Application of Flipped Classroom Teaching Model Based on Micro-Course in Practical Training Teaching of Contact Lens Fitting Technology

Objective:This paper aims to study the application of flipped classroom teaching model based on micro-course in the practical training teaching of contact lens fitting technology.Methods:From September 21 to July 23,120 students majoring in ophthalmology and optometry were selected and randomly divided into groups.The control group adopted the traditional teaching mode,and the study group adopted the flipped classroom teaching mode based on micro-course.Teaching scores and the skills,observation and judgment,adaptability,and communication skills were compared between the groups.Results:Statistical comparison of teaching scores under different management methods showed that the clinical thinking score and practice work quality in the study group were higher than those of the control group,and the effect of the study group was better(P<0.05).The overall scores of skills,observation and judgment,adaptability,and communication skills of the study group were better than those in the control group,and the comprehensive ability scores in the two groups were significantly different(P<0.05).Conclusion:In practical training teaching of contact lens fitting technology,the application of flipped classroom teaching based on micro-course can improve the skill scores of personnel,and the overall effect is good.This can lay the foundation for advanced ophthalmology and optometry talents with profound theoretical knowledge and professional skills.

Clinic study on silicone hydrogel contact lenses used as bandage contact lenses after LASEK surgery

AIM: To compare the clinical performance of two types of silicon hydrogel contact lenses used as bandage lenses after LASEK surgery. METHODS: A prospective, double-masked study was conducted on 42 eyes of 21 patients who received binocular LASEK surgeries. The interocular difference in spherical equivalent power was less than -1.50D. Patients were randomly assigned to wear Galyfilcon A (Lens A) bandage contact lens in one eye and Balafilcon A (Lens B) in the fellow eye after the surgery. The responses to a subjective questionnaire on comfort of wearing, corneal epithelial status, conjunctival hyperemia, limbal neovascularization, lens fitting and contact lens debris were assessed 1 and 5 days postoperatively. Corneal endothelium was assessed before and 5 days after the surgery upon bandage lens removal. RESULTS: There was no difference between the two groups in terms of conjunctival hyperemia, limbal neovascularization, contact lens fitting, corneal epithelial status, corneal endothelium cell density (CD) and endothelium cell size (CS) at any postoperative visit. Complaints of discomfort, including foreign body sensation, pain and intolerance were statistically more among Lens B wearers at any postoperative visit (P < 0.05). Lens B appeared to attract much more debris than Lens A at the 5-day post-operative follow-up visit (P < 0.01). CONCLUSION: The two types of silicon hydrogel lenses investigated in this study demonstrated similar clinical performance in terms of corneal responses and lens fitting. However, Lens A showed a better performance in terms of comfort of wearing and deposit resistance.

Comparation of effectiveness of silicone hydrogel contact lens and hydrogel contact lens in patients after LASEK

AIMTo conduct a comparative study of effectiveness of silicone hydrogel contact lens and hydrogel contact lens, which are used in patients after laser-assisted subepithelial keratomileusis (LASEK).METHODSSixty-three patients (121 eyes) with a spherical equivalent ≤-5.0 D were chosen after undergoing LASEK in 2012 at Guangdong General Hospital. They were randomly divided into 2 groups. The silicone hydrogel group included 32 cases (61 eyes) that wore silicone hydrogel contact lenses for 4-6d after the operation, while the hydrogel group included 31 cases (60 eyes) who wore hydrogel contact lenses for 4-6d after the operation. Patients' self-reported postoperative symptoms (including pain, photophobia, tears, and foreign body sensation) were evaluated. The healing time of the corneal epithelium, the visual acuity of patients without contact lens after epithelial healing, and the incidence of delayed corneal epithelial shedding were also assessed. The follow-up time was 1mo.RESULTSPostoperative symptoms were milder in the silicone hydrogel group than in the hydrogel group. There were significant differences in pain, foreign body sensation, and photophobia between the 2 groups (P<0.05), although there was no significant difference in postoperative tearing (P>0.05). The healing time of the corneal epithelium in the silicone hydrogel lens group was markedly shorter than that in the hydrogel group (4.07±0.25 vs 4.33±0.82d, t=2.43, P=0.02). Visual acuity without contact lenses after healing of the corneal epithelium was better in the silicone hydrogel group compared with the hydrogel group (χ2=7.76, P=0.02). There was no significant difference in the occurrence of delayed corneal epithelial shedding between the 2 groups (P>0.05).CONCLUSIONPatients with LASEK using silicon hydrogel contact lenses had less discomfort and shorter corneal epithelial healing time compared with those using hydrogel contact lenses, suggesting that silicon hydrogel contact lenses may be considered to be a better choice of bandage contact lens after LASEK.

