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J Opt om. 2010;3(3):123-124
Optometry
Journal
of
www.elsevier.com/ locat e/ j opt om
EDITORIAL
Innovation in contact lenses: basic research and clinical science
Innovacin en lentes de contacto: investigacin bsica y ciencia clnica
Eric Papasa, *, James S. Wolffsohnb, ** and Lyndon Jonesc, **
a
Brien Holden Vision Inst it ut e, Vision CRC and School of Opt omet ry and Vision Science,
Universit y of New Sout h Wales, Sydney, Aust ralia
b
Opht halmic Research Group, Lif e and Healt h Sciences, Ast on Universit y, Birmingham, UK
c
Cent re f or Cont act Lens Research, Universit y of Wat erloo, Toront o, Canada
Cont act lenses are among t he fast est progressing t opics in
opt omet r y and t he l ast decade has seen a number of
signif icant devel opment s occurring in t he f iel d. Among
t hese has been t he i ncr easi ng domi nance of sof t l ens
mat erials in t he market , albeit wit h subst ant ial differences
bet ween count ries. Opt ical designs have improved, allowing
t he opt i mi sat i on of di st ance vi si on t hr ough t he use of
aspherics, enhanced range of clear f ocus wit h mult if ocals
and mor e pr edi ct abl e t or i c desi gns f or ast i gmat i c
correct i on. Si l i cone hydrogel t echnol ogy has i ncreased
oxygen permeabilit y t o t he eye, wit h improved corneal and
ocular surf ace physiology being t he result . Due, however,
t o t heir mechanical propert ies, deposit ion proles and care
syst em i nt er act i ons, cl i ni cal pr obl ems have not been
ent irely absent , especially wit h non-compliant wearers.
Ef f ort s t o eliminat e end of day discomf ort , a maj or cause
of drop-out , have included incorporat ing viscous solut ions
i nt o l ens mat er i al s, as w el l as mani pul at i ng bot h
mul t i pur pose car e sol ut i ons and agent s w i t hi n t he
bl ist er-packaging in which l enses are del ivered. Final l y,
r i gi d gas per meabl e ( RGP) l enses have exhi bi t ed a
resurgence, founded on t he use of mat erials wit h increased
oxygen per meabi l i t y, t he devel opment of scl er a and
semi -scl er al desi gns t hat can be f i t t ed i n a r el at i vel y
syst emat ic manner, and sophist icat ed reverse geomet ry
st rat egies for reduct ion of refract ive error.
*Topical Edit or
**Guest Edit or
1888-4296/ $ - see front mat t er 2010 Spanish General Council of Opt omet ry. Published by Elsevier Espaa, S.L. All right s reserved.
Journal
of Optometry
P e e r- r e v i e w e d J o u r n a l o f t h e Spanish General Council of Optometry
ISSN: 1888-4296
July-September 2010 | Vo l . 3 | n . 3
Editorial
Innovation in contact lenses: basic research and clinical science
123 Eric Papas, James S. Wolfsohn, Lyndon Jones
Original Articles
Designing contact lenses for a wide ield of view via ocular wavefront tomography
125 Xin Wei, Larry Thibos
Development of a new contact lens multipurpose solution:
134 Comparative analysis of microbiological, biological and clinical performance
Simon Kilvington, Ling Huang, Eugenia Kao, Charles H. Powell
Ability of silver-impregnated contact lenses to control microbial growth and colonisation
143 Mark D.P. Willcox, Emma B.H. Hume, Ajay K. Vijay, Robert Petcavich
Visual and optical performance of silicone hydrogel contact lenses for moderate myopia
149 Nancy Keir, Treford Simpson, Desmond Fonn
Current applications and eicacy of scleral contact lenses a retrospective study
158 Boris Severinsky, Michel Millodot
Biochemical analyses of lipids deposited on silicone hydrogel lenses
164 Shin Hatou, Masaki Fukui, Keiichi Yatsui, Hiroshi Mochizuki, Yoko Akune, Masakazu Yamada
Comparison of the number of visits and diagnostic lenses required to it RGP,
169 conventional hydrogel and silicone hydrogel contact lenses
Raul Martn, Elena Alonso
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As cl i ni ci ans, we owe i t t o our pat i ent s t o r emai n
up-t o-dat e wit h new development s and adapt our clinical
pr act i ce based on eval uat i on of t he peer - r evi ewed
lit erat ure. In t his way t he benef it s of t he best evidence
based approaches can be brought int o t he consult ing room.
This special issue brings t oget her several such innovat ions in
t he cont act lens eld. Three basic research st udies cover
t he opt ical design of a cont act lens, microbiological t est ing
of a new mult ipurpose solut ion and t he ef f ect iveness of
ant ibact erial coat ings for lens cases, while t he performance
and lipid deposit ion of silicone hydrogel lenses, t t ing of
hydrogel, silicone hydrogel and RGP cont act lenses and t he
indicat ions for use and efcacy of modern scleral lenses are
addressed in clinical report s.
