Visual performance of optical films utilizing Spatio-Temporal Optical Phase technology

SIGNIFICANCE

Spatio-Temporal Optical Phase technology utilizes film pairs containing optical elements applied to standard single-vision spectacle lenses. This technology provides a dynamic optical cue that may have efficacy in reducing the rate of myopia progression, but the visual performance of this technology is unknown.

PURPOSE

This study aimed to assess the visual performance of film pairs containing optical elements (tests) and a film pair with no optical elements (control).

METHODS

In this randomized, single-masked, bilateral wear study, 42 participants aged 18 to 40 years wore four test designs (E, F-1, G, and F-2) and the control. Subjective data (subjective ratings [1 to 10 scale]: clarity of vision [far-away, intermediate, near] and vision [at night, while walking, overall satisfaction], and willingness to purchase [yes/no response]) were collected after 3 days. Visual acuity (VA)-based measures (monocular high/low-contrast VA [6 m], contrast sensitivity [6 m], and binocular high-contrast VA [6 m and 40 cm]) were collected at dispensing. Visual acuity-based measures were also collected while wearing spectacles with no film. Analyses were performed using linear mixed models and the χ2 test. Significance was set at 5%.

RESULTS

The control performed better than any test for all subjective ratings (mean differences, 1.6 to 3.1 units: p<0.001), willingness to purchase (p<0.001), and designs F-1 and F-2 for binocular high-contrast VA at 40 cm (p=0.001 and p=0.01, respectively). Clarity of vision was significantly worse with F-2 compared with F-1 and G (p<0.001 and p=0.02, respectively). There were no differences between tests for any other subjective rating (p>0.1), willingness to purchase (p=0.11), or any VA-based measure (p>0.08). There were no differences between control and spectacles with no film for any VA-based measure (p>0.08).

CONCLUSIONS

All four test film pairs reduced visual performance compared with control to a degree comparable with other myopia management devices. There was no difference in visual performance between three of the four test film pairs.

Chromatic dispersion of soft contact lens materials

PURPOSE

To investigate and evaluate the chromatic dispersion of various hydrogel and silicon hydrogel contact lens materials.

METHODS

Eighteen different soft contact lens materials with high and low water content in lens power of -1.00 DS were measured by one operator at temperature of 20 °C ± 0.5° soaked in ISO standard phosphate-buffered saline (PBS) and in their respective packaging solutions (PS). An analogue Abbe refractometer (Model Zuzi 320, AUXILAB, S.L., Navarra, Spain) was used for refractive index (RI) measurements at 5 different wavelengths. All contact lenses were presented in a random and masked order to the operator. The Bland-Altman method with 95 % limits of agreement (LoA) and coefficient of repeatability (CoR) was used to characterise the repeatability of refractive index measurements. The Abbe numbers for each material were calculated by entering the measured and interpolated refractive indices into the Abbe number equation. One-way ANOVA analysis was used to test if there were significant differences between the 5 different wavelengths (470 nm-680 nm) within each material. An unpaired t-test was used to determine if there were differences in refractive index or dispersion between packaging solution and PBS results.

RESULTS

Nelfilcon A (Dailies Aqua Comfort Plus) soaked in PS showed the best repeatability of all 18 examined soft contact lenses across all wavelengths with an average refractive index of 1.3848 for all 6 contact lenses with a standard deviation of 0.00064. The 95 % limits of agreement were between 1.3835 and 1.3860. The mean coefficient of repeatability for nelfilcon A was 0.00125. For contact lenses soaked in ISO Standard PBS comfilcon A (Biofinity) had the best repeatability. The average refractive index of all 6 contact lenses was 1.4041 with a standard deviation of 0.00031 and a coefficient of repeatability of 0.00060. The 95 % limits of agreement were between 1.4035 and 1.4047. The analysis with One-way ANOVA with multiple comparisons involving Holm-Sidak post-hoc, showed that there are significant differences (p < 0.001, Fratio = 376.2 between wavelengths and Fratio = 1559 between different refractive indices) in the refractive index of most common lens materials across the visible wavelength range. Based on unpaired t-test, there is no significant difference (p > 0.05) in the Abbe numbers of the tested lens materials whether they have been placed in the packaging solution or in standard PBS (p > 0.05, 95 % CI = -4.8070 to 5.8680, t = 0.2054). The Abbe numbers for the calculated contact lenses soaked in PS ranged between 43.7 and 89.9. For contact lenses stored in PBS the range was between 46.3 and 81.6.

CONCLUSION

There is a good repeatability between repeated RI measurements taken from the same lens and from the same material. The significant differences between the refractive indices across the 5 different wavelengths showed the presence of chromatic dispersion in the 18 evaluated soft contact lens materials. Furthermore, it could be shown that there is no significant difference in dispersion whether the contact lenses are soaked in standard PBS or in their respective packaging solutions. With no other published data available as a reference, absolute accuracy of the calculated Abbe numbers remains to be confirmed, however, this study did confirm that significant chromatic dispersion exists in soft contact lens materials.

Visual Performance and Binocular/Accommodative Function of S.T.O.P. Contact Lenses Compared With MiSight

OBJECTIVES

The objective of this study was to compare the visual performance and binocular/accommodative function of two novel S.T.O.P. design (F2 and DT) contact lenses against MiSight when worn by myopic, young adults.

METHOD

This was a prospective, randomized, cross-over, single-masked study. Each lens was worn daily wear with overnight peroxide disinfection for approximately 7 days. Visual performance was assessed with subjective ratings (0-100): clarity of vision and lack of ghosting (far away, intermediate, and near), vision when driving, overall vision satisfaction, and with monocular high-contrast and low-contrast visual acuity (HCVA/LCVA) at 6 m, binocular HCVA (6 m, 70 cm, 50 cm, and 40 cm), binocular LCVA (6 m and 70 cm). Binocular function was assessed with heterophorias (3 m and 40 cm). Accommodative function was assessed with monocular accommodative facility (AF: 40 cm) and dynamic monocular accommodative response (AR: 6 m, 70 cm, and 40 cm).

RESULTS

F2 was rated higher than MiSight for clarity of vision (near and intermediate) and lack-of-ghosting ( P <0.001), while MiSight was rated higher than DT for clarity of vision (near, P <0.001). MiSight was better than F2 and DT for monocular HCVA (6 m) and binocular HCVA (6 m and 40 cm, P ≤0.02), but the maximum difference was ≤2 letters. There were no differences between designs for heterophoria ( P =0.61) nor were there any differences between DT and MiSight for any accommodative measure ( P >0.1). F2 was higher for monocular-AF ( P =0.007) and lower for AR (70 cm and 40 cm; P ≤0.007) compared with MiSight.

CONCLUSIONS

The visual performance and binocular/accommodative function of S.T.O.P. designs F2 and DT were comparable with MiSight. F2 outperformed MiSight in some aspects of subjective visual performance and monocular accommodative function.

Peripheral refraction and spherical aberration profiles with single vision, bifocal and multifocal soft contact lenses

PURPOSE

To compare the peripheral refraction and spherical aberration profiles along three visual field meridians of 16 commercial single vision (SV), bifocal (BF) and multifocal (MF) test contact lenses with a single vision control.

METHOD

Forty-four participants [24.2±2.4 years, SE: -0.50 to -4.50D] were randomly fitted, contra-laterally, with 6 SV's [Air Optix Aqua (control), Acuvue Oasys, Biofinity, Clariti, Night & Day and Proclear], 3 BF's [Acuvue Bifocal low and high add, MiSight] and 8 MF's [Proclear D & N in 1.5 and 2.5D adds; AirOptix, PureVision low & high adds]. Peripheral refraction was performed across horizontal, oblique and vertical meridians, with lenses on eye using the BHVI-EyeMapper. The power vectors M, J₀, J₄₅ and the spherical aberration coefficient were analysed. The peripheral refraction and aberration profiles of the test lenses were compared with the profiles of the control lens using curvature and slope coefficients.

