Contact lenses

隐形眼镜
  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fnins.2024.1349436。].
    [This corrects the article DOI: 10.3389/fnins.2024.1349436.].
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  • 文章类型: Journal Article
    目的:巩膜镜片(SL)可以使用传统的诊断镜片配件或使用基于图像和/或印象的技术进行定制。这项研究描述了SL拟合技术在圆锥角膜患者中的可用性和使用。
    方法:一项在线调查询问了从业人员的实践模式,居住国,以及圆锥角膜完成SL拟合的估计数量。从业者被问及他们是否可以使用基于图像和/或印象的技术,并估计使用诊断拟合完成的拟合百分比,基于图像的技术,和基于印象的技术。在学术和社区实践之间比较了技术的获取和使用,美国和非美国,以及大批量(≥60SLs)和小批量钳工。
    结果:423名适合SL治疗圆锥角膜的从业者参加。与社区实践相比,基于图像和印象的技术在学术实践中更频繁地使用,与小批量从业者相比,大批量(P<0.005)。使用基于图像的技术的从业者将其用于5[25]%的SL配件的中位数[四分位数间距];那些使用基于印象的技术的从业者将其用于8[9]%的配件,和那些与这两种类型的技术使用基于图像的设备12[23]%的配件和基于印象的5[8]%的配件。
    结论:在这项研究中,大多数参与者报告使用诊断性镜片适合圆锥角膜患者的SLs.
    OBJECTIVE: Scleral lenses (SLs) can be customized using traditional diagnostic lens fitting or by using image- and/or impression-based technologies. This study describes the availability and usage of SL fitting technology in patients with keratoconus.
    METHODS: An online survey queried practitioners on the mode of practice, country of residence, and estimated number of SL fits completed for keratoconus. Practitioners were asked whether they had access to image- and/or impression-based technology and to estimate the percentage of fits completed using diagnostic fitting, image-based technology, and impression-based technology. Access and usage of technology was compared between academic and community practices, United States and non-United States, and high-volume (≥60 SLs) and low-volume fitters.
    RESULTS: 423 practitioners who fit SL for keratoconus participated. Image- and impression-based technologies were more frequently available in academic practices compared with community practices and high-volume compared with low-volume practitioners ( P <0.005). Practitioners with image-based technology used it for a median [interquartile range] 5 [25]% of SL fittings; those with impression-based technology used it for 8 [9]% of fittings, and those with both types of technology used image-based devices for 12 [23]% of fittings and impression-based for 5 [8]% of fittings.
    CONCLUSIONS: In this study, most participants report using diagnostic lenses to fit SLs for patients with keratoconus.
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  • 文章类型: Journal Article
    目的:需要屈光视力矫正的休闲跑步者将需要选择视力矫正的类型(眼镜,隐形眼镜,或无校正)运行时磨损。研究了矫正选择的普遍性和与这些矫正选择相关的区别人口统计学特征。
    方法:包含26项的在线问卷,涵盖人口统计学,跑步习惯,941人回答了使用的视觉校正。参与者年龄在18岁或以上,认为自己是一个休闲跑步者,并报告说日常生活需要屈光矫正。使用双变量分析和二元逻辑回归来确定与包括或避免跑步校正类型独立相关的变量。
    结论:参与者平均跑3.8次,3.6小时,每周33.4公里。跑步习惯与视觉矫正类型无关,这表明视觉矫正不会对参与休闲跑步构成障碍。仅使用眼镜跑步是最常见的选择(38.8%),至少有时会佩戴65.8%。戴眼镜跑步的人少于一般目的(98.9%),这表明眼镜有跑步的局限性。跑步时佩戴眼镜与没有隐形眼镜和更长的佩戴视力矫正时间显着相关。不加修正的跑步是一个常见的选择,15.5%的样本只运行,没有校正,26.2%的人至少有时在没有视力矫正的情况下跑步。不戴矫正与不戴隐形眼镜显著相关,佩戴视力矫正的持续时间较短,和较低的近视屈光不正。隐形眼镜是跑步15.6%的唯一矫正方法,有时至少要佩戴40.5%。女性和年轻跑步者更有可能使用隐形眼镜。如果以前没有考虑过这一点,建议将跑步者标记为隐形眼镜。
    OBJECTIVE: Recreational runners who need refractive visual correction will need to choose the type of visual correction (spectacles, contact lenses, or no correction) to wear when running. The prevalence of correction choices and distinguishing demographic features associated with these choices of correction were investigated.
