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Contact lenses have been instrumental in vision correction and are expected to be utilized in augmented reality (AR) displays through the integration of electronic and optical components. In optics, metasurfaces, an array of sub-wavelength nanostructures, have offered optical multifunctionality in an ultra-compact form factor, facilitating integration into various imaging, and display systems. However, transferring metasurfaces onto contact lenses remains challenging due to the non-biocompatible materials of extant imprinting methods and the structural instability caused by the swelling and shrinking of the wetted surface. Here, a biocompatible method is presented to transfer metasurfaces onto contact lenses using hyaluronic acid (HA) as a soft mold and to allow for holographic light projection. A high-efficiency metahologram is obtained with an all-metallic 3D meta-atom enhanced by the anisotropy of a rectangular structure, and a reflective background metal layer. A corrugated metal layer on the HA mold is supported with a SiO2 capping layer, to avoid unwanted wrinkles and to ensure structural stability when transferred to the surface of pliable and wettable contact lenses. Biocompatible method of transferring metasurfaces onto contact lenses promises the integration of diverse optical components, including holograms, lenses, gratings and more, to advance the visual experience for AR displays and human-computer interfaces.
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PURPOSE: Extended wear has long been considered as the ultimate contact lens modality in terms of user convenience. The purpose of this work is to update earlier surveys by describing international trends in extended wear soft lens fitting between 2000 and 2023, inclusive. METHOD: An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023, inclusive. Data relating to 282,142 soft contact lens fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of extended wear soft lens fitting. RESULTS: Over the duration of the work there was a very small decrease in the prescribing of extended wear soft lenses (p < 0.0001). More detailed inspection shows that prescribing of these lenses steadily increased from 5.8 % of all soft lens fits in 2000 to 11.6 % in 2007, then steadily decreased to 5.2 % in 2023. Of all soft contact lenses prescribed to males, 9.2 % were fitted for extended wear, compared with 6.7 % for females (p < 0.0001). The mean age of extended wear soft lens wearers at fitting was 34.7 ± 14.7 years, compared to 31.1. ± 14.10 years for daily soft lens wearers (p < 0.0001). Analysis of 1,948 recent extended wear soft lens fits (2019-2023, inclusive), in terms of material type, revealed that, on average, 86 % and 14 % of extended wear soft lenses were fitted using silicone hydrogel and hydrogel materials, respectively. CONCLUSION: A modest increase in extended wear soft lens prescribing from 2000 to 2007 corresponded with the introduction of high oxygen transmissibility silicone hydrogel lenses. However, prescribing of this lens type declined thereafter, probably due to ongoing concerns over their increased rate of microbial keratitis, resulting in a prescribing rate in 2023 (5.2%) that was little different to that observed in 2000 (5.8%).
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PURPOSE: To evaluate tear meniscus parameters in soft contact lens wearers (SCL) using optical coherence tomography (OCT) and ImageJ software. METHODS: This prospective study included 50 soft contact lens wearers (group 1: 25 symptomatic SCL wearers (SCLW), group 2: 25 asymptomatic SCL wearers (ASCW)) and 25 healthy non-CL wearers (group 3 (NCLW)). SCLs were fitted on each eye of CL wearers, and the lower tear meniscus was imaged using OCT before CL insertion, immediately afterward, and reimaged 2, 5 and 10 h after insertion. Tear meniscus parameters, including tear meniscus height (TMH), depth (TMD), turbidity, and percentage area occupied by particles (PAOP) were measured in all groups. RESULTS: Turbidity and PAOP measurements at baseline in SCLW were significantly higher than in other groups (p < 0.05). There was no significant difference between TMH, TMD, turbidity, and PAOP parameters calculated at baseline visit and two hours after SCL insertion in all groups (p > 0.05 for 2 comparisons). The symptomatic SCL users had a significant decrease in TMH and TMD in the fifth hour. The turbidity and PAOP measurements of SCLW and ASCW at the fifth and tenth hours were significantly higher than those of NCLW (p < 0.05). CONCLUSION: TMD and height TMH decrease throughout the day in all participants; however, a significant decrease in these parameters was observed only in symptomatic SCL users at the fifth hour, at the earliest. As the duration of CL wear increases, turbidity and PAOP even in asymptomatic SCL wearers become significantly higher than those in healthy non-CL wearers. KEY MESSAGES: What Is Known ⢠Contact lens wear is associated with an increased risk of dry eye. ⢠Tear volume decreases gradually during contact lens wear. What Is New ⢠Tear meniscus turbidity and particle area occupied by particles (PAOP) were higher in symptomatic contact lens wearers and they increase gradually during contact lens wear. ⢠Tear meniscus turbidity and PAOP may be measures of how well the tear film and meniscus are functioning in contact lens wearers.