RESULTS

Compared to the control, a relative peripheral hyperopic shift (M), a less negative J₀ curvature coefficient along the horizontal meridian, a less positive J₀ curvature coefficient along the vertical meridian, a less negative J₄₅ curvature coefficient along the oblique meridian and a more positive spherical aberration curvature coefficient along most meridians was seen with the Acuvue Bifocal and all center-near multifocal lenses. For the center-distance multifocal lenses the direction of the curvature coefficients of the same refraction and aberration components was opposite to that of the center-near lenses. The greatest differences in the slope coefficients when compared to the control were found for the Acuvue Bifocal lenses and all multifocal contact lenses for the refractive component M and the spherical aberration coefficient along the horizontal visual field meridian, with the Acuvue Bifocal and the center-near multifocal lenses having more positive coefficients and the center-distance lenses having more negative coefficients.

CONCLUSION

When worn on eye, different commercially available lens types produce differences in the direction and magnitude of the peripheral refraction and spherical aberration profiles along different visual field meridians. This information may be relevant to refractive development and myopia control.

Myopia control with novel central and peripheral plus contact lenses and extended depth of focus contact lenses: 2 year results from a randomised clinical trial

PURPOSE

We aimed to determine myopia control efficacy with novel contact lenses (CL) that (1) reduced both central and peripheral defocus, and (2) provided extended depth of focus with better global retinal image quality for points on, and anterior to, the retina and degraded for points posterior to the retina.

METHODS

Children (n = 508, 8-13 years) with cycloplegic spherical equivalent (SE) -0.75 to -3.50D were enrolled in a prospective, double blind trial and randomised to one of five groups: (1) single vision, silicone hydrogel (SH) CL; (2) two groups wearing SH CL that imposed myopic defocus across peripheral and central retina (test CL I and II; +1.00D centrally and +2.50 and +1.50 for CL I and II at 3 mm semi-chord respectively); and (3) two groups wearing extended depth of focus (EDOF) hydrogel CL incorporating higher order aberrations to modulate retinal image quality (test CL III and IV; extended depth of focus of up to +1.75D and +2.50D respectively). Cycloplegic autorefraction and axial length (AL) measurements were conducted at six monthly intervals. Compliance to lens wear was assessed with a diary and collected at each visit. Additionally, subjective responses to various aspects of lens wear were assessed. The trial commenced in February 2014 and was terminated in January 2017 due to site closure. Myopia progression over time between groups was compared using linear mixed models and where needed post hoc analysis with Bonferroni corrections conducted.

RESULTS

Myopia progressed with control CL -1.12 ± 0.51D/0.58 ± 0.27 mm for SE/AL at 24 months. In comparison, all test CL had reduced progression with SE/AL ranging from -0.78D to -0.87D/0.41-0.46 mm at 24 months (AL: p < 0.05 for all test CL; SE p < 0.05 for test CL III and IV) and represented a reduction in axial length elongation of about 22% to 32% and reduction in spherical equivalent of 24% to 32%. With test CL, a greater slowing ranging from 26% to 43% was observed in compliant wearers (≥6 days per week; Control CL: -0.64D/0.30 mm and -1.14D/0.58 mm vs test CL: -0.42D to -0.47D/0.12-0.18 mm and -0.70 to -0.81D/0.19-0.25 mm at 12 and 24 months respectively).

CONCLUSIONS

Contact lenses that either imposed myopic defocus at the retina or modulated retinal image quality resulted in a slower progression of myopia with greater efficacy seen in compliant wearers. Importantly, there was no difference in the myopia control provided by either of these strategies.

Extended depth of focus contact lenses vs. two commercial multifocals: Part 1. Optical performance evaluation via computed through-focus retinal image quality metrics

PURPOSE

To compare the computed optical performance of prototype lenses designed using deliberate manipulation of higher-order spherical aberrations to extend depth-of-focus (EDOF) with two commercial multifocals.

METHODS

Emmetropic, presbyopic, schematic eyes were coupled with prototype EDOF and commercial multifocal lenses (Acuvue Oasys for presbyopia, AOP, Johnson & Johnson & Air Optix Aqua multifocal, AOMF, Alcon). For each test configuration, the through-focus retinal image quality (TFRIQ) values were computed over 21 vergences, ranging from -0.50 to 2.00D, in 0.125D steps. Analysis was performed considering eyes with three different inherent aberration profiles: five different pupils and five different lens decentration levels.

RESULTS

Except the LOW design, the AOP lenses offered 'bifocal' like TFRIQ performance. Lens performance was relatively independent to pupil and aberrations but not centration. Contrastingly, AOMF demonstrated distance centric performance, most dominant in LOW followed by MED and HIGH designs. AOMF lenses were the most sensitive to pupil, aberrations and centration. The prototypes demonstrated a 'lift-off' in the TFRIQ performance, particularly at intermediate and near, without trading performance at distance. When compared with AOP and AOMF, EDOF lenses demonstrated reduced sensitivity to pupil, aberrations and centration.

CONCLUSION

With the through focus retinal image quality as the gauge of optical performance, we demonstrated that the prototype EDOF designs were less susceptible to variations in pupil, inherent ocular aberrations and decentration, compared to the commercial designs. To ascertain whether these incremental improvements translate to a clinically palpable outcome requires investigation through human trials.

Stabilisation effects of phosphane ligands in the homogeneous approach of sunlight induced hydrogen production

Most of the systems for photochemical hydrogen production are not stable and suffer from decomposition. With bis(bidentate) tetraphosphane ligands the stability increases enormously, up to more than 1000 h. This stability was achieved with a system containing osmium(ii) as a light harvesting antenna and palladium(ii) as a water reduction catalyst connected with a bis(bidentate) phosphane ligand in one molecule with the chemical formula [Os(bpy)₂(dppcb)Pd(dppm)](PF₆)₄. With the help of electrochemical measurements as well as photophysical data and its single crystal X-ray structure, the electron transfer between the two active metal centres (light harvesting antenna, water reduction catalyst) was analysed. The distance between the two active metal centres was determined to be 7.396(1) Å. In a noble metal free combination of a copper based photosensitiser and a cobalt diimine-dioxime complex as water reduction catalyst a further stabilisation effect by the phosphane ligands is observed. With the help of triethylamine as a sacrificial donor in the presence of different monophosphane ligands it was possible to produce hydrogen with a turnover number of 1176. This completely novel combination is also able to produce hydrogen in a wide pH-range from pH = 7.0 to 12.5 with the maximum production at pH = 11.0. The influence of monophosphane ligands with different Tolman cone angles was investigated. Monophosphane ligands with a large Tolman cone angle (>160°) could not stabilise the intermediate of the cobalt based water reduction catalyst and so the turnover number is lower than for systems with an addition of monophosphane ligands with a Tolman cone angle smaller than 160°. The role of the monophosphane ligand during sunlight-induced hydrogen production was analysed and these results were confirmed with DFT calculations. Furthermore the crystal structures of two important Co(i) intermediates, which are the catalytic active species during the catalytic pathway, were obtained. The exchange of PPh₃ with other tertiary phosphane ligands can have a major impact on the activity, depending on the coordination properties. By an exchange of monophosphane ligands with functionalised phosphane ligands (hybrid ligands) the hydrogen production was raised 2.17 times.

