- Email: [email protected]
Clinical spotlight on myopia – part II
Abstracts of the 2011 BCLA Annual Clinical Conference / Contact Lens & Anterior Eye 34, Supplement 1 (2011) S1–S43
studies have been completed showing myopia amongst adolescents to be as high as 90% So understandably, myopia control has received a great deal af attention over recent years. This has resulted in the commercialisation of myopia control in Eastern Asia. Already Carl Zeiss have introduced a spectacle lens on the Far East markets called MyoVision® . This lens is being closely monitored by competing Spectacle makers with a view to launching their own lens. Without doubt research work done by Dr Pauline Cho from Hong Kong Polytechnic has galvanised the local profession into becoming involved in the fitting of Ortho-k lenses. The latest results coming out of the Hong Kong Polytechnic show a distinct improvement over previous studies, and the local practitioners are embracing this technology to fit an increasing number of patients. In December 2009 CooperVision launched their myopia control lens MiSight® on to the Hong Kong market, this is only a seeding trial and the early results are awaited.
Clinical spotlight on myopia – part II Graeme Young, Arthur Back The science and application of myopia control heralds a completely new era of contact lens practice. For many years practitioners have been involved in the correction of myopia with either contact lenses or more commonly spectacles, but now it’s active treatment and so everything changes from both the way you deal with the child to the professional indemnity. The process of selection will be one of the biggest challenges for the practitioner, because predicting who will become myopic is very difficult. So if a practitioner advices against myopia control, but the child eventually does become myopic, is the practitioner accountable? On the other hand does this mean that all children of myopic parents should be treated for myopia control on the increased possibility that the child will become myopic. Obviously the professions will have to review their Professional Indemnity very closely. The decision on how to treat the child patient is dependent on the evidence that the practitioner finds from the Ocular history, parents myopia, siblings, ethnicity etc etc. Additional to this, will be the environmental influences, such as how long the patient spends outdoors, which research shows has a profound effect upon the risk of reducing the risk of becoming myopic.
CONFERENCE SESSION 14 – Scientific Paper Session on Care Systems
Biocompatibility between silicone hydrogel contact lenses and European lens care solutions: comfort, corneal staining and antimicrobial efficacy Lee A Hall 1, *, Graeme Young 1 , Florence Malet 2 , Jami R Kern 3 1 Visioncare Research Ltd, Farnham, UK; 2 CHU Bordeaux – Hôpital Pellegrin, Bordeaux, France; 3 Alcon Research Ltd, Fort Worth, USA
*E-mail address: [email protected] Purpose: To assess biocompatibility between various types of soft contact lenses and lens care systems. Methods: This was a two-site, controlled, double-masked and randomised multi-part study. Each part included 25-30 subjects, with re-enrolment permissible between parts. Subjects were consenting adult soft contact lens wearers with low baseline corneal staining scores. Study lenses were presoaked for a minimum of ten hours with designated solution. Assessments included baseline pre-insertion corneal fluorescein staining, baseline comfort questionnaire at 15 minutes post-insertion, and comfort and staining outcomes at two hours post-insertion. Antimicrobial efficacies were evaluated separately. Results: The first four study parts yielded assessment of 107 subjects, 11 solutions and two brands of lenses (balafilcon A and lotrafilcon B). Mean corneal staining area ranged from <10% with balafilcon A and/or lotrafilcon B with saline (OcuPure), Sauflon Synergi or Oté Elements to >40% with balafilcon A and/or lotrafilcon B with ReNu MultiPlus, Oté Hydro-shield, All Clean Soft or Aqua Balance. In one study part (of three analysed), significant correlations existed between more staining and less comfort. Of four solutions tested, only ReNu MPS met the International Organisation for Standardisation (ISO) stand-alone antimicrobial efficacy requirements (Aqua Balance, Synergi and Elements did not). Conclusions: Certain lens-solution combinations induced elevated corneal staining, which correlated in some instances with reduced comfort. Lower corneal staining could only be provided at the expense of antimicrobial efficacy.