Comparison of the effects of first and second generation silicone hydrogel contact lens wear on tear film osmolarity

AIM:To compare the effects of first and second generation silicone hydrogel(SiH) contact lens wear on tear film osmolarity.METHODS:The healthy subjects who have never used contact lenses before were enrolled in the study.Tear film osmolarity values of 16 eyes(group 1) who wore first generation SiH contact lenses were compared with those of 18 eyes(group 2) who wore second generation SiH contact lenses after three months follow-up.RESULTS:Beforecontactlenswear,tearfilmosmolarity of groups 1 and 2 were 305.02±49.08 milliosmole(mOsm) and 284.66±30.18mOsm,respectively.After three months of contact lens wear,osmolarity values were found 317.74±60.23mOsm in group 1 and 298.40±37.77mOsm in group 2.Although osmolarity values for both groups of SiH contact lens wear after three months periods were slightly higher than before the contact lens wear,the difference was not statistically significant. CONCLUSION:Contact lens wear may cause evaporation from the tear film and can increase tear film osmolarity leading to symptoms of dry eye disease.In the current study,there is a tendency to increase tear film osmolarity for both groups of SiH contact lens wear,but the difference is not statistically significant.

Does offering only the spherical contact lens trial to the low astigmats mislead the practitioners?

AIM:To compare the visual acuity(VA),comfort,and patient preference in a soft toric contact lens(TCL)versus soft spherical contact lens(SCL)in low astigmatic subjects during the contact lens(CL)trial.METHODS:This subject-masked,block randomized,2×2 crossover study recruited 40 neophyte subjects(80 eyes)aged 18 to 33 y with astigmatism in the range of 0.75-1.25 D with or without spherical power from-6.00 D to+6.00 D.The participants were scheduled for two days CL trial and were fitted with the best-fit SCL and TCL.After 4 h of wear,they were assessed objectively for high contrast VA and subjective vision,comfort,and preference.RESULTS:The responses of 36 subjects(response rate 90%)with a mean age of 23.02±2.97 y(range 18 to 33 y)were analyzed.One-line improvement of monocular VA in the logMAR chart was reported to TCL as compared to SCL(-0.044±0.06 vs 0.04±0.03 logMAR,P=0.01)but the binocular vision remained similar(-0.12±0.07 vs-0.14±0.04 logMAR,P=0.38).Subjects felt a noticeable difference in clarity when shifted to TCL as compared to the SCL.The satisfaction with vision(vision quality)was significantly better with TCL(P=0.03).The fatigue with TCL was graded less at 2.5±0.6,compared to SCL at 4.6±1.3(P=0.04).Thirty-three participants(91.6%)preferred to use contact lens of which 26 participants(79%)preferred TCL.CONCLUSION:The findings suggest that VA and comfort are better with TCL as compared to SCL which is only observed if the patient was offered both offering SCL with spherical equivalent power alone as the first option can mislead the practitioner;TCL trial should be the first choice of the lens in low-to-moderate astigmatism.

Curative effect assessment of bandage contact lens in neurogenic keratitis

AIM: To observe the curative effect of bandage contact lens in neurogenic keratitis.METHODS: Twenty cases of neurogenic keratitis were studied at the Department of Ophthalmology, the First Affiliated Hospital of China Medical University, between October 2012 and June 2013. These included 13 males and 7 females, aged from 35 to 88 y. Patients were voluntarily divided into an experimental group(lens wearing group, n =10) and control group(drug therapy,n =10). In experimental group patients wore silicone hydrogel bandage soft contact lens. Both groups used the following eyedrops: 0.5% levofloxacin TID; 0.5%Sodium carboxymethyl cellulose QID; fibroblast growth factor BID; ganciclovir BID [cases complicated with herpes simplex virus(HSV)]; compound tropicamide BID(cases concurrent hypopyon). The healing time of corneal ulcer and complication rates were observed in the two groups.RESULTS: The healing time of corneal ulcer in the experimental group was 10.80±4.44 d versus 46.70±13.88 d in the control group(P 【0.05). No complications occurred in the experimental group, except for the lens falling off twice in one case, the patient recovered eight days after rewearing the lens. While in the control group, all cases vascularized, 2 cases were complicated with descemetocele that recovered with amniotic membrane transplantation and 1 case was complicated with corneal perforation that recovered by autologous conjunctival flap covering.CONCLUSION: Bandage contact lens is a safe and effective method of treating neurogenic keratitis andsignificantly shortened the healing time of corneal ulcer.

