BCLA CLEAR - Effect of contact lens materials and designs on the anatomy and physiology of the eye

Morgan, Philip B.; Murphy, Paul J.; Gifford, Kate; Gifford, Paul; Golebiowski, Blanka; Johnson, Leah; Makrynioti, Dimitra; Moezzi, Amir; Moody, Kurt; Navascues‐Cornago, Maria; Schweizer, Helmer; Swiderska, Kasandra; Young, Graeme P.; Willcox, Mark

doi:10.1016/j.clae.2021.02.006

Cited by 45 publications

(37 citation statements)

References 476 publications

(682 reference statements)

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“…Optical treatments have the additional benefit of correcting myopia, 2 and of these orthokeratology and multifocal soft contact lenses (MFCL) typically have the highest reported efficacies of around 50% reduction for both axial length elongation and myopia progression 3–5 . Concentric MFCLs appear slightly more efficacious than continuous aspheric MFCLs 5,6 . Continuous aspheric MFCLs prescribed for myopia 7 have a range of labelled ‘add’ powers.…”

Section: Introductionmentioning

confidence: 99%

Multifocal contact lens design, not addition power, affects accommodation responses in young adult myopes

Gifford

Schmid

Collins

et al. 2021

Ophthalmic Physiologic Optic

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Purpose Prolonged nearwork has been implicated in myopia progression. Accommodation responses of young‐adult myopes wearing different multifocal contact lenses were compared. Methods Twenty adults, 18–25 years, with myopia (spherical equivalent refraction −0.50 to −5.50 D, mean −2.1 ± 1.6 D) wore five lens types in random order: Proclear single vision distance (SV), MiSight concentric dual‐focus +2.00 D Add (MS), Biofinity aspheric centre distance +1.50 D Add (CD1) and +2.50 D Add (CD2) (all Coopervision), and NaturalVue aspheric (Visioneering Technologies) (NVue). Using a Grand‐Seiko WAN‐5500 autorefractor with binocular correction and viewing right eye accommodative responses were measured after a 10 min adaptation period at 4.0, 1.0, 0.5, 0.33 and 0.25 m distances. Dynamic measurements were taken for 4 s at 6 Hz. Accommodative stimuli and responses were referenced to 4 m (i.e., refraction differences between 4 m and nearer distances). Accommodation lags and refraction instabilities (standard deviations of dynamic responses) were determined. For comparison, results were obtained for an absolute presbyopic eye, where trial lenses counteracted the accommodation stimulus. Results For SV and MS, accommodation responses were similar to the stimulus values. For aspheric lenses CD1, CD2 and NVue, accommodation responses were approximately 1.0 D lower across the stimulus range than with SV and MS, and rates of change were approximately 0.84 D per 1 D stimulus change. MS produced greater refraction instabilities than other lenses. For the presbyope, changes in refraction matched the trial lenses, indicating that corrections due to measurement through the different lenses were not needed. Conclusion Reductions in accommodation response occurred in young myopes wearing aspheric multifocal contact lenses independent of the labelled ‘add’ power. The concentric dual‐focus MS lens produced minimal lags but had greater instability than the other lenses. The results indicate that the mechanism of multifocal contact lenses slowing myopia progression is unlikely to be through relaxing accommodation, at least in young adults.

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Section: Introductionmentioning

confidence: 99%

Multifocal contact lens design, not addition power, affects accommodation responses in young adult myopes

Gifford

Schmid

Collins

et al. 2021

Ophthalmic Physiologic Optic

View full text Add to dashboard Cite

show abstract

“…A thorough examination of the anterior eye is required prior to fitting contact lenses and at each aftercare visit. The assessment requires a combination of different slit lamp biomicroscopy techniques [126] to evaluate the fit of the contact lens (section 5), anterior eye anatomy (see CLEAR Anatomy Report and CLEAR Material Impact Report) [127,128] and the health of the eye, and the use of ophthalmic dyes to monitor the eye for contact lens complications (section 7.4 and see CLEAR Complications Report) [38]. The least invasive tests in terms of illumination intensity, lid manipulation and dye application, should be performed first.…”

Section: Anterior Eye Examinationmentioning

confidence: 99%

“…The full extent of lid wiper staining (see CLEAR Material Impact Report and CLEAR Anatomy Report) [127,128] is visible after either instilling two drops of lissamine green or two drops of fluorescein one-minute apart, although these dyes have not been directly compared [175]. The TFOS DEWS II Diagnostic Methodology report recommends using two separate strips of lissamine dye wet with two drops of saline [142].…”

Section: Lid Wiper Epitheliopathy (Lwe)mentioning

confidence: 99%

“…There is a wide choice of soft contact lens materials, which can be categorised as hydrogel or silicone hydrogel. Selection is based on their differing oxygen permeability (related to silicone and water content), hydrophobicity (related to silicone content, wetting agents and surface modifications), modulus (related to silicone and water content) and susceptibility to deposition (related to ionicity) [304] (see CLEAR Material Impact Report) [128]. The coefficient of friction, but more so the lens surface lubricity, principally affect comfort [305,306], but the role of lens surface wettability is less clear [307] (see CLEAR Maintenance Report) [140].…”

Section: Modality and Materials Selection 421 Soft Contact Lensesmentioning

confidence: 99%

“…Decisions regarding solution choice may not be governed by efficacy alone (see CLEAR Maintenance Report, CLEAR Material Impact Report and CLEAR Complications Report) [38,128,140]. Factors affecting ease of use and comfort (such as solution pH, tonicity, osmolarity and wetting agents) may also be considered.…”

Section: Care Regimenmentioning

confidence: 99%

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