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BACKGROUND: This study aimed at measuring the effect of contact lens hygiene risk factors on the prevalence of contact lens-related keratitis and identifying the specific risk factors to both microbial and non-microbial keratitis independently. METHODS: A cross-sectional study was conducted at Alexandria Ophthalmology Hospital from May to October 2023. All contact lens wearers attending the outpatient clinic had undergone face-to-face interviews using a standardized validated questionnaire which included demographic data and contact lenses (CLs) hygiene risk factors. Participants were classified into two groups; normal group and keratitis group. Keratitis group was further subdivided into non-microbial and microbial group. RESULTS: The study included 245 contact lens wearers; 149 normal cases, 50 (20.4%) contact lens-related non-microbial keratitis (CLNK) cases, and 46 (18.8%) contact lens-related microbial keratitis (CLMK) cases. Sharing contact lenses and eye trauma were significant risk factors for both CLNK (p=0.036), (p=0.001) and CLMK (p=0.003), (p=0.017). CLs wear duration for more than 12 hours was associated with an increased risk of CLNK by about 4 times (p=0.030) and overnight wear of contact lenses increased the risk of CLNK by 2.6 times (p=0.030). Showering or swimming in lenses was identified as a significant risk factor for CLMK (p=0.012), moreover washing lenses with tap water increased the risk of CLMK (p=0.030). CONCLUSIONS: Poor compliance with contact lenses hygiene rules results in a high prevalence of contact lens-related keratitis. Eye trauma and sharing contact lenses were significant hygiene risk factors for both contact lens-related non-microbial keratitis and contact lens-related microbial keratitis.
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We aimed to assess long-term disease progression in patients with severe keratoconus (KC). Clinical records of 125 patients (201 eyes) with severe KC followed-up for > 12 months were retrospectively analyzed. From these, 28 patients (31 eyes) were included. Corneal topography parameters evaluated included thinnest corneal thickness (TCT), maximum keratometry (Kmax), anterior and posterior mean corneal radii of 3 mm (aKM, pKM), steep keratometry, and KC screening indices. All patients wore rigid gas permeable contact lenses (RGPCLs) for an extended period. The median patient age and follow-up period were 20 (interquartile range [IQR] 17-22) years and 25 (15-38) months, respectively. Compared to baseline, the aKM, Kmax, and KC screening indices on the anterior corneal surface were reduced at the final follow-up (P < 0.05). No changes were observed in RGP-corrected visual acuity, TCT, pKM, or KC screening indices on the posterior corneal surface. The higher the baseline value, the greater the reduction in aKM and Kmax. Five patients (16%) experienced disease progression during follow-up. Patients with severe KC showed reduced anterior corneal surface curvature and no change in corneal thickness during an average follow-up period of 2-3 years while wearing RGPCLs.
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Córnea , Topografía de la Córnea , Progresión de la Enfermedad , Queratocono , Humanos , Queratocono/diagnóstico , Topografía de la Córnea/métodos , Masculino , Femenino , Adulto Joven , Adolescente , Estudios Retrospectivos , Córnea/patología , Córnea/diagnóstico por imagen , Agudeza Visual/fisiología , Adulto , Estudios Longitudinales , Estudios de SeguimientoRESUMEN
BACKGROUND: Bandage contact lenses are important aids for aftercare following ocular surgery and for a wide variety of ocular surface conditions. However, bandage contact lenses also bear the risk of fostering microbial infections of the cornea. We herein report the safety profile of bandage contact lenses from a comprehensive review of medical records in a tertiary care eye hospital in Germany. METHODS: We identified 638 consecutive patients who had been prescribed at least one bandage lens during the past 10 years. For these, we performed a computerized search for the following adverse events: (1) endophthalmitis, (2) emergency keratoplasty and (3) vision loss of at least 2 lines according to the Early Treatment Diabetic Retinopathy Study (ETDRS). We manually assessed the relatedness of each event to the bandage lens. Events later than 100 days following the bandage lens prescription were not considered to be related to bandage contact lenses. RESULTS: We observed 267 adverse events, with 120 occurring within 100 days after bandage lens prescription. This left a total of 18 endophthalmitis events, 21 penetrating keratoplasties and 81 eyes with vision loss of at least 2 ETDRS lines (for individual review of relatedness). Only two episodes of endophthalmitis could be linked to bandage lens wear. All other adverse events were due to causative conditions that had already been present prior to bandage contact lens insertion. CONCLUSIONS: Severe adverse events after bandage contact lens wear are not uncommon because lenses are used in patients suffering from preexisting ocular conditions. However, severe adverse events were almost never caused by the bandage contact lenses directly in our hands. We therefore conclude that bandage contact lenses are safe given proper ophthalmological supervision.