Aberration changes of the corneal anterior surface following discontinued use of rigid gas permeable contact lenses

AIM: To record aberrations with a corneal topographic device on the anterior surface of the cornea at different time-points prior to wearing and following discontinued use of rigid gas permeable (RGP) contact lenses. The effect of wearing RGP on the anterior surface of the cornea was discussed to provide guidance for clinical refractive error correction.METHODS: The study objects were 24 eyes from 24 patients. All patients underwent identical examination procedures prior to lens use, as well as afterwards, including slit-lamp examination, non-contact tonometer measurement, computer optometry and corneal curvature measurement, subjective refraction test, and corneal topography analysis. The patients wore contact lenses everyday for 1 month and then discontinued. Corneal topographies were recorded at certain time points of 30 minutes, 1 day, 3, 7 and 14 days following use.RESULTS: Total corneal aberration at each time point following discontinued use of RGP contact lenses was less than the time point prior to use. Detailed results were as follows: root mean square (RMS) (pre)=(1.438± 0.328)μm, RMS (30 minutes) =(1.076 ±0.355)μm, RMS (1 day) =(1.362 ±0.402)μm, RMS (3 days) =(1.373 ±0.398)μm, RMS (7 days) =(1.387 ±0.415)μm, and RMS (14 days) = (1.430±0.423)μm. Results showed that at 30 minutes after discontinued use of RGP contact lenses, almost all 2 ndand 3 rd-order aberrations change. Quadrafoil Z10 and spherical Z12 of the 4 th-order were also changed. Alterations to Z5, Z6, and Z12 at 1 day after discontinued use were significant differences compared with the time period prior to RGP use: Z5 and Z6 decreased, and Z12 increased slightly. Z5 and Z6 remained decreased at 3 days after discontinued use, but Z9 and Z10 continued to increase and Z12 returned to levels prior to RGP use. At 14 days after discontinued use, all aberrations were notsignificantly different from the values prior to use.CONCLUSION: The use RGP contact lenses greatly reduced total aberration of the anterior surface of the cornea. Changes to 2 ndand 3 rd-order aberrations (including Z3, Z4, Z5, Z6, Z7, and Z8) were more significant. Following discontinued use of RGP contact lenses, the majority of lower order aberrations returned to original levels in a short period of time. During this process, a transient higher order aberration appeared, but all changes disappeared within 14 days after discontinued use of RGP contact lenses.

Effects of contact lens wearing on keratoconus:a confocal microscopy observation

AIM： To evaluate the corneal cell morphology of new keratoconus patients wearing two different types of rigid gas-permeable（RGP） contact lenses for 1y.METHODS： Thirty nine eyes of 39 new keratoconus patients were selected and randomly fitted with two types of RGP contact lenses.Group 1 had 21 eyes with regular rigid gas-permeable（RRGP） contact lens and rest 18 eyes were in group 2 with specially designed rigid gas-permeable（SRGP） contact lens.Corneal cell morphology was evaluated using a slit scanning confocal microscope at no-lens wear and after 1y of contact lens wearing.RESULTS： After 1y of contact lens wearing in group 1,the mean anterior and posterior stromal keratocyte density were significantly less（P=0.006 and P=0.001,respectively） compared to no-lens wear.The mean cell area of anterior and posterior stromal keratocyte were also significantly different（P=0.005 and P=0.001） from no-lens wear.The anterior and posterior stromal haze increased by 18.74% and 23.81%,respectively after 1y of contact lens wearing.Whereas in group 2,statistically significant changes were observed only in cell density ＆ area of anterior stroma（P=0.001 and P=0.001,respectively） after 1y.While,level of anterior and posterior stromal haze increased by 16.67% and 11.11% after 1y of contact lens wearing.Polymegathism and pleomorphism also increased after 1y of contact lens wearing in both the contact lens groups.CONCLUSION： Confocal microscopy observation shows the significant alterations in corneal cell morphology of keratoconic corneas wearing contact lenses especially in group 1.The type of contact lens must be carefully selected to minimize changes in corneal cell morphology.

