Cornea - ARVO

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ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Corneaastigmatism 60% of the time and Vision benefits 50% of the time.The health benefit of a DD contact lens for astigmatism waspresented 75% of the time. Doctors also presented conveniencebenefits and comfort benefits of a daily disposable contact lens forastigmatism 60% of the time and Vision benefits 50% of the time. 9out of 10 patients were willing to trial a DD contact lens forastigmatism based on doctor recommendation.Conclusions: This identifies a significant opportunity to fit newpatients and to upgrade more reusable contact lens wearers byproviding a strong recommendation and tying the benefits of DDcontact lenses for astigmatism to specific patient needs - whether itbe convenience, comfort, vision or health.Commercial Relationships: W L. Ball, Vistakon (E)Program Number: 5465 Poster Board Number: A0164Presentation Time: 8:30 AM - 10:15 AMVisual Correction for Irregular Corneas with Scleral LensesMuriel Schornack, Cherie B. Nau, Jeff Pyle, Sanjay V. Patel.Ophthalmology, Mayo Clinic, Rochester, MN.Purpose: Scleral rigid gas permeable lenses can optically neutralizecorneal surface irregularity in patients with primary corneal ectasia,corneal scarring, or post-surgical irregularity. In this study, wereviewed the outcomes of commercially available Jupiter sclerallenses for corneal irregularity.Methods: In a retrospective study, we identified 137 eyes of 96patients that were fit with Jupiter scleral lenses (Visionary Optics,Front Royal, VA, and Essilor Contact Lens, Inc., Dallas, TX)between June 2006 and November 2011 for primary or secondarycorneal irregularity. Specific indications for which scleral lenses wereprescribed, prior modes of optical correction, topographiccharacteristics, visual acuity prior to and after lens fitting, details ofthe fitting process, and clinical outcomes were recorded. Visualacuity with habitual correction before scleral lens wear was comparedto that with scleral lenses by using generalized estimating equationmodels to account for possible correlation between fellow eyes of thesame subject.Results: Mean age of patients was 46 years (range 11-83 years).Scleral lenses were prescribed for visual rehabilitation in patientswith keratoconus/pellucid marginal corneal degeneration (68 eyes),penetrating keratoplasty (27 eyes), post-refractive surgery (27 eyes),scarring after keratitis (7 eyes), Terrien marginal degeneration (3eyes), ocular trauma (2 eyes), monocular diplopia (2 eyes), andcongenital corneal defect (1 eye). Most patients had attempted towear corneal rigid gas permeable lenses, hybrid lenses, or piggybacklens systems prior to commencing scleral lens wear. The fittingprocess required an average of 3 visits (range 2-7), and an average of1.6 lenses (range 1-7) were ordered per eye. All patients wore lensessuccessfully at the conclusion of the fitting process. Mediansimulated steep K was 49.00 D (range 35.25-69.00 D), median flat Kwas 43.50 D (range 31.87-54.87 D), and median reference sphere was45.86 D (range 38.6-57.5 D). Median visual acuity improved from0.39 log MAR (Snellen equivalent, 20/49) with habitual correction to0.10 log MAR (Snellen equivalent, 20/25) after scleral lens wear(p
ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - Corneadependent activity of adsorbed lysozyme on six different contact lensmaterials during the first minute and up to one week of interactionwith the material surface. Total activity of extracted lysozyme, totalin-situ activity and the activity of the outer surface layer of sorbedlysozyme were determined using the two different techniques.Micrococcal cellular interaction with surface-adsorbed lysozyme wasimaged using confocal microscopy.Results: The differences between total extracted activities, total insituactivities and surface activities were both measurable andmaterial specific. In most cases the total extracted activity > total insituactivity > surface activity. After one week, etafilcon A had thehighest extracted activity at 137μg/lens, followed by omafilcon A,balafilcon A, comfilcon A, senofilcon A, and lotrafilcon B at 27.4μg,2.9μg, 2.0μg, 0.5μg, and 0.3μg respectively. Subsequent removal ofadhered micrococcal cells was greatest on balafilcon A, which hadthe highest surface activity, and lowest on lotrafilcon B, which hadthe lowest surface activity.Conclusions: This study measured and made direct comparisonsbetween two established techniques for measuring the activity ofadsorbed lysozyme. Both techniques demonstrate material dependentdifferences in activity. While individual extraction activitiesdemonstrate the activity of underlying layers of lysozyme orlysozyme within the matrix of the material, in-situ measurementsallow conclusions to be drawn about only the biologically relevantlysozyme, and surface activity measurements reveal the activity ofjust the outer surface of lysozyme.Commercial Relationships: Brad Hall, None; Chau-Minh Phan,None; Lakshman N. Subbaraman, None; Lyndon W. Jones, Alcon(F), Alcon (R), Allergan (F), Abbott Medical Optics (R), Bausch &Lomb (R), Ciba Vision (F), Ciba Vision (R), CooperVision (F),Johnson & Johnson (F), Johnson & Johnson (R); James A. Forrest,NoneSupport: NSERCProgram Number: 5468 Poster Board Number: A0167Presentation Time: 8:30 AM - 10:15 AMPRG4 as a Natural Boundary Lubricant for Commercial SiliconeHydrogel Contact LensesMichael L. Samsom 1 , Amanda Chan 1 , Lyndon W. Jones 2 , Tannin A.Schmidt 1 . 1 Biomedical Engineering, University of Calgary, Calgary,AB, Canada; 2 School of Optometry, University of Waterloo,Waterloo, ON, Canada.Purpose: The mucin-like glycoprotein proteoglycan 4 (PRG4) isexpressed and present at the epithelium of the ocular surface. Studiesindicate PRG4 reduces friction at ocular biointerfaces, and that PRG4reduces friction in vivo during blinking by acting as a naturalboundary lubricant. Friction may influence, and contribute to, contactlens (CL) discomfort. As such, supplementation with naturallyoccurring lubricants during CL wear could combat heightenedfriction and potential CL discomfort. Therefore, the objective of thisstudy was to determine whether PRG4 is an effective in vitroboundary lubricant at a human cornea - CL biointerface.Methods: Fresh human corneas were obtained from the AlbertaLions Eye Bank. Commercially available silicone hydrogel CL werestudied: Acuvue TrueEye® (TE); Acuvue Oasys® (OAS);Acuvue2® (AC2); AirOptix® (AO). Tissues and lenses weremounted on a BOSE ELF3200 biomechanical testing machine withcustom sample holders, forming a cornea-CL biointerface. Thesesurfaces were articulated against each other at effective slidingvelocities ranging from 0.3-30 mm/s under loads of 8-25 kPa. SalineTest: Sequential testing of the 4 lenses in saline was used to compareeach lens materials friction against the cornea (order: AC2, AO, TE,OAS; n=4). PRG4 Test: TE and OAS were tested in saline, thensoaked in 300 ug/mL PRG4 for 1h and tested. (Order: TE, TE-PRG4,OAS, OAS-PRG4, n=3; OAS, OAS-PRG4, TE, TE-PRG4, n=4).Results: Saline Test: Kinetic friction coefficients were relativelyinvariant with sliding velocity. Kinetic friction coefficients (averagedover all speeds) in saline appeared similar for the different CL tested:TE (0.13±0.03, mean±SEM), AC2 (0.16±0.05), OAS (0.18±0.04) andAO (0.23±0.09). PRG4 Tests: PRG4 functioned as an effectivefriction-reducing boundary lubricant for both TE and OAS lenses.Kinetic friction values were significantly lower in PRG4 for bothlenses (TE-PRG4 0.12±0.02); OAS-PRG4 (0.10±0.02), comparedtheir respective Saline controls (TE 0.16±0.03, p
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