Cornea - ARVO

ARVO 2013 Annual Meeting Abstracts by Scientific Section/Group - CorneaCommercial Relationships: Anna McKinney, None; William L.Miller, Contamac (F); Norman E. Leach, None; Cristina Polizzi,None; Eef van der Worp, Contamac (F); Jan P. Bergmanson,Contamac (F)Support: NIH/NEI grant T35EY00708 and Contamac USProgram Number: 5484 Poster Board Number: A0183Presentation Time: 8:30 AM - 10:15 AMDesigning Multifocal Contact Lenses using a Novel Through-Focus Image Quality Metric Highly Correlated with ClinicalVisual AcuityNishant Mohan, Amanda C. Kingston, Ian G. Cox. Bausch and Lomb,Rochester, NY.Purpose: The aim of this study was to validate the design process ofmultifocal contact lenses using a new through-focus image qualitymetric shown to correlate highly with clinical visual acuity.Methods: Individual eye models were created in commerciallyavailable optical design software (Zemax TM Bellevue, WA) andshown to correlate highly with baseline clinical through-focus visualacuity (R 2 = 0.85). For validation of predictability, 64 advancedpresbyopic eye models were used to predict through-focus imagequality of (5) multifocal contact lens designs. In Zemax TM , each ofthe (5) designs were inserted onto the anterior surface of the corneaand an over-refraction was done for each eye. Defocus wasminimized and the closest 0.25D lens was used to obtain peak imagequality at distance. Through-focus predicted logMAR wasdetermined for each eye model with each of the (5) multifocal lensesin place. To compare directly with clinical measurements of visualacuity, image quality with the contact lens on eye was subtractedfrom baseline values representing the individual eye's acuity withoutany corrective lens in place. This gives predicted normalizedlogMAR acuity. The same (7) object distances were used forcomputer modeling as in the actual clinical study. Normalized visualacuity for 24 mature presbyopes, tested monocularly, was measuredwith each of the (5) manufactured multifocals on-eye. Correlation ofclinical and predicted through-focus normalized acuity wasdetermined.Results: At all object distances, each multifocal had less than oneline difference on average between predicted and clinical normalizedlogMAR acuity. The Zemax TM models with predicted logMAR hadhigh correlation with through-focus visual acuity from the clinic (R 2between 0.90 and 0.97) for all multifocal lens designs.Conclusions: When multifocal contact lens designs were modeled onindividual computer eyes and normalized predicted logMAR wasused to determine how lenses would perform clinically, a highcorrelation was found between the computer database and averageclinical acuity results with all (5) multifocal contact lenses. Thisdesign process is highly effective in predicting on-eye performance.With this high level of predictability more design options can beexplored in the computer to optimize though-focus performancebefore a lens is manufactured and tested clinically.Commercial Relationships: Nishant Mohan, Bausch + Lomb (E);Amanda C. Kingston, Bausch & Lomb (E); Ian G. Cox, Bausch +Lomb (E)Program Number: 5485 Poster Board Number: A0184Presentation Time: 8:30 AM - 10:15 AMProsthetic Replacement of the Ocular Surface Ecosystem(PROSE) Treatment: A Partner Clinic ExperienceKira L. Segal 1 , Michelle N. Lee 2 , Kristin O. Chapman 2 , MarkRosenblatt 2 , Kimberly C. Sippel 2 , Christopher E. Starr 2 , JessicaCiralsky 2 . 1 Medicine, Memorial Sloan Kettering Cancer Center, NewYork, NY; 2 Ophthalmology, NewYork-Presbyterian, New York, NY.Purpose: PURPOSE: To evaluate demographics, clinical course, andoutcomes of patients who received the PROSE device at a partnerclinic.Methods: METHODS: Retrospective chart review of 37 consecutivepatients (66 eyes) fit with the PROSE device.Results: RESULTS: Indications for PROSE treatment includedectasia in 17 eyes (25.8%) and ocular surface disease in 49 eyes(74.2%). The average follow-up time was 4.76 months (2.4-9.35).Visual acuity improved with the PROSE device a statisticallysignificant amount (p=0.002). All patients had improved ocularsymptoms and decreased reliance on topical lubricants.Conclusions: CONCLUSIONS: PROSE is an effective treatmentoption for many patients with complex corneal diseases.Commercial Relationships: Kira L. Segal, None; Michelle N. Lee,None; Kristin O. Chapman, None; Mark Rosenblatt, None;Kimberly C. Sippel, None; Christopher E. Starr, None; JessicaCiralsky, NoneProgram Number: 5486 Poster Board Number: A0185Presentation Time: 8:30 AM - 10:15 AMEffect of Static and Non-Static in-vitro Techniques on LipidPenetration Into SiHy Contact LensesJean T. Jacob 1, 2 , Rebecca Frederick 1, 2 , Caitlin Tucker 1, 3 , LeaannLove 1, 4 . 1 Department of Ophthalmology, LSU Health SciencesCenter, New Orleans, LA; 2 Biomedical Engineering, TulaneUniversity, New Orleans, LA; 3 University of New Orleans, NewOrleans, LA; 4 Xavier University, New Orleans, LA.Purpose: We investigated the effect of replenishing the artificial tearfluid (ATF) over the study period on the lipid penetration profile intosilicone hydrogel lenses.Methods: We compared the lipid biofouling penetration profiles offive contact lens materials after 12 hours of exposure to static ATFdaily wear conditions and daily wear conditions where the ATF wasreplaced hourly using fluorescently-labeled phosphatidylcholine andcholesterol. Lipid penetration differences between the central 6 mmand the peripheral edges of the lenses were imaged with confocalmicroscopy.Results: The non-static method allowed for more adsorption andpenetration of both phosphatidylcholine and cholesterol into alllenses types tested (p=0.0001). There was approximately a 2-foldincrease in the amount of cholesterol found in all the lenses with thenon-static method as compared to the static. While there was also anincrease in the amount of PC within all lenses with the non-staticmethod compared to the static method is was not as significant as thecholesterol. The non-static method also showed more significantdifferences between the lipid penetration profiles for the lens typescompared to the static method. The non-static method showed moresurface penetration of PC in the periphery of the lens as compared tothe center for Acuvue Oasys, Biofinity and PureVision 2 than AirOptix and AirOptix Aqua which was not seen with the static method.However, the penetration profile for cholesterol did not changesignificantly between the non-static and the static methods for any ofthe lenses tested.Conclusions: The non-static method provided better differentialanalysis of lipid penetration into contact lens materials than the staticmethod. Specific differences based on lipid type and material surface©2013, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to iovs.org to access the version of record. For permissionto reproduce any abstract, contact the ARVO Office at arvo@arvo.org.