Contact lens impact on quality of life in keratoconus patients: rigid gas permeable versus soft siliconehydrogel keratoconus lenses

AIMTo determine the impact of rigid gas permeable (RGP) and silicone-hydrogel keratoconus lenses on the quality of life (QoL) in keratoconus (KCN) patients using the self-reported results from the Contact Lens Impact on Quality of Life (CLIQ) Questionnaire.METHODSFrom January 2013 to April 2013, 27 consecutive KCN patients who wore RGP contact lenses (conflexair100 UV KE Zeiss-W&#x000f6;hlk) or soft silicone-hydrogel contact lenses (SHCLs) for KCN (KeraSoft IC- Bausch&#x00026;Lomb or Hydrocone Toris K-Swiss lens) completed the CLIQ questionnaire.RESULTSThe mean age of 27 patients was 29.6&#x000b1;8.0y. Fifteen patients were RGP user. The groups were comparable with respect to the mean patient age, sex, and mean K values (P=0.1, P=0.8 and P=0.1, respectively). The mean CLIQperson measure was 42.8&#x000b1;5.5 in RGP group and 39.6&#x000b1;5.5 in SHCLs for KCN group (P=0.06). CLIQperson measure was positively correlated with steep K value (r=0.301, P=0.04). When eyes were stratified by visual acuity with contact lenses, the mean CLIQperson measure was 42.01&#x000b1;5.6 in eyes with a visual acuity of 20/20-20/25 (n=44) and 38.4&#x000b1;5.26 in eyes with a visual acuity of 20/32 or less (n=10; P=0.097).CONCLUSIONRGP lenses and SHCLs for KCN have similar impact on QoL.

Effect of rigid gas permeable contact lens on keratoconus progression: a review

The prevalence of keratoconus is 1/2000 in the general population and is high in adolescents.Keratoconus is a progressive disease,which has a great impact on patients’quality of life and mental health.It can be managed by surgical and non-surgical means,rigid gas permeable(RGP)contact lens as its main non-surgical method is widely used in clinic.The efficacy of wearing RGP contact lens has been confirmed to some extent,but some studies have found that wearing RGP contact lens has adverse effects,which may promote disease progression.In this paper,the advantages and disadvantages of RGP contact lens in controlling keratoconus were reviewed to provide more suggestions and references for the clinical application of RGP contact lens.

Evaluation of the safety and efficacy of therapeutic bandage contact lenses on post-cataract surgery patients

AIM： To evaluate the safety of therapeutic bandage contact lens for post-cataract surgery patients and to illustrate its efficacy on post-operative comfort and tear-film stability. METHODS： A total of 40 participants were recruited and randomly divided into two groups. Group one was instructed to wear bandage contact lenses for a week and use antibiotic eye drops for a month since the first day after surgery. Group two received sub-conjunctival injection of tobramycin and was asked to wear eye pads on the first day after surgery and then were instructed to use antibiotic eye drops as the first group did. Ocular surface disease index（OSDI） questionnaire, slit-lamp microscope examination of tear break-up time（TBUT）, corneal fluorescein score（CFS）, tear meniscus height（TMH） together with anterior segment optical coherence tomography（AS-OCT） and corneal topography were evaluated preoperatively and postoperatively. RESULTS： The subjective feeling（P=0.004）, TBUT（P〈0.001） and TMH（P=0.02） post-surgery had improved in patients who used bandage contact lenses compared with those who did not at 1wk post-surgery. Until three month postoperatively, the comfort degree（P=0.004） and TMH（P=0.01） of group two were still worse than group one. Moreover, TBUT（P〈0.001） and CFS（P=0.004） of the group with eye pads got worse than the results before, whereas the group with bandage contact lenses recovered to normal. None of these patients had infections or other complications. CONCLUSION： Wearing therapeutic bandage contact lens after cataract surgery, compared with traditional eye-pads, is a safe method to improve tear-film stability and reduce post-operative discomfort without hindering corneal incision recovery.