Short-term visual performance of soft multifocal contact lenses for presbyopia

PURPOSE

To compare visual acuity (VA), contrast sensitivity, stereopsis, and subjective visual performance of Acuvue® Oasys® for Presbyopia (AOP), Air Optix® Aqua Multifocal (AOMF), and Air Optix® Aqua Single Vision (AOSV) lenses in patients with presbyopia.

METHODS

A single-blinded crossover trial was conducted. Twenty patients with mild presbyopia (add ≤+1.25 D) and 22 with moderate/severe presbyopia (add ≥+1.50 D) who wore lenses bilaterally for 1 h, with a minimum overnight washout period between the use of each lens. Measurements included high- and low-contrast visual acuity (HCVA and LCVA, respectively) at a distance, contrast sensitivity (CS) at a distance, HCVA at intermediate (70 cm) and near (50 cm & 40 cm) distances, stereopsis, and subjective questionnaires regarding vision clarity, ghosting, overall vision satisfaction, and comfort. The test variables were compared among the lens types using repeated-measures ANOVA.

RESULTS

Distance variables (HCVA, LCVA, and CS) were significantly worse with multifocal lens than with AOSV lens (p≤0.008), except for AOMF lens in the mild presbyopia group in which no significant difference was observed (p>0.05). Multifocal lenses had significantly greater HCVA at 40 cm than AOSV lens (p≤0.026). AOMF lens had greater intermediate HCVA than AOP lens (p<0.03). AOP lens demonstrated greater improvements in stereopsis than AOMF and AOSV lens in the moderate/severe presbyopia group (p≤0.03). Few significant differences in subjective variables were observed, with no significant difference in the overall vision satisfaction observed between lens types (p>0.05). The proportions of patients willing to buy AOSV, AOMF, and AOP lenses were 20%, 40%, and 50%, respectively, in the mild presbyopia group and 14%, 32%, and 23%, respectively, in the moderate/severe presbyopia group; however, these differences were not statistically significant (p≥0.159).

CONCLUSIONS

Further development of multifocal lenses is required before significant advantages of multifocal lenses over single vision lens are observed in patients with presbyopia.

Short-term comparison between extended depth-of-focus prototype contact lenses and a commercially-available center-near multifocal

PURPOSE

To compare the visual performance of prototype contact lenses which extend depth-of-focus (EDOF) by deliberate manipulation of multiple higher-order spherical aberration terms and a commercially-available center-near lens (AIR OPTIX Aqua Multifocal, AOMF).

METHODS

This was a prospective, cross-over, randomized, single-masked (participant), short-term clinical trial where 52 participants (age 45-70 years) were stratified as low, medium or high presbyopes and wore EDOF and AOMF on different days. Objective measures comprised high and low contrast visual acuity (HCVA/LCVA, logMAR), and contrast sensitivity (log units) at 6m; HCVA at 70cm, 50cm and 40cm and stereopsis (seconds of arc) at 40cm. HCVA at 70cm, 50cm and 40cm were measured as "comfortable acuity" rather than conventional resolution acuity. Subjective measures comprised clarity-of-vision and ghosting at distance, intermediate and near, overall vision satisfaction and ocular comfort (1-10 numeric rating scale) and lens purchase (yes/no response). Statistical analysis included repeated measures ANOVA, paired t-tests and McNemar's test.

RESULTS

Significant differences between lens types were independent of strata (p≥0.119). EDOF was significantly better than AOMF for HCVA at 40cm (0.42±0.18 vs. 0.48±0.22, p=0.024), stereopsis (98±88 vs. 141±114, p<0.001), clarity-of-vision at intermediate (8.5±1.6 vs. 7.7±1.9, p=0.006) and near (7.3±2.5 vs. 6.2±2.5, p=0.005), lack-of-ghosting (p=0.012), overall vision satisfaction (7.5±1.7 vs. 6.4±2.2, p<0.001) and ocular comfort (9.0±1.0 vs. 8.3±1.7, p=0.002). Significantly more participants chose to only-purchase EDOF (33% vs. 6%, p=0.003).). There were no significant differences between lens types for any objective measure at 6m or clarity-of-vision at distance (p≥0.356).

CONCLUSIONS

EDOF provides better intermediate and near vision performance in presbyopes than AOMF with no difference for distance vision during short-term wear.

Association between multifocal soft contact lens decentration and visual performance

PURPOSE

The aim of this study was to assess the association between decentration of several commercial multifocal soft contact lenses (MFCLs) and various objective and subjective visual performance variables in presbyopic and non-presbyopic participants.

MATERIALS AND METHODS

All presbyopic (age >40 years, near add ≥+1.25 D) and non-presbyopic (age ≥18 years, no near add requirements, spherical equivalent ≤-0.50 D) participants were each fitted bilaterally with six and two MFCLs (test lens), respectively, and with one single vision lens (control lens). Lens decentration, ie, the x- and y-differences between the contact lens and pupil centers, was objectively determined. Third-order aberrations were measured and compared. Visual performance (high- and low-contrast acuities and several subjective variables) was analyzed for any associations (Pearson's correlation, r) with MFCL decentration.

RESULTS

A total of 17 presbyopic (55.1±6.9 years) and eight non-presbyopic (31.0±3.3 years) participants completed the study. All lenses displayed a temporal-inferior decentration (x=-0.36±0.29 mm, y=-0.28±0.28 mm, mean ± SD). Compared to the control, a significant inferior decentration was found for the Proclear® MFCL Near lens in both groups (ypresbyopic =-0.26 mm, ynon-presbyopic =-0.70 mm) and for the Proclear® MFCL Distance lens in the non-presbyopic group (ynon-presbyopic =-0.69 mm). In both groups, lens-induced vertical coma (C(3, -1)) was, by at least tenfold, significantly more positive for the Proclear® MFCL Distance lens and significantly more negative for the Proclear® MFCL Near lens. In the presbyopic group, the correlation of total MFCL decentration with vision variables was weak (r<|0.191|). Conversely, a moderate but significant correlation with total MFCL decentration was found in the non-presbyopic group for most of the vision variables, indicating a decrease in vision as decentration increased.

CONCLUSION

Certain MFCLs decentered more than others; the same lens designs also induced significant amounts of third-order aberrations. An association between MFCL decentration and seven out of nine vision variables was found in the non-presbyopic group, ie, the group where lenses were most decentered, which had larger pupils and lower levels of inherent third-order aberrations.

Corneal Mechanical Thresholds Negatively Associate With Dry Eye and Ocular Pain Symptoms

PURPOSE

To examine associations between corneal mechanical thresholds and metrics of dry eye.

METHODS

This was a cross-sectional study of individuals seen in the Miami Veterans Affairs eye clinic. The evaluation consisted of questionnaires regarding dry eye symptoms and ocular pain, corneal mechanical detection and pain thresholds, and a comprehensive ocular surface examination. The main outcome measures were correlations between corneal thresholds and signs and symptoms of dry eye and ocular pain.

RESULTS

A total of 129 subjects participated in the study (mean age 64 ± 10 years). Mechanical detection and pain thresholds on the cornea correlated with age (Spearman's ρ = 0.26, 0.23, respectively; both P < 0.05), implying decreased corneal sensitivity with age. Dry eye symptom severity scores and Neuropathic Pain Symptom Inventory (modified for the eye) scores negatively correlated with corneal detection and pain thresholds (range, r = -0.13 to -0.27, P < 0.05 for values between -0.18 and -0.27), suggesting increased corneal sensitivity in those with more severe ocular complaints. Ocular signs, on the other hand, correlated poorly and nonsignificantly with mechanical detection and pain thresholds on the cornea. A multivariable linear regression model found that both posttraumatic stress disorder (PTSD) score (β = 0.21, SE = 0.03) and corneal pain threshold (β = -0.03, SE = 0.01) were significantly associated with self-reported evoked eye pain (pain to wind, light, temperature) and explained approximately 32% of measurement variability (R = 0.57).