Xin Wei and Larry Thibos1 propose t he applicat ion of a
t echni que t er med ocul ar wavef r ont t omogr aphy t o
cont act lens opt ics t o correct off-axis wavefront aberrat ions,
and demonst rat e how t his can be applied t o complex opt ical
designs. This has pot ent ial applicat ion not only for improving
peripheral vision, but also in t he diagnost ic imaging of t he
ret ina and in t he hot t opic of myopia ret ardat ion t hrough
manipulat ion of t he peripheral opt ical eld. An ext ensive
st udy of a new sof t cont act l ens mul t ipurpose sol ut ion 2
shows it is safe and has broad spect rum act ivit y when used
in combinat ion wit h 4 dif f erent sil icone hydrogel l enses
aft er 2-4 weeks of wear and t he associat ed t ear deposit ion.
Document downloaded from http://www.elsevier.es, day 07/06/2017. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited.
124
Effect ivit y under 2x or 4x evaporat ion was also conrmed,
unlike some of t he ot her mult ipurpose solut ions under t est .
Anot her place in which cont act lenses can rapidly become
cont ami nat ed i s i n t he l ens case. Wi l l cox et al . 3 have
assessed t he abi l i t y of si l ver -i mpr egnat i on t o i nhi bi t
microbial growt h in t hese circumst ances and were able t o
show a dose-relat ed reduct ion in growt h of t wo bact erial
species, as well as Acant hamoeba, on a hydrogel lens.
The Cent re for Cont act Lens Research in Wat erloo, Canada,
assess t he visual and opt ical performance of silicone hydrogel
lenses in patients with myopia 3.0D in scotopic conditions. 4
Despit e dif f erences in t he aberrat ions of t he eye/ cont act
lens combinat ions, no differences in visual performance were
evi dent . The aut hor s acknowl edge t he need f or t he
development of more precise vision measurement s or new
met rics relat ed t o visual performance, t o furt her underst and
t he clinical signicance of opt ical lens design.
A st udy f r om Japan 5 al so exami ned sever al si l i cone
hydrogel cont act l enses, i nvest i gat i ng deposi t i on af t er
2 weeks of wear. While bot h lipids and cholest erol levels
were similar bet ween lens t ypes, t he quant it y of deposit ed
phosphol ipid, which may benef it wet t abil it y and hence
increase comfort , did differ.
The f inal t wo papers examine lens f it t ing. The f irst , a
hospit al based invest igat ion, describes t he indicat ions f or
t t ing scleral lenses6 and t he result ing visual out comes. It
shows an approximat el y 80 % success rat e across a wide
range of corneal disorders, mainly involving irregular corneal
surf aces, and provides an excellent alt ernat ive t o corneal
t r anspl ant at i on. Second and l ast , a paper f r om Spai n
ret rospect ively compares t he number of visit s and diagnost ic
lenses required t o t RGPs, hydrogel and silicone hydrogel
E. Papas et al
pat ient s in non-pat hological eyes. 7 The aut hors conclude
t he number of visit s and diagnost ic lenses required were
slight ly higher wit h RGPs and suggest t hat t he result s could
inform fut ure clinical guidelines for t t ing cont act lenses.
Art icles in t his Special Issue of t he Journal of Opt omet ry,
on recent innovat ions in cont act lenses, will help t o keep
t he reader abreast of t he development s in t his fast moving
eld and allow t hem t o incorporat e t he benet s of t hese
st udies int o t he clinical care of t heir pat ient s.
References
1. Wei X, Thibos L. Designing cont act lenses for a wide eld of view
via ocular wavefront t omography. J Opt om. 2010;3:124-132.
2. Kilvingt on S, Huang L, Kao E, Powel CH. Development of a new
cont act lens mult ipurpose solut ion: Comparat ive analysis of
microbiological, biological and clinical performance. J Opt om.
2010;3:133-141.
3. Willcox MDP, Hume EBH, Vij ay AK, Pet cavich R. Abilit y of silver-
impregnat ed cont act lenses t o cont rol microbial growt h and
colonizat ion. J Opt om. 2010;3:142-147.
4. Kier N, Simpson T, Fonn D. Visual and opt ical perf ormance of
silicone hydrogel cont act lenses for moderat e myopia. J Opt om.
2010;3:149-157.
5. Hat ou S, Fukui M, Yat sui K, Mochizuki H, Akune Y, Yamada M.
Biochemical analyses of lipids deposit ed on silicone hydrogel
lenses. J Opt om. 2010;3:156-160.
6. Severinsky B, Millodot M. Current applicat ions and ef cacy of
scleral cont act lenses a ret rospect ive st udy. J Opt om. 2010;3:
150-155.
7. Mart in R, Alonso E. Comparison of t he number of visit s and
diagnost ic lenses required t o t RGP, convent ional hydrogel
and silicone hydrogel cont act lenses. J Opt om. 2010;3:161-166.