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Vendajes , Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Estudios Retrospectivos , Adulto , Endoftalmitis/etiología , Endoftalmitis/terapia , Agudeza Visual , Lentes de Contacto/efectos adversos , Anciano de 80 o más Años , Adulto Joven , Alemania/epidemiologíaRESUMEN
PURPOSE: This study aimed to assess the susceptibility of ocular isolates of Pseudomonas aeruginosa to two multi-purpose disinfectant solutions (MPDS) and to determine if there was a relationship with resistance to antibiotics. METHODS: Twenty-three strains of P. aeruginosa isolated from microbial keratitis cases in Australia were utilized in this study. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of two commercially available MPDSs, Biotrue and cleadew MPS were determined. Additionally, the MIC of the strains to five antibiotics, ciprofloxacin, levofloxacin, gentamicin, ceftazidime, and imipenem, were analyzed. RESULTS: All strains were susceptible to 100 % of each of the MPDS. However, when MPDSs were diluted, cleadew MPS had significantly lower median MIC (median = 12.5 vs 25; p = 0.00008) and MBC (median = 25 vs 50; p = 0.0027) compared to Biotrue. All tested strains were susceptible to levofloxacin and gentamicin. Susceptibility rates to ciprofloxacin, imipenem, and ceftazidime were 52.2 %, 30.4 %, and 91.3 %, respectively. There were no significant relations between MIC or MBC to either MPDS and resistance to the antibiotics (pâ§0.23). CONCLUSION: Both MPDSs were active against P. aeruginosa isolated from microbial keratitis in Australia. However, after dilution, cleadew MPS remained active against P. aeruginosa at lower concentrations. Certain strains of P. aeruginosa were resistant to imipenem, ceftazidime or ciprofloxacin. The lack of association of susceptibility to MPDS and antibiotics suggest that resistance to one did not predispose to resistance to the other.
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This study aims to formulate and evaluate Eudragit nanoparticles-laden hydrogel contact lenses for controlled delivery of acetazolamide (ACZ) using experimental design. Eudragit S-100 was selected for the preparation of nanoparticles. The optimization of Eudragit S100 concentration (X1), polyvinyl alcohol concentration (X2), and the sonication time (X3) was attempted by applying a central composite experimental design. Mean size of nanoparticles (nm), percent in vitro drug release and drug leaching from the ACZ-ENs laden contact lens were considered as dependent variables. Nanoparticles-laden contact lens was prepared through the direct loading method and characterized. Optimum check-point formulation was selected based on validated quadratic polynomial equations developed using response surface methodology. The optimized formulation of ACZ-ENs exhibited spherical shape with a size of 244.3 nm and a zeta potential of -13.2 mV. The entrapment efficiency of nanoparticles was found to be 82.7 ± 1.21%. Transparent contact lenses loaded ACZ-ENs were successfully prepared using the free radical polymerization technique. ACZ-ENs incorporated in contact lens exhibited a swelling of 83.4 ± 0.82% and transmittance of 80.1 ± 1.23%. ACZ-ENs showed a significantly lower burst release of the drug when incorporated in the contact lens and release was sustained over a period of 24 h. The sterilized formulation of ACZ-ENs laden contact lens did not show any sign of toxicity in rabbit eyes. ACZ-ENs incorporated in contact lens could be considered as a potential alternative in glaucoma patients due to their ability to provide sustained drug release and thus enhance patient compliance.
