Prevention of localized corneal hyperosmolarity spikes by soft-contact-lens wear

Kim, Young Hyun; Lin, Meng C.; Peng, Cheng-Chun; Radke, Clayton J.

doi:10.1016/j.clae.2022.101722

Cited by 5 publications

(3 citation statements)

References 40 publications

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“…We conclude that midday lens removal and reinsertion do not protect the cornea from hyperosmotic post-lens tear. Instead, low- D s soft contact lenses should be worn to protect the cornea from hyperosmolarity 3,12 while at the same time not initiating lens adherence 14 . Benefits that some patients experience with midday lens removal and reinsertion 15 are likely attributed to other lens-wear comfort factors (e.g., lens-surface dehydration, lens-surface wettability, lens-fouling immunity, lens-edge design, lens-wear fatigue), 16 and not necessarily to hyperosmotic post-lens tear.…”

Section: Discussionmentioning

confidence: 99%

“…Post-lens tear-film osmolarity depends heavily on the lens-salt diffusivity ( D s ) because a large D s allows more salt transport from the pre-lens tear film to the post-lens tear film 3,11 . Published results show that commercially available soft contact lenses with small D s can prevent the post-lens tear film from becoming hyperosmotic for both normal and dry eyes 3,12 . Those works, however, are limited to the periodic steady-state osmolarity of the tear compartments.…”

mentioning

confidence: 99%

“…3,11 Published results show that commercially available soft contact lenses with small D s can prevent the post-lens tear film from becoming hyperosmotic for both normal and dry eyes. 3,12 Those works, however, are limited to the periodic steady-state osmolarity of the tear compartments. If the time to periodic steady state for post-lens tear-film osmolarity is hours or more, simple midday lens removal and reinsertion can prevent the post-lens tear film from becoming hyperosmotic even when wearing lenses with high D s .…”

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confidence: 99%

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Clinical Report: Midday Removal and Reinsertion of Soft Contact Lens Cannot Prevent Post-lens Tear-film Hyperosmolarity

et al. 2022

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SIGNIFICANCE:Our analysis shows that post-lens tear-film (PoLTF) hyperosmolarity is not preventable with midday removal and reinsertion of soft contact lenses. However, low lens-salt diffusivity can prevent the PoLTF from becoming hyperosmotic. Lens-salt diffusivity should be lowered to minimize PoLTF osmolarity while also avoiding lens adhesion.PURPOSE: Soft contact lenses with high lens-salt diffusivity result in hyperosmotic PoLTFs. If the time it takes for PoLTF osmolarity to reach periodic steady state is multiple hours, simple midday lens removal and reinsertion can prevent the PoLTF from becoming hyperosmotic. We investigate whether midday removal and reinsertion of a soft contact lens can prevent the PoLTF from becoming hyperosmotic.METHODS: Time to periodic steady state for PoLTF osmolarity upon soft-contact-lens wear is determined with a previously developed transient tear-dynamics continuum model. Interblink period, lens-salt diffusivity, and lens thickness was varied to assess their effects on time to periodic steady state for PoLTF osmolarity. Time to periodic steady states were assessed for both normal and dry eyes.RESULTS: Within the physically realistic ranges of lens-salt diffusivity, lens thickness, and interblink period, PoLTF osmolarity reaches the periodic steady state well within the first hour of lens wear for both normal and dry eyes. Time to periodic steady state for PoLTF osmolarity is predominately dictated by the salt transport across the contact lens between the PoLTF and the pre-lens tear film and water transport from the ocular surface to the PoLTF.CONCLUSIONS: Since the time to periodic steady state is less than 1 hour for physically realistic ranges of lens-salt diffusivity, interblink period, and lens thickness, midday lens removal and reinsertion cannot prevent PoLTF hyperosmolarity. Instead, focus should be on using soft contact lenses with low salt diffusivity to prevent PoLTF hyperosmolarity.

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