The ability of various cleaning procedures to remove biofilm from contact lens storage cases Fiona Stapleton 1, *, Ajay K Vijay 2 , Hua Zhu 2 , Roya N Borazjani 3 , Mark DP Willcox 2 University of New South Wales, Sydney, Australia; 2 Brien Holden Vision Institute, Sydney, Australia; 3 Alcon Laboratories Inc., Fort Worth, USA
Utility of a pulsating contact lens case to aid cholesterol removal from contact lens materials soaked in a no rub MPS regimen
1
Alex Müntz 1, *, Lorentz 2 , Walther 1 , Heynen 2 , Joyce 2 , Jones 2 , Sickenberger 1
*E-mail address: [email protected]
1
2
University of Applied Sciences Jena, Jena, Germany; University of Waterloo, Waterloo, Canada *E-mail address: [email protected] Purpose: To examine the use of a vibrating contact lens case to remove deposited cholesterol from four contact lens materials soaked in a no rub multipurpose solution (MPS), using an in vitro model. Method: Balafilcon A, lotrafilcon B, senofilcon A, and etafilcon A were incubated for 14hrs, in a fresh complex artificial tear solution (ATS) containing radiolabeled (14C) cholesterol. Following every 14hrs of incubation, lenses (n=6) were rinsed in saline and soaked in a Polyquad-based MPS solution for six hours using a no-rub regime under two conditions: three lenses were soaked in the static MPS and the other three lenses were placed in a modified vibrating contact lens case, which vibrated the lenses for 15 seconds every 15 minutes. Following cleaning, the lenses were rinsed in saline and placed back in the ATS. This cycle was conducted for 1, 3, 7 and 14 days. Results: The use of the vibrating case did not significantly decrease the amount of cholesterol depositing on the lenses. For all incubation times and lens materials, cleaning with the vibrating case removed <5% more cholesterol from the lenses, with the exception of lotrafilcon B after 14 days of incubation, which had 14% less cholesterol deposited. These differences were not statistically significant (p>0.05). Conclusions: In conclusion, case vibration did not reduce the amount of cholesterol depositing on the four lens materials more than soaking in a static, no-rub MPS regime. To remove lipid, manual rubbing with an MPS may be required to reduce accumulating lipid deposition
S9
Purpose: Persistent microbial contamination of contact lens storage cases is common and may be associated with increased risk of developing microbial keratitis or corneal infiltrates. This study investigated the ability of storage case care and cleaning regimens to remove robust microbial biofilms. Method: Cases with biofilms of either P. aeruginosa or S. aureus were treated with either (1) a rub and rinse in the MPDS, followed by air-drying for six hours and/or tissue wiping or (2) incubation in MPDS for four hours followed by air-drying for 18 hours and/or tissue wiping. The number of survivors was enumerated. Results: Initial biofilms comprised 8.3±0.2 log CFU (P. aeruginosa) and 6.9±0.5 log CFU (S. aureus). Soaking in MPDS for four hours followed by rinsing and air drying for 18 hours caused a significant reduction in the biofilm of P. aeruginosa (1.0 log CFU survivors) and S. aureus (3.8 log CFU survivors). Adding a tissue wipe to this regime increased its effectiveness (0.3 log CFU survivors P. aeruginosa; 2.3 log CFU survivors S. aureus). The next most effective cleaning procedure was rinsing in MPDS, followed by tissue wiping and airdrying face down for six hours (0.8 log CFU survivors P. aeruginosa; 3.3 log CFU survivors S. aureus). Conclusions: Biofilms formed by S. aureus were more resistant to hygiene procedures than those of P. aeruginosa. Allowing the MPDS to disinfect for four hours followed by tissue wiping the case and air drying overnight was the most effect way to remove biofilm of either bacterial type
studies have been completed showing myopia amongst adolescents to be as high as 90% So understandably, myopia control has received a great deal af attention over recent years. This has resulted in the commercialisation of myopia control in Eastern Asia. Already Carl Zeiss have introduced a spectacle lens on the Far East markets called MyoVision® . This lens is being closely monitored by competing Spectacle makers with a view to launching their own lens. Without doubt research work done by Dr Pauline Cho from Hong Kong Polytechnic has galvanised the local profession into becoming involved in the fitting of Ortho-k lenses. The latest results coming out of the Hong Kong Polytechnic show a distinct improvement over previous studies, and the local practitioners are embracing this technology to fit an increasing number of patients. In December 2009 CooperVision launched their myopia control lens MiSight® on to the Hong Kong market, this is only a seeding trial and the early results are awaited.
Clinical spotlight on myopia – part II Graeme Young, Arthur Back The science and application of myopia control heralds a completely new era of contact lens practice. For many years practitioners have been involved in the correction of myopia with either contact lenses or more commonly spectacles, but now it’s active treatment and so everything changes from both the way you deal with the child to the professional indemnity. The process of selection will be one of the biggest challenges for the practitioner, because predicting who will become myopic is very difficult. So if a practitioner advices against myopia control, but the child eventually does become myopic, is the practitioner accountable? On the other hand does this mean that all children of myopic parents should be treated for myopia control on the increased possibility that the child will become myopic. Obviously the professions will have to review their Professional Indemnity very closely. The decision on how to treat the child patient is dependent on the evidence that the practitioner finds from the Ocular history, parents myopia, siblings, ethnicity etc etc. Additional to this, will be the environmental influences, such as how long the patient spends outdoors, which research shows has a profound effect upon the risk of reducing the risk of becoming myopic.
