PMMA lens were separately worn in combination with the ultrathin soft lens. Each of 3 subjects with keratoconus was fitted with an ultrathin soft lens combined with a PMMA lens. For the normal corneas, the combination that produced the least corneal edema after 5 hr was an ultrathin soft lens with either a PPM or CAB lens of best fit. Two of the 3 keratoconic subjects were able to wear their contact lens combination for the 5-hr test period; corneal swelling was 1.7% and 5.3% For all subjects, acuity with a combination co ntact lens system was better than with a soft or hard lens alone.     

Comparison of corneal thickness and curvature in myopic and keratoconic eyes of patients from French Caribbean Isles and continental France

Purpose: To evaluate the corneal thickness and curvature of myopic and patients with keratoconus from two countries. Methods: This cross‐sectional study was conducted at Cabinet Opale, Fort de France, French West Indies and University Hospital of Bordeaux, France. Corneal thickness and curvature were assessed in 170 keratoconic eyes of 89 residents of the French Caribbean Islands (FCI) and 159 keratoconic eyes of 91 residents of the Aquitaine region of southwest France. A group of age‐matched keratoconus‐free patients who had been referred for refractive surgery owing to myopia (173 FCI [173 eyes; 87 individuals] and Aquitaine [181 eyes; 93 individuals]) were also assessed. Results: The mean age at keratoconus diagnosis was significantly higher among FCI than Aquitaine residents (p = 0.009). The mean keratometric (Km) reading was statistically higher for keratoconic FCI than Aquitaine patients, at 48.06 versus 46.21 diopters (p = 0.001). This difference was more pronounced among patients aged >40 years than those ≤40 years (p = 0.009). Patients with keratoconus showed no significant difference in mean central corneal thickness and thinnest corneal point values, irrespective of region. Myopic individuals from the FCI, however, had significantly lower mean central corneal thickness and thinnest corneal point measurements than Aquitaine myopics, irrespective of age group (p ≤ 0.0008). Conclusion: The corneas of patients with keratoconus of African‐Caribbean and Caucasian origins are of similar thickness. Myopic African‐Caribbean patients referred for refractive surgery tend to present with thinner corneas than Caucasians.     

The effect of contact lens wear on the central and peripheral corneal endothelium

PURPOSE: To compare central and peripheral corneal endothelial cell morphometry in normal subjects and long-term contact lens wearers. METHODS: Endothelial cell density (ECD), coefficient of variation of cell area (CV), and percentage of six-sided cells were measured by contact specular microscopy in the corneal center and temporal periphery of both eyes of 43 long-term contact lens wearers and in 84 normal subjects who had never worn contact lenses. The latter group included 43 age- and sex-matched controls for the contact lens wearers. ECDs were corrected for magnification changes due to corneal thickness. RESULTS: Central ECD (2,723+/-366 cells/mm2, mean +/- SD) was significantly higher than peripheral ECD (2,646+/-394 cells/mm2) for the normal group (p = 0.01) but not for the contact lens wear group (2,855+/-428 cells/mm2 central, 2,844+/-494 cells/mm2 peripheral, p = 0.84). Peripheral CV was significantly higher than central for normal subjects and contact lens wearers and was significantly higher in both center and periphery in contact lens wearers than in controls. Central percentage of six-sided cells was significantly higher than peripheral for normal subjects and contact lens wearers and was lower in both center and periphery in contact lens wearers than in controls. CONCLUSIONS: Central ECD was significantly higher by 3% than peripheral ECD in normal subjects, but not in contact lens wearers. The results suggest that contact lens wear causes a mild redistribution of endothelial cells from the central to the peripheral cornea. A reversal of this redistribution after contact lens wear is discontinued for refractive surgery could mask mild central endothelial damage from the refractive procedure.     

Corneal endothelial cell morphometry and corneal thickness in diabetic contact lens wearers.

PURPOSE: To assess corneal endothelial cell morphometry and corneal thickness in diabetic patients who wear contact lenses. METHODS: Images of the central corneal endothelium were analyzed quantitatively and qualitatively and corneal thickness was measured in a group of diabetic patients (type 1, N = 26; type 2, N = 4) who wear soft contact lenses and in a group of nondiabetic age-matched control subjects who were also contact lens wearers. RESULTS: Endothelial cell characteristics and corneal thickness values were similar for the two groups (p > 0.05). Four of the diabetic patients (and none of the nondiabetic patients) displayed folds in the endothelial mosaic. CONCLUSIONS: The morphometry of corneal endothelial cells and central corneal thickness values in diabetic patients who wear soft contact lenses were not appreciably different from those found in lens-wearing control subjects.     

