Nonpolar Lipids Contribute to Midday Fogging During Scleral Lens Wear

Purpose

To determine correlations between lipids in the fluid reservoir (FR) and the severity of midday fogging (MDF) in scleral lens (SL) wear.

Methods

SL neophytes were recruited to wear custom SL for 4 days, examined after 8 hours on days 1 and 4. Lens vault and MDF were quantified from anterior segment optical coherence tomography (AS-OCT), and the FR was collected and analyzed by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Relative abundance of lipids was compared to MDF scores using nonparametric correlation testing (Spearman rank). Ocular surface and SL fitting characteristics (lens vault, fitting curves) were likewise compared to MDF.

Results

Thirteen participants (26 eyes, 69% female, 28 ± 9 years old) were included in this study. MDF severity after 8 hours of SL wear was 33 ± 29 units on day 1 and 28 ± 24 units on day 4 (r = .94; P < 0.01). Twelve samples were analyzed using LC-MS/MS, and a total of 170 distinct lipid species were detected. The lipid classes with greatest correlation to MDF were the wax esters (r = .73, P = 0.01), cholesteryl esters (r = .59; P = 0.049), and triacylglycerols (r = .64, P = 0.03). Polar lipids were observed abundantly in all samples. None of the measured ocular surface or fitting outcomes were correlated to MDF.

Conclusions

Nonpolar lipids were the greatest contributors to MDF among these normal participants. Polar lipids may be due to cellular debris, although they do not appear contributory to MDF.

Effects of Differences in Fibre Composition and Maturity of Forage-Based Diets on the Fluid Balance, Water-Holding Capacity and Viscosity in Equine Caecum and Colon Digesta

Horses are herbivores, and their hindgut functions as a fluid reservoir as forage fibre properties have great impact on the water content of digesta and the milieu in the ecosystem. Our objective was to compare the effect of grass fibre maturity and legume forage on the water-holding capacity (WHC) and viscosity of the equine hindgut and the body weight (BW) and fluid balance of horses. Three diets: concentrate and late harvested grass haylage (35:65 energy ratio) (C); early and late harvested grass haylage (80:20) (G); lucerne and late harvested grass haylage (80:20) (L) were fed to six caecum and colon fistulated horses for 28 days in a Latin-square design. Total water intake and BW were higher when the horses were fed Diet L, but the digesta WHC was higher when fed Diet G. Total water excretion (via faeces + urine) and the difference in total water intake-output was higher when fed Diet L. Viscosity, measured on centrifuged digesta fluid, did not differ between diets, but the individual colon data of one horse were higher. In conclusion, early harvested forage might be beneficial for the fluid balance of athletic horses providing a higher WHC of hindgut digesta without increasing BW. The importance of digesta viscosity in relation to equine diets needs further investigations.

Corneal oedema during open-eye fenestrated scleral lens wear

Introduction

Studies examining the effect of fenestrating soft and corneal rigid contact lenses upon corneal oedema have yielded conflicting results. Although often utilised in clinical practice, no studies have quantified the effect of fenestrating a scleral contact lens upon corneal oedema. Therefore, the aim of this experiment was to examine the effect of incorporating a single peripheral fenestration on central corneal oedema during short‐term open‐eye scleral lens wear, while controlling for potential confounding variables.

Methods

Nine participants (mean age 30 years) with normal corneas wore a fenestrated (1 × 0.3 mm limbal fenestration) and non‐fenestrated scleral lens (both lenses manufactured using a material Dk of 141 × 10⁻¹¹ cm³ O₂(cm)/[(sec.)(cm²)(mmHg)]) under open‐eye conditions on separate days. Scleral lens thickness profiles were measured using a high‐resolution optical coherence tomographer (OCT). Epithelial, stromal and total central corneal oedema were also measured using the OCT immediately after lens application and following 90 min of wear, prior to lens removal.

Results

After adjusting for differences in initial central fluid reservoir thickness and scleral lens thickness between the two lens conditions, the mean (standard error) total corrected central corneal oedema was 0.50 (0.36)% for the fenestrated lens and 0.62 (0.16)% for the non‐fenestrated lens. This small difference was not statistically significant (t₈ = 2.31, p = 0.81) and represents a 19% relative reduction in central corneal oedema. Similarly, epithelial (t₈ = 2.31, p = 0.82) and stromal (t₈ = 2.31, p = 0.92) corneal oedema were not significantly different following the fenestrated and non‐fenestrated wearing conditions.

Conclusion

Central corneal oedema in healthy corneas was comparable between fenestrated and non‐fenestrated high Dk scleral lenses under short‐term open‐eye conditions when controlling for lens oxygen transmissibility and initial central fluid reservoir thickness.