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John Lennon has an enduring, instantly recognisable, iconic, spectacle look. However, prior to 1966, he was rarely seen wearing glasses in public. From ages 7 to 26, he effectively hid his myopia away, including a period of unsuccessful contact lens wear during Beatlemania. This narrative review examines John's experience with contact lenses from 1963 to 1966 when he wore corneal rigid lenses made from polymethylmethacrylate, which regularly fell out. This frequent lens ejection was most likely due to the interaction between his upper eyelid and a spherical back surface rigid lens fitted to his right eye, which had a moderate degree of with-the-rule corneal astigmatism. John's recollection that his contact lenses stayed in place while 'stoned' supports this hypothesis, as a cannabis-induced upper eyelid ptosis would reduce the likelihood of lens ejection.
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Lentes de Contacto , Miopía , Humanos , Lentes de Contacto/efectos adversos , Miopía/fisiopatología , Miopía/terapia , Historia del Siglo XX , MasculinoRESUMEN
Purpose: To explore links between subjective comfort and vision in habitual multifocal soft contact lens (MFCL) wearers when refit with daily disposable MFCLs, to determine which factors are relevant for success with MFCLs and evaluate consistency between MFCLs of different designs. Patients and Methods: This work examined subjective measures in a randomised, participant masked, bilateral wear crossover study at five optometry practices. Fifty-eight habitual MFCL wearers wore stenfilcon A multifocal (stenA-MF; CooperVision Inc) and delefilcon A multifocal (delA-MF; Alcon) for two-weeks. Subjective ratings included satisfaction with comfort and vision and agreement questions. Results: Agreement with "I would like to wear this MFCL in the future" was taken to indicate success with each MFCL; agreement was significantly higher with stenA-MF. There was strong correlation between agreement responses for "I would like to wear this MFCL in the future" and "MFCL met my needs for vision" with both lenses (p<0.01). However, it was only with stenA-MF, which had higher agreement responses to both statements (p<0.05), that responses to these two statements correlated with satisfaction with end-of-day (EOD) comfort (p<0.01). These differences in correlations between the two lenses are seemingly driven by greater satisfaction with stenA-MF for near and intermediate vision (p<0.05). Conclusion: Subjective vision and comfort were only correlated when vision met the needs of most participants. Meeting participants' needs for vision correlated strongly with wanting to wear a MFCL. Results indicate that meeting vision needs is more important than meeting comfort needs when influencing whether presbyopic patients continue wearing MFCLs.
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Smart contact lenses represent a breakthrough in the intersection of medical science and innovative technology, offering transformative potential in ophthalmology. This review article delves into the technological underpinnings of smart contact lenses, emphasizing the current landscape and advancements in biosensors, power supply, biomaterials, and the transmission of ocular information. This review further applies new innovations to their emerging role in the diagnosis, monitoring, and management of various ocular conditions. Moreover, we explore the impact of technical innovations on the application of smart contact lenses in monitoring glaucoma, managing postoperative care, and dry eye syndrome, further elucidating the non-invasive nature of these devices in continuous ocular health monitoring. The therapeutic potential of smart contact lenses such as treatment through targeted drug delivery and the monitoring of inflammatory biomarkers is also highlighted. Despite promising advancements, the implementation of smart contact lenses faces technical, regulatory, and patient compliance challenges. This review synthesizes the recent advances to provide an outlook on the state of smart contact lens technology. Furthermore, we discuss future directions, focusing on potential technological enhancements and new applications within ophthalmology.