CONCLUSIONS

Mechanical detection and pain thresholds measured on the cornea are correlated with dry eye symptoms and ocular pain. This suggests hypersensitivity within the corneal somatosensory pathways in patients with greater dry eye and ocular pain complaints.

Visual performance with multifocal soft contact lenses in non-presbyopic myopic eyes during an adaptation period

PURPOSE

Multifocal soft contact lenses (MFCLs) have been proposed and used for controlling the rate of myopia progression; however, little is known on the performance and adaptation with MFCLs in non-presbyopes. This study aims to evaluate the visual performance of four commercially available MFCLs in non-presbyopic myopic eyes during an adaptation period.

METHODS

Fifty-two experienced myopic contact lens wearers (67% female; mean age 21.4±2.0 years) were enrolled in this trial and 40 completed the trial. Twenty-six participants (Group 1) wore Lotrafilcon B single vision (SV, control), Omafilcon A MFCL center-distance (D) and center-near (N) and the other 26 participants (Group 2) wore Lotrafilcon B SV, Lotrafilcon B MFCL N, and Balafilcon A MFCL N. Lens order was randomized. Participants wore each allocated lens for a minimum of 8 days over four scheduled visits (dispensing and three follow-up visits) with a 1-week washout period between the lens types. At each visit, high-contrast visual acuity (HCVA) (in logarithm of the minimum angle of resolution [logMAR]) and seven subjective performance variables (via questionnaire) were obtained. Power profiles of each lens type, pupil size, and contact lens centration, with lens placed on the eye, were measured.

RESULTS

The SV control outperformed the MFCLs in all variables (P<0.05). There were no significant differences in HCVA over time, with the exception of monocular HCVA with Omafilcon A MFCL N, which at the end of the adaptation period had significantly (P<0.05) improved by 0.10 logMAR. No differences were found between visits for any subjective variables. Subjectively, Lotrafilcon B MFCL N performed best and was the only lens that did not decenter significantly compared to the SV control. Conversely, Omafilcon A MFCL N was the worst performing and most decentered lens (P<0.05, y=-0.39 mm), with the greatest plus area under the power profile.

CONCLUSION

MFCLs with greatest power variation across the optic zone, a greater plus area under the distance labeled power profile, and/or lenses that were significantly decentered resulted in the lowest subjective ratings. Over time, quality of vision with MFCLs did not change in non-presbyopic myopic participants, with the exception of Omafilcon A MFCL N, which showed some adaptation effects.

Reliability of power profiles measured on NIMO TR1504 (Lambda-X) and effects of lens decentration for single vision, bifocal and multifocal contact lenses

PURPOSE

To evaluate the repeatability of power profiles measured on NIMO TR1504 (Lambda-X, Belgium) and investigate the effects of lens decentration on the power profiles for single vision (SV), bifocal (BF) and multifocal (MF) contact lenses.

METHODS

Accuracy of the sphere power was evaluated using single vision BK-7 calibration glass lenses of six minus and six plus powers. Three SV and four BF/MF contact lenses - three lenses each, were measured five times to calculate the coefficients of repeatability (COR) of the instrument. The COR was computed for each chord position, lens design, prescription power and operator. One lens from each type was measured with a deliberate decentration up to ±0.5mm in 0.1mm steps.

RESULTS

For all lenses, the COR varied across different regions of the half-chord position. In general, SV lenses showed lower COR compared to the BF/MF group lenses. There were no noticeable trends of COR between prescription powers for SV and BF/MF lenses. The shape of the power profiles was not affected when lenses were deliberately decentered for all SV and PureVision MF lenses. However, for Acuvue BF lenses, the peak to trough amplitude of the power profiles flattened up to 1.00D.

CONCLUSION

The COR across the half-chord of the optic zone diameter was mostly within clinical relevance except for the central 0.5mm half-chord position. COR were dependent on the lens type, whereby BF/MF group produced higher COR than SV lenses. The effects of deliberate decentration on the shape of power profiles were pronounced for lenses where the profiles had sharp transitions of power.

Peripheral refraction and higher-order aberrations with cycloplegia and fogging lenses using the BHVI-EyeMapper

PURPOSE

To determine if a fogging lens ameliorates accommodative effects driven by the closed-view design of the BHVI-EyeMapper (EM) instrument. We compared cycloplegic refraction and higher-order aberration measurements of the EM with those obtained with a fogging lens.

METHODS

Twenty-six, young, participants (15F, 25±5 years, range: 18-35 years, SE: +0.25 D and -3.50 D) with good ocular health were recruited. Five independent measurements of on- and off-axis refraction and higher-order aberrations were recorded across the horizontal visual field, under two conditions: non-cycloplegic measurements with +1.00 D fogging lens and cycloplegia, always in the same sequence. The contralateral eye was occluded during the measurements. Two drops of 1% Tropicamide delivered within 5 min facilitated cycloplegic measurements. All participants were refracted 30 min after installation of the second drop.

RESULTS

Mean spherical equivalent measures of the non-cycloplegic condition were significantly more myopic than their cycloplegic counterparts (p<0.05); approximately by 0.50 D centrally, increasing to 1.00 D towards the periphery. The horizontal astigmatic component, J180, demonstrated small but statistically significant differences between the test conditions. Differences were predominant for eccentricities greater than 30°, in both nasal and temporal meridians. The oblique astigmatic component, J45, was not significantly different between the test conditions. The primary spherical aberration coefficient C(4, 0) was significantly less positive for the non-cycloplegic state than its cycloplegic counterpart. This result held true across the entire horizontal visual field. The horizontal coma and trefoil coefficients C(3, 1) and C(3, 3) were not significantly different between the two conditions.

CONCLUSIONS

The use of +1.00 D fogging lens without cycloplegia did not provide complete relaxation of accommodation. The discrepancies between cycloplegic and non-cycloplegic EM measurements were found to be more pronounced for peripheral field angles than central measures, for both M and J180 components.

Comparing the relative peripheral refraction effect of single vision and multifocal contact lenses measured using an autorefractor and an aberrometer: A pilot study

PURPOSE

To compare the contributions of single vision (SVCL) and multifocal contact lenses (MFCL) to the relative peripheral refraction (RPR) profiles obtained via an autorefractor and an aberrometer in a pilot study.

METHODS

Two instruments, Shin-Nippon NVision K5001 (SN) and COAS-HD, were modified to permit open field PR measurements. Two myopic adults (CF, RB) were refracted (cycloplegia) under eight conditions: baseline (no CL); three SVCLs: Focus Dailies(®) (Alcon, USA), PureVision(®) (Bausch & Lomb, USA) and AirOptix(®) (Alcon, USA); and four MFCLs: AirOptix(®) (Alcon, USA), Proclear(®) Distant and Near (Cooper Vision, USA), and PureVision(®) (Bausch & Lomb, USA). CLs had a distance prescription of -2.00D and for MFCLs, a +2.50D Add was selected. Five independent measurements were performed at field angles from -40° to +40° in 10° increments with both instruments. The COAS-HD measures were analyzed at 3mm pupil diameter. Results are reported as a change in the relative PR profile, as refractive power vector components: M, J180, and J45.

RESULTS

Overall, at baseline, M, J180 and J45 measures obtained with SN and COAS-HD were considerably different only for field angles ≥±30°, which agreed well with previous studies. With respect to M, this observation held true for most SVCLs with a few exceptions. The J180 measures obtained with COAS-HD were considerably greater in magnitude than those acquired with SN. For SVCLs, the greatest difference was found at -40° for AirOptix SV (ΔCF=3.20D, ΔRB=1.56D) and for MFCLs it was for Proclear Distance at -40° (ΔCF=2.58D, ΔRB=1.39D). The J45 measures obtained with SN were noticeably different to the respective measures with COAS-HD, both in magnitude and sign. The greatest difference was found with AirOptix Multifocal in subject RB at -40°, where the COAS-HD measurement was 1.50D more positive. In some cases, the difference in the RPR profiles observed between subjects appeared to be associated with CL decentration.

