Evaluation of the Efficacy of a New Dichoptic Digital Platform to Treat the Anisometropic and Isometropic Amblyopia.

The aim of the current study was to evaluate the results of a novel dichoptic training program using an online platform in a group of subjects with refractive amblyopia, performing a comparative analysis of unilateral and bilateral amblyopic cases. For this purpose, a retrospective study analysis of data of 161 children (4−13 years) who underwent dichoptic treatment with the Bynocs® platform (Kanohi Eye Pvt. Ltd., Mumbai, India) was performed. In all cases, the therapy protocol consisted of sessions of training of 30 min daily 5 times a week for 6 weeks. Best corrected visual acuity (BCVA) in the non-dominant eye improved significantly with the treatment, with a mean change of 0.39 logMAR in the whole sample (p < 0.001). Regarding binocularity, the binocular function (BF) score also experienced a significant improvement (p < 0.001), with a mean change of 1.55 with therapy in the whole sample. The BCVA of the dominant eye only improved significantly (p < 0.001) in the isometropic amblyopic subgroup. In conclusion, the use of the dichoptic therapy with the digital platform evaluated allows an effective restoration of visual acuity and binocular function in children with anisometropic and isometropic amblyopia.

Ocular microbiota and lens contamination following Mel4 peptide-coated antimicrobial contact lens (MACL) extended wear.

PURPOSE: The purpose of this study was to investigate the effect of Mel4 antimicrobial peptide-coated contact lenses (MACL) on the microbiota of the conjunctiva and lenses during three months of extended wear. METHODS: One hundred and seventy-six participants were recruited into a randomised, contralateral, double masked, biweekly extended wear MACL and uncoated control lens trial. At the one month and 3-month visit, the conjunctival microbiota was sampled using sterile cotton swabs and contact lenses were collected aseptically. Standard microbiological procedures were employed for culture of the swabs and contact lenses and identification of the isolated microorganisms. RESULTS: Gram-positive bacteria (predominantly coagulase-negative staphylococci) were the most frequently isolated microbes from both contact lenses and conjunctiva. There was no difference in the frequency of isolation of most bacteria or fungi from the conjunctival swabs of eyes wearing either MACL or control lenses. The only exception was a higher frequency of eyes harbouring Staphylococcus arlettae when wearing control lenses (5%) versus MACL (<1%) (p = 0.002). There was no significant difference in the frequency of microbes isolated from MACL or control contact lenses. There were also no differences between lens types in the frequency of isolation of >1 microbial type per sampling occasion for either conjunctiva swabs or contact lenses. CONCLUSION: MACL wear did not change the conjunctival microbiota during extended wear, and the types of microbes isolated from MACL were similar to those isolated from control lenses.

A new technique for fitting of tricurve rigid gas-permeable contact lens in penetrating keratoplasty eyes using Scheimpflug imaging.

Purpose: Rigid gas-permeable (RGP) contact lens fitting after penetrating keratoplasty (PK) is challenging due to significant irregular astigmatism. The aim of the study was to determine a guideline for selecting the initial base curve (BC) of the RGP contact lens fitting in post PK eyes. Methods: The data of patients who had tricurve RGP contact lens fitting post PK were collected retrospectively. The following data were collected: best-corrected visual acuity with glasses and contact lenses; contact lens parameters which included the BC and diameter; corneal topography parameters which included steep keratometry value (K), flat-K, and mean-K; and anterior best fit sphere (BFS) measured using Scheimpflug imaging. Results: The median age of the 40 subjects (46 eyes) who met the inclusion criteria was 37.5 years (IQR 26.7-45.5). The spherical equivalent was -3.00 diopter (D) (-8.31 to -1.56). The median steep-K, flat-K, and mean-K in them were 6.76 mm (6.28-7.07), 7.78 mm (7.37-8.14), and 7.26 mm (6.93-7.46), respectively. The median anterior BFS value of the transplanted cornea was 6.96 mm (6.6-7.37). The median BC of the final RGP lens was 7.0 mm (6.7-7.23) and the median diameter was 9.8 mm (9.4-10.4). Among all the Scheimpflug imaging parameters, the BFS correlated well with the final BC of the RGP contact lens dispensed (R 0.742, P < 0.0001). Conclusion: The anterior corneal surface BFS value can be used as a reference in selecting the initial BC of tricurve RGP contact lens to achieve the best fitting and reducing the chair time of patients after PK.

Prosthetic replacement of the ocular surface ecosystem for corneal irregularity: Visual improvement and optical device characteristics.

PURPOSE: To describe patterns of prescribing Prosthetic Replacement of Ocular Surface Ecosystem (PROSE) in irregular corneas and compare various components of lens design. METHODS: Design: Retrospective, observational case series. 244 eyes of 173 patients with keratoconus (n=178), pellucid marginal degeneration (n=21), keratoglobus (n=6), following refractive surgery (n=19) and following keratoplasty (n=20) fitted with the PROSE device were retrospectively analyzed. Simulated keratometry value along the steep meridian (Steep-K) and anterior chamber depth (ACD) were measured using Scheimpflug imaging. Improvement in visual acuity and parameters of lens design such as vault, front surface eccentricity (FSE) and toricity were analyzed and compared across all conditions. RESULTS: PROSE improved visual acuity, both uncorrected (median, 1.30 logMAR) and spectacle-corrected (median, 0.60 logMAR), to a median of 0.22 logMAR. Positive correlation was observed between Steep-K and ACD with lens vault, especially in keratoconus. Multiple regression analysis established ACD as the most reliable factor while choosing vault. FSE value of 0.6 was the most common across diagnostic subgroups. The distribution of FSE values did not differ between keratoconus patients with Steep keratometry of <60D or those >60D. In every diagnostic subgroup, at least 20% of eyes required a lens design of with-the-rule toricity of haptic. CONCLUSION: The PROSE device resulted in significant improvement in vision in this population. A trend of prescribing higher lens vault with increased keratometry value was evident especially in keratoconus. ACD appeared to be more important than Steep K in vault selection. An FSE of 0.6 and vertical peripheral lens toricity were used most frequently in this subset of patients.