    METHODS: A 26-item online questionnaire covering demographics, running habits, and visual corrections used was answered by 941 people. Participants were aged 18 years or older, considered themselves a recreational runner and reported needing refractive correction for everyday life. Bivariate analyses and binary logistic regression were used to determine the variables independently associated with including or avoiding types of correction for running.
    CONCLUSIONS: Participants ran an average of 3.8times, 3.6hours, and 33.4km per week. Running habits were not associated with type of visual correction, suggesting that visual correction does not present a barrier to participating in recreational running. Solely using spectacles for running was the most common choice (38.8%) and they were worn for running at least sometimes by 65.8%. Fewer people wore spectacles for running than for general purposes (98.9%), suggesting spectacles have limitations for running. Spectacle wear for running was significantly associated with not having contact lenses available and longer duration of wearing visual correction. Running without correction was a common choice, with 15.5% of the sample only running without correction, and 26.2% running at least sometimes without their visual correction. Not wearing correction was significantly associated with not having contact lenses, a shorter duration of wearing visual correction, and a lower myopic refractive error. Contact lenses were the sole correction for running for 15.6% and were worn for running at least sometimes by 40.5%. Contact lenses were significantly more likely to be used by women and younger runners. Signposting runners to contact lenses if this has not previously been considered is recommended.
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  • 文章类型: Case Reports
    报告一例67岁男性,该男性在7年的时间内使用人工眼表生态系统置换(PROSE)治疗成功治疗了眼部移植物抗宿主病(oGVHD)继发的后代囊肿。
    我们先前报道了一名患者使用PROSE设备治疗OGVHD继发的严重干眼,随后发展为中央角膜后胚层囊肿。由于继发于oGVHD的角膜缘干细胞缺乏,该患者被认为是不良的手术候选者。因此,当患者继续PROSE治疗时,我们选择密切监测后代囊肿.在整个7年的随访期间,患者的后代囊肿得到了成功的治疗,没有穿孔,受影响的眼睛的矫正视力保持稳定在20/50。
    脱粒囊肿是眼部移植物抗宿主病的一种罕见并发症。这是用PROSE治疗角膜后代囊肿的最长发表报告。我们的报告表明,在手术后并发症高风险的适当患者中,PROSE与其他医疗管理相结合应被视为角膜移植的替代方法。
    UNASSIGNED: To report a case of a 67-year-old male who was successfully managed over a 7-year period for descemetocele secondary to ocular graft versus host disease (oGVHD) using Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) treatment.
    UNASSIGNED: We previously reported on a patient managed with a PROSE device for severe dry eyes secondary to oGVHD, who subsequently developed a central corneal descemetocele. The patient was deemed a poor surgical candidate due to limbal stem cell deficiency secondary to oGVHD. Therefore, we elected to closely monitor the descemetocele as the patient continued PROSE therapy. The patient\'s descemetocele has been managed successfully without perforation throughout a 7-year follow-up period with corrected distance visual acuity remaining stable at 20/50 in the affected eye.
    UNASSIGNED: Descemetoceles are an uncommon complication of ocular graft versus host disease. This is the longest published report of a corneal descemetocele managed with PROSE. Our report suggests that in appropriate patients who are at high-risk for post-surgical complications, PROSE in conjunction with other medical management should be considered as an alternative to corneal transplantation.