CONCLUSION

For most test conditions, distinct differences were observed between the RPR measures obtained with the two modified instruments. The differences varied with CL design and centration. Although the pilot study supports the interchangeable use of the two instruments for on- and off-axis refraction in unaided eyes or eyes corrected with low/no spherical aberration; we advocate the use of the COAS-HD over the SN for special purposes like refracting through multifocal CLs.

The zonules selectively alter the shape of the lens during accommodation based on the location of their anchorage points

PURPOSE

To determine the role of anterior and posterior zonular tension on the optomechanical lens response during accommodation simulation.

METHODS

Ten eyes from nine hamadryas baboons (4.9 ± 0.7 years) and 20 eyes from 18 cynomolgus monkeys (5.4 ± 0.3 years) were dissected, leaving the lens, zonules, ciliary body, hyaloid membrane, anterior vitreous, and a segmented scleral rim intact. The lens preparation was mounted in a lens stretcher, and the outer scleral shell was displaced radially in a stepwise fashion. The load, lens, and ciliary body diameters, lens power, lens thickness, and the anterior and posterior radius of curvature were measured during stretching. The zonular fibers attached to either the posterior or anterior lens surface were then carefully transected and the experiment was repeated. Zonular transection was confirmed in four eyes via laser scanning confocal microscopy after immunostaining. The effect of zonular transection on the tissue response to stretching was quantified.

RESULTS

Without anterior zonules, 48% and 97% of the changes in anterior and posterior radii are retained. Without posterior zonules, 81% and 67% of the changes in anterior and posterior radii are retained. The changes in lens shape were reduced after transecting either the anterior or posterior zonules; however, both surfaces still changed shape.

CONCLUSIONS

While either the anterior or posterior zonules alone are capable of changing the shape of both lens surfaces, the anterior zonules have a greater effect on the anterior lens surface, and the posterior zonules have a greater effect on the posterior lens surface.

The BHVI-EyeMapper: peripheral refraction and aberration profiles

PURPOSE

The aim of this article was to present the optical design of a new instrument (BHVI-EyeMapper, EM), which is dedicated to rapid peripheral wavefront measurements across the visual field for distance and near, and to compare the peripheral refraction and higher-order aberration profiles obtained in myopic eyes with and without accommodation.

METHODS

Central and peripheral refractive errors (M, J180, and J45) and higher-order aberrations (C[3, 1], C[3, 3], and C[4, 0]) were measured in 26 myopic participants (mean [±SD] age, 20.9 [±2.0] years; mean [±SD] spherical equivalent, -3.00 [±0.90] diopters [D]) corrected for distance. Measurements were performed along the horizontal visual field with (-2.00 to -5.00 D) and without (+1.00 D fogging) accommodation. Changes as a function of accommodation were compared using tilt and curvature coefficients of peripheral refraction and aberration profiles.

RESULTS

As accommodation increased, the relative peripheral refraction profiles of M and J180 became significantly (p < 0.05) more negative and the profile of M became significantly (p < 0.05) more asymmetric. No significant differences were found for the J45 profiles (p > 0.05). The peripheral aberration profiles of C[3, 1], C[3, 3], and C[4, 0] became significantly (p < 0.05) less asymmetric as accommodation increased, but no differences were found in the curvature.

CONCLUSIONS

The current study showed that significant changes in peripheral refraction and higher-order aberration profiles occurred during accommodation in myopic eyes. With its extended measurement capabilities, that is, permitting rapid peripheral refraction and higher-order aberration measurements up to visual field angles of ±50 degrees for distance and near (up to -5.00 D), the EM is a new advanced instrument that may provide additional insights in the ongoing quest to understand and monitor myopia development.

Power profiles of single vision and multifocal soft contact lenses

PURPOSE

The purpose of this study was to investigate the optical zone power profile of the most commonly prescribed soft contact lenses to assess their potential impact on peripheral refractive error and hence myopia progression.

METHODS

The optical power profiles of six single vision and ten multifocal contact lenses of five manufacturers in the powers -1.00 D, -3.00 D, and -6.00 D were measured using the SHSOphthalmic (Optocraft GmbH, Erlangen, Germany). Instrument repeatability was also investigated.

RESULTS

Instrument repeatability was dependent on the distance from the optical centre, manifesting unreliable data for the central 1mm of the optic zone. Single vision contact lens measurements of -6.00 D lenses revealed omafilcon A having the most negative spherical aberration, lotrafilcon A having the least. Somofilcon A had the highest minus power and lotrafilcon A the biggest deviation in positive direction, relative to their respective labelled powers. Negative spherical aberration occurred for almost all of the multifocal contact lenses, including the centre-distance designs etafilcon A bifocal and omafilcon A multifocal. Lotrafilcon B and balafilcon A seem to rely predominantly on the spherical aberration component to provide multifocality.

CONCLUSIONS

Power profiles of single vision soft contact lenses varied greatly, many having a negative spherical aberration profile that would exacerbate myopia. Some lens types and powers are affected by large intra-batch variability or power offsets of more than 0.25 dioptres. Evaluation of power profiles of multifocal lenses was derived that provides helpful information for prescribing lenses for presbyopes and progressing myopes.

In vivo corneal oxygen uptake during soft-contact-lens wear

PURPOSE

We develop a new method to compute in situ corneal oxygen uptake during soft-contact-lens (SCL) wear using a micro-polarographic Clark electrode.

METHODS

After steady SCL wear and subsequent removal, a membrane-covered polarographic microelectrode is immediately placed onto the cornea. The resulting polarographic signal is related to the steady-state corneal oxygen uptake rate during soft-contact-lens wear. We devise a new analysis to quantify oxygen uptake into the cornea during lens wear. The proposed procedure is applied to new polarographic data for 10 human subjects with 12 different commercial lenses during open eye. We compare our results with recent theory.

RESULTS

Average corneal oxygen uptake rates at open eye during SCL wear for 10 subjects wearing 12 different commercial lenses vary from 2 to 10 μL(STP)/cm(2)/h. High oxygen permeability lenses have uptake rates of -10 μL(STP)/cm(2)/h, in close agreement with our previously obtained no-lens human uptake rates of 9 to 13 μL(STP)/cm(2)/h at open eye.(40) Application of the classical data-interpretation procedure to our experimental data gives corneal-uptake results that are approximately three to five times smaller than those obtained with our new interpretation scheme.

CONCLUSIONS

We provide a simple and reliable tool to quantify corneal-oxygen-uptake rates during in vivo soft-contact-lens wear. Comparison of our newly measured in vivo oxygen uptakes to model prediction for SCLs of varying oxygen transmissibility is in good agreement with available theory.

Lens parameter changes under in vitro and ex vivo conditions and their effect on the conjunctiva

PURPOSE

To quantify changes in contact lens parameters induced by lens wear and determine whether these changes are associated with contact lens-induced conjunctival staining (CLICS).

METHODS

In vitro: Lens diameter, sag, edge shape, base curve of six contact lens brands (balafilcon, comfilcon, etafilcon, lotrafilcon B, omafilcon and senofilcon) measured at 21°C and 35°C (eye temperature). Ex vivo: Diameter of lenses collected from a prospective, randomised, contra-lateral, cross-over clinical trial from 36 subjects wearing all lens types for 1 week daily wear, measured in 35°C PBS after removal. Ocular surface was examined for lens-induced conjunctival staining by masked examiner.

