As a result of their hydrophobicity, the extended wear silicone-hydrogel lenses (lotrafilcon A and balafilcon A) may carry higher risk of microbial contamination than both the hydrophilic daily wear silicone-hydrogel lens, galyfilcon A and the conventional hydrogel lens, etafilcon A.
Our results suggest that more hydrophobic CLs are more prone to S. epidermidis adhesion. Although the Ra appears to be related to S. epidermidis adhesion, the influence of Rku and Rsk on this variable remains unclear.
Background:The aim of this study was to investigate the biomechanical properties of the cornea and their association with intraocular pressure (IOP), central corneal thickness (CCT) and the central corneal radius of curvature (Rc). Methods: Eighty-three eyes were divided into two groups. The biomechanical properties of the cornea were measured in 63 normal eyes and in 20 post-laser in situ keratomileusis (LASIK) eyes. The IOP, corneal hysteresis (CH) and corneal resistance factor (CRF) were measured by the Ocular Response Analyzer (ORA). The Rc and CCT were measured using the corneal topographer Medmont E-300 and the Tomey SP-100 Handy ultrasonic pachymeter. Other parameters measured by the ORA, such as TimeIn and TimeOut, were also studied. Results: A mean corneal hysteresis of 10.8 mmHg and CRF of 10.6 mmHg were recorded for the normal eyes. There was no significant association with central curvature. All parameters measured by the ORA showed a significant correlation with the CCT, except for the corneal-compensated intraocular pressure (IOPcc). Both IOPs measured by the ORA had the same values for the mean CH and CRF. For the post-LASIK eyes, the CH and CRF were lower than in the normal non-operated eyes. The TimeIn and the TimeOut also presented lower values for the post-LASIK eyes, suggesting that additional data can be obtained with the ORA measurements.
Conclusions:The results of this study indicate that there is no correlation between the parameters measured with the Ocular Response Analyzer and central corneal radius of curvature. Some of the biomechanical properties of the cornea studied were found to differ in the normal eyes compared to the post-LASIK eyes.
Acanthamoeba keratitis is an infection caused by a unicellular protozoan of the genus Acanthamoeba that is universally widespread. Until now, most cases were reported in contact lens wearers, although it is also a reality for non‐wearers, mostly connected to corneal trauma. There is also a variation in incidence regarding the aetiology of the disease between developed and developing countries.
Purpose
This work is based on a literature review, and the main goal is to deepen the knowledge about Acanthamoeba keratitis, presenting the main risk factors and focusing on prevention actions for this type of corneal infection since the treatments are not always effective. It targets specialists in visual health to strengthen their knowledge in this area, as well as to allow them to better inform their patients about hygiene care, appropriate measures of disinfection and ways to minimise the risk of infection. At this stage, it is important to highlight the essential role that practitioners play in fitting, monitoring and following‐up patients to minimise the danger of infection.
Recent findings
It is well recognised that corneal trauma facilitates invasion by leaving an open door for microorganisms to penetrate the cornea. In addition to trauma, risk factors are mostly associated with patients’ behaviours, such as interaction of contact lenses with contaminated water in the shower, swimming pools and beaches, etc., lack of hygiene habits with contact lenses and respective cases, and the use of ineffective disinfecting solutions. The fact that a disinfecting solution is not completely effective against trophozoites and/or cysts, both forms of Acanthamoeba’s lifecycle, can cause the infection since one cyst alone leads to the emergence of a whole new population of Acanthamoeba.
Summary
It is necessary to reduce the risk of infection and, beyond the need to promote patient education to encourage correct CL hygiene behaviours, it should also be highlighted that there is an urgent need to enhance the efficacy of CL disinfection systems against all strains and both stages of Acanthamoeba through the creation of standardised methods. The ease of purchasing CLs without any supervision must also be considered a concern, and, in the near future, it is also important to develop and implement effective diagnostic methods and treatments for Acanthamoeba keratitis.
New relationships are presented that correlate nominal and measured values of EWC and refractive index for the silicone containing hydrogels. The linear relationships derived fit well to the data. Hand refractometry overestimates the EWC of silicone hydrogel materials and this bias is related to the proportion of siloxane moieties in the material. Conversely, refractive index can be obtained more accurately with automated refractometry for silicone hydrogels than for conventional hydrogels. Present results are of interest in planning future clinical studies involving the measurement of EWC of current hydrogels.
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