Peer-reviewed Articles

Please use the archived list on the right to look at past peer-reviewed articles.


Haque,S., Fonn,D., Simpson,T., Jones,L. Corneal and epithelial thickness changes after 4 weeks of overnight corneal refractive therapy lens wear, measured with optical coherence tomography. Eye and Contact Lens 2004;30,4:189-193. [ Show Abstract ]

Purpose. To investigate thickness changes of the total cornea and epithelium across the horizontal corneal meridian after 4 weeks of overnight corneal refractive therapy (CRT) rigid contact lens (Paragon Vision Sciences, Mesa, AZ) wear. Methods. Thirty subjects were fitted with CRT contact lenses (Dk/t = 67), which were worn overnight for 4 weeks. Corneal thickness was measured at nine locations along the horizontal meridian by using optical coherence tomography (OCT) before lens insertion in the evening. Corneal thickness was measured the next morning immediately after lens removal and 1, 3, 7, and 14 hours later. This was repeated on days 4, 10, and 28 of the study and then 3 days after discontinuing lens wear. Results. Twenty-three subjects completed the study. At lens removal on day 1, the central and paracentral cornea swelled by 4.9% and 6.2%, respectively (both P = 0.000). The central epithelium thinned by 7.3%, and the mid peripheral epithelium thickened by 13% (both P = 0.000). Corneal swelling recovered throughout the day, with most of the deswelling taking place within the first 3 hours after lens removal. Maximal central epithelial thinning reached 13.5% by day 4. Three days after the study completion, corneal and epithelial thickness had recovered to baseline values. Conclusions. This study shows that CRT lenses induce differential overnight swelling across the cornea, with rapid deswelling during the day. Central epithelial thinning and paracentral thickening occurs, with recovery 3 days after discontinuation of lens wear. © 2004 Contact Lens Association of Ophthalmologists, Inc.

Karlgard,C. C. S., Sarkar,D. K., Jones,L. W., Moresoli,C., Leung,K. T. Drying methods for XPS analysis of PureVision™, Focus® Night&Day™ and conventional hydrogel contact lenses. Applied Surface Science 2004;230,1-4:106-114. [ Show Abstract ]

The surface composition of hydrogel contact lenses that contain silicon-based monomers, PureVision™ (balafilcon A) and Focus® Night&Day™ (lotrafilcon A), were investigated by X-ray photoelectron spectroscopy (XPS). Conventional and daily disposable hydrogel lenses based on hydroxyethyl methacrylate (HEMA) were also studied, with the commonly prescribed 1-day Acuvue® lens (etafilcon A) used as a control. All the lenses were pre-washed and dehydrated by three different methods, including drying in air, drying in nitrogen or freezing with subsequent freeze-drying, before the XPS analysis. The lenses dried in air had more impurities on the surface, and the lenses that were freeze-dried lost transparency, suggesting that drying lenses in nitrogen is the preferred preparation method for XPS analysis. Surface compositions for all lens materials were obtained and this data can be used as a control/base-value for future analysis of the interactions of soft contact lens materials with chemicals such as drugs or tear components. © 2004 Elsevier B.V. All rights reserved.

Moezzi,A. M., Fonn,D., Simpson,T. L., Sorbara,L. Contact lens-induced corneal swelling and surface changes measured with the Orbscan II corneal topographer. Optometry and Vision Science 2004;81,3:189-193. [ Show Abstract ]

Purpose. The purpose of this study was to measure central and topographical corneal swelling in response to contact lens wear and eye closure, to determine whether the swelling induced by soft and polymethyl methacrylate (PMMA) lenses is different, and to determine whether the anterior and/or posterior corneal shape alters with corneal swelling. Methods. An Orbscan II corneal topographer was used to measure corneal swelling and the shape of the anterior and posterior corneal surfaces of 16 neophytes before and after wearing soft and PMMA contact lenses with near-zero oxygen transmissibility. The lens-wearing eye was patched for 3 h. Results. The mean 15.1% ± 3.8% (±SD) central corneal swelling with soft lenses was significantly > 12.6% ± 4.1% with PMMA lenses. Topographical corneal swelling was significantly greater with soft vs. PMMA lenses. However, the difference between central and peripheral corneal swelling was much greater with PMMA lenses. With both lenses, the cornea swelled significantly more in the center than the periphery. The anterior best-fit sphere radius remained unchanged in response to soft lenses (0.00 ± 0.04 mm) and steepened slightly but significantly with PMMA lenses (-0.04. ± 0.05 mm). The posterior best-fit sphere radius flattened significantly with both lenses (0.12 ± 0.07 mm with soft and 0.14 ± 0.08 mm with PMMA lenses). Conclusions. Corneal swelling (greater centrally than peripherally) flattens the posterior surface of the cornea and is independent of lens type. Although the anterior best-fit sphere radius steepened with PMMA, the magnitude is probably clinically unimportant. Both lens types produced greater central vs. peripheral corneal swelling. However, the soft lens induced significantly greater overall swelling than PMMA. Because their oxygen transmission was the same, these results suggest that there is lateral diffusion of oxygen from the peripheral area of the cornea (that is not covered by the lens) toward the center.

Sorbara,L., Simpson,T., Vaccari,S., Jones,L., Fonn,D. Tear turnover rate is reduced in patients with symptomatic dry eye. Contact Lens and Anterior Eye 2004;27,1:15-20. [ Show Abstract ]

Purpose: Tear turnover rate (TTR) is defined as the percent decrease of fluorescein concentration in the tears per minute after the instillation of fluorescein. The purpose of this study was to examine differences in TTR in a sample with symptoms of dry eye and an asymptomatic control sample using the Fluorotron Master™ Fluorophotometer. Methods: TTR was measured using the OcuMetrics Fluorotron Master™. It measures the decay of the fluorescence of high molecular weight fluorescein FITC Dextran instilled into the tear film. Twenty participants (post-menopausal women) were enrolled in the study (10 asymptomatic (age 64.7±6.99) and 10 symptomatic (age 61.5±7.98)). Participants were grouped according to either a positive (symptomatic) or negative (asymptomatic) McMonnies Dry Eye Questionnaire, i.e., an indication of self-reported ocular dryness and the use of rewetting/lubricating drops (questions 4 and 5). TTR was measured in the afternoon only. Measurements were made on the right eye with a controlled blink rate (15 blinks/min), for up to 30 min, post-insertion of 2 μl of 2% FITC Dextran (MW 9500). The scan data were used to construct a graph of log fluorescein concentration (ng/ml) as a function of time and the TTR calculated (%/min=(1-ln (slope))×100). Results: There was a significant difference in the TTR between symptomatic and asymptomatic subjects. Mean TTR (symptomatic) was 4.89±2.74%/min (range, 2.04-11.81) and mean TTR (asymptomatic) was 11.85±3.31%/min (range, 5.76-16.45) (P<0.0001). Conclusions: Fluorophotometry may be used to demonstrate differences in the tear turnover rate in this post-menopausal group of women, with patients experiencing symptoms of dry eye having a lower TTR than the normals. © 2003 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.