RESULTS

In vitro: Changes in diameter and base curve outside ISO tolerance were found with etafilcon A and omafilcon A. Ex vivo: Comfilcon A and etafilcon A had greatest shrinkage in diameter (0.18mm) and base curve (0.11mm steeper) with temperature increase from 21°C to 35°C. Senofilcon A, lotrafilcon B and balafilcon A maintained most stable parameters between 21°C and 35°C. Changes in diameter and base curve from lens wear were not correlated with CLICS (p>0.49). Multivariate analysis showed significantly greater levels of lens induced staining were associated with lens modulus (p<0.001) and knife (p<0.001) and chisel (p<0.001) edge shapes.

CONCLUSIONS

Parameter changes induced by lens wear were associated with increasing temperature, but these changes in lens diameter and base curve did not induce CLICS. Modulus and edge shape were associated with increased CLICS. The susceptibility of etafilcon A and omafilcon A lenses to parameter changes might be related to their high water content.

Assessment of accuracy and repeatability of anterior segment optical coherence tomography and reproducibility of measurements using a customised software program

PURPOSE

The aim was to study the reliability of measurements of the RTVue (Optovue, Fremont, CA, USA) anterior segment optical coherence tomographer (AS-OCT) and assess how results can be improved by analysing raw optical coherence tomography data with customised image analysis software and applying correction factors.

METHODS

Five RTVue AS-OCT instruments (ver. 4.0) were assessed by imaging gauge blocks of three different lengths, single/stepped glass plate (microscope slides) and flat window glass to check for width, depth and linearity of the measurement scans. Five repeats per calibration tool were imaged and averaged. Raw data were exported and loaded into customised image analysis software written in LabWindows/CVI for further analysis. Using two calibration balls with different radii, measurement scans were validated. Repeatability of the optical coherence tomographs and the edge detection procedure were checked and statistical analyses performed.

RESULTS

Variations ranging from 0.01 to 1.93 mm in scan width and 0.1 to 0.17 mm in scan depth were found between the five instruments. Slight curvature distortion of 0.06 ± 0.01 mm (mean and standard deviation) was found in the raw images. By isolating the three sources of image distortion and applying individual correction factors, accuracy for corneal curvature measurements could be improved to better than 0.1 mm. Manual edge detection limited the coefficient of repeatability value to 0.06 and 0.08 mm for anterior and posterior radii of curvature, respectively. The coefficient of repeatability of corneal thickness measurements was less than 8 µm.

CONCLUSIONS

Accuracy of the RTVue AS-OCT varied between instruments. By applying calibration scale factors calculated by customised software, accuracy of thickness and curvature values of the anterior eye was improved. The achievable precision is sufficient to detect clinically relevant corneal curvature variations.

Semiautomated analysis of optical coherence tomography crystalline lens images under simulated accommodation

Presbyopia is an age related, gradual loss of accommodation, mainly due to changes in the crystalline lens. As part of research efforts to understand and cure this condition, ex vivo, cross-sectional optical coherence tomography images of crystalline lenses were obtained by using the Ex-Vivo Accommodation Simulator (EVAS II) instrument and analyzed to extract their physical and optical properties. Various filters and edge detection methods were applied to isolate the edge contour. An ellipse is fitted to the lens outline to obtain central reference point for transforming the pixel data into the analysis coordinate system. This allows for the fitting of a high order equation to obtain a mathematical description of the edge contour, which obeys constraints of continuity as well as zero to infinite surface slopes from apex to equator. Geometrical parameters of the lens were determined for the lens images captured at different accommodative states. Various curve fitting functions were developed to mathematically describe the anterior and posterior surfaces of the lens. Their differences were evaluated and their suitability for extracting optical performance of the lens was assessed. The robustness of these algorithms was tested by analyzing the same images repeated times.

Physical human model eye and methods of its use to analyse optical performance of soft contact lenses

A bench-top physical model eye that closely replicates both anatomical and optical properties of an average human eye was designed and constructed. The cornea was sourced from a flouro-polymer with refractive index (RI) of 1.376 and crystalline lenses were made of Boston RGP polymers, EO and Equalens II, with an equivalent RI of 1.429 and 1.423 respectively. These materials served to make crystalline lens components of different age groups and accommodative states. De-Ionized water, with RI of 1.334 represented both aqueous and vitreous humor. The complementary metal-oxide sensor of a PixelLink digital camera with a resolution of 5MP and a 2.2 microm pixel pitch, hosted on a motor-base, served as the 'acting' retina. The translation and rotary functions of the motor-base facilitated the simulation of different states of ametropia and assessment of peripheral visual function, respectively. We validated one of its configurations to suit normal viewing conditions and results from the on and off-axis optical quality measurements are presented. As a demonstration of potential practical uses, several corrective soft contact lenses were placed on the model eye and their optical performance evaluated.

Finite Element Modeling of Inverted (Inside Out) Soft Contact Lenses

Soft contact lenses (SCLs) can be inserted inside out with consequences for optical, mechanical, and on-eye comfort performance. Wearing lenses inside out may also cause corneal deformation especially with silicone hydrogel lenses. Since inside out insertion of SCLs cannot always be avoided, it is important to study their effects, and it may even be feasible to use these inside out forces to reshape the cornea. To study these possible scenarios, a finite element (FE) based model capable of simulating the inversion of soft contact lenses was developed and validated by comparing modeled results with laboratory measurements of lenses in right side and inside out conformations. In this study, the front surface contour of five SCLs (four commercially available and one custom design) was determined using a profile projector. The lenses were turned inside out, and the front surface contour was remeasured. The thickness profile obtained by a profilometer was “added” to the front surface shape in both orientations to derive the back surface shape. A detailed nonlinear 2D axisymmetric FE model of each lens in its right side in state was created, and the lens was inverted by applying a rigid probe. The modeled and measured inverted lens shapes were compared with respect to parameter alterations (sagittal depth (sag) and diameter) and overall geometry changes using a Procrustes analysis. Measured and modeled results revealed very substantial geometry changes when turning the lens inside out; however, the maximum sagittal deviation between measured and modeled inside out lens shapes was less than 0.05 mm over the central 6 mm half chord. Overall, the modeled results matched the inverted geometries for both parameter changes as well as overall shape changes. The developed FE model is able to predict the geometry of soft contact lenses when they are inverted.

Depth-of-Focus and its Association with the Spherical Aberration Sign. A Ray-Tracing Analysis

Purpose

To investigate the relationship between the sign of spherical aberration (SA) and the corresponding depth-of-focus (DoF) values around best focus, at three different spatial frequencies (SF). Additionally, to study the influence of the Stiles-Crawford effect (SCE) on DoF.

Methods

We modeled schematic eyes having a range of SA values, C (4, 0), from -0.20 to 0.20 μm, at 6 mm pupil, in a ray-tracing software (Zemax). The through-focus optical performance was obtained via Modulation Transfer Function (MTF) calculations using thin paraxial lenses in-front of the model eye, from -2.00 to+2.00 D in 0.05D steps. Through-focus full-width (defocus) occurring at the half maximum of MTF value was considered as DoF, in diopters.

Results

For the low-SF configuration, +SA and –SA results were close to being mirror symmetries of one another. However, for midand high- SF targets, in the SA range spanning from -0.15 to 0.15 μm, models of equal SA magnitude but opposite sign produced similar DoF measures, but those with SA more negative than -0.15 μm showed marginally higher DoF than their positive counterparts. The SCE improved DoF for low SF (10 cycles/mm), while for mid and higher SF (>30 cycles/mm) mixed results were observed.