Human cornea: Superior and central oxygen demands

Corneal oxygen demands, expressed as ratios of uptake rate relative to baseline rates derived from unstressed corneas, were determined with a micropolarographic system for central (closed eye) and superior (open eye) locations of one cornea of each of seven human subjects. The closed-eye central corneal measurements were repeated during two additional experimental sessions. Intrasubject variability of the three mean closed-eye central corneal rate ratios ranged as high as 23%, possibly representing effects of homeostatic mechanisms on the palpebral conjunctival capillaries of some subjects. For the open-eye superior cornea, which was covered by the upper eyelid of every subject prior to measurement, oxygen demand was found to have a greater intersubject range, but was diminished in magnitude relative to the demand associated with the closed-eye central cornea. Superior corneal oxygen demand was not found to be predictable from closed-eye central corneal oxygen demand or extent of eyelid overlap onto the cornea and thus indicated localized open-eye superior corneal environments that were significantly different from those of the corresponding closed-eye central corneas. Such localized environments may be critically important when gauging the susceptibility of particular eyes to superior corneal pathology during contact lens wear.     

Corneal thickness changes following sleep and overnight contact lens wear in the primate (Macaca fascicularis)

Corneal thickness was monitored on seven cynomolgus monkeys (Macaca fascicularis) over a 76 hour period. During this time, corneal thickness measurements were also made on six monkeys after overnight wear of a hydrogel contact lens in one eye. Mean corneal thickness was 417 +/- 12 microns. An overall diurnal variation of 16 +/- 5 microns (3.8 +/- 1.2%) was found. During the first half hour after waking, corneal thickness changes ranged from -9 microns to +14 microns. After overnight contact lens wear, the cornea had swelled an average of 42 +/- 24 microns (9.1 +/- 4.8%). Following lens removal, the cornea returned to normal thickness within approximately 90 minutes. These results are similar to those found in humans and indicate that with respect to contact lens induced corneal thickness changes, the cynomolgus monkey is a suitable model for the physiological response to contact lens wear.     

Relation between optical coherence tomography and optical pachymetry measurements of corneal swelling induced by hypoxia

PURPOSE: To determine the relation between optical coherence tomography (OCT) and optical pachymetry (OP) measurements of corneal swelling induced by hypoxia. DESIGN: Experimental study. METHODS: One randomly selected eye of 20 noncontact lens wearers (10 males and 10 females, age 35.6 +/- 9.6 years) was patched during 3 hours of soft contact lens (SCL) wear while the contralateral eye acted as control. Central corneal thickness of both eyes was measured before and after SCL wear using OCT and OP in randomized order. RESULTS: Baseline central corneal thickness was 523.6 +/- 33.0 microm (mean +/- standard deviation [SD]) measured with OCT and 490.6 +/- 25.5 microm with OP. Immediately after contact lens removal, corneal thickness measured with OCT increased by 13.8 +/- 2.3% compared with 12.1 +/- 1.8% (paired t test: P <.001) measured with OP. Thereafter, corneal thickness decreased at the rate of 5.6% per hour for OCT and 5.4% per hour for OP. The difference in thickness between instruments before lens insertion, which was 33 microm compared with the difference after lens removal (edematous cornea), which ranged from 46 to 41 microm. The difference between instruments decreased during the corneal deswelling period after lens removal. The correlation coefficient between OCT and OP was 0.914 before lens insertion and 0.932 after lens removal. CONCLUSION: This study has demonstrated the difference of corneal thickness measured with OCT and OP. Although both instruments are correlated highly in all conditions tested, OCT may overestimate corneal thickness in normal and edematous corneas.     

The basis for corneal shape change during contact lens wear.

Trials were conducted in which subjects wore various contact lenses while their corneas were exposed to gases of varying oxygen content. Measurements of central and peripheral corneal thickness and corneal topography show that corneal topography changes after contact lens wear can have at least two causes, an unevenly distributed corneal thickness change and/or a mechanical molding of the shape.     

Swelling and deswelling of rabbit corneas in response to rigid gas permeable, hydrogel and elastomer contact lens wear

We determined diurnal variation in corneal thickness in rabbits prior to and following overnight wear of: (i) selected rigid contact lenses with different Dk values; (ii) hydrogel lenses of low and high water content; and (iii) elastomer lenses. The degree of contact lens-induced corneal swelling observed during 24 hours of lens wear, and the rates of deswelling in the subsequent 24 hours, correlated well with the different oxygen transmissibilities of the individual RGP contact lenses. The greatest swelling (21.6 +/- 5.4%) followed the wear of PMMA lenses. The least swelling, 2.9 +/- 4.0%, followed the wear of rigid gas permeable (RGP) Menicon SF-P (melafocon A) lenses, a value nearly identical to the swelling observed in the morning following sleep without lenses, (0.0 +/- 3.1%). By contrast, low-water content hydrogel soft contact lens use was associated with drastic corneal deswelling rates (-15.1 +/- 4.5%) during the hours after lens wear. The difference between these and control corneas was significant by paired t-test (P less than 0.01). Eyes wearing high water content lenses had less deswelling than eyes with their low-water counterparts. Corneal swelling produced by elastomer lenses was similar to that seen with RGP lenses.