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  • 文章类型: Journal Article
    巩膜镜片(SL)是大直径的刚性隐形眼镜,是角膜不规则眼睛的主要治疗方法。近年来,人们对SL管理干眼症(DED)的作用越来越感兴趣,许多DED患者报告SL磨损症状缓解。个别病例报告和研究支持了SLs在相关角膜不规则性时对DED管理的作用。这促使从业者开始提倡在DED案例中使用SL,即使没有相关的角膜不规则和其他眼表疾病(OSD)。也有关于在DED的治疗层次结构中可能更早地放置SL的讨论,在TFOSDEWSII报告中,它目前处于更高级的干预水平(步骤3)。这篇评论将介绍目前可用的,尽管稀疏,支持并暗示这种做法的证据,以及辅助证据支持SL磨损在DED中的所谓好处。SL磨损的优点,比如角膜愈合,没有泪液蒸发和隐形眼镜脱水,和改善的视敏度与相关的增加佩戴舒适度,将探讨这将如何使DED患者受益。相反,与DED患者拟合SL相关的挑战,包括增加中午起雾,润湿性差,和患者的主观满意度,还将介绍,以及讨论在这个群体中SL拟合的关键考虑因素。总的来说,虽然需要更多的研究来支持在没有相关角膜不规则和其他形式OSD的DED患者中使用SL,考虑到这些镜片在这些人群中的辅助获益,这些镜片的使用可能被证明具有潜在的更广泛的作用.
    Scleral lenses (SLs) are large-diameter rigid contact lenses that are a mainstay treatment for eyes with corneal irregularities. In recent years, there has been increased interest in the role of managing dry eye disease (DED) with SLs, as many patients with DED have reported symptomatic relief with SL wear. The role of SLs for DED management when there are associated corneal irregularities is supported by individual case reports and studies. This has prompted practitioners to begin advocating using SLs in DED cases, even in the absence of associated corneal irregularities and other ocular surface diseases (OSDs). There have also been discussions on potentially placing SLs earlier in the treatment hierarchy of DED, where it currently sits at a more advanced level of intervention (Step 3) in the TFOS DEWS II Report. This review will present the currently available, albeit sparse, evidence that supports and suggests this practice, as well as ancillary evidence supporting the purported benefits of SL wear in DED. The advantages of SL wear, such as corneal healing, absence of tear evaporation and contact lens dehydration, and improved visual acuity with associated increased wear comfort, and how this will benefit DED patients will be explored. Conversely, the challenges associated with fitting SLs in DED patients, including increased midday fogging, poor wettability, and subjective patient satisfaction, will also be presented, as well as a discussion on the key considerations for SL fitting in this population. Overall, while more research is needed to support the use of SLs in DED patients without associated corneal irregularities and other forms of OSD, the use of these lenses may prove to have a potentially wider role given their reported ancillary benefits in these populations.
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  • 文章类型: Journal Article
    背景:先前的研究表明,光线可能与隐形眼镜相互作用,可能会影响其透射率。
    目的:本研究旨在研究可见光和紫外线(UV)-A光源对一些市售日常透光率的影响,每周,和每月隐形眼镜。
    方法:用太阳模拟器照射九种市售软性隐形眼镜,发光二极管(LED)源,激光源,和UV-A源。受测镜片在紫外线照射前后的平均透射率,可见,使用安捷伦紫外可见分光光度计确定红外光的波长范围,模型8453。
    结果:结果显示,Bio真正的日常隐形眼镜在UV-B区域(300nm)和UV-A区域(355nm)处的UV透射部分或完全阻断,以及AcuvueOasys,Avaira,和生物55每周镜片。在可见光区(555nm),不同光源照射隐形眼镜导致透光率降低。在红外区域(900nm),每周和每月的隐形眼镜部分阻挡了红外透射,而日常镜片显示红外透射率增加或减少。
    结论:太阳能和人工照明,以及高功率激光器,构成对隐形眼镜的光透射和光学特性的主要关注。开发具有光防护性能同时保持可见光透射率的软接触透镜是必要的。
    BACKGROUND: Previous studies have suggested that light rays may interact with contact lenses, potentially affecting their transmittance.