Evaluation of refractive correction for standard automated perimetry in eyes wearing multifocal contact lenses

AIM：To evaluate the refractive correction for standard automated perimetry（SAP）in eyes with refractive multifocal contact lenses（CL）in healthy young participants.METHODS：Twenty-nine eyes of 29 participants were included.Accommodation was paralyzed in all participants with 1%cyclopentolate hydrochloride.SAP was performed using the Humphrey SITA-standard 24-2 and 10-2 protocol under three refractive conditions：monofocal CL corrected for near distance（baseline）;multifocal CL corrected for distance（m CL-D）;and m CL-D corrected for near vision using a spectacle lens（m CL-N）.Primary outcome measures were the foveal threshold,mean deviation（MD）,and pattern standard deviation（PSD）.RESULTS：The foveal threshold of m CL-N with both the24-2 and 10-2 protocols significantly decreased by 2.2-2.5 d B（P〈0.001）,while that of m CL-D with the 24-2 protocol significantly decreased by 1.5 d B（P=0.0427）,as compared with that of baseline.Although there was no significant difference between the MD of baseline and m CL-D with the24-2 and 10-2 protocols,the MD of m CL-N was significantly decreased by 1.0-1.3 d B（P〈0.001）as compared with that of both baseline and m CL-D,with both 24-2 and 10-2 protocols.There was no significant difference in the PSD among the three refractive conditions with both the 24-2 and 10-2 protocols.CONCLUSION：Despite the induced mydriasis and the optical design of the multifocal lens used in this study,our results indicated that,when the dome-shaped visual field test is performed with eyes with large pupils and wearing refractive multifocal CLs,distance correction without additional near correction is to be recommended.

Amniotic membrane welded to contact lens by 1470-nm diode laser:a novel method for sutureless amniotic membrane transplantation

AIM: To avoid the side effects of the suture usage by welding amniotic membrane(AM) to contact lens(CL)with laser.METHODS: AM was taken from pregnant women and cleaned from blood clots with sterile phosphate-buffered physiological saline solution which included antibiotics.Stromal side of the AM was spread inside of the CL and it was welded to CL by 1470 nm diode laser. And 600 μm diameter fiber tip of the laser was contacted with the epithelial side of the AM from 4 separate points. After welding excess amniotic membrane around the CL was cut with a scalpel.RESULTS: Stromal side of the AM was spread inside of the CL and then with laser fiber, different power levels and exposure times were applied on the epithelium of AM and 340 m W for seven seconds was found optimal.CL and AM attached with the spot welding effect in 4points by touching fiber tip. CL-AM welded complex did not separated from each other while holding AM that extend beyond the CL with the help of two forceps.CONCLUSION: As a conclusion, it was aimed in this study to achieve the success of the conventional amniotic membrane transplantation(AMT) with the easiness of applying a CL and to avoid risks and side effects of corneal or conjunctival suturing. The results showed that the application of the CL-AM complex will be as easy as the application of a CL and lasts shortly.

Intraocular pressure measurement over soft contact lens by rebound tonometer: a comparative study

AIM: To evaluate the intraocular pressure(IOP)measurements by Icare rebound tonometer over a contact lens in comparison with Goldmann applanation tonometry(GAT). METHODS: Fifty patients using contact lens were included in this study. One of the eyes of the patients was selected randomly and their IOP were measured by rebound tonometer with and without contact lens(RTCL,RT respectively) and by GAT, as well as their central corneal thickness(CCT) by optical pachymeter. The results of both methods were compared by correlation analysis, general linear method repeated measure and Bland-Altman analysis.RESULTS: Mean IOP values measured by RTCL, RT and GAT were 15.68 ±3.7, 14.50 ±3.4 and 14.16 ±2.8(P 【0.001), respectively. Mean IOP by RTCL was significantly higher than the measurements implemented by RT and GAT(P 【0.001), while there was no difference between the measurements by GAT and RT(P =0.629). There was a good level of positive correlation between GAT and RTCL as well as RT(r =0.786 P 【0.001, r =0.833 P 【0.001, respectively). We have observed that CCT increase did not show any correlation with the differences of the measurements between RTCL and RT(P =0.329), RTCL and GAT(P =0.07) as well as RT and GAT(P =0.189) in linear regression model.CONCLUSION: The average of the measurements over contact lens by rebound tonometer was found to be higher than what was measured by GAT. Although this difference is statistically significant, it may be clinically negligible in the normal population.