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PURPOSE: Daily disposable contact lenses offer numerous benefits in terms of ocular health and wearer convenience. The purpose of this work is to update earlier surveys by describing global trends in daily disposable lens fitting between 2000 and 2023. METHOD: An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023, inclusive. Data relating to 265,106 daily wear soft lens fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of daily disposable lens fitting. RESULTS: Overall, daily disposable lens prescribing increased over time, from 17.1 % of daily wear soft lens fits in 2000 to 46.7 % in 2023 (p < 0.0001). There were significant differences between countries in daily disposable lens prescribing (p < 0.0001), and between the percentage of males fitted with daily disposable lenses, as a proportion of all daily wear soft lenses (37.2 %), compared to females (35.2 %) (p < 0.0001). Daily disposable lens wearers are slightly younger at fitting than reusable soft lens wearers (31.0 vs 31.2 years, respectively) (p < 0.0001), although this difference is not clinically meaningful. Analysis of 50,240 daily wear soft lenses fitted recently (2019-2023) were found to be prescribed for the following replacement frequencies: daily - 47 %; monthly - 42 %; 1-2 weekly - 9 %; and ≥3 monthly - 2 %. CONCLUSION: There has been a substantial increase in daily disposable lens fitting throughout the first 24 years of this century. The gradual nature of this increase is commensurate with the staged introduction of daily disposable lens designs and expanded parameter ranges over the survey period.
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Purpose: To investigate the physical properties of commercially available multipurpose soft contact lens solutions in Ghana. Methods: pH (Kelilong ICL-099 pH meter, China), osmolality (OSMOMAT 3000, GONOTEC, Germany), surface tension (Sigma 700 Tensiometer, Sweden), and viscosity (CFOC-200 Viscometer, Cannon Company, USA) of various soft contact lens multipurpose solutions (MPS) were measured in triplicates at room temperature. Viscosity measurements were also taken at 34 °C ocular surface temperature. The solutions examined were Opti-Free Replenish (OFR), Trufresh (TF), Avizor (AV), Freshlook (FL), and Refresh (RF). Results: Several solutions were largely hypo-osmotic in the range of 108-231 mOsm/kg, the exception being Avizor, which had osmolality values that were closer to human tears (301 ± 0.58 mOsm/kg). The range of pH values of the solutions (6.33-8.24, mean (SD) = 7.53 ± 0.18) fell within the reported tolerable range for the ocular surface (6.20-9.00). Surface tension values ranged from 35.86 to 42.27 mNm with a mean of 38.49 ± 2.32 mNm. The average viscosity of most solutions at room temperature (25 °C) was 1.44 ± 0.49 cP with a range of 1.04-2.15 cP. Significantly lower values ranging from 0.79 to 1.58 cP were obtained at ocular surface temperature (34 °C), p = 0.0001). Conclusions: The physical properties of many of the solutions used as MPS in Ghana are markedly variable. Nevertheless, pH, surface tension, and viscosity fall within the acceptable limits of ocular physiological tolerance; except for osmolality, which majority were outside the reported tolerable range for the ocular surface. This information may partly explain the reason some patients exhibit strong preferences for certain care systems and should aid clinical decision-making when prescribing eye care systems to patients.
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Purpose: This study aimed to compare subjective allergic conjunctivitis symptoms and anti-allergic eye drop use patterns between antihistamine-releasing contact lens users and daily disposable soft contact lens users during Japan's hay fever season. Methods: This web-based retrospective cohort study included daily disposable soft contact lens or antihistamine-releasing contact lens users with a history of seasonal allergic conjunctivitis who regularly used daily disposable soft contact lenses since the previous year. The total ocular symptom score (range 0-20) based on 5-item questionnaire scores and time from the start of the hay fever season to the initiation of anti-allergic eye drop treatment were compared between antihistamine-releasing contact lens users and daily disposable soft contact lens users. Results: The study included 24 participants: 17 using daily disposable soft contact lenses and 7 using antihistamine-releasing contact lenses. Antihistamine-releasing contact lens users experienced a greater reduction in total ocular symptom score from 2021 to 2022 compared with daily disposable soft contact lens users (mean total ocular symptom score [standard deviation]: daily disposable soft contact lens: -0.65 [1.4], antihistamine-releasing contact lens: -4.7 [3.6]; n = 24; Mann-Whitney U test, P = 0.010). Fourteen daily disposable soft contact lens users and five antihistamine-releasing contact lens users eventually required anti-allergic eye drops. Kaplan-Meier analysis revealed a significant delay in the initiation of anti-allergic eye drop treatment among those using antihistamine-releasing contact lenses compared with those using daily disposable soft contact lenses (median days, daily disposable soft contact lenses: 19 days, antihistamine-releasing contact lens: 57 days; n = 24; log-rank test, P = 0.045). Conclusions: Antihistamine-releasing contact lenses can potentially mitigate worsening ocular allergic responses during the hay fever season when used appropriately as a preventive measure.