    OBJECTIVE: This study aimed to investigate the effects of visible and ultraviolet (UV)-A light sources on the transmittance of some commercially available daily, weekly, and monthly contact lenses.
    METHODS: Nine commercially available soft contact lenses were irradiated with a solar simulator, light-emitting diode (LED) source, laser source, and UV-A source. The average transmittance of the tested lenses before and after irradiation in the UV, visible, and infrared light wavelength ranges was determined using an Agilent UV-visible spectrophotometer, model 8453.
    RESULTS: The results showed a partial or complete block of UV transmission at the UV-B region (300 nm) and the UV-A region (355 nm) by the Bio true daily contact lens, as well as the Acuvue Oasys, Avaira, and Biomedics 55 weekly lenses. At the visible region (555 nm), irradiation of the contact lenses by different light sources resulted in reduced light transmittance. At the infrared region (900 nm), the weekly and monthly contact lenses partially blocked infrared transmission, while the daily lenses showed either increased or decreased infrared transmission.
    CONCLUSIONS: Solar and artificial lighting, as well as high-powered lasers, constitute a major concern on the contact lenses\' light transmission and optical properties. It is essential to develop soft contact lenses that have photoprotective properties while maintaining visible light transmittance.
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  • 文章类型: Journal Article
    连续监测眼内压(IOP)的可穿戴隐形眼镜有助于及时和早期治疗青光眼等眼病,术后近视,等。然而,在没有神经反馈成分的情况下,服用药物进行预处理或延迟治疗过程都无法实现准确的诊断或有效的治疗。在这里,据报道,一种神经假肢接触镜启用的感觉运动系统,由带有Ti3C2Tx惠斯通电桥结构IOP应变传感器的智能隐形眼镜组成,Ti3C2Tx温度传感器和IOP护理点监测/显示系统。由于神经假体隐形眼镜的12.52mVmmHg-1的高灵敏度,可以实现即时眼压监测和警告。兔眼的体内实验表明,神经假体隐形眼镜具有出色的耐磨性和生物相容性。对体外存活率的进一步实验成功地模拟了生物感觉运动环。当IOP偏离正常范围(较高或较低)时,在体感皮层控制的运动皮层的命令下,证明了活体大鼠的腿部抽搐(较大或较小的角度)。
    The wearable contact lens that continuously monitors intraocular pressure (IOP) facilitates prompt and early-state medical treatments of oculopathies such as glaucoma, postoperative myopia, etc. However, either taking drugs for pre-treatment or delaying the treatment process in the absence of a neural feedback component cannot realize accurate diagnosis or effective treatment. Herein, a neuroprosthetic contact lens enabled sensorimotor system is reported, which consists of a smart contact lens with Ti3C2Tx Wheatstone bridge structured IOP strain sensor, a Ti3C2Tx temperature sensor and an IOP point-of-care monitoring/display system. The point-of-care IOP monitoring and warning can be realized due to the high sensitivity of 12.52 mV mmHg-1 of the neuroprosthetic contact lens. In vivo experiments on rabbit eyes demonstrate the excellent wearability and biocompatibility of the neuroprosthetic contact lens. Further experiments on a living rate in vitro successfully mimic the biological sensorimotor loop. The leg twitching (larger or smaller angles) of the living rat was demonstrated under the command of motor cortex controlled by somatosensory cortex when the IOP is away from the normal range (higher or lower).