Effects of rigid gas permeable contact lens on morphological parameters and vision-related quality of life in keratoconus patients

AIM: To evaluate the effect of rigid gas permeable contact lens(RGP-CL) on corneal morphological parameters and vision-related quality of life in keratoconus(KC) patients.METHODS: Totally 57 eyes of 30 KC patients who were followed-up for more than two years, including 17 RGP wearers(32 eyes) and 13 non-wearers(25 eyes) were retrospectively analyzed. Initial medical history and corneal topography were collected at baseline. Corneal topography, corneal aberration, optical coherence tomography, and vision-related quality of life questionnaires were performed at the last follow-up.RESULTS: According to corneal topography, increase of the flattest keratometric values was higher in RGP wearers than in non-wearers(P=0.038). The morphological parameters, including symmetry index of front corneal curvature(P=0.004) and Baiocchi-Calossi-Versaci index front(P=0.047), were lower in RGP wearers than in nonwearers. Vertical coma was smaller in RGP wearers than non-wearers in 3.0, 5.0, 6.0, and 7.0 mm pupil diameters, respectively(P<0.05). The environmental triggering domain of ocular surface disease index was worse in RGP wearers as compared to non-wearers(P=0.003). At the last followup, there were no significant differences in constituent ratios of KC progression, corneal thickness topography, epithelial thickness topography, morphological parameters of corneal topography, and other questionnaire scores between the two groups(all P>0.05).CONCLUSION: Long-term use of RGP does not worsen KC but may cause corneal epithelial remodeling to increase symmetry of corneal anterior surface, reduce corneal vertical coma and improve visual quality. However, RGP wearing causes a slight decrease in vision-related quality of life. The occurrence of ocular surface symptoms is mainly associated with environmental triggering factors.

Oxygen permeability of soft contact lenses in different pH, osmolality and buffering solution

AIMTo determine the effect of pH, osmolality, and buffering system on the oxygen permeability (Dk) of soft contact lenses.METHODSTwo hydrogel lenses (nelfilcon A and etafilcon A) and 2 silicone hydrogel lenses (lotrafilcon A and balafilcon A) were used in the study. These lenses were incubated in phosphate-buffered saline (PBS) and borate-buffered saline (BBS) solutions adjusted by 0.8 pH increments to a pH in the range of 5.8-9.0 or in hypotonic (280 mOsmol/kg), isotonic (310 mOsmol/kg) and hypertonic (380 mOsmol/kg) PBS solutions. Polarographic method was used for measuring the Dk and lenses were stacked as 4 layers to correct the boundary effect.RESULTSDk values of all contact lenses measured in BBS solutions were more stable than those in PBS solutions. Especially the etafilcon A lens showed a relative big change compared with other types of contact lenses at the same conditions. When the osmolality of PBS solution increased from hypotonic to hypertonic, Dk of all contact lenses decreased. Variations in Dk existed depending on lens materials, etafilcon A lens was the most affected and nelfilcon A was the least affected by osmolality.CONCLUSIONFrom the result obtained, it is revealed that Dk of contact lenses is changed by the pH, osmolality, and buffering condition of tear. Thus, Dk of contact lens can be varied by the lens wearers' physiological and/or pathological conditions.

Application of Sodium Ion Sensor Based on the SnO_2/ITO Glass in the Detection of Rinsing Solution for Contact Lenses

This paper presents the studying results of the sodium ion sensor device based on the SnO_2/ITO glass structure in the detection of rinsing solution for contact lenses.The selective membrane contains poly (vinyl chloride) (PVC),bis (2-ethylhexyl) sebacate (DOS),(12-crown-4) methylmalonate (B12C4),and sodium tetrakis (4-fluoropbenyl) borate dehydrate (NaTFBD). The final weight ratios are PVC:DOS:B12C4:NaTFBD=33:66:2:2.In this condition,the sensor has performances with linear sensitivity,short response time,good repeatability and selectivity.The sensor was used to measure the rinsing solution for the contact lenses.Because the experimental results show close to the accurate value for four commercial products,this sensor can preliminary be used in detecting the rinsing solution for the contact lenses.Using this structure and sodium-sensing membrane to construct the sodium sensor is proven successfully in this application.