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Purpose: Employing "relative plus" (Add) power to extend the functional vision range is a primary method to correct presbyopia with contact lenses. Simultaneous vision contact lenses are typically associated with visual disturbances at higher Add powers, often resulting in compromised vision and necessitating specialized fitting methods. Among mature individuals suffering from presbyopia, we evaluated the visual performance of a catenary curve-based extended depth of focus (EDOF) optical profile contact lens with a simplified fitting process. Methods: Mature individuals suffering from presbyopia with Add requirements of +2.00 D or more were recruited. Monocular and binocular visual acuities were obtained across optical vergences ranging from -4.00 D to +2.00 D to generate defocus curves for best spectacle-corrected distance vision (baseline) and center-distance, catenary curve-based contact lenses (catenary). A subjective questionnaire evaluating the lenses was employed. Results: Twenty-four mature individuals suffering from presbyopia, average age 59.2 (range: 51-68 years) and average Add requirement of +2.24 D (range +2.00 D to +2.50 D) were enrolled. Under high-contrast conditions, the catenary lens provided functional binocular vision (0.30 logMAR or better) at all optical vergences from distance to -3.50 D (equivalent to 28 cm). Participants demonstrated a significant improvement (p < 0.05) in binocular visual acuity while wearing the catenary lens with an imposed defocus of -1.50 D to -4.00 D (equivalent to object distances from 66 cm to 25 cm). Subjective ratings with the catenary lens were equivalent to those documented at baseline. Conclusion: The catenary curve-based lenses provided a full range of functional vision while maintaining clear distance vision for individuals suffering from advanced presbyopia. Comparison with previous results involving this lens indicates that these findings are also generalizable to wearers with lower Add requirements. This EDOF design provides a universal Add which is sufficient for advanced presbyopia. Trial Registration: ClinicalTrials.gov. Identifier: NCT05495971.
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PURPOSE: To investigate the roles of neural adaptation and sensitization in contact lens discomfort (CLD). METHODS: Cooling stimuli (20 °C) were applied to the cornea in a group comprising 24 symptomatic and 25 asymptomatic contact lens (CL) wearers as well as 15 non-CL wearing controls, using a computerized Belmonte esthesiometer. The adaptation paradigm consisted of 20 repetitive stimuli at threshold, sub- and supra-threshold levels. The sensitization paradigm involved five levels of suprathreshold stimuli ranging between 1x to 2x threshold. Following each stimulus, participants rated the sensation magnitude regarding intensity, coolness and irritation. Measurements were taken with habitual CL (BL_CL), after 2 weeks of no-CL (No_CL) and after restarting habitual CL wear (ReSt_CL). RESULTS: The symptomatic subjects exhibited a lower threshold but reported enhanced sensations during the adaptation and sensitization paradigm, compared to the asymptomatic and control groups (all p ≤ 0.021). At the BL_CL and ReSt_CL visits, they showed increased ratings to repeated subthreshold stimuli (p = 0.025) and greater irritation during the sensitization paradigm (p ≤ 0.032). Ratings in asymptomatic and control groups were relatively unchanged over time (p ≥ 0.181). Logistic regression revealed a link between the augmented sensory responses and increased likelihood with CLD. CONCLUSION: The maladaptive sensory responses seen in CLD subjects, with reduced adaptation and heightened sensitization to ocular surface stimulation, suggest an imbalance between sensitization and adaptation in CLD. As CLD may represent a reversible subcategory of dry eye, it can serve as a human dry eye model for studying the neurosensory effect of ocular surface stimulation.