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  • 文章类型: Journal Article
    背景和目的:干眼症(DED)是一种慢性疾病,其特征是泪膜不稳定和眼表破坏,显著影响患者生活质量。本研究旨在为脱水羊膜(dAM,Omnigen®)通过专用绷带隐形眼镜(sBCL,OmniLenz)用于管理中度至重度DED。材料和方法:这项随机对照试验(NCT04553432)涉及93名中度至重度DED患者,随机接受为期1周的双侧dAM治疗(直径17mm,中央窗口6mm),应用于sBCL或单独的sBCL。参与者在基线时进行评估,并在治疗后1、3和6个月进行随访。结果包括症状学的变化,泪膜和眼表测量,角膜神经参数和角膜树突状细胞(CDC)计数的体内共聚焦显微镜成像。结果:dAM-sBCL组在6个月时OSDI评分降低了65%(p<0.001),88%的参与者在1个月时表现出改善。两组角膜染色均明显降低。dAM-sBCL在1个月时提供了角膜神经参数的显着改善,持续3个月的积极趋势。此外,dAM-sBCL显着减少成熟的CDC计数,表明有抗炎作用.结论:用dAM-sBCL治疗仅1周显著且快速改善干眼症状以及眼表体征至少3个月。它还可以增强角膜神经健康,同时减少激活/成熟的角膜炎症细胞数量,为中度至重度DED提供安全且有希望的新疗法。
    Background and Objectives: Dry Eye Disease (DED) is a chronic condition characterised by tear film instability and ocular surface disruption, significantly impacting patients\' quality of life. This study aimed to provide top-level clinical evidence for the long-term efficacy of dehydrated amniotic membrane (dAM, Omnigen®) delivered via a specialised bandage contact lens (sBCL, OmniLenz) for managing moderate-to-severe DED. Materials and Methods: This randomised controlled trial (NCT04553432) involved 93 participants with moderate-to-severe DED, randomised to receive a 1-week bilateral treatment of either dAM (17 mm diameter with 6 mm central \'window\') applied under a sBCL or sBCL alone. Participants were assessed at baseline and followed up at 1, 3, and 6 months post-treatment. Outcomes included changes in symptomatology, tear film and ocular surface measurements, and in vivo confocal microscopy imaging of corneal nerve parameters and corneal dendritic cell (CDC) counts. Results: The dAM-sBCL group demonstrated a 65% reduction in OSDI scores at 6 months (p < 0.001), with 88% of participants showing improvement at 1 month. Corneal staining was significantly reduced in both groups. dAM-sBCL provided significant improvements in corneal nerve parameters at 1 month, with sustained positive trends at 3 months. Additionally, dAM-sBCL significantly reduced mature CDC counts, suggesting an anti-inflammatory effect. Conclusions: Treatment with dAM-sBCL for just 1 week significantly and rapidly improved dry eye symptoms as well as ocular surface signs for at least 3 months. It also enhanced corneal nerve health while reducing activated/mature corneal inflammatory cell numbers, presenting a safe and promising new treatment for moderate-to-severe DED.
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  • 文章类型: Journal Article
    如今,识别眼部疾病的新生物标志物对于早期诊断和治疗至关重要。表观遗传学是一个迅速发展的新兴研究领域,其参与眼部疾病的病理生理学和调节机制对于诊断目的具有无可争议的重要性。环境变化可能会影响眼表,而对诱导的表观遗传变化的认识可能有助于阐明眼表疾病的机制。在这项试点研究中,我们研究了戴广泛接触镜(CL)对人角膜上皮表观遗传学的影响。我们对参与细胞凋亡和慢性炎症过程的miR-320和miR-423-5p的表达进行了离体分析。在光折变角膜切除术(PRK)之前,从健康患者中采集人角膜上皮。根据CL佩戴史,将患者分为年龄和性别匹配的两个组,没有CL佩戴者作为对照。将上皮冷冻储存在干冰中,在-80℃下进行miRNA提取;之后,使用实时PCR检测miRNA水平。两种miRNA在CL佩戴者中高表达(p<0.001),提示慢性眼表应激中发生的表观遗传修饰。这些初步结果显示了所选miRNA表达与广泛使用CL相关的慢性眼表应激之间的关系。MicroRNAs可能被认为是诊断眼表疾病和环境因素对眼表表观遗传学影响的生物标志物。此外,它们可能被认为是眼表疾病的新治疗靶点。
    The identification of new biomarkers of ocular diseases is nowadays of outmost importance both for early diagnosis and treatment. Epigenetics is a rapidly growing emerging area of research and its involvement in the pathophysiology of ocular disease and regulatory mechanisms is of undisputable importance for diagnostic purposes. Environmental changes may impact the ocular surface, and the knowledge of induced epigenetic changes might help to elucidate the mechanisms of ocular surface disorders. In this pilot study, we investigated the impact of extensive contact lens (CL) wearing on human corneal epithelium epigenetics. We performed ex vivo analysis of the expression of the miR-320 and miR-423-5p involved in the processes of cellular apoptosis and chronic inflammation. The human corneal epithelium was harvested from healthy patients before the photorefractive keratectomy (PRK). The patients were divided into two age- and sex-matched groups accordingly to CL wearing history with no CL wearers used as a control. The epithelium was stored frozen in dry ice at -80 °C and forwarded for miRNA extraction; afterwards, miRNA levels were detected using real-time PCR. Both miRNAs were highly expressed in CL wearers (p < 0.001), suggesting epigenetic modifications occurring in chronic ocular surface stress. These preliminary results show the relationships between selected miRNA expression and the chronic ocular surface stress associated with extensive CL use. MicroRNAs might be considered as biomarkers for the diagnosis of ocular surface conditions and the impact of environmental factors on ocular surface epigenetic. Furthermore, they might be considered as new therapeutic targets in ocular surface diseases.