Conclusions

As regards presbyopic-correction strategies that use deliberately induced aberrations to increase the depth of focus, the current study suggests that both positive and negative SA have equal potential. However, practical considerations will probably limit the useful DoF achievable through the utilization of SCE in presbyopes. for reference to a contemporary record detailing refractive history.

Do Peripheral Refraction and Aberration Profiles Vary with the Type of Myopia? - An Illustration Using a Ray-Tracing Approach

Purpose

Myopia is considered to be the most common refractive error occurring in children and young adults, around the world. Motivated to elucidate how the process of emmetropization is disrupted, potentially causing myopia and its progression, researchers have shown great interest in peripheral refraction. This study assessed the effect of the myopia type, either refractive or axial, on peripheral refraction and aberration profiles.

Methods

Using customized schematic eye models for myopia in a ray tracing algorithm, peripheral aberrations, including the refractive error, were calculated as a function of myopia type.

Results

In all the selected models, hyperopic shifts in the mean spherical equivalent (MSE) component were found whose magnitude seemed to be largely dependent on the field angle. The MSE profiles showed larger hyperopic shifts for the axial type of myopic models than the refractive ones and were evident in -4 and -6 D prescriptions. Additionally, greater levels of astigmatic component (J180) were also seen in axial-length-dependent models, while refractive models showed higher levels of spherical aberration and coma.

Conclusion

This study has indicated that myopic eyes with primarily an axial component may have a greater risk of progression than their refractive counterparts albeit with the same degree of refractive error. This prediction emerges from the presented theoretical ray tracing model and, therefore, requires clinical confirmation.

Biomechanical analysis of the accommodative apparatus in primates

BACKGROUND

The restoration of natural accommodation in the presbyopic and cataract affected eye is a subject of intense research effort. A new instrument has been developed to test the viability and efficacy of procedures and methods to restore accommodation ex vivo in animal or human eyes.

METHODS

A section of the globe containing the crystalline lens, zonules, ciliary muscle and sclera is bonded into eight curved shoes. After dissecting the sclera between the shoes, even radial load is applied to stretch the zonules and capsular bag to simulate the natural accommodative process. The associated change in optical power is measured using a modified Scheiner's disk method. Changes in the diameter of the lens and ciliary processes are recorded, as well as zonular load.

RESULTS

No effective change in power was observed for the three presbyopic human eyes under four millimetres diameter stretching; the diameter of the ciliary aperture increased by between 1.8 mm and 2.3 mm, while the maximum increase in lens diameter was 0.19 mm. For the three younger monkey eyes, the diameter of the ciliary aperture increased by 1.4 mm with a corresponding increase in the lens diameter of between 0.50 mm and 0.65 mm. Stretching forces were generally higher for the human than for the monkey eyes, reaching maxima of 35 mN and 52 mN, respectively. The monkey eyes changed power by between 9.1 and 10.1 dioptres. An almost identical, progressive increase for lens diameter, power and stretching force versus stretch distance was found for all three monkey eyes.

CONCLUSION

The better understanding of the mechanisms and forces involved in the primate accommodative apparatus will assist with the development of accommodating IOLs and other methods to restore accommodation.

Carboxymethylcellulose Binds to Human Corneal Epithelial Cells and Is a Modulator of Corneal Epithelial Wound Healing

PURPOSE

In this study, the ability of carboxymethylcellulose (CMC), used in artificial tear formulations, to interact with corneal-epithelial-cells (HCECs) and facilitate corneal epithelial wound healing was investigated.

METHODS

HCECs were incubated with fluorescein-labeled CMC (F-CMC). CMC-epithelial binding was measured by spectrophotometry. The effect on F-CMC binding by hyaluronic acid (HA) or glucose was measured after preincubation in HA, mAb to CD44, or glucose, or mAb to GluT-1. F-CMC binding to fibronectin or collagen was measured by incubating proteins with F-CMC. The wound widths were measured 18 hours after confluent HCECs were scratch wounded. The ability of CMC to induce cell chemotaxis, proliferation, or migration was measured by quantitative assay. The efficacy of CMC in promoting epithelial wound healing was also tested in a rabbit epithelial scrape-wound model.

RESULTS

CMC remained bound to the HCECs for 2 hours. Preincubation of HCECs with glucose or mAb to GluT-1, but not with HA or mAb to CD44, reduced the binding of CMC to HCECs from 43.7% to 67.2% or 10.9% to 25.3%, respectively. CMC bound significantly to fibronectin (3.1-fold) or collagen (9.3-fold) compared with the control (BSA), and such binding enhanced cell adhesion. CMC stimulated re-epithelialization of HCECs scratched in vitro and in vivo rabbit cornea epithelial scrape wounds. CMC stimulated cell migration but not proliferation.

CONCLUSIONS

CMC probably binds to HCECs through interaction of its glucopyranose subunits with glucose transporters. CMC binding to the matrix proteins stimulated HCEC attachment, migration, and re-epithelialization of corneal wounds.

Microfabricated solenoids and Helmholtz coils for NMR spectroscopy of mammalian cells

NMR-microprobes based on solenoids and Helmholtz coils have been microfabricated and NMR-spectra of mammalian cells have successfully been taken. The microfabrication technology developed for these probes consists of three electroplated copper levels for low resistance coils and three SU-8 layers for the integration of microchannels. This technology allows fabricating solenoids, Helmholtz and planar coils on the same wafer. The coils have inner diameters in the range of 160 to 400 microm and detection volumes of 5 to 22 nL. The solenoid and Helmholtz coils show improved RF-field characteristics compared to a planar coil fabricated with the same process. The fabricated solenoid has a particularly low resistance of only 0.46 Omega at 300 MHz. Moreover, it is very sensitive and has a very uniform RF-field, but shows large line width. The Helmholtz coils are slightly less sensitive, but display a far narrower line width, and are therefore a good compromise. With a Helmholtz coil, a SNR of 620 has been measured after one scan on 9 nL pure water. An NMR-microprobe based on a Helmholtz coil has also been used to take spectra of CHO cells that have been concentrated in the sensitive region of the coil with a mechanical filter integrated into the channel.

NMR spectroscopy and perfusion of mammalian cells using surface microprobes

NMR spectra of mammalian cells are taken using surface microprobes that are based on microfabricated planar coils. The surface microprobe resembles a miniaturized Petri dish commonly used in biological research. The diameter of the planar coils is 1 mm. Chinese Hamster Ovaries are immobilized in a uniform layer on the microprobe surface or patterned by an ink-jet printer in the centre of the microcoil, where the rf-field of the planar microcoil is most uniform. The acquired NMR spectra show the prevalent metabolites found in mammalian cells. The volumes of the detected samples range from 25 nL to 1 nL (or 50,000 to 1800 cells). With an extended set-up that provides fluid inlets and outlets to the microprobe, the cells can be perfused within the NMR-magnet while constantly taking NMR spectra. Perfusion of the cells opens the way to increased cell viability for long acquisitions or to analysis of the cells' response to environmental change.

[Results of two nationwide "smoke-free" campaigns]

BACKGROUND

"Rauchfrei" -- the German part of the international contest "Quit and Win"-- is the biggest smoking cessation campaign in Germany. Already in the year 2000 24,925 smokers participated. A total of 90,458 adolescents and adults participated in "Rauchfrei 2002", that means about 0.5 % of all German smokers.

OBJECTIVE

Main aim of the quit smoking campaign is to motivate as many smokers as possible to stop smoking for at least four-weeks and herewith to achieve a stop of the tobacco consumption in the long run. In this context the continuous 4-weeks and 12-months abstinence rates of the participants serve as indicators for success.

METHODS

A survey with the adult participants aged 18 and older was carried out one year after each campaign. The samples were drawn randomly from all 10 German postal zip code-areas. A response rate of over 60 % in both surveys resulted in a sample size of n = 651 (2000) and n = 996 (2002).