Removal of intraocular foreign body in anterior chamber angle with prism contact lens and 23-gauge foreign body forceps

AIM：To introduce a novel approach in removal of anterior chamber angle foreign body（ACFB） using a prism contact lens and 23-gauge foreign body forceps.METHODS：Data of 42 eyes of 42 patients who had undergone removal of ACFB using a prism contact lens and 23-gauge foreign body forceps from January 2008 to October 2013 were collected and analyzed. Twenty eyes in group A received the conventional approach by using toothed forceps through corneal limbus incision, and 22 eyes in group B underwent the novel method through the opposite corneal limbus incision. RESULTS：The success rate of ACFB once removal was 75%（15/20） in group A, and 100%（22/22） in group B. The average operation time of group A was significantly longer compared with group B（34.9±9.88 min vs 22.13±8.85min; P〈0.05）. The average size of corneal limbus incision in group A was significantly larger than that of group B（4.85±1.89 mm vs 3.95±1.17 mm; P〈0.05）. The corneal limbus incision suturing were conducted in all eyes in group A, and only 5 eyes in group B. CONCLUSION：Removal of ACFB using a prism contact lens and 23-gauge foreign body forceps is a safer, more effective, and convenient technique compared with the conventional approach.

Is the Use of Empirically Designed Custom Soft Contact Lenses a Good Option for Challenging Patients?

Purpose: Reasons for the lack of success for contact lens patients range from poor fit, to discomfort or to a less than optimum wearing schedule. This project was a preliminary investigation of customized soft toric contact lenses as an alternative for unsuccessful contact lens patients or potential drop-outs. Methods: Fifteen healthy non-compromised, previously unsuccessful contact lens wearing patients (13 women, 2 men) with ages from 21 to 33 years (25.1 ± 2.7 years) were the subjects for this study. They were empirically fitted with 15 astigmatic and 5 spherical customized SpecialEyes soft contact lenses. Visual acuities, comfort, lens movement, and rotation were evaluated. Results: Patients fitted with customized SpecialEyes soft contact lenses had statistically significant better visual acuities than with Phoropter Manifest Refraction. The lenses used in this study centered well and moved no more than 1 mm upon each blink. Lens rotation was less than 10 degrees for all toric lenses. Patients gave very positive vision and comfort ratings. Conclusion: This preliminary study supports the application of a software program to empirically design and manufacture Special Eyes custom soft lenses based upon corneal topographical parameters and subjective manifest refraction for those patients who either have challenging corneal parameters, high sphero-cylindrical prescriptions, or are currently dissatisfied with their contact lenses and are potential drop-outs.

ZERNIKE ASTIGMATISM AND VISUAL PERFORMANCE IN MYOPIC EYES BY RIGID GAS PERMEABLE CONTACT LENSES WEAR

To investigate the effects of rigid-gas-permeable contact lens(RGP-CL)wear on Zernike astigmatism and visual performance in myopic eyes.Methods:A wavefront sensor was used to evaluate Zernike astigmatism for 21 eyes with minimum astigmatism and 18 eyes with moderate astigmatism under three different modes of refractive correction:the RGP-CL,spectacle lens correcting spherical equivalent(SL)and spectacle lens fully correcting spherical error and astigmatism(fSL).Contrast visual acuity was assessed with a VA tester at four contrast levels and two luminance backgrounds.Results:Compared to the SL wear,RGP-CL wear changed the main axis astigmatism(Z_(2)^(2))from
0:09-0:34 to 0.34-0.22 for the minimum astigmatism group,while the contrast VA was improved about 0.05 LogMAR(F=8:06,p<0:01).For the group with moderate astigmatism,significant reduction in Z_(2)^(2)was found for both fSL wear(t=4:78,p<0:001)and RGP-CL wear(t=6:29,p<0:0001).The changes in astigmatism were significantly correlated between the fSL and RGP-CL wears(r=0:897,p<0:0001 for Z_(2)^(-2);and r=0:643,p=0:004 for Z_(2)^(2)).Contrast VA was significantly improved for both fSL and RGP-CL wears and the improvements were significantly correlated between each other for all four contrast levels and two backgrounds.Conclusion:RGP-CL wear induces astigmatism for the eyes with minor astigmatism probably due to a correction of corneal astigmatism and thus a manifesting of the lens astigmatism.For the astigmatic eyes,RGP-CL wear has similar effect on correcting astigmatism as the spectacle lens wear with spherical-cylinder correction and also produces similar visual improvement.