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  • 文章类型: Journal Article
    背景:这项荟萃分析回顾了与儿童和成人近视控制的其他方法相比,与角膜塑形术(OK)治疗相关的风险和收益的证据。
    方法:对Cochrane中央对照试验登记册的系统搜索,Pubmed,Embase和Ovid从数据库成立到2021年8月22日进行。报告风险的研究,纳入了5岁以上近视(-0.75~-6.00D)患者OK的视觉和眼部生物统计学效应。主要结果是轴向长度的变化和任何不良事件。
    结果:本系统综述和荟萃分析包括45篇论文。数据的质量是可变的,具有中等的确定性,选择偏差可能会使结果偏向于对OK的相对好处。一年时,与其他治疗方式相比,OK治疗儿童的轴向伸长率较低(MD-0.16mm,95%CI-0.25至-0.07)。与继续治疗的参与者相比,中止OK后儿童的轴向长度变化率反弹(MD0.10mm,95%CI0.06至0.14)。与常规隐形眼镜相比,佩戴OK的成人和儿童发生不良事件的可能性高出3.79倍(OR3.79,95%CI1.24至11。),尽管这个证据基础不发达,需要额外的精心设计的研究才能得出实质性的结论。
    结论:可以在使用过程中阻止近视进展,然而,关于最佳治疗持续时间的问题仍然没有答案,停药效果和不良事件的长期风险。
    BACKGROUND: This meta-analysis reviews the evidence for the risks and benefits associated with orthokeratology (OK) treatment compared with other methods of myopia control in children and adults.
    METHODS: A systematic search of Cochrane Central Register of Controlled Trials, Pubmed, Embase and Ovid was conducted from database inception to 22nd August 2021. Studies that reported on risks, visual and ocular biometric effects of OK in patients > 5 years of age with myopia (- 0.75 to - 6.00D) were included. Main outcomes are change in axial length and any adverse event.
    RESULTS: Fourty-five papers were included in this systematic review and meta-analysis. The quality of data was variable and of moderate certainty, and selection bias likely skewed the results towards a relative benefit for OK. The rate of axial elongation in children was lower for OK treatment compared to other treatment modalities at one year (MD - 0.16 mm, 95% CI - 0.25 to - 0.07). Rate of change in axial length in children rebounded after OK discontinuation compared to participants who continued treatment (MD 0.10 mm, 95% CI 0.06 to 0.14). Adults and children wearing OK were up to 3.79 times more likely to experience an adverse event when compared with conventional contact lenses (OR 3.79, 95% CI 1.24 to ll.), though this evidence base is underdeveloped and requires additional well-designed studies for substantial conclusions to be drawn.
    CONCLUSIONS: OK arrests myopia progression while in use, however, there remain unanswered questions about the optimal duration of treatment, discontinuation effects and long-term risk for adverse events.
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