RESULTS

By the end of "Quit and Win 2000" (2002) 72 % (69 %) of the participants were smoke-free; 12 months after the campaign 30 % (22 %) of the participants were continuously smoke-free. Overall, men were more successful than women, and participants with a lower education were as successful as participants with a higher school education. Substantially more participants, who had received support from either family members, friends or colleagues, had abstinence rates above the average.

CONCLUSION

"Rauchfrei" was successfully implemented in Germany and contributed to draw attention to the risks of smoking nationwide.

A novel instrument to quantify the tension of upper and lower eyelids

An instrument was developed for the objective measurement of passive lid tension of the upper and lower eyelid. Eyelid tension is defined as the first derivative of the force over elongation function. Lid tension was determined by gripping the eyelid at the eyelashes and displacing the lid while measuring the force exerted by the eyelid. Two motorised spindles provided motion control of the gripper in anterior/posterior and nasal/temporal directions. Each axis was fitted with a sensitive force transducer to record the force while stretching and relaxing the eyelid. Motion control, data collection and data analysis were computer controlled, with various user-selectable options for measurement speed, direction and end-of-measurement conditions. Calibration of the instrument reduced the maximum error of the recorded forces to +/- 10 mN. Repeatability for on-eye measurements was verified by multiple measurements on the same eye under identical conditions. Preliminary results from a pilot study, investigating differences between Asian and Caucasian lid tension showed no statistically significant difference between the two groups.

Sample patterning on NMR surface microcoils

Aligned microcontact printing for patterning the sample in areas of homogeneous RF-field on the highly sensitive surface of planar NMR microprobes is presented. We experimentally demonstrate that sample patterning allows drastic improvement of the spin excitation uniformity. The NMR microprobes are designed for cell analysis and characterized using lipid vesicles as cell substitutes. Lipid vesicles are advantageous as composition and concentration of the confined solution are precisely controlled and because of their similarity to living cells. Using aligned microcontact printing, a monolayer of lipid vesicles is immobilized on the surface of the planar NMR microprobe in a patterned way. 1H NMR spectra and CPMG spin echoes of sucrose solution confined within the lipid vesicles are successfully recorded. Nutation curves of the sample structured in different patterns demonstrate the impact of patterning on the spin excitation uniformity. The total detection volumes are between 1 and 2 nL and derived with help of a theoretic model based on 3D finite element simulation. This model predicts the signal-to-noise ratio and the progression of the nutation curves.

A novel method for assessing variations in visual acuity after the blink

A novel instrument was developed to assess the visual acuity in correlation with time after blink. The method uses an optical blink detector which triggers the display of a random target symbol on a computer monitor. The delay time between blink and symbol display varies randomly from blink to blink, the exposure duration is fixed at 100 ms. The subject has to identify the correct symbol, a score is kept of the correct responses in correlation to delay time. The recovery of visual acuity after blink was measured for subjects wearing two types of bifocal contact lenses and a control group of non-contact lens wearers. All groups required between 200 and 500 ms to achieve their best visual acuity. Subjects wearing the translating bifocal lenses recovered their vision significantly faster than the subjects wearing no lens or the simultaneous vision bifocal lens.

Lower eyelid tensometry in younger and older normal subjects

PURPOSE

This study aimed to establish normative and repeatability data for lower eyelid tensometry (LET) using a newly developed eyelid tensometer.

METHODS

In this prospective consecutive observational case series, 32 normal adult subjects, comprising 12 younger (aged 29+/-5 years, 6M:6F) and 20 older subjects (aged 74+/-6 years, 10M:10F), underwent LET. In the younger group, LET was measured for postero-anterior (PA), nasal and temporal displacement. Duplicate measurements were taken and these were repeated on a separate occasion. Associations between repeated measurements and between right and left eyes were determined and the coefficient of repeatability for PA measurements was estimated. Differences in LET between males and females were determined using ANOVA. Only PA tensions, with duplicate measurements, were assessed in the older group, and age effects were determined.

RESULTS

Mean temporal tension in the younger group was 7.8+/-2.9 mN (milliNewtons)/mm, while nasal tension was 13.0+/-4.6 mN/mm and PA tension was 11.2+/-5.3 mN/mm. There was a good correlation between interoccasion PA measurements (r=0.82-0.84, P<0.005) and between the right and left eyes (r=0.48, P<0.005). The coefficient of repeatability for PA tension was 1.8 mN/mm. In the younger group, overall eyelid tension (for all directions) for males was significantly higher than for females (ANOVA, P=0.03). For measurements in older subjects on a single occasion, PA tension was 11.1+/-3.5 mN/mm and in younger subjects 12.8+/-4.2 mN/mm (P=0.22).

CONCLUSIONS

LET is rapid, repeatable, feasible, and acceptable. PA tension was the most repeatable measurement. Younger males had higher eyelid tension than females, and there was no significant reduction in PA tension with age.

Corneal and conjunctival sensitivity to air stimuli

AIMS

To determine the repeatability of ocular surface sensitivity to mechanical stimulation using air stimuli and the effect of contact lens (CL) wear on sensitivity.

METHODS

Repeatability: 14 subjects (24-39 years) participated. Mechanical sensitivity to warmed (34 degrees C) and ambient (20 degrees C) air was measured for the central cornea (CC), inferior cornea (IC), and inferior conjunctiva (ICON). Measurements were taken on 12 days; six morning and six afternoon measurements. Differences between sites, time of day, and stimulus temperature were evaluated. CL wear: 10 subjects (22-30 years) participated. Measurements were taken at the same time of day, either following no wear, wear of a CL of oxygen permeability [Dk] of 28 x 10(-9) [cm/s][ml O(2)/ml mm Hg] or wear of a CL of Dk 140 x 10(-9) [cm/s][ml O(2)/ml mm Hg]. Differences between sites and wear conditions were evaluated.

RESULTS

Repeatability: Sensitivity varied between sites (p<0.01), time of day (p<0.05), and stimulus temperatures (p<0.01). There were no significant differences between days. Mean thresholds for eye temperature stimuli were; CC 64.4 (SD 28.6) ml/min; IC 84.6 (40.0) ml/min; ICON 120.6 (40.4) ml/min and for ambient temperature stimuli were CC 53.9 (16.0) ml/min, IC 59.0 (20.0) ml/min; ICON 72.6 (43.7) ml/min. CL wear: Sensitivity varied between sites and wear conditions (p<0.05). Conjunctival sensitivity was increased after wear of highly oxygen permeable CLs but unaffected by wear of low oxygen permeable CLs.

CONCLUSIONS

The prototype gas aesthesiometer is able to repeatably measure ocular surface sensitivity and measurements are consistent with previously reported techniques.

Planar microcoil-based microfluidic NMR probes

Microfabricated small-volume NMR probes consisting of electroplated planar microcoils integrated on a glass substrate with etched microfluidic channels are fabricated and tested. 1H NMR spectra are acquired at 300 MHz with three different probes having observed sample volumes of respectively 30, 120, and 470 nL. The achieved sensitivity enables acquisition of an 1H spectrum of 160 microg sucrose in D2O, corresponding to a proof-of-concept for on-chip NMR spectroscopy. Increase of mass-sensitivity with coil diameter reduction is demonstrated experimentally for planar microcoils. Models that enable quantitative prediction of the signal-to-noise ratio and of the influence of microfluidic channel geometry on spectral resolution are presented and successfully compared to the experimental data. The main factor presently limiting sensitivity for high-resolution applications is identified as being probe-induced static magnetic field distortions. Finally, based on the presented model and measured data, future performance of planar microcoil-based microfluidic NMR probes is extrapolated and discussed.