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PURPOSE: There have been significant advancements in toric soft contact lens design and manufacturing technology, and increased product availability, over the past half a century. The purpose of this work is to update earlier surveys by describing international trends in toric soft lens fitting between 2000 and 2023, inclusive. METHOD: An annual contact lens prescribing survey was sent to eye care practitioners in up to 71 countries between 2000 and 2023, inclusive. Data relating to 220,934 standard soft daily wear single vision lens fits undertaken in 20 countries returning reliable longitudinal data were analysed in respect of toric soft lens fitting. RESULTS: Overall, toric soft lens prescribing almost doubled over the time-course of this survey, from 24.4 % of standard soft daily wear single vision lens fits in 2000 to 46.2 % in 2023 (p < 0.0001). There were significant differences between countries in toric soft lens prescribing (p < 0.0001). Of all standard soft daily wear single vision contact lenses prescribed to males, 32.0 % were toric soft lenses, compared with 28.7 % for females (p < 0.0001). The mean age of toric soft lens wearers was 30.5 ± 12.5 years, compared to 27.9. ± 12.1 years for spherical soft lens wearers (p < 0.0001). Analysis of 13,582 recent toric soft lens fits (2019-2023, inclusive), in terms of material type and replacement frequency, revealed the following proportions: reusable silicone hydrogel - 51 %; daily disposable silicone hydrogel - 27 %; daily disposable hydrogel - 12 %; and reusable hydrogel - 10 %. CONCLUSION: There has been a substantial increase in toric soft lens fitting throughout the 24 years of this survey, to a point whereby almost all clinically significant astigmatism is being corrected among those wearing standard soft daily wear single vision lenses.
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PURPOSE: To examine the safety and efficacy of soft multifocal contact lenses on slowing the rate of myopia progression. METHODS: A prospective, randomized, double-masked clinical trial was conducted including 115 children (55 boys and 60 girls) aged 8 to 15 years. Children were assigned to wear one of two daily disposable soft contact lens designs; a multifocal design (Pegavision) or a dual-focus design (MiSight, Coopervision) in both eyes for at least 8 h per day for one year. All contact lenses were replaced on a daily basis. Measurements were obtained using a logMAR vision meter, including objective refraction, handheld retinoscopy, high (96 %) and low (12 %) contrast sensitivity, and distance and near visual acuity. Axial length was measured every 6 months. RESULTS: After one year, the spherical equivalent refractive error and axial length of the experimental group (Pegavision) increased by -0.50 ± 0.48 D and 0.24 ± 0.16 mm, respectively, in the right eye and -0.47 ± 0.37 D and 0.23 ± 0.16 mm, respectively, in the left eye. The spherical equivalent refractive error and axial length of the control group (MiSight) increased by -0.48 ± 0.47 D and 0.22 ± 0.13 mm, respectively, in the right eye and by -0.50 ± 0.44 D and 0.23 ± 0.14 mm, respectively, in the left eye, with no significant differences observed between the two lens types. CONCLUSIONS: The one-year results from this clinical trial show that the multifocal soft contact lenses used in the experimental group have a similar myopia control efficacy with respect to spherical equivalent refraction and axial length elongation as a commercially available dual focus soft contact lens design.
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Purpose: Verofilcon A, a new daily disposable silicone hydrogel soft contact lens (SCL), is expected to be more comfortable to wear due to its smooth surface. This study aims to compare the comfort level of verofilcon A with eyeglasses in first-time SCL wearers. Methods: A total of 58 new SCL wearers participated in this study. Participants' comfort scores while wearing glasses or verofilcon A were examined at baseline (glasses) and one and four weeks after starting to wear the SCLs. Results: At the end of the one-month study period, no participants had abandoned wearing the SCLs due to discomfort. The vision scores (1-10) for glasses (baseline) and SCLs (week one, week four) were better with SCLs than glasses in the morning (7.9 ± 1.9 vs 8.9 ± 1.3, 9.0 ± 1.2, p<0.01), during the day (8.0 ± 1.6 vs 9.0 ± 1.1, 8.9 ± 1.2, p<0.01), at the end of the day (7.2 ± 2.1 vs 8.5 ± 1.5, 8.7 ± 1.4, p<0.01), and the entire day (7.7 ± 1.7 vs 8.9 ± 1.2, 8.7 ± 1.3, p<0.01). The percentages of participants who agreed that wearing SCLs at week four was as good as or better than glasses in terms of overall vision, peripheral vision, vision at the end of the day, comfort during the day, comfort at the end of the day, less fatigue during the day, and less fatigue at the end of the day were 91.4%, 100.0%, 91.4%, 89.7%, 82.8%, 87.9%, and 89.7%, respectively. Of the participants, 93.1%, 100.0%, and 93.1% felt that the SCLs were easy to wear, more comfortable than expected, and would like to purchase the same lenses in the future, respectively. Conclusion: These findings suggest that verofilcon A is more comfortable than glasses and is effective as an introductory lens for first-time SCL wearers.