CONFERENCE SESSION 14 – Scientific Paper Session on Care Systems
Biocompatibility between silicone hydrogel contact lenses and European lens care solutions: comfort, corneal staining and antimicrobial efficacy Lee A Hall 1, *, Graeme Young 1 , Florence Malet 2 , Jami R Kern 3 1 Visioncare Research Ltd, Farnham, UK; 2 CHU Bordeaux – Hôpital Pellegrin, Bordeaux, France; 3 Alcon Research Ltd, Fort Worth, USA
*E-mail address: [email protected] Purpose: To assess biocompatibility between various types of soft contact lenses and lens care systems. Methods: This was a two-site, controlled, double-masked and randomised multi-part study. Each part included 25-30 subjects, with re-enrolment permissible between parts. Subjects were consenting adult soft contact lens wearers with low baseline corneal staining scores. Study lenses were presoaked for a minimum of ten hours with designated solution. Assessments included baseline pre-insertion corneal fluorescein staining, baseline comfort questionnaire at 15 minutes post-insertion, and comfort and staining outcomes at two hours post-insertion. Antimicrobial efficacies were evaluated separately. Results: The first four study parts yielded assessment of 107 subjects, 11 solutions and two brands of lenses (balafilcon A and lotrafilcon B). Mean corneal staining area ranged from <10% with balafilcon A and/or lotrafilcon B with saline (OcuPure), Sauflon Synergi or Oté Elements to >40% with balafilcon A and/or lotrafilcon B with ReNu MultiPlus, Oté Hydro-shield, All Clean Soft or Aqua Balance. In one study part (of three analysed), significant correlations existed between more staining and less comfort. Of four solutions tested, only ReNu MPS met the International Organisation for Standardisation (ISO) stand-alone antimicrobial efficacy requirements (Aqua Balance, Synergi and Elements did not). Conclusions: Certain lens-solution combinations induced elevated corneal staining, which correlated in some instances with reduced comfort. Lower corneal staining could only be provided at the expense of antimicrobial efficacy.
The ability of various cleaning procedures to remove biofilm from contact lens storage cases Fiona Stapleton 1, *, Ajay K Vijay 2 , Hua Zhu 2 , Roya N Borazjani 3 , Mark DP Willcox 2 University of New South Wales, Sydney, Australia; 2 Brien Holden Vision Institute, Sydney, Australia; 3 Alcon Laboratories Inc., Fort Worth, USA
Utility of a pulsating contact lens case to aid cholesterol removal from contact lens materials soaked in a no rub MPS regimen
1
Alex Müntz 1, *, Lorentz 2 , Walther 1 , Heynen 2 , Joyce 2 , Jones 2 , Sickenberger 1
*E-mail address: [email protected]
1
2
University of Applied Sciences Jena, Jena, Germany; University of Waterloo, Waterloo, Canada *E-mail address: [email protected] Purpose: To examine the use of a vibrating contact lens case to remove deposited cholesterol from four contact lens materials soaked in a no rub multipurpose solution (MPS), using an in vitro model. Method: Balafilcon A, lotrafilcon B, senofilcon A, and etafilcon A were incubated for 14hrs, in a fresh complex artificial tear solution (ATS) containing radiolabeled (14C) cholesterol. Following every 14hrs of incubation, lenses (n=6) were rinsed in saline and soaked in a Polyquad-based MPS solution for six hours using a no-rub regime under two conditions: three lenses were soaked in the static MPS and the other three lenses were placed in a modified vibrating contact lens case, which vibrated the lenses for 15 seconds every 15 minutes. Following cleaning, the lenses were rinsed in saline and placed back in the ATS. This cycle was conducted for 1, 3, 7 and 14 days. Results: The use of the vibrating case did not significantly decrease the amount of cholesterol depositing on the lenses. For all incubation times and lens materials, cleaning with the vibrating case removed <5% more cholesterol from the lenses, with the exception of lotrafilcon B after 14 days of incubation, which had 14% less cholesterol deposited. These differences were not statistically significant (p>0.05). Conclusions: In conclusion, case vibration did not reduce the amount of cholesterol depositing on the four lens materials more than soaking in a static, no-rub MPS regime. To remove lipid, manual rubbing with an MPS may be required to reduce accumulating lipid deposition
S9
Purpose: Persistent microbial contamination of contact lens storage cases is common and may be associated with increased risk of developing microbial keratitis or corneal infiltrates. This study investigated the ability of storage case care and cleaning regimens to remove robust microbial biofilms. Method: Cases with biofilms of either P. aeruginosa or S. aureus were treated with either (1) a rub and rinse in the MPDS, followed by air-drying for six hours and/or tissue wiping or (2) incubation in MPDS for four hours followed by air-drying for 18 hours and/or tissue wiping. The number of survivors was enumerated. Results: Initial biofilms comprised 8.3±0.2 log CFU (P. aeruginosa) and 6.9±0.5 log CFU (S. aureus). Soaking in MPDS for four hours followed by rinsing and air drying for 18 hours caused a significant reduction in the biofilm of P. aeruginosa (1.0 log CFU survivors) and S. aureus (3.8 log CFU survivors). Adding a tissue wipe to this regime increased its effectiveness (0.3 log CFU survivors P. aeruginosa; 2.3 log CFU survivors S. aureus). The next most effective cleaning procedure was rinsing in MPDS, followed by tissue wiping and airdrying face down for six hours (0.8 log CFU survivors P. aeruginosa; 3.3 log CFU survivors S. aureus). Conclusions: Biofilms formed by S. aureus were more resistant to hygiene procedures than those of P. aeruginosa. Allowing the MPDS to disinfect for four hours followed by tissue wiping the case and air drying overnight was the most effect way to remove biofilm of either bacterial type